Pediatric Anecdotes, Raleigh, NC, June, 2015 to June, 2017

Anecdotes, Raleigh, NC

Glenn Feole, M.D.

Starting July, 2015  through June, 2017 

Also, there are 2,600 prior anecdotes: Westport, Ct (1987-1998), Migrant Clinic in NC; CHC in Columbia, SC;  CHC in Greenwood, SC (2007 to June, 2015)

Names my patients have called me:

Dr. Feole: 

Dr. Fehari

Feoleo

Seofeole

Dr.  Wright (former partner) 

Foley

Dr. Foree-ehtah

Dr. Flowee

Dr. Feeley

Patient Names: 

Wisdom, Honesty, Lovie  (three sisters)

Genesis

Ronreko

Yuleny

Fazy

Wilmer and his sister, Willmary (Latino)

Zuleimia (female)

Reuben

Honesty

Deoleo-Lopez  (“dee OH lee oh”)

April

Winter Pappy

Pinasagastume  (“PEE nya sah gah stoo may”)

Theatric

Skye

Benedi

Igweogbonnaya

Yester D.

Honesty

Raleigh and her brother Rahyeh (“RAH yeh”)

Goddess and Titan (brother and sister)

Jarius “Darius”

Reality

Promyse

Seraphin Kebonge

Chisimdi   (Nigeria: “The Lord  will let me leave.” )  3 year old boy, very happy, big smile:  had heart disease and was in hospital in Nigeria for 8 months, ha d surgery, finally was able to leave the hospital.

Mgumbaboma

Maita (My EE tah) and Yeukai (YOH key) are from Zimbabwe.  Very beautiful young girls (7 and 9)

Chingombe (Chin OOM bay – very nasal “oom”):  which means little cow

Olisaagoziem  which is  Nigerian for  “God has blessed me.”  Olissa (Oh LEE sah): God

        Brothers: Chissom, Chukwidi 

Yetsivate (from the Ukriaine; similar to “Elizabeth”  - “three Russian queens named Yestsivate”

Olissagoziem: Nigerian “God has blessed me.”  Olissa (Oh LEE sah): God

Chukwidi Okeke (Nigerian) 

Mbumagoma (Congolese)

Hay Twa

Thunder

Blessin’

January 2017

Blessstariah

Life’s H. (Life’s Harmony…with an apostrophe)

Loyal

Praise

Darwin

Heaven and Nevaeh  (heaven spelled backwards) …two sisters

Mother’s name: Unique; child’s name: Unique

Phorever

Image

Gorgeous and Generous (sisters)

Hclaire (Vietnamese) see anecdote #93

Serinity

Adonis  (I am currently reading Shakespeare’s poem Venus and Adonis…of no relevance here at the clinc)

Neftali

Olajesu (“OH lah JAY sue”) from Nigeria, meaning “God’s grace”)

Gift

Zipporah

Rainbow

Gorgeous

Nation

Shtonia

Kebin

Kyng

Harmony

Chance

Ifechukwude (middle name)

Essence

Philding

August and Lyric: two sisters, ages 2 and 4

Kumkum  (from Bangladesh, the name is from a story in the Koran)

Pheonix

January, 2016:

Preciousgift

Cherish

Knowledge

Melo-Lizardo

Messiah

Precious gift Kamsiyuouchukwu Ndu

Essence

Rous (I asked how you pronounce that…”Rose” A latino name)

Reality

Ayatollah

Fatou (ten year old girl, from French speaking Congo)

Cadence

Osiris

Signal

Gift

Siblings: Isis, Osiris, Anubis  (Egyptian and Greco-Roman gods and goddesses)

Thunder

Luluvita: very beautiful African-American mother with striking facial features, said that her Mother is Hawaiian and her name was Lulu.  She will find out what that means in Hawaiian.  The other Grandmother went by Luluvita as well.

Adream 

Atlantis (“How did you pick that name?”  “I heard it on a commercial.”)

Mother: Mamiecoco   Daughter: Mamiegrace  (Mother is from Africa)

Hclaire (from Vietnam)

Stormmy

Diadai (Latino)

Baby Girl (3 years old)

Fnu

Ingeleco (in gel AY choh) and  Chungula (chun goo’ lah): brothers from The Congo

Moses

Ming

Serenity

Italia

Luluvita (Grandmother from Hawaii)

Chisimdi (Nigeria, Ebo language: meaning “God saying it is ok to be alive.”

Toluwanimi (first name)

Maximus

Tink

GeoVani

Avion (I asked the Mother how she picked that name…she said from a label on a Tequila bottle)

Violet (a young, very quiet 3 year old Hispanic girl)

Sincere

Chief Complaint:

“hands with swelin”

In answer to a screening questionnaire, “Spend more time alone?”  Noah wrote, “Only when in pain.”

“Ichen medicine”

“here for art”

“here for hands, foot, mouth”

“rash dipper”

“metal fume fever” “argyria” (computer diagnosis for ‘nickel allergy’)

“left eye wonders”

“patient mother called and states that WIC needs a RX written for Enfamil Liquid for a laughing and crying child.”

“chief complaint was no chief complaint”  (note on a referral)

January, 2017

pain in the pain

consult request: “…needs a second opinion. They need the first opinion in hand to do a second opinion.”

cries – mouth open

temperature 130 !  (ER report)

brest lump

“His asthma is quiescent.”  (Note on chart.)

Mother’s answer to developmental questionnaire about 2 year old’s hearing: “Hears too much”

Ear pain: “acupuncturist said her chi is off”

January, 2016:

“infant is wheezing parents spot on”

“irritated penis”

“chief complaint: 7 years old”

“booty itching at nighttime but I don’t see anything”

“complains of” 

“eyes stuck together”

“return form to PreEnminent Charter School

“itchy and leaking fluid”

“trouble resting at knight”

“patient broked his ankle”

Summary of Call: “Mom is calling because patient was seen at Wake Med ER 7/5/16 seen for pain and soreness in mouth. Pt was given a magic mouth wash to use”

Karleeyah's parent(s) is/are a healthcare . 

She has pets that include no pets.

Gender Dysphoria (consult report)

Age listed on vaccine record: 1 year and 1 day

Computer Auto-correct errors:

Robitussin = Robots sin

Rizatripan (for migraines): Roast riprap

Raghlei  (Mother’s spelling of her address…Raleigh)

Ankle Glossy (for tongue tie or ankyloglossia)

Anecdotes

1. (7/15)  Brandon, age 8, was a quiet African-America boy who was here for a rash.  He sat quietly on the exam table as I talked with his Grandmother.  Brandon was very interested in math he informed me.  I left the room for a minute to order some medicine and when I came back in, I heard him tell his grandmother,  “I am getting shorter.  I was much taller last week.”

2. (7/15)  My first patient here in Raleigh:  a Spanish infant named “Genesis” 

3. (7/16)  The stern care giver was a very well dressed woman in her 60’s; the patient was an athletic looking African-American boy of 16.   After I talked about his asthma, she looked at me and said, “Can I ask your opinion?”

I said sure.

“He wants to play football.  What do you think?”

I asked her how she felt about that.

“Absolutely not!” she shouted out.  “ I don’t want him lying down on the field knocked out.”  She froze me with a stern look.

He was shaking his head side to side in resignation.   I turned to him and asked him what he wanted to do.  He said quietly, almost imperceptibly, “I want to play football.”  We then started to talk; I mentioned to both of them that it was a tough decision; accidents do occur but, on the other hand, football would instill a strong work ethic, develop cooperation and friendships, and  would also be great exercise.

    She paused and said, “I see what you mean.  Yes, I think that would be fine.”  She paused and then said vehemently, “You know, I have raised 24 children and 17 grandchildren.  I care about them.  No one was on food stamps.”  I told her how much I admired her.  They both smiled as they left the office.

4. (7/15)  I went to a flea market in down town Raleigh with my daughter Kelly and walked into a leather shop with a huge head of a Texas Longhorn mounted on the wall.  The owner, an exuberant woman in her 40’s showed us pictures of her farm in Rollins, NC.  Some of the things I learned:

• “My family has lived on this same large property since the 1600’s.  We have thirty-three people on the land right now.  No one leaves.  My father raises Texas Longhorns.” 

“Why?” I asked. 

“Because they’re  meat…they are hamburger.  It pays well.  My Father is in his 60’s and will come into the kitchen covered with cow manure, go to the refrigerator and throw a ball of raw ground beef into his mouth.  So does his brother, who raises 50 horses next door.  My Father started to rope cattle when he was 14, dropped out of school and has been doing this ever since.”

• “My grandmother is 88 and rides a four wheeler.  She chops wood for her stove too.” 

 I asked if she ate beef. 

“She eats anything.  She still traps.  If a possum comes up onto the porch, she will grab it by the tail.” 

Does she eat it, I asked? 

“Hell yeah.  She boils it up and eats it.”

Her Father is also a cattle auctioneer and sells cattle in Silar City every Friday, from morning until sometimes into the late evening.  “They sell hamburgers there at the café and they are the best hamburgers in the state.”

Then, as Kelly and I were waiting for my son Ben to pick us up, we sat down by a stone monument surrounded by verdant trees as the sun declined in the fading dusk.  A special time to be with my daughter who was visiting from Virginia.  A white haired older gentleman, a little chubby and very kindly, walked by…he looked like the angel from “It’s a Wonderful Live.”   He smiled and said that he was a minister.  He pointed across the way and pointed to a small, dilapidated book case.  He said that he had just bought it for his apartment so that he had some place to put  all of his spiritual books. 

    He walked over to a monument that was facing us and said, “Do any of you know Latin?” I love Latin and we had just been talking about Latin quotes yesterday.  The state motto of North Carolina was “Esse quam verdir,” which means “To be rather than to seem.”  He made some beautiful comments about how our actions come from our being, what kind of person we really are and gave references to Jesus and the Bible and how authentic  Jesus was.  This led to talk about Dr. Albert Schweitzer and his life devoted to serving the poor.  Kelly mentioned my vocation at the clinic.  I noticed that he had a star of David on a chain around his neck and asked him about that, especially since he was a minister.   He shared that his Mother was Jewish and he wore it to honor her…and all religions.  Then he walked away with a smile.    

5. (7/15)  Deron, age 14 yrs, was very self conscious when he came in for his first visit.  His parents were very gentle and they were concerned that he had scoliosis.  He wanted to play football and he was concerned.  The Father then told me that he had had back surgery for this.  I asked the nurse if they had a scoliometer, which picks up very subtle cases of scoliosis…the office didn’t have one.  When I lifted up his shirt, I saw one of the worse cases of scoliosis I had ever seen.  The was a 5 inch elevation of the right side of his back and a severe “S” curve of the spine.  

     I explained the situation to the parents and sent him to the orthopedist.  The diagnoses are often not subtle or mild in this clinic, and inversely related to the tools we have to evaluate and treat.

6. (7/15)  I was talking with Christy, the MA (Medical Assistant) who goes to the migrant farms once a week to draw blood for pesticide levels.  This is part of a study at Duke .  They pay each laborer $50 and they are eager to participate.   Currently they are working with tobacco and she described the working conditions.  Sometimes, if they are lucky, they are housed in separate small, connected units that look like little motel rooms.   Usually they are crammed into a double wide trailer, very dirty and filled with mattresses, bugs abounding.  There may be a central room with 8 or 10 refrigerators or stoves.  The workers are usually very young Mexican men and they travel the country harvesting the crop in season (sometimes strawberries up north, their next job, tobacco, sweat potatoes, peaches in Georgia).  They send the money home to their families in Mexico…the are all legal immigrants per Christy. 

     I told her how I saw a flat bed trailer of what I though was leaves of green lettuce when I first started working at a migrant health clinic here 15 years ago…it was uncured tobacco.  Christy laughed and will tell her Father, a farmer, who will enjoy that story.  She said that as a child, each farmer would harvest their own tobacco and the children would have their own plots for extra cash.  This way the children were taught to work hard and also taught the ways of farming.  They would break off the tops of the tobacco plants, which were sticky with the nicotine resin.  They would then “barn” the tobacco…lay the large leaves out, place a stick across the bundles and then tie them in bunches and hang then in a “packing” house.  The house had to be a certain temperature and it could take a month or two for the tobacco to cure.  Christy smiled and said, “I loved the smell of the tobacco leaves curing.  It was very sweet.  You could see smoke (vapor from the leaves) leaving the top of the packing house.”  They would then take the tobacco to an auction house where all the top tobacco companies would come to buy it, such as Phillp Morris.  It paid a lot of money.  The state of NC would give the farmers money to continue to grow tobacco and the companies would make arrangements with the farmers to continue to grow it (but limit the amount of tobacco grown).   If they exceeded the limit, they would come and burn the tobacco.

