Category: Nonfiction

Categories
Nonfiction Reflection Seattle

How About Those Mariners?

In January of 2024, I made a deliberate choice to be a Baseball Fan. There were two reasons behind this:

  • My spouse is a lifelong baseball fan and I wanted to be a better spouse. We had gone to a few games when his team was in town to play the Seattle Mariners, but my appreciation was limited to “vibes” only.
  • Someone I loved very much was disintegrating. Cheering a baseball team was a socially acceptable way to shout and channel my heartache in public.

I had choices to make, though: Do I invest my enthusiasm in my spouse’s team? In their pinstripes they have won the most number of World Series (and reminds everyone of it). Or do I dedicate my ardor to the team that has never been to the World Series, the Seattle Mariners?

Dear reader, you already know who got my vote. The West Coast is the Best Coast.

A sponge for learning, I asked many questions during my 2024 baseball education. Once I understood what “starting rotation” meant, what made the Mariner pitchers so effective? Why does “Wins Above Replacement” matter? What does “On-base Plus Slugging” represent? Why did Ty France get hit by pitch so much? Teams can designate players for assignment just like that???

My spouse’s eyes never rolled out of his head, though that would have been a reasonable response to some of my questions. Every morning I read the SB Nation site for the Mariners, Lookout Landing. I announced my burgeoning interest in baseball to other Mariners fans. They all looked at me with some amount of pity.

In our 2024 Christmas card I commented that my choice to become a fan of the Seattle Mariners was a mistake. I now understood the shirt I had seen around town: A trident, to represent the Mariners, and the text, “Maybe next year!“

Before the baseball season started in 2025, the person I loved very much died. As the year unfolded, wars continued, injustice ascended, ethics eroded. Cheering a baseball team is a socially acceptable way to redirect the energies of grief and anger in public.

My investment in the Seattle Mariners grew. This culminated in the sheer amount of kilojoules I spent this week on this team, which is now the American League West champion! This hasn’t happened in 24 years.

Furthermore, our humble catcher, Cal Raleigh, made home run history, both as a catcher and as a switch hitter. (His nickname is “The Big Dumper”. Have you seen the size of his butt?)

This has prompted questions about identity:

  • I didn’t grow up in a baseball household. (Basketball came first, then football.)
  • I historically have found baseball boring.
  • Could fans of America’s pastime look like me?
  • Am I now one of those people who can spout random facts about baseball?

Dear reader, the answer to all those questions is yes. That’s super weird.

As the Seattle Mariners crested towards the end of the season, baseball became a laboratory of communication.

I previously envied the way men who did not know each other could immediately engage in energetic conversations about sports. Sometimes it seemed like they had known each other for years.

What I noticed now, though, was the increasing amount of communication — particularly in the form of text messages — solely about baseball. Practically all these people are good friends I have known for years. There are real tragedies happening in their lives: parents who are deteriorating; pets dying; friends with conditions that elude treatment; people losing their jobs.

Meanwhile, they send messages acknowledging Cal Raleigh’s 60th home run.

How are they themselves doing? No comment.

I don’t know if it’s true that, because of my professional training, it is easier for me to have in-depth conversations with people. Do I have skills to create conditions so people will be more likely to share sensitive personal information with me? I hope so, but I don’t actually know.

It’s true: Talking about baseball is easier than talking about hopes, fears, dreams, and loss. It’s natural to avoid delving into more meaningful topics. We fear how others will react to our vulnerabilities, to the soft spots we keep covered to prevent bruises from the outside world.

The thing is, we’re often our own harshest critics. Our good friends aren’t umpires. They’re not calling balls and strikes on us. They are instead in the dugout or on deck, admiring our approaches to the plate.

But let me be honest: Have I already forgotten the reasons why I chose to become a Baseball Fan? Weren’t there thoughts and emotions I sought to shun? I couldn’t escape anticipatory grief. The crying was exhausting. Wasn’t I looking for a healthy yet avoidant way to cope?

So, here’s to the 2025 Seattle Mariners. May their success continue. May they go to (and win!) the World Series. May they continue to be a bright spot amid the challenges we all have in our small lives and big communities.

Categories
Homelessness Nonfiction Policy Public health psychiatry

Who is Actually Unsafe?

Before she and I reached the gate in the chain-link fence, a man approached us from the opposite direction. A hoodie shaded his face and his hands were in his pockets.

When she and I got closer, we waved first, all smiles. This was intentional. Hello! We are harmless, but we are paying attention!

He slowed down and pulled the hoodie off of his head, revealing the AirPods in his ears and a tentative smile on his face.

He and my colleague started greeting each other at the same time. She deferred to him.

“I’m just out for a walk,” he said. The accent in his voice revealed that English was not his first language.

“So are we,” my colleague said. This was a lie.

“Oh,” he said, his face now soft and kind. “A worker, a government worker, told me yesterday to be careful when walking here. He said that there are dangerous people back there”—he pointed to the area behind the chain-link fence—“people who are homeless.”

“Oh, okay, thanks,” we replied. His intentions were kind; he was looking out for us. He continued on to the parking lot. 

