Bac Sai

Part 2/2

Bac Sai, Part II.

The first two years of medical school were boring, consisting of lectures, reading textbooks, and taking examinations requiring only rote memorization. I craved the hands-on medical treatment I practiced in the field. In our first year, we learned anatomy. In the second year, we studied the diseases of the body. The textbooks, lectures, grizzly photographs, and the anatomy lab were nothing like I witnessed in battle. There were many times I thought about giving up on medical school but Kate encouraged me to finish. I received a postcard from Kate many years later learning she accepted a Midwest faculty post in OB/GYN after finishing her residency. I was fortunate to have known Kate and will never forget her.

After completing our second year in medical school, I started two years of study within the hospital learning to examine patients while rotating through the various specialties of medicine. I reveled in my ability to treat patients again but now with an increased sophistication I learned in medical school. I was beginning to feel like a physician. As I rotated through the various medical specialties, my surgery rotation felt natural as I stood side by side with surgeons whom I only watched from the sidelines as a medic. I was a quick study and my surgical professors and residents knew I had seen action and saved lives. I was fascinated by all of the surgical specialties including general surgery, neuro, cardiac, and orthopedic surgery but gravitated towards trauma surgery. I reveled in the uncertainty of emergency surgery where my medical skills were tested by the clock. 

I accepted a trauma surgery residency at a major New York City hospital. Although the stabbings, shootings, and beatings I treated were reminiscent of Vietnam, they were senseless. Although they were the casualties of a type of war being raged in the poverty stricken neighborhoods of New York, they were not battlefield casualties and could be prevented with political intervention if anybody gave a damn.  I had come a long way from a draftee and longed to put my medical education and skills to the best use possible and the only remuneration I wanted was to feel satisfied that I was making a difference. I’d return home after a long shift exhausted but not feeling satisfied. My parents suggested I join a successful surgical practice and the money would improve my morale. They still didn’t understand me. My stuttering was beginning to return and I was turning to marijuana and booze just to make it through the week. A nest of birds showed up outside my window. It reminded me to consider Redbirds advice and examine my feelings “from the inside out”. I had to leave New York and find somewhere to heal from the horrors of Vietnam and the senseless carnage I was treating in the city.

I had dinner with the Dean of the medical college who had admitted me years before and explained my situation. It didn’t take him long to conclude, “Abby, you’re a brilliant surgeon but you need time to heal from Vietnam. You haven’t had a break from medicine since leaving the Army.” He encouraged me to consider working for a time at a rural medical clinic. These clinics were in desperate need of surgeons. It was going to be a cold winter and he said, “Why don’t you head out West, Abby? I have a friend at the Bureau of Indian Affairs who might find an opportunity for you.” The Dean told me it was beautiful wide open country and he was confidant I would find the personal reward I was seeking and emotional healing I needed to continue medicine. Within days, the Dean called me and said he found a small medical clinic on the Hopi Indian Reservation about 110 miles north of Flagstaff off Interstate 40 with only an RN providing medical care. He warned me it would be no vacation paradise because the poverty and sickness I would encounter on the reservation was no different than the villages of Vietnam saying, “Poverty and sickness doesn’t have a nationality or international border, Abby.” I immediately accepted and the decision would change my life forever.

I was met at the baggage terminal in Phoenix by an elderly Hopi woman holding a cardboard sign reading, “Dr. Singer”. My heart skipped a beat thinking this old woman was the RN and asked her: “Are you Cat Azure?” The old toothless woman didn’t speak English but nodded “no” to my question. When I reached for my suitcase, she quickly grabbed it and motioned towards the parking lot. The old woman was quick on her feet. We arrived at a beat up old van with large red crosses painted on. I opened the passenger door to see that it was the reservation ambulance equipped only with a stretcher and oxygen tank. We didn’t speak one word during the four hour trip to the reservation. I had fallen asleep but was awakened when the old woman veered off Interstate 40 onto a dusty single lane dirt road which extended for miles through the beautiful desert punctuated with cactus and orange mesas. I had never been to the Southwest and was impressed with the landscape.