7. (8/15)  A cute four year old was getting her eyes checked by identifying pictures.  Every time she was asked what the picture was, she would answer very slowly with a hesitating lilt, “That…might…be…”

8. (8/15)  Jeremiah was a precocious 5 year old.  Well, he was going to be 5 in 2 weeks.  I asked how it felt to be almost 5.

“I would rather be older.”

“How old would you like to be.”

“159”

“159?  How about 158?”

“No…that’s not old enough.”

9. (8/15)  A five year old was here for his check-up.  I asked what grade he was in.

“Kindergarden last year.”

“Did you like it?”

“No.”

“Why?”
“I was bored.”

9. (8/15)  Ja’Koby was a 2 month old African-American baby with chubby cheeks.  The Mom was petite and explained to me that she was both breast feeding and bottle feeding him.  He had a cough and had been to the Emergency Room twice for very thorough exams but just had a mild cold.  I could hear some wheezing today, however, so I gave the Mother a nebulizer to take home.  I asked if anyone was sick at home.  She said that she was staying at a homeless shelter and there were a lot of coughing children just running around.  “The parents don’t care,” she explained to me.  She was hoping to get back on her feet; a mention on the chart of some addiction problems, but she was doing well today.  

10. (8/15)  This inner city clinic in Raleigh is different that rural South Carolina.  Many more STD’s, of all varieties.  Travis was a very soft-spoken Egyptian 17 year old.  He had gonorrhea  and the Father came back with him on the re-visit, along with his loving Mother.  They were not angry, but very concerned.  The Father bent over and spoke to me eye to eye as I sat at my desk explaining treatment options.  The Father at one point had his arm around Travis’ shoulder in support of him.  He said that all he could do was pray to God that God would protect him and get him through this.  He needed to show more self-restraint.  

11. (8/15)  A Mother and her 5 year old daughter, H’Laing, were here for a well child check…newly arrived form Berma (Myanmar).  They spoke no English and were here with there sponsor, a middle-aged woman named Carla.  Carla was taciturn and would roll her eyes when I would ask the Mother to pronounce a Bermese word several times.  She said the language was “mystifying.”  

    I had a Bermese translator on the phone and when I asked him how to spell a certain word, he was confused and said, “I can’t spell it.  You just have to listen to it.”  

    The Mother had a shawl  over her head and was covered down to her ankles.  The little girl was gentle and quiet, but smiled with big eyes whenever I would place my hand on her cheek and smile.   The translator and Mother taught me to say “hello”  (NEE koo lah), “bye”  (tey’ tah) and “thank you” (kee zoo tien ba tee).  I later taught this to the nurses to their great amusement.  I  later learned that Burmese is a Sino-Tibetan language (Chinese), monosyllabic and archaic, with great emphasis on tone and inflection.

    The little girl, Nee yah, was very malnourished.  She suffered from stomach pain (no stress in her life…), was going to have surgery on her teeth for extensive dental cavities, was exposed to tuberculosis by her parents and grandfather and was also exposed  to hepatitis B from her Mother.  Yet, we did have fun during the exam…she smiled at the paper airplane I made her.

12.  (8/15)  I saw a nice young man, 10 years old, from the Congo.  His Mother was very pleasant.  His name was Benedi (BEN’ ah dee).   I said what a nice name and asked how she picked it out.  She said that it means benediction.  I asked… just as in Benedict.  She agreed and said that she just left the “ct” off because she liked the sound.

13. (9/15) Areyah was a very gentle, petite five year old girl.  She was here with her brother, Amari, who both had check-ups.  They were very close and supportive of each other during their exams…we became close during the exam and had much fun.  

     I left the room and the nurse gave Areyah her vaccinations.  I could hear Areyah crying during the shots.   When I went back in she was very sad.  Amari looked up at me and said, “When she cried…I cried.”

14. (9/15)  Angel was a very sweet six year old African-American girl.  We had a great time during her exam and at the end I told her that I had a present for her…a paper airplane.  She asked me if I was going to make it.  I said yes, just for her.  She asked if I could color it.  I said that I had some crayons in my office and would bring them in for her to color the plane.  She looked hurt and said with sad eyes, “I want you to color it.”

14. (9/15)  It had been an international morning…all three hours of it.  Bishal was a very gentle 12 year old boy from Nepal.  His Father was equally gentle and kind.  He was here for chronic joint pain and he pointed to his Father’s swollen ankles…he had Rheumatoid Arthritis.  They had come from Nepal 9 years ago.  I asked if his family was still in Nepal and if he visited them.  Bishal explained that his Mother’s parents were in Nepal and they went back occasionally.  His Father’s parents were in Canada.  

     Bishal loved math and I showed him some calculator tricks.  The Father had a large smile and explained that Bishal routinely mystified him with card tricks that he learned on the computer.  

     Right after I saw Bishal, Rahda, one of the other pediatricians, who is from India, came in with a question.   She showed me an Arabian immunization record…all in Arabic.  The doctor and Mother with both wearing long shawls over their heads…the illustration showing the smiling baby sitting on the Mother’s lap, the Mother’s face covered in a Berka.  Later, I asked Radha if she spoke Hindi.  She said yes…that is the official language of India but she really spoke Telugu, which is her dialect in a Southern Indian state.  (India has 25 states, many of who have their own dialect.)

    My next patient only spoke Spanish…a relief for me.

15. (9/15)   Alassya was a gentle seven year old who came in with a history of classic migraines (throbbing headaches, sometimes lasting for 2 days, seeing wavy lines, blurry vision).  I asked if anyone in the family had migraines.  The Mother , also very soft spoken and kind, said, “You know, everything that you asked her…I have the same.  I’ve had headache for over ten years but nobody told me I had migraines though.”

    I asked if she was giving her anything  for pain.  She said, “I haven’t had any cash, but it was pay day yesterday so I went to the Dollar Store and bought some ibuprofen.”

16. (9/15)  Ariana Deolio was a cute, vivacious six year old.  She was from the Dominican Repulbic, was petite, her dark brown curly hair tied in a pony tail on the top of her head that sprouted into a beautiful blossom that was bigger than her face.  Since my name (Feole) rhymed with theirs (Deolio), she and her brother called me Feoleo.  The Mother said that they love me and kept wanting to come to see me. 

    She drew me a note that said in big letters, “I LOVE FEOLEO…LOOLOOLOOLOO.  I thanked her and she told me, seriously as she looked into my eyes, “When I talk to my friends, I talk about you.”

17. (10/15)  Today I saw patients from Yemen, the Ukraine and Mexico.  All were very kind and appreciative for the health care available for their children.  I makes me wonder at the animosity that is generated by the media and by political leaders in general … we all have families and children that we love.  

18. (10/15)  Tyquon was a very gentle seven year old African-American.  He was here for a follow-up visit with his older brother and his Mother for possible ADHD.  I asked how he was doing and then said, “So, are you excited about Halloween?”  He was quiet and didn’t respond right away and I said, “What are you going to be?”   His Mother said, “We’re not doing Halloween…with the state of our neighborhood and the world.  It’s not safe.”  

19. (10/15)  It’s hard to understand or react to the prevalence of divorce and broken families that I see.  Mavi was a little overweight with a cute face and a gentle, kind personality to match.  I asked about her name and with a smile she said Mavi means blue in Turkish.  She then laughed and explained  that she had no Turkish blood though.  I asked why her Mother chose that name.  It brought back my own family’s conversations about how we chose our children’s names, grandparents, parents...it was an emotional thread among many that made my own family loving and close.    Mavi said, “I don’t know.  I looked it up on line.  Once I asked her about it and told her what I found and she nodded.”  

    We had a nice conversation about school, activities (she is a cheer leader) but when I reviewed the screening questionnaire for emotional issues there were a lot of checkmarks about sadness.  I asked her how she was feeling. She said, “Well, my Mother just moved to Minneapolis for work.  She’s been away for 9 months.”  I asked where she stayed.  “I stay with my step-Father…but we aren’t close.  But my Mother said I can come join her next year.”  

    We hugged and she left.  I told her to call me if she ever felt the need to talk.  A sweet girl.

20. (11/15)  Two of my patients this morning were refugees.  I saw Twa,  a eleven  year old boy from Myanmar (Burma) and his Father.   The Family Counselor was so friendly and involved, as she explained to me that the Father spoke no English.  He was very lean, dark complected with black hair and has black stained teeth, I assume from the juices that they ingest.  He was very humble, averting his eyes as we shook hands.  Twa spoke some English but was “very shy” per the counselor.  He hesitated to convey any of my words to his Father and just smiled.  His height and weight were much less than the 3% of the “American” graph and he looked like he was eight years old with very little musculature.  I loaded him up with vaccines (he had received some starting doses from the Health Department) and looked forward to him putting on some weight as he acclimated to the American diet.  Interestingly, he was one of the very few patients I see on a day to day basis without a smart phone or tablet clutched to his hand.  Is that better?  The Father and son didn’t seem to be communicating and I suspected that their exposure to cultural affairs was pretty minimal as well…   I said my only Burmese word that his sister had taught me, “Tee tah” which means ‘good bye.”  

    A little later, I went in to see a cute little four year old, Ameli (“AH meh lee”) from Somalia.  The Mother spoke no English.  She, like her daughter, had her head covered tightly with a ‘hijab,’  the brightly colored cloth that enveloped her head and neck, leaving only a small window for her bright yes and cheeks to peer through.  I couldn’t exam her ears very easily and was struggling to pull the cloth back.  The Mother reached down, apparently a woman of action, grabbed the back of the cloth by Ameli’s  neck and rapidly, with a violent jerk, pulled it off her head.  Her smiling face popped out like a cork…Ameli was delighted as she gleamed up at me, her hair waving everywhere in tangles.  I examined her ears, trying to repeat the word for ear (?”dechk’) which always resulted in peels of laughter at my pronunciation.  

     At the end of the visit, I made four paper airplanes for all the children (Abdulahi and Mohammed among them) and they squealed with laughter as we threw them in the room, some of them bouncing off the back of their sponsor, an older gentleman…even the Mother was laughing.  

21. (11/15)   I asked nine year old Xavier if he was eating well.  Any fruit?   His Mother responded, “Any  fruit?  He loves fruit.  He put fruit on his Christmas list.”

22. (11/15)  I was in the UNC Dermatology waiting room in Southern Village in Chapel Hill and I saw an white haired women in her 80’s two seats from me.  She looked frail with stooped shoulders, was wearing navy blue sneakers that were right in style and her very fair skin and pale blue eyes  portended some Irish heritage.  She had a hint of a smile as she surveyed the room with equanimity.   I almost subconsciously made a mental note of two things: she wasn’t xenophobically staring into a smart phone and she, like me, had a large gauze bandage on her cheek.  

    I smiled and said, “I like your bandage better than mine.”  She smiled and said, “Yes…I have a squamous carcinoma.”  I nodded and shared that mine was a basal cell.  

   She didn’t respond right away but rather glanced around the room calmly.  Then she said, “Well, I guess the basal cells are deeper down than the squamous.”  I raised my eyebrows and said, “Well, squamous refers to the epithelial cells, and the basal cells are near the bottom of the epidermis.”  She nodded in agreement.  My curiosity was peaked.  

   “Do you have a background in biology?”  I asked, almost a little pleadingly.

   Again she didn’t answer right away but scanned the room, taking in the details, probably formulating an answer in her mind.  Who did this now a days?  Who says “now a days” anymore?  I was going to enjoy this.  Like Thoreau, a good conversation has to simmer and mature.  It will progress when it is time and all the better for it.  

   Her head came back towards me and she said, “Well…I guess so.  Yes, I do.”  She laughed quietly. 

“Did you major in biology?”

“Yes.”  

    More time went by and she said, “I used to do lab work in biology…clinical research really.  I did all the dirty work for the other professors.”

   “What did you study?”  

   “I did all the work that proved the para-amino benzoic acid was a sun block.”  She didn’t say PABA.  She said, “para-amino benzoic acid.”  

   I asked her what that entailed; did you shine lights on mice?.  “Well, we used ultraviolet light and it was amazing.  It spared the skin on their ears. “   She sighed.  “It wasn’t pretty what the UV light did to their unprotected skin.  We didn’t shine it on them for very long.”

   I took it all in.  Then she said, “You know, one of my friends is an avid anti-vivisectionist.”  Then she looked at me.  I didn’t respond right away.  Medical memories were drifting through my thoughts gently.  I said, “You know, I haven’t had this memory for 45 years but I was a first year medical student in New York City at Columbia College of Physicians and Surgeons.  I was a philosophy major and was out of my depth in some ways in medical school with all the biochemistry majors.   I was standing in a dingy city elevator in our dorm when another medical student entered the elevator.  He was a friendly, outspoken Anthony Burgess kind of guy, hair askew, disheveled clothes, overweight with a bushy beard.  A true intellectual, and he actually was smoking a pipe that accompanied him everywhere.  He said, “You look pensive.”  I had gotten to know him a little and I knew that he was a thinker…an observer and commentator on what he saw.   We talked about how I was a vegetarian but yet I was wearing leather shoes.   A quandary for me.  He said, “You’re a vegetarian medical student…ummh…so you don’t believe in vivisection?  How about medical progress from experiments on animals?”  He looked at me matter of factly, interested in my reply.  That is pretty much the extent of that memory; it was actually deep and philosophical, as far as elevator conversations go.  Little did I know that my next conversation on vivisection was going to happen forty-five years later with an eighty year old woman/scientist as we sat in the waiting room at the mercy of medical science and research.

