Tuesday, January 19, 2010


The doorman took my keys. The concierge asked me to sign in. She called up to the tenth floor condominium and then guided me to the elevator. Everything gleamed. A black Jamaican woman answered the door and led me down a long hallway, through a heavily decorated living room, a dining room, and then into the bedroom. The woman I had come to visit was in bed, buried under mounds of down and 800 count cotton sheets. She wore tailored stylish pajamas that probably cost more than my first car. Her skin was polished, more pink than white.

I mention her only as a point of reference. The patient I saw next was the one who really made me stop and think. The woman with the silk pajamas was as sick as anyone I have seen. But if it was discovered that eating caviar could cure her cancer, this woman could have had cases delivered in an hour, and her personal attendant could scoop it out with a silver teaspoon.

Marie Jean Baptiste, on the other hand, came out from her bedroom dressed in a loose fitting stained dress. She was a stocky Haitian woman who avoided eye contact, only stealing furtive glances at me when I asked her questions. She was a diabetic, her sugar out of control, and the doctor had adjusted her medications. The apartment was stark, naked, and all around us were stacks of boxes. Her daughter was sprawled on a couch in the next room, and four or five small children kept popping out of the bedrooms, dancing and laughing.

“It’s a mess in here, I know,” said her daughter, her eyes closed, “They just got finished spraying the apartment for bugs. We had to move out for a couple of days. We’re trying to put it back together, but I’m sick too, diabetes like my mother, I can’t see.”

I checked Marie’s blood sugar – over three hundred.

I asked her what she had for breakfast this morning.

She answered in a heavy Creole accent, covering her eyes with a leathery hand as she spoke.

“Bread, coffee, spaghetti.”

I began my spiel.

“Carbohydrates are like sugar,” blah, blah, “You should eat more fresh vegetables,” blah, blah, “Buy chicken without the skin,” blah, blah.

Then it struck me as I was talking. This woman, and the entire family that was stuffed into this freshly fumigated apartment, probably could not afford to buy fresh vegetables and skinless chicken. The closest supermarket was a Whole Foods supermarket. Closer, there were two convenience stores, a Chinese fast food take out, and a pizza joint.

I stopped talking and watched Marie wipe her wrinkled hand over her face. She looked drawn, defeated. He daughter was reclining now on the couch, a pillow over her head. A smiling two-year old came running out of a bedroom, stopped in front of me, giggled, and then ran away. I noticed the huge cereal boxes on top of the refrigerator.

Back in the downtown condo the woman in the silk pajamas might have been eating a chicken salad sandwich on thinly sliced white bread. The crusts would have been cut off.

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