We came upon an assemblage of mobile homes pieced together like building blocks and the old woman parked the van, hurriedly leapt from her seat, grabbed my suitcase, and motioned me towards the “Reservation Medical Clinic”. The waiting room was cooled only with a ceiling fan and was filled with Hopi ranging from the elderly to newborns all patiently waiting their turn to see the nurse. Each gave me a warm smile as if they knew I was the new physician and surgeon. The old woman dropped my suitcase behind her receptionist counter, handed me a white coat, and a pair of sterile gloves. She led me into an examination room where I met the RN who was splintering a fractured index finger of a crying boy. The Hopi nurse was wearing surgical scrubs, tennis shoes, and a beautiful braided necklace. I worked with some great nurses in Vietnam but I was particularly impressed by her flawless orthopedic skills, speed, calming bedside manner, and multitasking ability. She was about five feet four inches tall, medium build, and her long straight black hair was braided. I was attracted to her large brown eyes, delicate smile, and natural beauty. I was eager to introduce myself but before I could say a word, the RN said, “Dr. Singer, I’m Cat Azure the clinic RN. Please go to exam room two and check on the baby who is crowning, I’ll be in shortly to assist.” Her nursing skills and English were impeccable and I knew she received excellent nursing training.

I arrived at the clinic sometime in the morning and it was already dark outside when we finished our last of many cases.  Cat introduced herself, “It’s a pleasure to meet you, Dr. Singer. You must be famished. Follow me to the break room and we can get acquainted.”  Cat led me into a room with a refrigerator, hot plates, sink, table, chairs, freshly cooked foods, breads, pies, soda pop, and wine. Cat saw I was surprised by the culinary bounty and remarked, “Perks of the job, Dr. Singer. Our patients pay with home cooked food. Please help yourself.” Cat and I each took a paper plate, plastic utensils, and loaded our plates. We sat and Cat said, “Thank you for coming, Dr. Singer. The community hasn’t had a physician in years. So, what’s a nice Jewish boy from the Upper East doing in a place like this? Running from something?” I replied:  “Please call me Abby for now on. I’m just a guy seeking a new tribe to join.”  Cat broke out laughing. For a Hopi girl, Cat was surprisingly hip to Jewish zeitgeist. I was drawn to her sense of humor and we connected immediately.  She was a native Hopi and only child to a hardworking mother who hand-crafted jewelry which she sold wholesale to the merchants of Phoenix, Tucson, Flagstaff, and Scottsdale. Her father was an abusive alcoholic and split when she was a teenager. Cat tired of the reservation and obtained a scholarship to attend nursing school in Phoenix, obtained a BS in Nursing, and rose to chief RN of the family medicine department at the university hospital. On her trips home to visit her mother, Cat saw the need for a clinic on the reservation since the nearest hospital was over a hundred miles away in Flagstaff. Cat applied for and obtained a grant to open a clinic which she single handedly had been running for five years. Her only staff consisted of Hopi volunteers many of which she trained to the level of LVN’s.

At the end of dinner, Cat walked me out of the clinic and to my new accommodations. The night was warm; there was a full moon, and the sky so clear I had never seen so many stars. She pointed to an old house trailer saying, “It’s not the Plaza Hotel but at least you don’t have a commute! I live in the trailer next door. We work around the clock, Abby. The clinic is open 24/7 and staffed in the evenings by a clerk who will knock on my trailer if we have a case. I’ll do my best to provide you as much sleep as possible but if I need you, I’ll come knocking.” Cat’s trailer was in no better condition than mine but I had lived in more austere conditions in Vietnam. I looked forward to a good night's sleep and starting work in the morning. I lay in my musty old trailer and heard coyotes wail for the first time. I also couldn’t get Cat off my mind.