    I told her (her name was Mary) that I was  ambivalent about being a vegetarian at times because it was hard to be a pure vegetarian.  

   She said, “Ambivalence is good.”   

   I thought about this awhile and she said, “You must be filled with ambivalence as a pediatrician, after all.  I mean, you love taking care of the children but you have to cause them pain at times.”  She was hitting all the nails right on the head, non-ambivalently and gently.  

   I asked how long she lived in the Chapel Hill area and she said, “My husband and I spent a lot of our lives in the outback of Australia.”  I asked what he did.  “He’s a zoologist.”   “What does he specialize in since he was in Australia?”  She said, “Jelly fish.”

   At that moment, she was called away by the nurse.   We shook hands and she left.  

23.  (Nov, 2015)  Jouseff was an insightful, short Egyptian boy who was here for a check-up.  He was a thinker and answered my questions, and came up with his own, in detail.  He was delightful and filled with energy.  

“How are you Jouseff?   Any problems?”

“Well, I’m fat.”  He shrugged his shoulders.  It was just an observation, a piece of data.   (He was a little overweight but down played this and reassured  him.)    

“How are you doing in school?”

“Actually, not too well.  My grades are 40’s, 30’s and 50’s.”

“Why do you think that is?”

“Because I’m bored and I keep thinking of my X-Box.”

“How many hours a day do you watch TV or play X-Box?”

“About fourteen.”  (His Mother rolled her eyes.)

We talked about decreasing his TV and screen time and he suddenly looked at his Mother and said, “Don’t get any ideas.”

As we finished up, I asked him if he had any questions for me…anything.  Just ask.  He looked pensive as his Mother and I observed him like some new, unknown species we had discovered.  He said, “When I was born, I had hiccups as a newborn.   Could that have caused my lungs to be restricted?”

24. (12/15)  Connor was a new patient: he was a fair skinned Irish looking four year old with brilliant red curly hair.  He was very quiet and tentative as I walked in the room for his check-up.  The Father was a kind, lean African-American man in his 50’s.  It was unusual to even see a patient like Connor in this clinic and I was wondering about the situation, feeling pleased at our accepting society.  Connor and I laughed as he checked me as much as I checked him.  He had a lazy eye and I wondered why it wasn’t picked up before.  “Did you know he has a lazy eye?” I gently asked as I demonstrated to the Father.  The Father jumped up from his chair and said, “Yes…I see that now.  No, I didn’t know.”  He then added as he sat down, “I’ve only had him for two weeks.  I’m his Foster dad.  He is a good boy, very smart and happy.  He is going to do well.”   He said this with a peaceful smile. 
“Do you have other foster children?”

“No.  I usually have two but not now.  My Mother used to raise foster children and I wanted to do this too.  I try to get them back to their families.  You know, Connor’s Father just visited him last weekend so I think that it is going to work out.”  He pulled two colored pictures from his pocket and showed them to me.  They were of Connor, his Mother, and two other siblings.  One had Down syndrome and was missing a leg.”  Connor explained to me that his brother was going to grow his leg back.  

 I asked where the Mother was and the Foster Father said that she was not ever involved.  She had given up her rights to her children.  Connor broke in, “My Mother is at work.”  I made him some paper airplanes and as they were getting ready to leave, the Father asked if I would always be his pediatrician.  I said that I would be honored.   I told him how I admired him and what a wonderful thing he was doing; Connor was loved and full of life.  The Father looked back at me and said, “He is a good child, very happy.  We are on our way to a movie tonight.”

25. (12/15)  I treated Vivian, a 15 month old cute little girl from Honduras, for wheezing and she felt better after a nebulizer treatment. The Mother spoke no English but we had a nice time talking with my limited Spanish.   I was holding Vivian while her Mother checked out at the front desk and was making  her laugh at the Christmas tree in the lobby.  The Mother told the receptionist and me that her Father was in Honduras and had never seen his granddaughter…and probably never would. They couldn’t travel back and forth due to the cost.  She was smiling and told the receptionist that she wanted me to be Vivian’s “abeulo” (Grandfather) and was glad that I loved her daughter so much.

26. (12/15) Christy is one of the medical assistants at the clinic - a very friendly, outgoing woman in her 30’s.  She is chubby  and has a heart as big as her body.  Someone asked what she was getting for Christmas…and she couldn’t answer.  She finally said, “I just love to give other people presents at Christmas.”  (She had brought me a bottle of “cucumber” Gatorade today, since I love cucumbers.)  This reminded me of a past experience:   I was telling one of the children here what I had gotten my family for Christmas.  He looked at me with concern (he was about 5 years old) and said seriously, “But what are you getting for Christmas?”  I paused.  He was worried and said, “What do you want for Christmas?”  I couldn’t answer;  I was stymied.  I didn’t ever seem to want anything for myself for Christmas.  (Of course I am always delighted with all the licorice, candy and books that my family forces on me.)   

     Christy then told me what she was getting her Father for Christmas (they live in Benson, NC, a very small rural town).  “I got him a big box with twelve containers of his favorite chewing tobacco…Winter mint Skoal.  He chews it all day long.   When I was growing up, I used to go to the kitchen and put some coconut in my cheek, pretending it was chewing tobacco, and keep spitting in the yard.”

27. (1/16)  I had a very nice visit with a poor African-American mother.  She wore jeans and a worn leather jacket that hadn’t been washed in awhile.  I gave her a lot of advice about her baby – eczema, reflux, lactose intolerance, samples of formula, diaper rash medicine.  We really connected and I was quietly thinking about how wonderful this was – the two of us so different and yet making a connection and appreciating each other.  

     As I was leaving, Christy, one of the nurses, ran up to me and said, “How did you do in there?”  I said that we had a nice visit…a very nice Mom.  Christy shook her head warily and said, “Oooh  nooo.  She’s is a tough cookie.  Nothing good in there.  Did you read the back of her jacket?”  I admitted that I am pretty oblivious to what the Mothers are wearing or their appearance.  Ignorance is bliss in my case.  Christy frowned and said, “Go look.”   The Mother had to use the bathroom so I helped her unharness her infant from her carrying apparatus and removed her jacket.  When she came back in the room, we were happily talking as I gently helped her put her jacket on.  The back was hand embroidered with large colorful silk letters surrounded by dozens of bright, gaudy plastic beads.  It said, “F…k y..u  ----“ (The last word I just can’t write down; it is a piece of anatomy; when I told this story to my 88 year old Mother, she was intrigued and enthusiastically, and correctly, volunteered some words…with gusto and a smile.  She laughed and said,  ‘I bet  you didn’t think I knew that word.’)

28. (1/16)  The Father was African-American and was dressed in oil stained jeans and a heavily soiled denim coat.  He explained in great detail the symptoms of his 11 month old daughter and two year old son.  He was very concerned , asked many questions and followed my instructions with great concentration and worry.  I told him what a dedicated Father he was and he said as he left, “They are my heart…my pride and joy.  I missed work today to bring them here today.  No pay, but it’s worth it.  They keep me going.”

29. (1/16) Two children, new from Nigeria, were here with the Mother and Grandmother, who was brightly dressed in a colorful striped flowing dress that loosely went to the floor.  The infant had her hair intricately braided into 2 inch strands that sprouted from her head  in all directions.  She had an enormous smile.  I asked if she was talking yet.  “Yes, she says some words.  Some in English.  Some in another language.”  I asked what the language was.  She said “Yoruba” (your oo BAH), which she spoke in Nigeria.  I asked how you said Mommy in Yoruba.  She said “Mammy.”  I asked how you said “Papa.”  She said “papa.”

30. (1/16)  I saw Hope today.  She was a very gentle, self-possessed 15 year old from the Ivory Coast.  She had been in the US for several years.  Her peaceful Father stood up when I came in the room and gave me the history in a soft, melodious voice…he later told me he was a pastor, which I could tell by his kind demeanor and soft spoken ways.  

     Hope had been having abdominal pain for two years, twice a day, severe.  A clue was that when I asked her how school was going she said, “I get all A’s.”  She loved math and history.  Socially, she had been in the US for several years but the kind Father said that he had just arrived from the Ivory Coast because of his daughter’s stomach pains.  Interestingly, her pain was nonexistent on the weekends, which baffled her.  I reassured her, put her on a powerful antacid and talked about exercise and meditation and other ways to relax.

    When they left, the Father thanked me for my kindness and gentleness.  He told me another story from the Ivory Coast.  His eldest daughter had had abdominal pain for years, ever since she was six years of age.  They used to tie a rope around her waist and she got a little relief from this.  Years later, they operated on her for appendicitis and her pain was cured.

31. (1/16)  Sinhan was a very polite, very serious five year old from India.  No matter what joke I made or how much I smiled, he would answer “Yes sir” with his eye brows knit together in concentration, looking at me directly in the eyes, trying to fathom what data I was looking for.  He was handsome with big brown eyes, a milk-chocolate complexion, just like his Mother was beautiful and courteous.  He spoke meticulously measured English with a British accent.  He had dark hair, parted neatly on the side with a little wave in front that his Mother kept long “in the Winter to keep his head warm” she informed me with a heart-melting  smile.  With the same smile she informed me that his name meant “lion” in Hindu.  

     I examined him and it turned out that he had fluid in his ears and a mild ear infection; he carefully, repetitively demonstrated how, if he opened his jaw wide and grimaced, it affected his ears.  I asked, “Does that relieve the pressure and make it feel  better?”  He said, scientifically speaking, “No, it makes them hurt.”  He demonstrated this for me a few more times as proof to his hypothesis.    The Mother then pulled out a huge x-ray (old school I thought…an actual dark, mysterious translucent film) of his head that had been done in India, showing large adenoids.  The ancient x-ray was creased…she had kept it in her pocket book for awhile.    He had a bump on the back of his head that both he and his Mother were very worried about.  When I explained that it was a small lymph node, very normal and not cancer, she was extremely thankful for my kind words.

    At the end of the visit, as Sinhan methodically, sincerely answered my questions about his school and teacher, she smiled and laughed.  “He is just so tense about coming to the doctor.”

    Sinhan seemed to take offense at this and urgently interrupted her as he stood in front of me, face to face, eye ball to eye ball, as I sat down in a chair. 
“Doctor, doctor…no…I am not tense.  I was excited to come and see the doctor today.”  I think he was feeling relieved that the bump on his head was not malignant.  He then tapped me on the shoulder and interrupted me, saying, “Do you know what I got the last time I saw the doctor?”  We were finally connecting.  I said no.  He said, “Shots.”  It was my turn to take offense and I immediately, apologetically said that the shots we used were very tiny; they barely hurt.  He again felt the need to interrupt me and say seriously, waving his hands gently, “I love shots.”  He paused, “I love everything.”

He and his Mother were gentle souls.

32. (2/16)  A Mother came in with her friendly, stoic ten year old son, JaQuize,  who had severe scoliosis.  As usual, he was impoverished.  I had met him before and we had talked at great length about his scoliosis and also poorly controlled asthma.  He was in the process of being evaluated by the pediatric orthopedist, although some appointments were missed.  Four months had passed by and she hadn’t followed up.  She was very friendly to me and we really connected, as we had before.   I enjoyed talking with her and JaQuize.  I paused and thought to myself as I often do how fortunate these patients were to receive such comprehensive care from specialists at no cost to them.   JiQuize sat there, quiet and accepting, all bent over, and I suddenly heard him cough.   It was a deep, wheezy cough that didn’t sound good.  It turned out that the Mother had run out of his medicines.   Between the refills and the new medicines for a sinus infection, wheezing and allergies, I ordered nine prescriptions…some pricey I am sure (QVAR, Augmentin, inhalers, antihistamines).  His nebulizer was old and broken, so I dispensed a new one as well as a spacer.  All of this was charged to Medicaid.  

     Finally, I got to the real reason he was here…lice in his hair.  The school nurse had insisted that there was an epidemic of head lice that was resistant to the over the counter medicines that were not covered by Medicaid.  The Mother was gently insistent that all her children receive this prescription medicine.  I asked, “OK.  How many children do you have?”  She answered, “Nine.”  I gave out a sudden laugh as JaQuize and his brother also broke out laughing.  