When we arrived at the gate in the chain-link fence, we ignored the sign posted on it: DO NOT CROSS.


Despite years of doing homeless outreach, I still feel my heart beat a little faster and my shoulders tense a bit whenever I approach an encampment. It doesn’t matter if it’s tucked in a wooded area, under a freeway, or behind a building.

Nothing dangerous has ever happened to me when I’ve outreached more remote locations. Sites where I have been at risk of injury were almost all public places with plenty of people milling about, or in spaces where people are literally locked in.

I don’t ignore my anxiety—our emotions are sources of information—but continue to wonder how much of my unease is due to stigma.

She and I followed the worn footpath through the overgrown grass and were soon under a canopy of leafy trees. On one branch hung a jacket that had been singed by fire. As we approached the underpass, the vegetation receded. A small river was on one side; on the other was a slope of rocks and loose dirt that led up to the concrete base of the road.

A small tent was closer to the river. A larger structure was tucked further away, just underneath the roadway. Old clothing, food wrappers, worn blankets, and other detritus were scattered about, evidence of people who were once there. Maybe they had moved on?

We saw no signs of life.

“Outreach!” my colleague called out. The rumbling of the cars overhead muffled her voice.

The small tent shifted back and forth; we heard rustling sounds.

“Outreach, hello?” my colleague called to the small tent.

“Yes, I’m coming out,” a tired voice responded. Within a few minutes, the person inside unzipped the door flap. A young woman wearing a soiled sweatshirt adorned with the name of a law school peered out. Her face was thin and her limbs were slender.

She didn’t need anything, but accepted some snacks and water. She wasn’t the one we were looking for. We wondered if she had seen The Person?

“Yeah, from time to time,” she replied. “She might be up there.”

After thanking her, we plodded through the soft dirt and climbed over wobbling rocks to the larger structure. A multi-gallon clear barrel in front of the tent was about half full of water. Nearby were piles of blankets and clothes.

The tent was wide open. There were no blankets, sleeping bags, or pillows inside. At the back of the tent was The Person. She was sleeping directly on a tarp.

The Person is not well, but aside from sleeping underneath a road, she breaks no laws. She mumbles and often says things that only she understands. In stores she quickly picks up what she wants and pays with cash and coins. 

As far as we know, she’s lived outdoors for years. And now she is over 60 years old.

These two women are homeless, but they do not contribute to crime and disorder on America’s streets. They are not safety threats.

Who is truly unsafe: Us, or them?

Categories
Homelessness Nonfiction Public health psychiatry

Opening Doors.

For our first appointment, she didn’t come downstairs. The building staff, who described her as a high-priority patient, had predicted this.

After I knocked on her door, a gruff voice shouted back, “What do you want?!”

She eventually opened her door. Inside, the room was furnished with only a bed and nightstand. The mattress still looked brand new; no linens or blankets were on it. The only item on her nightstand was a lamp, the shade still wrapped in plastic. The walls were bare; her closet was empty. Blinds kept the sunlight out.

The only personal item in her room was a flattened cardboard box. It was next to her bed. Though she had lived in that unit for almost a full year, she was still sleeping on the floor. She preferred the cardboard to the mattress.

“I don’t need anything, I’m fine, I’m fine,” she grumbled. She pointed an arthritic finger at the door before announcing, “I’m leaving now.” I stepped to the side. She hobbled past me towards the elevator, mumbling to herself. She didn’t close the door to her apartment. I did.

That first appointment was a success! Not only did she open her door, but she also spoke to me. Sure, it was a short and superficial conversation. Her primary goal, it seemed, was to get away from me. But she didn’t yell at me, despite my introduction: “Hi, my name is Dr. Yang. I work as a psychiatrist. I just wanted to introduce myself. How are you doing?”

There was a fair chance that she would talk to me again in the future. I had two goals now: Create conditions so that she would (1) talk with me again and (2) tolerate a longer conversation with me. Maybe two to three minutes next time?

Back downstairs, I tapped out a quick note:

This is a 79yo woman with a historical diagnosis of schizophrenia. She reportedly has a history of street homelessness of at least twenty years, though housing staff believe that she had been homeless for longer. She finally moved into housing about a year ago….

Categories
Nonfiction

Why I Never Went Camping.

I have never gone camping.

During my short stint in Girl Scouts[1], my parents never allowed me to go on troop camping trips. During our family vacations to national parks, we always stayed in a motel in an outlying town. Though we loved the outdoors, we always slept indoors.

Now that I’m well into adulthood, I’m Too Old to go camping. Despite the pressures of living on the West Coast (the Best Coast!) and REI’s endless advertising efforts, I’m convinced my camping window has closed.

People wonder why. I usually quip, “My parents didn’t immigrate to the US so their only child would sleep outside!”

Both of my parents were born in China, but moved to Taiwan before their first birthdays. Their parents were able to get out of China before the Communists took over. In Taiwan they lived under a military dictatorship. Everyone was poor.

No one had plumbing in their homes. It was up to the sons to bring buckets of water from the town well back home. Balance was essential when using the outhouses. Meat was a luxury and served only on special occasions.