Cat was born and raised on the reservation. She was not only beautiful but smart, humble and a determined nurse reminding me of the nurses in Vietnam. We worked fifteen to eighteen hour days, seven days a week, including holidays. I may have been the physician and surgeon, but Cat and her cadre of volunteers ran the clinic freeing me up to practice medicine. Never in my life was my work so satisfying. Cat and I provided routine examinations and inoculations, delivered babies, sutured wounds, set broken bones, and performed minor surgeries. Those cases requiring more sophisticated care and hospitalization were stabilized in our clinic and then driven or flown by helicopter to hospitals in Flagstaff or Phoenix.

Cat introduced me to her mother who I admired. Mrs. Azure was a single mother who raised a wonderful daughter but it wasn’t lost on me that they struggled as a family. Cat and I ventured into the reservation and I was impressed by the rich culture and heritage of the Hopi. It broke my heart to witness their poverty and reminded me of the poverty I witnessed in Vietnam. There was virtually no opportunity for the youth on the reservation to advance as the schools were inferior and Cat was lucky to have attended college. I admired Cat for returning to the Hopi as she could live a comfortable life off the reservation.

Cat knew I saw horror in Vietnam and knew I yearned for the love and nurturing of a family. Cat learned from me that life was not always “greener on the other side of the fence.” She admired my sacrifice and dedication to the clinic and we grew close.

It was a harvest moon and the US Forest Service was fighting a raging brush fire about two hundred miles off the reservation.  Our clinic was the only alternative for the life flight helicopters to stop on their way to the hospital and seek immediate care for the most critical who might otherwise die in route to the university hospital over one hundred miles away. Cat and I did our best to stabilize the firefighters suffering from severe burns and respiratory trauma before their “dust off” to the university hospital.

Cat and I worked seventy two hours straight with time for only naps. We worked as one and she anticipated my every move. It brought back memories of the MASH units. As the brush fire was contained and the life flights stopped, Cat retrieved a bottle of wine and said, “Let's head out to the mesa”. It was approaching sunset as she drove the beat up ambulance van towards the mesa. She unbraided her hair and it blew in the wind. We pulled up to the mesa providing us with a beautiful view of the setting sun. We sat on the edge of the mesa, our feet dangling off the edge with the canyon hundreds of feet below us. I was reminded of my night on the balcony with Chloe. We watched the flames of the dying fire dance their last waltz in the distance below the setting sun. It was hot and the wine quenched our thirst and a cool breeze brushed over us. We watched the sun set into the west leaving behind a band of flickering flames against the pitch dark night then we kissed passionately succumbing to an emotional tension which had been building for months. Our daughter Aiyana or “Eternal Blossom” was conceived that night.

We were married by the Justice of the Peace in Flagstaff. We returned to the reservation for a small celebration. The specter of marrying a Hopi woman and having a baby with her would be incomprehensible to my parents although it might be hip for them to mention at one of their parties. I wrote them a letter including photos of Cat and our baby. My parents responded with an expensive Reed and Barton tea set and place-setting for eighteen. The gifts were appreciated but not useful. We hawked them and used the money to purchase surgical instruments.

Cat was a wonderful mother for the first ten years of Aiyana’s life. These were the most wonderful years of my life. We were a loving family and the love I felt was deeper than any emotion I ever experienced. Aiyana looked just like her mother and I can still see my loving wife in her eyes and smile. We took Aiyana everywhere with us. We camped, swam, and Cat was mindful to introduce Aiyana to both the rich traditions of her Hopi heritage and my Ashkenazi roots. Aiyana blossomed in the wide open spaces of nature. Before beginning school, she spent her days with us at the clinic. She was fond of wearing her own scrub suit and proudly wore a toy stethoscope. She assumed the position of entertaining the waiting patients and following them to their treatment rooms. She took to medicine like a natural. Aiyana was inquisitive. We read to her daily and engaged in games and puzzles to stimulate her intellectual growth. It became obvious to us that she was having difficulty reading. Stuttering didn't prevent me from becoming a surgeon so we figured Aiyana would learn at her own pace and grow out of it.