     It took me half an hour to order the Natroba on the computer.  I actually counted the clicks for each patient…for each medication: 41 clicks with the mouse (finding the chart, typing in the name, creating a note, finding the pharmacy, etc).  I then searched the internet for pharmacy costs to check on the Natroba.  I had done this before and I knew that it was very expensive.  The cost ranged for $186 to $198 per bottle.

     Taking my calculator out, $198 x 9 children = $1,782 dollars.  Plus half an hour of my time as a physician.  At 41 clicks per patient’s prescription, that is 369 clicks total…or $4.82 per click.  

33. (2/16)  I saw Darriana, a beautiful Puerto Rican girl of 5 years, and her baby sister, Alana, today.  I had seen Alana several times as I loved seeing the soft spoken young Mother.  Darriana was thin and wasted, her ribs poked through and every vertebra was visible.  She had big dark beautiful eyes though and her ink black hair was pulled back in a pony tail.  She looked like a young Sade. 

     She was covered with dry skin and had a sore throat.  I gently examined her and asked the Mother many questions about her health.  She didn’t like to swallow food and with more questioning  I found out that she had been severely constipated for years.  I spent about 40 minutes talking to them, explaining what I wanted to do to make her feel better, giving her handouts, medicines, telling her to come back in a week or two.  Darriana just watched me as we talked about school and laughed.  I made her an airplane.  At the end of the visit, her Mother bent over and Darriana whispered in her ear.  All our talk was in Spanish.  The Mother rose up and asked, “Can Darriana give you a hug?”  I said yes and she came over and we hugged …it was a long hug.  She then looked into my eyes and said, “I love you.”  I talked a little more to the Mother and then Darriana hugged me again before leaving and said, “I love you so much.”

34. (3/2016)  Milton was a very exuberant ten year old African-American with ADHD.  I hadn’t seen him in 3 months and he was here for a re-check on his medications.  The current dose was working wonders.  When I entered the room, I smiled and shook his hand.  He was happy to see me and said, “Dr. Feole!  It’s good to see you.  It’s been a long time.”   I laughed and he said, “So, you’re working part-time?”

35. (3/16)     I had made a really cool yellow paper airplane for a four year old patient.  It twisted beautifully when she threw it, which she did (and I did) repeatedly as she ran down the hall laughing after her visit with me.   A little boy in one of the exam rooms happened to see this phenomenon and wanted an airplane too.  His nurse, Christy, came up to my desk and asked almost apologetically, “Can he have an airplane too?”   I quickly made one and it was a beauty…elegant, sleek, angled.    As Christy rounded the corner holding the plane, someone asked her, “Did a child make that airplane?”   

     My partner, Jill, a pediatrician I sit by, yelled out, “Yes.”

36. (3/16) Jaquavion, an energetic, friendly and very tiny eleven year old was here with his younger sister for ADHD.  When we had finished the exam, having made airplanes and looked at some math tricks on my phone, the Grandmother said that she had just one more question.  

“Javion plays the drums.”   His eyes lit up.  I smiled. 

“He plays at church and plays very loudly.  He goes wild.”   

“He is in a zone.  And he wheezes when he plays.  Can you do something for this exertional asthma?”

37. (3/16)   This morning was very ecumenical.   I saw some very kind patients from around the world.  Teshome was from Ethiopia, a shy, quiet 5 year old girl with an ear ache, who wore a pretty red dress, hair in braids.   Omer (8) and Mohammed (10) were two very funny, astute brothers with a comment or acute observation on everything.  We laughed the whole visit and did calculator tricks.   Omer wanted to make sure that I knew that they were from “North Sudan, not the other part.”  The Mother said she was so happy to be in America, so clean and safe.   

     A very quiet and kind Father was here with his two sons, Surjib and Morjub, one in high school, the other in 5^th grade.   He was gentle and handsome, looking like he could have been an actor.   They were from Afghanistan, having arrived a few months ago.   One had the flu and also had a broken forearm from soccer.   

     Then, two Mexican families who spoke no English came in.  They thanked me over and over for being so patient with their two year old who didn’t want to be examined.  

38. (4/16)   I went into the room to see a meek, thin little four year old African-American girl standing in front of her very poor, very overweight Grandmother seated in the chair, her arms enveloping the little girl.  The Grandmother, besides being very protective, was very outspoken as I found out before my shoe even hit the floor as I entered the room.  I can still see my shoe two inches above the floor as she yelled out, “She has chicken pox!  I know what it looks like.  Look at it!  It’s chicken pox!”  I usually pride myself on taking a thorough history before I even examine the patient, to logically construct an algorithm of deduction so that I may be thorough and precise.  Even during the exam I try not to commit my thoughts to the patient or even to myself until I have gone through all the evidence, carefully accumulating subtle clues on a meticulous, patient and astute exam.  

    So much for that… That all flew out the window in 0.1 seconds with Mrs. Hadley.  I trotted across the floor under the verbal machine gun barrage from the Grandmother, reached for the little girl’s arm and, before I could even look at it, the Grandmother was pointing to the rash,  exclaiming in an hysterical voice,  “See?  Can you see it?  Look!  It has scabs! It’s chicken pox.   Look at the other ones.  That’s chicken pox.  I know it’s chicken pox!’    I started to open my mouth but she flipped Latoya’s arm over to find the lonely, sole surviving hint of a clear vesicle, barely perceptible to the human eye.  I leaned over and started to look at it closely and murmured, “That does almost look like a vesicle…”  That’s as far as I got as the Grandmother threw her arms down by her sides, looked up at the ceiling and yelled out, “See?  It’s chickenpox!  I knew it.  I can see that blister!  That’s a chickenpox blister!”  Her voice was reaching a crescendo.   

    Miraculously, there was a slight break in her monologue, probably from exhaustion or dyspnea.  She flung herself back into the chair in silence.  She looked at me in the eye for the first time.  I looked back in amazement.  I hadn’t said five words yet.  I waited.

    With equanimity, she said slowly, “So, what do you think it is?”

    I paused, savoring this moment.   The return of rationality.  My mind drifted and I imagined that this must have been what it was like at the closing of the Dark Ages and the beginning of the Renaissance.  I hesitantly said in a measured voice, “Almost all of the lesions are scabs and look like impetigo.” She was looking disappointed, her eyebrows lowered.  “But, because of the blister, there is a chance it could be…”  She abruptly leaned forward and yelled out with renewed energy, “Chicken pox!  I knew it.  That’s chicken pox.  Look at it.  I’ve seen it before, It’s chicken pox.”  She again made eye contact with a steely glare.  “It’s chicken pox!”  

     I sat back and just laughed out loud.  Big belly laughs.  And she actually joined me.

39. (4/16)  Yousiff was a very tiny, emaciated 9 year old boy…I was surprised because I thought he was 4 or 5 years of age.  He was quiet and shy, with big dark eyes, gentle black irises and a tan Arabian face.  The Father was handsome and also very polite with a gentle, grateful demeanor.  He humbly stood as I entered the room to shake his hand.  

     Yousiff was there for a rash…some eczema on his elbows.  The Father hesitantly explained that he also would get the same rash on his hands that was painful, cracking, but only occurred in the Spring.  “Not in my country; only since I came here.”  We talked about all types of soaps and lotions, medicated creams I could prescribe.  I gave him some samples for his own use as well. 

     I asked him where he was from and he frowned and said, “Iraq.”  I told him that I was so happy that he was here and that I hoped everyone was treating him well and he was doing well.  He said, “No.  No.  I am having a hard time here.  I am so happy to be here.   It is for my children, not for me.  My life is over.”  He waved his hand to the side, dismissing his life.  “It is for them to have a chance.”  I asked him how things were in Iraq.  He said, “Terrible.  Violent.  ISIS destroyed everything.  All the buildings.  I used to be the manager of a very big air conditioning company but they destroyed it.  In America, I don’t have the certificates to find a job with air conditioning.  Maybe a few hours here, a few hours there.”  I told him of some areas with much construction that could possibly use him and he was grateful, giving me his card.  He had a g-mail address.  We shook hands as good friends as he slowly walked off with his son, thanking me.

40. (4/16)  Shiya was a chubby, friendly six year old.  Her BMI was off the charts.  I told her how nice she looked but mentioned that it was best to get exercise and not eat sweets.  I asked her, “What kind of soda do you drink?”

She smiled, so grateful that I had asked, and exclaimed happily, “Any kind.”

41. (4/16) Hana was a sweet, thin six year old girl from Iraq.  The father is very handsome and soft spoken, an Omar Sharif look-alike.  Very kind.   I had seen his son a few weeks before and now sweet Hana sat before me with big, dark eyes, calmly and softly answering all my questions.  Her Mother sat silently in the corner, a black Hijab covering her head and a long black gown covering her body.  She smiled.  I went to shake her hand after I shook her husband’s but he said “No, she’s not allowed to shake your hand.”  

     Hana was there for a check-up and also abdominal pain.  Her appetite was poor according to her father and when I asked her what she liked to eat she said, “burgers and chicken nuggets.”  We acknowledged, sadly, that she was acclimatizing to her new society very well.  She was shy and a little timid but we had a good visit and hugged as she left.  On her PSC questionnaire, checking her emotional state, it said “school grades dropping…wants to be with parents  more and more…has trouble concentrating…is afraid of new situations.”  I thought this was all normal and to be expected, of course, having just moved here.  I made her an origami flower/two ice cream cones and she was looking forward to some ice cream she said.  

42. (4/16)  I found myself writing acronym after acronym on a patient’s chart today:

Went to ER, US for HPS was OK.  (ultrasound for hypertrophic pyloric stenosis) 

43. (4/16)   I was questioning a Mother in the clinic about some possible blood in her baby’s spit up.  I often get very vague, non-descriptive answers.  “How long?” universally is answered with “It’s been awhile” or “It’s been a minute.”  Never anything concrete.   I was surprised when the Mother, who was poorly dressed and impoverished, teeth missing, smiled and said, “There was an abundance of pink throughout.”

44. (4/16)  Xavier was a ten year old African-American boy, the son of one of the receptionists.  He was here for a sore knee that he had fallen on in PE yesterday.  I examined his knee and noticed that he had some sort of crutch leaning up against the chair by his knee.  I asked if I could see it.  He said “Yes, you can see my ‘protector.’ “

    It was a baseball bat that was well worn, spotted with divots, almost all the black paint having been hacked off the main body of the bat by hundreds of baseball hits.  The handle was only half there, the lip and bottom portion having cracked in half long ago.  A layer of tattered silver duct tape was wrapped around the handle and extended half way up the bat.  I asked if I could look at it and he obliged as I carefully admired all these detail, handling it as if it were an antique book in the Rare Book Collection.   I showed it to two of the other doctors as we admired its detail, Xavier limping along the hallway with the help of this bat.  

     After he had left, one of the nurses came up to me and said, “Do you know that he calls it his Protector?”  I said that he had told me that.  Christy then said, “You know that he sleeps with it.  He also sleeps with a plastic saw and two butter knives.  He says that, as the second man in the house, he needs to protect his family.  His Mother says that before he goes to bed, he says to these objects, “Say your prayers and pray to Jesus to protect your dreams.”

45. (4/16)  My last patient of the day was little Sara.  She was five years old and weighed 23 lbs.  She was newly arrived from Afghanistan, brought in by the kind Father of two of my other patients form Iran.   The parents spoke no English and when I tried to print out some Farsi on the computer, they quickly shook their heads back and forth saying “no”…they couldn’t read.   They were very quiet and gentle and Sara, who kept screaming when I first met her, was letting me caress her hair and make paper flowers and airplanes by the time I finished gently  examining her.  She had jet black hair and beautiful almond shaped dark eyes, as did her Mother.  They were worried that she had no appetite and was thin.  She had fevers for two months, burning when she urinated and constipation all her life.  I gave them many directions and some medicine.   I then measured both of the parents’ heights: the Father was 5 foot 2 inches and the beautiful Mother was 4 foot 9.  Their heights on the graphs were the same as the 3% on the graph of Sara’s height, but way below the “American” heights.  I reassured them.   

    They had no car and could only get the prescriptions within walking distance from where they were staying.  The follow-up appointment, the neighbor told me, couldn’t be on Tuesday or Friday because they were in class…the classes were provided by an agency to help new refugees adapt to American and eventually find jobs.  We left with such heartfelt thanks and appreciation for each other.   They taught me a few words in Farsi too as I said thank you as well.

46.  (4/16)  I saw a Mother and Father from Rwanda.  Only the Father spoke a little English, very broken and hard to understand.  His six year old son had a viral rash all over his face for months and an infected thigh.  At the end of the visit, I asked them to teach me some of their language.  The Mother, stone-faced throughout, broke into a huge smile and laughed when I tried to say ‘hello.’  I told them I was happy that they were here in America and that I hoped everyone was treating them well.  The Father was kind and appreciative and the diminutive son was beaming with a smile, holding the paper airplane I had made.  

