More memories from the STD Clinic Journal….
November 8, 1996 – I spent a couple more hours in Estrella Jail this morning. I conducted two interviews on patients for whom we had been looking since July of this year.
Crystal B. was finally in jail long enough to receive her twice-daily doses of Doxycycline. The last time I had spoken with her, she was released the next day and never made it to the clinic. She had sworn that she would make it to the clinic so she could be “cured.” It never happened. Since August 7th, her blood had risen from 1:128 to 1:256, bringing forth new symptoms of the infection. This time, she had vaginal and perineal lesions. The chart said that she may also have herpes.
I mildly admonished Crystal, telling her how I had driven for hours, several times, trying to find her on the street. I also told her that one of my partners had driven around looking for her, as well. Even “ex” prostitutes have feelings – Crystal’s blue-green eyes filled with tears as she told me that she had made a mistake. I wasn’t looking directly at her, and not seeing the tears, continued with my scolding. I told her that I wasn’t concerned with all the aspects of her life, I was just interested in how this disease had come to play. When I looked up and saw her tears, I felt that I should back-up and go more slowly. “Can’t a person make a mistake, huh? We all make mistakes, don’t we?” Crystal asked. Yes, I said; we all make mistakes. I was just concerned that she was going to become sicker and possibly spread the disease further. She assured me, kind of, that she hadn’t had contact with anyone since both of her sex partners were locked-up. She denied any contact with dates. Crystal could have been acting, but she seemed sincere.
Crystal had been on twice-daily Doxycycline for about a week now, halfway to her cure. The sores were healing nicely and she said she’s feeling better about herself. She said that she is tired of this life, here in Phoenix. Crystal said that she never had a record till she moved here. Now, at 24yo, she is ready to move back to California where her family and children are. Crystal told me that she will be released on November 21st and hopes to leave right away. My proof of this move and restart on a new life will happen when the health department from her California town calls to let me know that she has had her blood tested again. We’ll see what happens.
After leaving the jail, I went to the field to try to locate a person with 1:128 dilution blood that had just been released from another jail. The person didn’t even know the results yet. I had spoken with Stephanie at the jail this morning and she had given me the address and phone number, supposedly belonging to the patient’s uncle. I had already called the number and left a message, so now, in the field, I hoped to be able to speak with the patient face to face.
Approaching the door, I wondered if this was really where the patient lived. I am almost ashamed to say it, but the house did not fit the stereotypical house of a young, black male who was recently released from jail. As it turned-out, the house was that of his girlfriend. She, Nicole, answered the door, and to my question about whether or not Sammy lived there, she replied that he did. After I learned that she was his girlfriend, I told her that both she and Sammy needed to come to the clinic. Suddenly, Nicole’s face changed from a look of curiosity to one of fear. Then, just as suddenly, she recognized me. She said, “You came to my school and did a talk on STDs. You’re from Maricopa….”
Nicole recognized me from the presentation I conducted at her school, The Center for Xxxxx, where my wife was serving her internship for the BSW program as ASU. Nicole remembered the pictures of syphilis and gonorrhea. The realization of who I was and what I represented slowly spread across her face. She assured me that she and Sammy would be to the clinic that day, and they were. Nicole ended-up having the infection and was treated the same day. Sammy ended-up being the dog, having at least two other sex partners, completely unbeknownst to Nicole.
It’s now March 28, 1997, and I’m just now finishing this entry. Nicole didn’t return to The Center for Xxxxx until just last week. Five months have passed since she was there, working on her GED so she could become independent of her family’s support and get a job on her own. Nicole never mentioned anything to my wife about that afternoon in November, she did, however, ask her to tell me “thank you.” For several weeks after Nicole failed to return to The Center, my wife and I occasionally discussed the situation. I had resolved to go past the house and check-in on her under the guise of follow-up for the syphilis. I never made it to the house, and further, don’t know if that would have been a good thing to do or not. Maybe things would have been too difficult for her in the face to face encounter that would have occurred in her doorway or in the front yard of her house. At any rate, she is back in school and it’s almost time for me to get back to The Center for another STD presentation. “Thank you” is a small reward, but in this job, it is often everything that we can hope for. A few times in my almost eight years here with the county, a patient has ended-up dead, sliced to bits and tossed into a garbage dumpster after finding-out she had something and subsequently telling someone else of her situation. I will take the “thank you” any day. It means more to both Nicole and me than words can really describe. Not that I thrive on the appreciation of my clients, it just doesn’t come often, and is, therefore, a real reward. Thank you, Nicole.