One of my grandmothers did not have the opportunity to attend any school.[2] She only started to learn how to read Chinese after she got married. Her husband was a teacher.

My mother attended school, but society expected her to be a beautiful and dutiful mother.

The educational opportunities in the United States exceeded the imaginations of both women. My grandmother was illiterate. My mother got an associate’s degree. I became a physician.

Such was the promise of the United States.

Only after my dad moved to Seattle did I learn about one of his favorite songs, Abraham, Martin And John, by Dion. Released in 1968, this song was a tribute to Abraham Lincoln, Martin Luther King, Jr., and John F. Kennedy. Dion mourned, “[They] freed a lot of people but it seems the good they die young.”

The result of the 2016 Presidential election was dispiriting for my father. The man who would become the 45th (and 47th) President was unlike Abraham, Martin, and John.

My parents didn’t immigrate to the United States for this sh!t. What drew them to the United States were the ideals of democracy, justice, and freedom.

Didn’t you love

The things that they stood for

Didn’t they try to

Find some good

For you and me

“They don’t make music like that anymore,” my dad lamented when he introduced me to Dion’s song. The music changed; the nation changed.

We write, rally, and protest to denounce the federal government’s cruel and unjust actions. We recognize the humanity in our friends and neighbors, even as the government fails to do the same. We advocate for people in our various and overlapping communities.

We also write, rally, and protest to honor the people who came before us. Our immigrant parents recognized the value of democracy, justice, and freedom. These were abstract ideas that existed only within the confines of their imaginations. In the United States these worthy ideals promised to manifest in three dimensions. They strived and worked so what seemed possible to them could be real for us.

(Thanks, Dad. I miss you.)

[1] I’m not sure why my mom enrolled me in Girl Scouts. I suspect she had two reasons: (1) Because I didn’t have siblings, she wanted me to have more friends. (2) This seemed like a very American activity. The pressure to assimilate was great. I eventually asked to drop out of Girl Scouts. Disappointed, she asked why. “I don’t fit in,” I said. At the time I could not articulate why I felt uncomfortable: All the other girls were white.

[2] I never got to meet this grandmother, as she died when my dad was only 21 years old. Despite her inability to read, she apparently picked up languages with ease. What she lacked in literacy, she made up for in emotional and social intelligence.

Categories
Consult-Liaison Nonfiction

Learning from Those Who Hear Voices.

When we learn that someone hears voices, we may assume that this person must be “crazy.” Some people who hear voices have a diagnosis of schizophrenia. Others hear voices because of past trauma or profound depression. Despite their symptoms, many of them cultivate peaceful lives. Their ways of coping can teach the rest of us something about cultivating sanity during times of cruelty and injustice.

When people share with me that they hear voices, I aim to ask as soon as possible, “If the voices suddenly disappeared and never came back, would you miss them?”

A small number of people pause before answering, “Yes.” They want to hear the voices of their parents, friends, and other loved ones again. Sometimes they don’t recognize the voices, but the things they say are hilarious.

Most people, though, offer an emphatic “no!” What they hear are constant attacks on their character (“you’re not worthy of love”), frightening instructions (“go punch that woman”), or unwanted chatter (play-by-play commentary of their lives). In desperate bids to shut the voices up, some people resort to stuffing their ears with cotton, screaming back, or drinking alcohol to drown them out. Sometimes they attempt suicide because they can’t tolerate the torment any longer.

However, many people find ways to manage the voices. They learn that increases in stress—hunger, not enough sleep, drug use—make the voices louder and meaner. While grieving the death of a loved one, the voices are noticeably overwhelming. More stability brings more symptom relief.

People who hear voices often have multiple healthful strategies to manage their voices. They’ve tried things and made discoveries. So when I ask, “What do you do now so the voices bother you less?”, they reply:

  • “I put on headphones and listen to music.”
  • “I put on headphones and sing so people think I’m listening to music.”
  • “I call my family or friends.”
  • “I go outside for a long walk and look at trees.”
  • “I go to church and pray to God to make them go away.”
  • “I find people to talk to.”
  • “I go to the library and look at maps.”
  • “I fix bikes with my friends.”

(And, for some people, “Take medicine.”)

While doing these activities, the voices may not go away completely. However, they quiet down enough to be ignored. They are small acts of defiance against despair. Any respite gives them some peace of mind. Furthermore, these activities are self-reinforcing: They improve the quality of their lives in other ways, so they learn to incorporate these activities into their daily routines.

You may not think this post about people hearing voices has anything to offer you. But, if you are seeking more peace of mind right now from things that seem out of your control, we can learn from our friends and neighbors who hear voices.

They, like you, largely do not want to cause problems for themselves or other people. The voices distress them, but they don’t give up in their pursuit for peace and sanity. Instead of waiting for someone else to make the world feel sane, they create their own quiet.

Persisting in the face of adversity reinforces our dignity as people. Maintaining our sanity is a form of resistance. Continuing to do good and refusing to do harm, even just within the limits of the six-foot radius that surrounds each of us, is an act of courage.