Hello: bite (BEE tay)

How are you?  Amakuru

Bye or goodnight: Muramuke (Mur ah MOO kay.  

I always wear a tie and khaki pants and a nice dress shirt for my patients; the children often finger the neck tie in amazement and say “What is that?”  The Father, with a friendly smile as he shook my hand, pointed to my body and said, “I like the way you dress!”

47. (5/16) Bonita was a very independent 12 year old African-American girl.  She was here to see me again with her kind Grandmother and a friend.  I shook all their hands and we laughed a little and talked first.  She was 100 lbs overweight and had actually returned for a recheck of her weight.  She had lost 5 lbs and I congratulated here, passing her a note showing the two weights.  I was very excited.  I asked her what she was doing differently. 

She sad in a noncommittal voice, a monotone, “Nothing.”  

“Are you exercising?”  I sounded hopeful. 

“No.  No exercise.  Ever.”

“Are you eating better?”
“No.  I eat the same things.”

“Did you stop soda?”

“No.  I love soda.”

“French fries?  Cheese burgers?”

“No.  I still eat them all the time.  And I love pizza.”

“How about time on your cell phone?”

She and her friend, an effervescent red-haired Caucasian girl, were clutching their cell phones as we talked.

“I am always on my cell phone.   Especially snap-chat.”  The Grandmother confirmed this with a silent grim look and a roll of the eyes. 

I laughed and said, “Let’s try an experiment.”  I reached over and, to their horror, actually had to pry the phones from their hands.  We all started laughing but Bonita was very worried too as I placed the phones far away…three feet away...by the sink.  Their eyes were riveted on them. 
I said, “Now guess what’s going to happen?”  Her friend shrugged her shoulders and said with a trace of a smile, “We are going to be really bored.” 

Then, for the next 20 minutes, we talked about having fun without a screen, about walking, chasing each other around.  I showed them some math tricks and then we all made origami and some paper airplanes, a flower.  They were intrigued and wanted me to make extras, as they also tried some themselves.  As we left, her friend, a little chubby also, wanted me to weigh her as well.  The Grandmother was so happy that they were having fun.  They wanted to come back in a month. 

48. (5/16)  I saw a new refugee family from Kenya today.  The Father was very shy and soft spoken…I could barely hear him talking.  They were accompanied by a young, very attractive African-American woman from the refugee center as well.  They had just arrived two months ago and already his seven year old daughter was speaking some English.  She also was quite beautiful, with long, flowing red dreadlocks down her back. 

I asked the Father what language he spoke and he said “Swahili.”  He also said that he spoke French, as many do in Kenya.  We traded some French words as he started to converse with me in French, asking me if I comprehended French…in French.

    The daughter’s name was Mediatrice and I asked what that meant (knowing the Catholic definition of imparting spirituality).  He said, “It means to bring two people closer together.”  Her brother was there too and his name, appropriately for this gentle family, was Bonheur.  We made paper airplanes and laughed in our universal language.

49. (5/16)  Frank Enuolybya was an energetic five year old, mostly ignoring my presence as he whirled around the room.  With his last name, I thought I would see a new African refugee but the Father was a short, stocky Asian.  He told me that he was from Viet Nam…South Viet Nam.  His home had been near Saigon and he had fled to Cambodia sixteen years ago.  After spending a year there, the United Nations sent him to Australia.  Eventually, he had made it to America and he was happy that he was here.  His son was thin and active, apparently not totally acclimated to the U.S. lifestyle of chicken nuggets, French fries and soda.  The Father said that they hadn’t gone back to Viet Nam because it was not safe or stable; the grandparents had visited here though and liked it.

50. (5/16)  I had seen Denajiya six months before.  He was a quiet, tough acting young man.  His Father was also poor with worn clothes and had the ubiquitous, gang-looking ‘dew rag’ (I think that is what it is called)…a cloth like a nylon sock wrapped tightly around his head. The last time I had seen Denajiya, we all hit it off and I had made paper airplanes for him.  We had fun.  

     Today, when I explained that his son didn’t have appendicitis, I showed him several things to look for on the physical exam to reassure him.  He suddenly reached out his hand with a sincere smile and shook my hand in gratitude.  “Thanks so much, doc.  I always learn so much from you.”  We then made paper airplanes again and flew them in the hallway for awhile with much laughter.  He said, “We kept the other airplane that you made him but the dog got it.  We’ll see you soon again.”  As he turned to walk down the hall he looked back and smiled, saying, “We’ll make up some excuse to come and see you.”

51. (5/16)   The social situations here are often heart-breaking.  Not just often…every day.  One young child had diarrhea when I saw him at 1 p.m.   I asked what he had to eat for breakfast. 
“Nothing.”  (This is the usual answer.)

“Nothing?” I asked.  He thought and said, “Well, I had some Doritos from my brother’s bag.”

“Did you have any juice or milk?”

“No, just water.”

52. (5/16)   Omar was a very tall seventeen year old who was here for a check-up.  The Mother was Persian and wore a hajib.   She was very sedate, expressionless.  After the exam, I asked where they were from.  She said Syria.  I asked how long they had been here.

“Omar was born in the United States but I came over 20 years ago.”

I asked if she would ever go back.  Did she have family there?

“I won’t go back.  My brother lives in Syria though.”

“Will he come here?”

“No.  He said that he would rather die in Syria that go to a refugee camp.”

53. (5/16)   One of the temporary social workers is also an RN.  Her name is Mercedes and I asked how she got that name.  She is lean, dark skinned with black hair.  She told me that she is Cuban and that when her Mother went into labor, she and her Father hailed a cab and started to drive quickly to her doctor’s house.  She didn’t make it.  They stopped the cab and the Father jumped out and ran the rest of the way to the doctor’s.  The kindly doctor rushed to the cab as her Mother delivered her in the cab…between the seat and the door.  They were so grateful that they named her after the Doctor’s wife, Mercedes.

54. (5/16)  I saw little Sara from Afghanistan again.  It had been a month since her last visit and this 23 lb five year old had actually gained 1 ½ lbs since then.   I had treated her for a couple of illnesses and her appetite apparently was gradually returning.  Actually, I was wondering if she was becoming Americanized and was eating Big Macs and Chicken McNuggets.  (No per the Father.)  It sure seemed like it, although you couldn’t tell by looking at her skeletal arms and legs.  She had a lot of fear and usually screamed the first five or ten minutes when she arrived here in the office.   She also seemed to stay up all night while lying in a bed next to her parents.  I thought that this might have been a normal, expected response thinking of the things she had been though.  As she left, she accepted a paper airplane and a paper flower, although she would not give me a hug yet.  The parents were very kind.  I asked the gentle neighbor, who brings his children to me as well and who also translates for them, how to say hello in Farsi: salam.  

“How do you say good bye?”

  Khuda hafiz.   Khuda means “God,” Hafiz meaning “be with you.”

55. (5/16)  Eduardo was a new patient from Brazil.  He was six years old and spoke only a little English.  His Father was very friendly and regaled me with stories of Rio de Janero, filling me in on the dirty, dusty and polluted conditions of this city of over 27 million people.  I asked about family history of any illnesses and he said, “We have good genes.  His Great Grandmother is 92.  And his Great Grandfather was 96 when he died.”  I asked what he died of.  He said, “He was a tall, 6 foot 4 inch German and he married his neighbor’s daughter who was 60.  They got into an argument and she shot him six times.”

56. (6/16) Alexis was a very tall 17 year old African-American girl.  She sat on the exam table alone waiting for her check-up.  She seemed a little reserved and quiet but answered all my questions in a friendly manner, with her eyes averted.  I looked at the screening test for any emotional issues and noticed many check marks for “feeling angry,”  “feeling sad,” “hopeless.”  I asked her how she was doing emotionally.  She said very hesitantly, “Well, I didn’t have what you would say is a good life.”  She didn’t say anything else right away and I asked her what she meant.  Her story slowly emerged and was so sad and painful to me.  She said she was in Foster Care and I asked if she grew up with Foster parents.  

  “I guess you could say that my Father was the local pimp and drug pusher.  And my Mom used drugs too.  Some people say that it is better to be with your family but they weren’t stable.  They finally put me in Foster Care when I was 14 years old and I wondered why it took so long.  I have 6 brothers and 3 sisters.  My Father has a 42 year old son that he had as a teenager.  For awhile I stayed with my Father but I didn’t get along with my step-mom.  I am staying with my Aunt now but it is clear, as she reminds me, that she is not my Mother.  She doesn’t really care about me.  I tried staying with my Mother a few times and she made me come back and live with her but that never worked out.”  We talked about how tough life can be and she agreed.  “People always tell me they don’t know how I do it and I wonder too.”  She said that she talks with a nice therapist and that helps but she has issues with forming relationships.  She raised her arms and snapped her fingers together, saying “I am coping.”  I asked if she had any close friends she could talk with and she said, “No…I have abandonment issues.”  We really did talk deeply and she even smiled once at the end.  I felt like hugging her, which I often do, but didn’t want to join the list of people who abandoned her if I ever decide to leave here soon.

57. (6/16)  Bryan was a very out-going, vivacious eight year old Spanish boy.  He had a gleam in his eyes, his hair cut and combed perfectly.  He also was very chubby but it didn’t affect his level of energy and self-confidence.  His Mother was very gentle and caring as we talked at length about his weight, how it made him feel, how he was always hungry and was angry if he couldn’t eat more.  On questioning, he ate well…just a lot.  He loved his soups, meat, fruits, beans.  He wasn’t big on candy or soda.  He frowned when I asked him about lunch at school.  He emphatically said that he didn’t like the school cafeteria food.  His Mother agreed and I think he was an aficionado of his Mother’s Spanish cooking.  He was very close to her and often looked her right in the eyes, closely, nose to nose, when they discussed an answer to my question.  I mentioned exercise and he interrupted me vigorously, saying, “No! No! No!  I have that box checked off.  I play outside all the time.  TV and computers are boring to me.”  Music to my ears. 

58. (6/16)  Daniel was a joyful, charming, chubby eight year old African-American who also had cerebral palsy.  He walked well and weakly shook my hand with an asthenic grip, all the time with an engaging drooping eye-to-eye smile when I introduced myself.  He was doing well with some stomach problems but his asthma was not in good control.  He was on a daily steroid inhaler (QVAR) and I asked the Mother is she had it with her.  She did.  She handed it to Daniel, who shook it, made a massive, dramatic, deep inhalation so that not another molecule of oxygen could possible enter his lungs, put the inhaler in his mouth, eyes bulging, and pressed the  inhaler.  Because he inhaled first, none of the medicine went into his lungs.  It stayed in his open mouth and the fine white serpiginous mist slowly drifted out in billowing, wispy strands, enveloping his entire face at one point.  It was impressive.  I was enjoying this spectacle and he seemed to relish this immense pleasure.  

     I explained to the Mother that he wasn’t getting any of the medicine into his lungs.  She was shocked but laughed, saying, “He likes the fact that it looks like cigarette smoke coming out of his mouth, just likes he sees on TV.”

59. (6/16)   Little Maria was a vivacious five year old.  I noticed as part of her check-up that she had bad allergies of her nose.  I hurried out of the room and brought back a handout that listed possible allergy triggers in her bedroom such as feather pillows, carpets, etc.  I asked if she had many stuffed pillows on her bed.  The Mother said no.  

“Any pillows?”

“Well, yes.  She has a favorite doll, a huge doll.  She is stuffed and soft. It’s her favorite.”

“Can you wash it in hot water?”

The little girl interjected.  “Mommy washed her once.  If I squeeze her, she says “I love you.’  Since she washed her, she still says “I love you” but sometimes she says “mmm…mmm…I…mmm...love…mmmmmm…you.”     

60. (6/16)   One Mother was waiting in the chair in the exam room, staring straight ahead, expressionless as her teenage son waited for me on the examining table.  I was wondering about their relationship when the nurse pulled to the side and told me that the Mother had diabetes for eight years that went undiagnosed.  Her HgbA1C was 17 initially before they brought it down.  It had damaged her eyes and she was totally blind in her left eye and only had 10% of her vision left in her right eye.

61. (6/16)   Radha, one of the pediatricians that I work with in this inner city clinic in Raleigh, is from India.  I quiz her about India and have even tried to learn some Talugu which is her Indian dialect.  Her English is excellent but she does have a strong Indian accent.  Today I overheard her tell one of the nurses, “You know what they say, whatever goes down must come up.”

62. (7/16)  I just saw two brothers, 8 and 13 years of age, newly arrived from The Congo:   Ingeleco and Chungula.  They and their Mother spoke no English and the young woman who brought them today from The Lutheran Center that sponsored them as refugees spoke no Swahili.  My Swahili was also rusty, not speaking Swahili at all.  The Mother was very short, and very much under five feet tall even with her flowing gown.   The boys had very dark skin and were timid at first.  They had new dress pants on and shiny shoes.  I asked the translator on the phone if the Mother had any questions at the end of our visit and she said, “We have no money, clothes or food.  We signed something to receive that. Do you know when that will happen?”  The volunteer said that they receive those things at the house where they stay.  The boys were extremely thin, almost skeletal.  By the end, we were smiling, especially when I gave them paper airplanes that we launched in the waiting room.  The Mother bowed to me and she shook my hand, as we connected and the boys shook my hand with big smiles.  I had asked the translator about two words to teach me and they laughed as I said Ashanti (thank you) and Quaheri  (kwah hear’ ee, good  bye).

63. (7/16)  A Father brought in his teenage son for a sports physical.  They were from Mexico, having arrived here 12 days ago.   The son had been born here but they went back to Mexico because all of their family was there.  I asked why he came back.  He said, “I wanted my children to have a good education but in Mexico there are some many drug gangs that it wasn’t even safe to walk to school.”  I asked if he played soccer like his son does, telling him of how I had played on a Latino soccer team during medical school.  He said, “I have a family now and have to work.  I don’t have time to play.  I have to earn money to survive.”  He wore a stained, thread bare work shirt.  He also said that his wife had triplets after they moved back to Mexico and he took this as a blessing, a sign that they were very fortunate.

64. (7/16)  Moses Mugisho, a five year old from The Congo, was here.  What is it about this culture?  Every parent is humble, self-effacing and gentle, as are the sweet children.  I learned a third Swahili word: vizuri (good).  They smiled with a start when I said good bye and thank you in their language.  The young volunteer who brought them was a young girl, an undergraduate at UNC, whose major is International Refugee Care, Latino cultures.  She was spending the summer at the Refugee Placement Center in Raleigh, acculturating the newly arrived families.   We talked a little as I asked her questions.  There are six families that have arrived this month.  All are approved by the Federal Government and get a stipend for three months for food, clothes and shelter.  She helps them find an apartment.  I asked where they lived and she said that they have found some landlords who are open to having refugees rent from them.  The families mostly come from Syria, Burma (Myanmar) and The Congo.  She was also a very quiet, gentle woman, long uncombed hair, jeans…a flash back to the compassionate 70’s for me.  I had never thought of such a college major, I told her, and said how much I greatly admired what she was doing.  

65. (7/16)   As I quickly entered the room to examine the 2 month old baby, three African-American boys were sitting on stools and chairs, ages 5 through 10.  As soon as they saw me they smiled and yelled out, “It’s him!  Alright!  Can you make us paper airplanes?”   After the exam, they crowded around me as I showed them how to make three different versions of airplanes and they had fun flying them around the room.  As I left, one called out with a huge grin, “Thank you, Mr. Nice Guy.”

66. (7/16)  Delali was a shy 18 month old African-American girl.  She was built like a sprinter already and had well formed, muscular calves and thighs.  I asked the Mother about her name and she pronounced it “Dah LAH lee,” explaining that they were from Ghana.  They spoke two  languages at home, English and Twi (“twee”) from Ghana.   (Last name: Dzongbadzorh)  When I examined her abdomen and genitals, I notice a very colorful, multicolored strand of delicate beads on a fine gold chain that encircled her waist, hanging very low on her hips and buttocks.  It was very attractive, similar to a pretty ankle bracelet.  There must have been about 5 strands.  I asked if this was a tradition in Ghana, similar to the ubiquitous braided string bracelets on Latino babies’ wrists.  She said, “Yes.  All the babies have this…and the young girls as well, even teenagers.”  I asked what the purpose of this was.  She smiled and said, “It’s for the (buttocks).  It makes the (buttocks) bigger.  We can also tell if the waist is getting too large when it gets tight.”   

67. (8/16)   A very pretty Mother from Hawaii was here with her two young daughters.  I had noticed that one of their middle names was Luluvita.  She said that was the name of their Grandmother in Hawaii.  Meanwhile, the girls were full of life, whirling around the room laughing, putting on plastic gloves and helping me exam each other, their hair sweaty and in tangles from all their activity.  I turned to the Mother and said, “I bet you sleep well at night.”  She smiled and said that she has two others at home too, brothers age 7 and 12.  She then said that she doesn’t sleep well on the weekends though.  I asked why.  

“Because they all go and stay with their Father every weekend… I worry about them.”

68. (8/16)  Best birthdate of one of my patients today: 1/11/11.  The next week I had a patient with the birthday 11/11/11.

69. (8/16)  An exasperated Grandmother brought her exuberant three year old grandson, Isaiah, in for a speech follow up.  He saw me, screamed with delight, ran forward, lept at me, hugging my knees, yelling, “Make me an airplane!”   The rest of the exam was punctuated by high velocity acrobatics as well.  The Grandmother looked at me, deadpan, and said in a monotone, “Don’t you think he needs some of that cool down medicine?”

70. (8/16)  I asked the proud parents of a one year old how his speech was.  Does he say Mama, Dada?  Two or three words?  The Mother smiled and said, “Josiah, how old are you?”  Of course there was no response and he refused to perform on command.  After four or five attempts he looked at me with a blasé look…and held up one finger.

71. (8/16)  I had never heard such commotion inside the exam room.  The doors seemed to shake as the four year old let out a steady stream of shouts and sad entreaties to not give him any shots.  At one point he yelled out,”I don’t want to die!”  Then after that, “I don’t want to live.”  After the shots were given, he told his Grandmother, “I don’t want to live with you any more.”

72. (8/16)  A sweet African American eleven year old girl was just starting puberty.  I explained to her that her period would probably start within a year or two.  It always lagged behind the very first signs of puberty.  She was very interested, of course, and the Mother interjected,
“I didn’t have my period until I was 15.”  The girl’s eyes were wide, her mouth open in shock as she exclaimed, “Oh… my…Lord…Jesus.”)

73. (8/16)  Sudhan was a very inquisitive eight year old, chubby Indian boy.  He was here for a stomach ache.  I was making conversation and asked how school was going.   He said, “It’s hardish.”   As I left, I made him a paper airplane with many folds.  He took it and said, “Oh, you put a staple in it.  Actually, it is quite amazing.”  I told the Father what to do about his stomach pain and said, “Please come back if he is still having problems.  There is more to do…I can show you a few more tricks to help.”  As I turned to leave, Sudhan called out, “Am I going to get a shot?”  I smiled and said, “No, no Sudhan.  No shot today.”  He said, “I heard you say ‘trick.’ “

74. (8/16)  Dylan was a handsome three year old, half African-American and the other half inherited from his beautiful Japanese Mother.  He had a terrible cough and fever.  As I usually do, to be thorough and to get a hint at the possible diagnosis, I ask about exposures.  I said, “Is there anyone sick at home?”   Dylan yelled out, “Yes.  Me.”

75. (8/16)  Sainte sat on the stretcher, a muscular stolid seven year old African girl with frizzy hair.  The Mother spoke to her in French and I didn’t let on that I could understand her conversation.  I asked if Sainte meant “saint” and she smiled, saying yes.   Their last name was incongruous, looking Latina…Francisco.  I asked, “St. Francis?”  She smiled again and said yes.  “But we call her Terese.”  I said, “As in Mother Theresa?”  She said yes, they named her after Mother Theresa, although her name was already St. Francis.  I told her of my meeting Mother Theresa and she was very moved, saying “What a blessing.”

76. (10/16)   A very gentle young African American mother was here with her happy, active five year old son, Sunsir.  He peppered me with questions and screamed with delight at the paper airplane I made him.  My notes said that the Mother had been a young teenager at his birth, living with her Grandmother, Aunt and several other people with her newborn baby.  She was wearing a fast foods uniform shirt today and I wondered if she was still at home with her extended family.  

     Sunsir had asthma and was not doing well.  I usually try to be very thorough so I sprinted out of the room and came back with my handout about allergy triggers in hopes that this would help him…getting a hypoallergenic pillow, allergy covers, removing stuffed pillows.  I went to hand this to her as I said, “Does his bedroom have a carpet?”  She smiled apologetically and said, “We’re living in a shelter.”  I frowned, sad.    She tried to reassure me.  “It’s a Salvation Army shelter so it’s better but…  So many germs and viruses.  I have chlorox with me all the time and I spray everything.”  I smiled and put my handout away. 

77. (10/16)  Tyquan was a lanky, sullen 14 year old boy.  He was playing a game on his cell phone as I entered to see how he was doing today.  His chart revealed that he had very high cholesterol levels in the past, despite his lean appearance.  His Grandmother, a hugely overweight African American woman, sat there placidly.  I explained to them that his HDL, the protective cholesterol, was very high.  This was good.  Did he exercise?  “No, never.”  The Grandmother nodded and said that he just played games on his cell phone, day and night.  He looked bored.  I asked if anyone in the family had problems with cholesterol.  She said, “Yes, me.  Mine is very high but I take medicine for it.”  I said that eating a low cholesterol diet would help as well as exercise.  Also, eating a non-saturated oil such as olive oil or safflower oil every day could reduce this.  I might as well have been speaking Russian.  She was baffled and looked at me as if she doubted my sanity.  Her face was grimacing the whole time like she had suddenly smelled some kale or spinach as opposed to a vat of frying grease.   She said, “Olive oil?  No!  Never!  I would never eat that.  I like Crisco.  I do all my cooking with Crisco.   I’m a cook and I love to eat.  We drink whole milk.”   So much for preventive medicine; so much for adult medicine as well, I thought.  

78. (10/16)  Xavier was a very polite six year old African-American boy.  He was here for poorly controlled asthma and as I was examining him, I asked what grade he was in.  

“First.”  

“How is it going?”  

“Not good.”  

“Do you like school?”  

“Not the much.”  

“What don’t you like about it?”  

“The food.”

79. (10/16)  A very precocious 20 month old African-American girl was here for a check-up.  She raised her arms and walked over to me for me to pick her up.  I asked her Mother how her speech was.  She said it was incredible.  She was learning from her older siblings.  Her favorite word: “back up.”

80.  (10/16)  A very sweet six year old Caucasian girl was here for a dental pre-op exam.  She was going to have surgery to put crowns on many of her decayed teeth.  Her Grandmother, very overweight, was as friendly as can be.  Marissa had long brown straggly hair that hadn’t been washed in a while.  Her faded clothes had that typical non-descript frayed, thin, stained appearance that I have seen for decades.  A sour smell filled the room.  She lay down on the stretcher for me, all smiles.  She was chubby and laughed as I felt her abdomen.  I asked what kinds of foods she liked to eat.  Any fruits? Vegetables?  She said that they didn’t buy fruits.  How about cookies, I asked, digging a little deeper.  She raised her eyebrows expectantly and eagerly explained to me, “We don’t got no money for cookies.  Right Grandma?”  

81. (10/16)  Savior was a 14 month old little African-American boy.  He walked right over to me and I picked him up as he sat on my knee, discussing everything with his nice Mother.  The Mother was very petite and lean.  Her arms and chest were thin; she was in good shape.  The young Aunt, also in her twenties, was a full figured, very buxom young woman.  When I asked about how Savior was sleeping, the Mother laughed and said, “He needs ities first and then he comes to me so I can put him to sleep.”  My hearing, at age 64, is going, fading into a quiet, peaceful sunset.  The audiologist said I definitely need hearing aids, but I couldn’t hear her to respond.  In any case, I leaned forward and asked the Mother what she had said.  She repeated the muffled phrase a couple of times and I finally understood as they both started laughing.  “He needs to go to sleep against his Aunt’s t..tties, and then he comes over to my bony body and is able to keep sleeping.”

82. (10/16) Kahri was a lean, muscular and unhappy 16 year old African-American teenager.  He was here for abdominal pain.  The ER thought he had an ulcer so they referred him here.  He was sullen and angry.  The Mother, with long dreadlocks and a bored expression, initially didn’t make much eye contact as she sat looking angry herself.  When I asked why he was here, she answered indifferently, “Ask him.”  We had a good encounter and he answered all my questions thoroughly.  I told him my impression and explained what I thought was going on to the Mother, who was half listening, expressionless.  We needed some blood work for an H pylori infection, a GI referral, some medications, etc.  The medical assistant came in and was having a hard time drawing the blood.  Kahri was complaining in an angry voice, refusing more attempts.  The Mother looked at me pleadingly and I smiled, saying how hard this could be.  The Mother then looked at me and said, “See?  The ER doctors said that it was his anger.  That was what was causing this.”  I nodded to her and touched his shoulder – it would be ok.  We had enough blood for the important test I sad.  I apologized.  The Mother said, “Can we talk outside?”  We both sat down in the adjoining room and the Mother told me his story.  I asked how he was doing in school.  “Terrible.  Fighting with the teachers, not doing his work, never reading.”  Then she said, “You know, he was a Father last year and has a 7 month old daughter.  He is angry all the time.  I think he has that ‘ODD’ diagnosis.”  She couldn’t remember the term.  I asked if he had attention issues and it turned out he had great difficulty paying attention and was unsuccessfully treated years ago.  He had a hard time reading.  We talked about ADHD evaluation, learning disability and also the value of counselling since people with ADHD sometimes have issues that can make them feel badly about themselves, not doing well in school.  I gave her some forms and she could return and we would all look into this.  All is not as it seems with a clear cup diagnosis of ‘ulcer disease’ I thought.  He needed more than a simple prescription; I was happy that they both knew that I cared about both of them.  She thanked me warmly as they left. 

83. (10/16) Jorge was an eleven year old Hispanic boy, very short and malnourished looking, with a genetic syndrome that made his face a little unusual in appearance.  He appeared to be about six years old in his frailty.  He was kind and stoic.  I wondered how he was doing in school and at home with his frail condition.  Was he happy?  Did he have friends?

     His 12 year old sister was here with him and I examined her and treated her for a sinus infection.  Jorge’s check-up was long and complicated with many issues but he seemed to take them in stride.  Asthma, allergies, genetics, orthopedic issues, short stature, malnutrition…  His screening form for emotional issues showed many concerns…heavily inked and marked up.  Any attention issues at school, I asked?  The gentle Mother who spoke Spanish smiled and said no.  Jorge looked at her and silently nodded his head yes vigorously.  She grinned, raised her eyebrows and said, “Well I guess so…” so we started an evaluation.  I asked if he was eating well.  He said no.  Vegetables?  No.  Cookies, I asked hopefullly?  Yes.  Candy?  Yes.  The sister was enjoying this.  What subject do you like in school?  Math.  Math! I said.  Do you want me to show you a math trick?  “No” he said with a flat affect.  The sister smiled again.  His Mother pointed out several bruises on his torso as I took off his shirt.  On his back was a perfect purple outline of a mouth – I could see all the teeth marks, molars, cuspids.  The Mother and sister laughed and said that one of his friends had bit him at school.  There was another 2 inch bruise on the front of his chest.  The sister again laughed shyly and said she did that by mistake.   I laughed… you guys are having fun,  I told them.  I asked how it happened.  She said that she had been dragging him around the house by his feet on the carpet.  I said, “At least it was carpet.”  It was a nice visit.  My worries about his being coddle evaporated. 

84. (11/16)   I went in to exam a newborn, having checked the chief complaint.  It said, “weight check, Newborn, Eric.”   I glanced at the weight as I opened the door: 225 lbs.  On the stretcher sat a massive 225 lb teenage boy…his last name was Newborn.

85. (11/16)   Christopher was a very chubby, cordial 13 year old African-American boy.  He was unhappy when I walked in the room as he sat there with his cell phone in his hand.  He wasn’t using it at least.  I asked what was wrong and he said, “My cell phone stopped working.  I’m so mad.”  I asked him what happened.  “It dropped into a glass of beer.”

86. (11/16)  Daeshawn was a very social, happy six year old.  I went into the room to see him for a follow-up visit for his asthma.  It had been three weeks from his last visit and it was nice to see him.  As soon as I stepped into the room, he looked at me with a grin, threw his arms in the air, and exclaimed “It’s you again.”  I laughed and pointed at him with mock disappointment and said, “It’s you again.”

87. (12/16)    Adbel was a quiet six year old from Syria.  He was adapting to our American way of life very well and was watching TV all the time.  He was even a picky eater, preferring not to have dinner.  The nutritionist’s notes said, “He is doing better.  The Father turns the electricity off to the TV room at dinner time (!!) and he comes over to the dinner table to eat now.”

88. (12/16)  Abdiel was as very smart four year old Latino.  He came in with a cough and had a mischievous look on his face as he sat on the stretcher.   He very animatedly asked me many questions as soon as I came in the room.  I took out my stethoscope to listen to him but I paused and said, “First, let me hear you cough.”  I demonstrated taking a deep breath and coughing.  His eyes lowered and he looked dejected.  I encouraged him but to no avail.  He had shut down.  The Mother was at a lose too.  I asked him one more time and he murmured, eyes downcast, “I can’t.  I’m just a child.”

89. (12/17)   I was examining a 6 month old boy and his sister, in kindergarten, was taking it all in.  She suddenly came up to me and asked, “Guess how old Daquan is?”  

I said I didn’t know.

“He is zero years.”

90. (1/17)  Julion, a gentle, inquisitive nine year old was wheezing for the first time ever and he was wheezing badly. His Mother was very articulate and was very concerned since she had asthma as well.   I gave him a breathing treatment and some liquid prednisone, which has a very unpleasant taste.  When I asked if he would rather have a pill next time, he asked if the pill was bitter.  The Mother and I laughed.   I said to her, “Youth… he never has had to swallow a bitter pill yet.”

 91. (1/17)  Bonita was a very obese 12 year old African-American girl.  She came to see me with her Grandmother who was very concerned and animated as she inquired about Bonita’s health.  The grandmother looked to be in her 80’s, probably a great grandmother, and was dressed in a frayed, dirty sweatshirt, her face wrinkled, gray hair disheveled and uncut.  She was very worried about Bonita’s weight, about diabetes, sleeping habits, her inattention at school.  Bonita, noncommittally sitting on the stretcher in a stained, thin gray tee shirt with spots of dirt and water stains, clutched her iphone and rolled her eyes in barely disguised mock distain at my encouraging comments…yet she did really listen.  

     The Grandmother told me that Bonita likes me and always asks to see “the man doctor.”  We laughed as I teased her and make gentle suggestions…just suggestions because everything I mention is met with a “no” and a shrug.  She has lost 9 lbs in six months and I am excited and delighted as I burst into the room, showing her the graph and numbers.  She pretends to be unimpressed.  

“What are you doing differently?” 

“Nothing.”  

“Exercising?” 

“Never.”  

“Candy, soda?”  

“Yes.  I still eat them.”  

“Caffeine?”  

“Dr. Pepper, coffee.”  

She finally, shyly, admitted that she was eating less.  She was over a hundred pounds overweight but this is such progress.  

     She always brings a girlfriend and this particular time her friend, all smiles, is holding an iphone up and recording almost all of the visit as I laugh and offer encouragement.  Bonita refuses a blood test saying she is afraid, and refuses to try her ADHD medication, claiming side effects of dizziness with this miniscule dose that would be too big for a Chihuahua.  After gentle explanations, she quietly agrees with a small nod to the blood test and to re-try the medicine.  Most of her denials are just to show her independence.  It’s normal for this age and I admire her tenacity and independence which I try to foster.  A prior note from a belligerent pediatrician here stated, “Bonita is angry that she had to give up soda AND chips at the same time.  She also refuses to give up bananas because they are fruit.”  ‘You go, Bonita,’ I think to myself and smile.  When she leaves, I shake all their hands, we laugh and I give her a big hug.  

92. (1/17)   Javon, seven years old, had a diagnosis of ADHD on his chart.  I asked how it was going at school and the Mother said, “He’s ok.  He doesn’t really have ADHD.  It’s the teacher.”  I was fascinated by this line of thought.  Intriguing…the endless possibilities of medical practice.  I told her that I never thought of evaluating the teacher instead of the child.  The Mother said, “She’s nice but she’s boring.  I yawn and fall asleep when she talks.”

93. (1/17)  I saw a very soft-spoken and gentle four year old Vietnamese girl named Hclair.  Her teenage sister did much of the translating for the Mother who did not speak English, even though she has been here for ten years.  I asked about the the “H” in Hclaire.  She said that their family spoke two tribal languages in Vietnam.  This was common outside of the cities and once you entered the mountains and country side.  Their languages were Rade (Rah’ day) and M’nong (em MOHg, very nasal).  There were other languages such as H’mong as well.  Rade has some similarities to Vietnamese but not many.  “People who visit Vietnam only hear Vietnamese since they don’t visit the mountains and country side.”  

     The H signifies a female.  It is followed by an apostrophe: H’claire.  Usually, people pronounce the H and the H is also written as part of their names. This H sound consists of a  very gentle, soft of ‘huh’ – sometimes barely spoken.  If there is a large gathering of women, they leave the H sound out since it is obvious that they are all females.  I had her sister repeat the sound and the name many times for me…so subtle.  I asked if the boys had a similar sound and letter and she said yes.  They put the letter “Y” before boys’ names, pronouncing it as “ee.”  Interestingly, it is followed by a dash instead of an apostrophe.  We all laughed when I asked why this difference occurred.   Nobody knows.  Can anyone explain the differences between the sexes?  My name would be Y-Glenn.  The letters themselves don’t have a particular meaning or word associated with them.  

     We had a very nice conversation; the Mother, ancient in appearance with toughened skin and myriads of wrinkles, said that her own Mother, Father and grandparents still live in Vietnam.  They never saw them but would love someday to travel back to Vietnam.  I told them that I had heard it is very beautiful country.   They smiled. 

94. (1/17)  For Jorge’s ear infection, I made a mental calculation of his dose of the antibiotic cefdinir.  I enjoy this mental challenge instead of pulling out my calculator as a knee-jerk response.  I recall one very meticulous, quiet female Japanese resident signing off a Pediatric ICU patient to me who was very complicated and on many medications.  If I asked a dose, she calculated it with a pen…priding herself, she told me, with rarely using a calculator.  I guess her message has stuck with me for 35 years.  In any case, I figured that he needed 14 mg per kg per day…multiplying his weight in my head by 0.454 to convert from pounds to kilograms  (take 50% and then another 5% off, or ½ of 10%)…and then multiplying by 14.  It came out to be 6 ml daily.  I ordered this on the computer but the computer balked and put up an ominous red stop sign as a warning.  I clicked on it.   I had exceeded the recommended dose…he needed 5.826 ml, not 6 ml.   I was 174 thousands of a millilitter off. 

95. (1/17)  A young, gentle Vietnamese Mother came in because her six month old infant son had a fever.  As usual, I am always impressed by the very gentle nature of this culture…so humble and quiet.  She spoke broken English (better than my broken Vietnamese) and we communicated well.  I asked how high his fever was.  She paused in deep concentration and then slowly, seriously said, “nine hundred and ninety-six.”  She had also filled out a developmental questionnaire and the last question was, “Does anything about your baby worry you?”  She wrote down, “When I go outside she see me cry – when I come pick he up she stop cry.”

96. (1/17)  The eight month old baby was smiling, hair disheveled and dirty, propped up on the exam table with his soiled clothes around his waist, his kind Mother leaning over, straining, holding him.  She smiled at me warmly as we greeted each other.  I was happy to see her.  She was poor, overweight, her head covered in a gaudy, cheap hand-knit lime green winter hat, her body stuffed into a worn, dirty winter coat.    I thought to myself that his external circumstances did not live up to his name…Adonis, the Greek god of love.   This was not how he was depicted in Titian’s painting.  I had just started reading Shakespeare’s poem, Venus and Adonis, last night on my quixotic quest to read all of Shakespeare’s works - plays and poetry.  The lyrical, sensual beauty and romanticism of the poem…with ”seeds springing from seeds, and beauty breedeth beauty”… “like a nymph, with long disheveled hair, dance on the sands” (lines 167, 148)…was juxtaposed with this beautiful little boy with unwashed body and dry, cracked skin.  But beneath these surface appearances, peering into the deeper reality, I could see that he had his own Venus as she also murmured to him “I’ll smother thee with kisses” (17).

97. (1/17)  A patient named Phorever was coming in for an appointment but was late.  The head nurse, Natasha, wondered out loud, “I wonder if Phorever is coming or not.”  I said forlornly, “Forever will never come.”

98. (1/17)  I don’t use codeine much at all – it seems to work too well.  Sometimes I will prescribe an ounce for a day or two, for cough and pain but even then some patients will come back asking, aka David Copperfield,  pleading for more, please.  

     My 89 year old Father suffered a very bad fracture and laceration of his thumb during a fall, even hitting his head badly.  The doctor had prescribed hydrocodone for pain.   I gave him one tablet that evening as I hovered over him, worrying about his pain and his mental status.  I tucked him into his bed and just before he drifted off to sleep, he said to me, “This is pure bliss.  I am going to enjoy this.”  I slept on his couch that night.  I got up at 7 to go to work and when I peeked in to check on him, he was sleeping flat on his back, a big smile on his face.  

     Two nights later, as I put him to sleep again, he was still on a little codeine.   He was so happy to get in bed, saying, “I didn’t know that I had so many happy buttons.”  I laughed.  “And they’re all being pushed.”

99. (2/17) I was seeing two teenage siblings from Nigeria for their annual physicals and at the end of the visit the Father smiled and said that he was going to see me again shortly for the third sibling… in about an hour.  I hadn’t seen his other son’s name on my list of patients so I called out to my nurse, Christy, to check my schedule.  She said, “Oh, I see it.”  She pointed with satisfaction to the name: Mubumbagoma.  The only problem was that my next patient’s last name was Ogungbemi.  We laughed.  I told her that, as usual, she was she getting her Mubumbagoma’s mixed up with here Ogungbemi’s.

100. (2/17)  I took care of Maximus today.  He is a 7 month old Caucasian baby, very poor as is his Father.  Worn, frayed clothes and poor hygiene but a loving Father.  At the end of the exam I asked how he had chosen the name Maximus.  He said, ”It’s a very strong name, just like my son.”  They were also considering Maximillian.  

     Just as I was about to leave, he said, “And Adonis.  We were considering Adonis.”  I stopped in my tracks, thinking and then laughed.  I told him that I had just read all of Shakespeare’s poetry and that his first poem was Venus and Adonis.  Adonis was a Greek character that was known for his beauty; a symbol of love.  The Father shook his head but I wasn’t sure if he understood the connection.

101. (2/17)  Henry and James, four year old twins, came over to wish me a happy 65^th birthday.  When Henry asked how old I was, I slowly told him 65 so that he could understand this amazing mathematical concept. Sort of like explaining infinity, I thought.  He looked at me without expression for a long time… and then just walked away.  Stunned.

    I asked them what the best thing about being a twin was, especially since Kelly was visiting with Pauline and Louise, 8 month old twins.  He said, “Tackling.”  I asked if there was anything else.  He said, “When one gets hurts, there is another one.”

102. (2/17) Danni was an exuberant six year old from Syria.  He was a little chubby, had a bowl cut of thick brown hair down to his eyebrows that highlighted his angelic face and innocent, demonstrative ways.  I had seen him a month ago and he had been very scared and was crying.  He had had a sore throat and didn’t want a throat culture.  I talked with him for a long time and we worked everything out.  He had gone home very happy.  Today, he was here for a well-child check-up and when he saw me walking through the waiting room he ran up to me and hugged me.  He shouted out to  the nurse, “That’s Dr. Feole!  He knew right away what my illness was!”

103. (2/17) Deondre was a gentle giant of a seven year old from a very poor African-American family.  He was huge and stocky, silent and accepting in his stoic way as he sat there on the exam table.   He appeared to be perhaps 12 or 14 due to his size.  He was very placid, expressionless as I examined him.  I asked him if he loved sports, expecting him to say that he was the starting fullback on his all-state football team.  He quietly thought and then finally murmured, “I was thinking of learning chess.  I saw it on the internet…and it was…interesting.”

104. (2/17)  I saw a beautiful young North Viet Namese girl for her check up.  The Mother was very shy and did not speak English.  Her older sister, H’Be (“Bee”) was 17 years old and very articulate and mature.  She gave me all the information and had many questions about treatments and medications.  She said that she is interested in medical school and perhaps Pediatrics.  Very inspiring.  She explained that they are from a small ethnic group  that is rural, call Montagnard  (silent g).   The language is Jarai.  

105. (2/17) Another of my patients, from Somalia, was seen by Teri, the new Nurse Practitioner.  She knows my interests and came up to me with something that the Mother had written on a piece of paper: it was her son’s name in four languages (English, Somali, Arabic and Anharic, an African dialect).  The Mother speaks all four.

106. (3/17)  Jetorie, age 9 years, was a very obese.  He was a very self-contained; a very quiet, kind African-American boy.  He was here for a sinus infection.  The Father, very poor, was not communicating much, cell phone in hand.  Jetorie had a soiled, worn white tee shirt on, smudges of dirt and yellow stains everywhere, his long nails dirty.  

     We talked about his sinus infection and also about being healthy, stopping soda and trying to exercise.  In his soft voice, he said, “We don’t have much space to exercise.”  I said to try to just walk and get outside, maybe with Dad.  He was hopeful and added, “We get exercise going to the bus stop.”  I spent the rest of the visit showing him how to make a paper airplane (he had never made one before) and how to throw it, the Father sullen and impatient.  As they left, Jetori ran up to me and gave me a big hug.  

107. (3/17)  Vanessa was 12 and her sister Alyssa was 15.  They were Caucasian with long black hair, lean and pretty as they sat there trading sisterly jabs at each other.   I loved the Mother…very open and funny, hopping out of her chair, rushing up to me with a loud exclamation to ask me a question or show me a rash…even to look in her throat to see if she had the same bumps as her daughter; full of life, funny…and honest.  

     Alyssa was very smart with that insouciant look, blasé and bored at school (“I hate school”) but she liked art.  She greeted me like her Mother did with delight when I walked in the room…a loud, joyful hello…happy to see me, but reverted to her defensive, sarcastic demeanor when talking with her family, unsmiling and serious.  I said how good her height and weight were but she felt that she was overweight…maybe just a little.  I mentioned aerobic exercise, 1 hour a day; good for mood and also for sleep as well.  She said, “I can’t walk in my neighborhood.  It’s too dangerous.”  The Mother looked worried and said dramatically, “We hate where we live.  When Alyssa walks outside, men make cat calls, approach her.  It’s awful.   Erections everywhere.”  Alyssa said, “We can go to the gym, but even there men are waiting for me, eyeing me, making sexual comments.”  I told her how upset I was and apologized for the male species, our hormones, our society even.  An eye opener as usual about the harsh realities of poverty and city life.

108. (3/17) Angel was newly arrived from Honduras.  He was 9 years old and gentle, as was his Mother and very shy 3 year old sister.  He pronounces his name “Ahn HEL” and I asked what his sister’s name was: “Angel!” with a hard G sound.   He laughed and pointed to his Mother:
“And her name was Angelica!”   I wanted to know if his Father’s name was Gabriel. 

109. (3/17)  Sharod was a muscular 18 month old.  He was tough; he even walked tough as he sauntered around the room like he owned it, holding his own bottle in his mouth with one massive hand.   I had known his mother well and was always struck at how she managed her life.   She was still living in a women’s shelter…with these four children.  I gave her a hug and praised her for the job she was doing as I examined two of the children.   The room was a scene of chaos with all four children talking, crying, walking around, tipping things over, grabbing examining gloves, playing with the otoscope.   The Mother had lungs of leather as she would periodically let out a shocking, explosive yell that made my hair stream back on my head from its shear velocity.  The children would freeze momentarily like deer and then nonchalantly resume their activity. 

    I asked her how Sharod’s speech was doing and she said, “Fine.  He’s cursing really well.”

110. (3/17)  The Mother was into drugs and was not involved with the family, but the Grandmother was very devoted, bringing her sometimes troubled twelve year old grandson in to see me frequently for behavioral issues, hearing problems and ADHD.  Anthony was a quiet and reserved as his Grandmother was loud and boisterous.  She took everything in stride.  I liked her attitude.  Anthony was here for a well child check-up.  

     When I examined his private parts, she held up a sheet of paper in front of her eyes to block her view as we laughed.  I announced, “Everything is fine.  No puberty.”  She yelled out, “He better not have any puberty yet.”

111. (4/17)  I examined Kayden, a hyperactive 9 year old who had run out of his ADHD medicine.   He was full of life, asking a barrage of questions, usually in a stream of conscious flow of any ideas that came into his brain.  He was very friendly and engaging with his high energy.  We did a lot of laughing.

       There was some question of difficulty urinating and after examining him, I observed him urinating in the bathroom to make sure his stream was normal…it was.  I had the Mother come in the bathroom for reassurance for him.  As we walked out of the bathroom, he blurted out, “Ok, now let’s check Mom.”  

112. (4/17)   I had sent a 20 month old to speech therapy since he was not saying any words.  The family was bilingual which may have accounted for some of this.  The report said, “He did respond visually to a duck by making duck sounds, which is a good prognostic indicated for improvement in his speech.”  

113. (4/17)  The African-American Grandmother was very upbeat and friendly as I went in the room and introduced myself.  She was a large woman with a loud, buoyant voice and big smile.  She was well dressed with make-up and lipstick on but I noticed that her clothes were thread bare, with a profusion of piles built up on the front of her yellow sweatshirt.  She was a kind but strict disciplinarian for the 4 and 6 year old girls, having them say thank you when I gave them paper airplanes.  

     She was also legally blind and Christy sat with her to help her fill out the developmental questionnaire.  Christy came out and said, “That Grandmother is very good with them.  A disciplinarian.  She told me that the Mother just went to jail and that the Father just dropped her and her step-daughter off to take care of them.  He wasn’t going to be involved with them any more.”  I looked back on the record and the girl was born with growth retardation (IUGR, Intrauterine Growth Retardation) and the Mother had smoked marijuana for 6 months during the pregnancy.  

     And the girl?  She was happy and cooperative, her skin immaculately washed, with clean clothes on…her name was Harmony.

114. (5/17)  “Are your periods regular?” I asked the teenage girl during her exam.  

“Yes.  They come sometimes at the beginning of the month…sometimes in the middle…sometimes at the end.”

115. (5/17)  Johan was a very insightful, refreshing, shoot from the hit, patient.  He was 16 years old and had ADHD.  When I asked a question, he told me the truth.  His Spanish Mother was there and listened attentively, nodding in acquiescence.  

“How is the medicine working?”

“I don’t like it.  It makes me feel isolated.  I concentrate too much.  I don’t talk with my friends as much.  I like feeling hyper when I’m with my friends.”

He also had some feelings of anger and I asked why.  He said, “It’s puberty.  I argue with my Mom.  I want to do what I want to do.”  The Mother nodded in agreement.

He filled me in that his grades were bad in science and math…because he didn’t like the subjects.  He also didn’t like to study but crammed the night before a test.  So he didn’t need any medicine to help him study in the afternoons.  All this was said nonchalantly.  This was his reality and he accepted it; even desired it.  I asked what they both wanted to do with the dose and after much conversation (the Mother really thought it helped his grades) he looked at me an said, “OK.  We’ll keep it the same.”

116. (5/17)  The love the Latino families I see.  They are so close knit and caring.  I saw a 14 year old boy and his 10 year old sister for check-ups together.  He was very verbal and answered my questions in depth as his Mother sat and observed.  When I examined his sister, I asked her if she had had her period yet.  Her brother broke in, “No.  She hasn’t had her period yet.  Do you think it will happen soon?  Do you think that she and my Mother will have their periods at the same time?”  He was sincere and very interested in his sister’s welfare.  She took if for granted that he would take care of her in this way.  When it was time for me to examine his private parts, I asked if he wanted his Mother to leave the room or close her eyes.  The Mother jumped out of her seat and headed for the door but he stopped her and said, “Mom!  I want you in here!”  It wasn’t of any import that she leave and he felt more comfortable with her there.  Very moving.

117. (5/17)  A few days earlier, I had seen another Latino brother and sister;  She was 15 and he was ten.  I examined them at the same time and excused myself to write my clinical note.  When I came back in, his sister was lying on the stretcher on her back with her hair draped over the edge of the examining table.  Her brother had brought his chair to the edge of the table and was slowly caressing her scalp and long hair.  When I walked in, they just turned their heads to look at me with a smile.  

118. (5/17)  A Filopina Mother was in for a visit with her two sons, ages 11 and 12.  She was very open with them and as she filled out the PSC form about their emotional well being, she looked up and matter-of-factly asked Andrew, “Are you happy?”  He replied, “Yes Mom.  I’m happy.”  She looked down at the paper.  “Do you have hope?”  He said, “I have hope.”  

119. (5/17)  The Maternal Grandfather of Mrs. Calero, a wonderful, devoted Mother of three young children, was visiting from Florida.  They were a very loving Latino family.  Our computers were not working and after I had seen the 9 month old son and the young daughter, they had left without taking their written prescription and notes.  I ran down to the parking lot and gave the children paper airplanes and also gave my notes and prescription to the Mother.  I introduced myself to the Grandfather and he shook my hand so hard.  I told him what a loving daughter he had and how proud he must be.  He said that they were going to move here from Florida to be near the grandchildren and I told him I knew the feeling.  I thanked him for bine here today.  He said, “I want to thank you so much.  We need doctors like you who are so human and friendly.  Look at this…coming down to the parking lot for us.”  He was very kind.

120. (6/17)   A 16 year old had seen a neurologist for ear pain and a burning feeling in her ear.  The consult report from the neurologist said, “Mother states that they see an acupuncturist and her chi is off.”

121. (6/17)   I was treating a 1 ½ year old from the Congo.  Her brother, seven years old, was very kind and helpful.  At the end of the visit, he came up to me and told me how much he was enjoying reading the book he had found in the room.  He was very articulate and had the wonderful British accent to his clearly pronounced English.  I thought to myself that this was such a great thing…helping refugees increase their English and give them some intellectual stimulation along the way.  I said to both of them, “Come with me!  We’ll pick out some books that you both can take home.”  We went to the used book area and he silently picked out two books for his sister, eagerly watching.  I then asked if he would like a couple of books, holding up some rudimentary pre-K books.  He said,  “Ok, but I think I’ll take those two non-fiction books.”