Despite being a dutiful mother, Cat kept a herculean pace at the clinic. She was happy. During a routine examination, a lump in Cat’s breast led to a double mastectomy but the cancer cells left behind were too tough of a match for Cat who fought valiantly to her death a year later. Aiyana and I buried Cat on the mesa where Aiyana was conceived and where Cat could enjoy the sunset for eternity.

It was impossible for me to practice medicine and fill the void left by Cat. Although I loved Aiyana, I could never be the mother she needed and deserved. Cat’s mother loved Aiyana, treating her like her own daughter and the volunteers all pitched in to help me raise her.

When Aiyana began grade school, the Principal at the reservation school expressed concern about her academic progress and suggested I have her reading difficulties assessed.  I consulted a speech pathologist who diagnosed Aiyana with Dyslexia. Complicating matters further, being half white, Aiyana wasn’t fitting in with the Hopi kids and was being teased. Cat would have wanted the best treatment for her daughter but I would have to get her off the reservation and into an environment where her Dyslexia could be treated and receive the best education available. Phoenix was my only local option but four hours from the reservation. I wouldn't place Aiyana in a boarding school and Cat would have agreed with me. It broke my heart to leave behind the clinic and patients of the reservation but I had Aiyana to consider.

I contacted my former Dean at the medical college and explained my circumstances. He offered me a tenure track position as a Clinical Professor of Surgery which would afford me stable hours and maximum time with Aiyana. My parent’s health was also failing and returning home would enable me to care for them. I accepted the position subject to finding my replacement at the clinic. Although it took six months, the clinic welcomed a Peace Corps surgeon and his wife trained as a Physician's Assistant. They had spent the last ten years in French Polynesia. Doctor Alvin and Rose Fisk were an energetic, retirement age couple with a passion for medicine and the clinic was fortunate to have them. It was a tearful goodbye to the beautiful Hopi people and I would never forget them.

I found a three bedroom apartment in Greenwich Village with a small back yard and walking distance to work and Aiyana’s school. My professorship provided me with a flexible working schedule and I enrolled Aiyana in a private school trained in treating Dyslexia. Aiyana and I returned to the reservation two years later to bury Cat’s mother next to her daughter on the Mesa. It gave me great satisfaction to see that the clinic was flourishing under Dr. and Mrs. Fisk.

Before entering medical school, Dr. Fisk was a mechanical engineer and inventor. During his off hours at the reservation clinic, he conceived of and patented several groundbreaking endoscopic surgical instruments he sold to big pharmaceutical companies. To his credit, he used his millions to build and staff a state of the art clinic and hospital on the reservation. I thanked him for picking up the baton but instead he thanked me saying, “Coming here revitalized my career and re-ignited my inventive spirit, Abby. The reservation gave me a second turn at life. I want you to know these people loved and appreciated you.” He placed his arm around me and said, “All us docs know when we begin to lose our edge. When your time comes many years from now, look me up and I'll point you in the right direction.” I was in the prime of my career and his suggestion felt awkward but I dismissed it as nothing more than a goodbye from an old doc.

My parents were kind to Aiyana but they simply couldn’t provide the love and emotional support of grandparents because they couldn’t provide the love and emotional support to their son. They remained detached and unemotional. 

I did my best to spend the the type of quality time with Aiyana I never received from my parents. I hoped to meet a woman who would accept an adopted daughter but the city had changed. It was absorbed by cocaine and materialism. I missed the gracious, humble, and gentle Hopi. It crossed my mind to return and seek a bride on the reservation but I had chosen to take another path and needed to stay the course for the time being.

Aiyana learned to manage her Dyslexia but worked twice as hard as the other kids to graduate prep school. She lacked the academic record and ambition to attend college. She met me in my office and told me she had enlisted in the Army and was going to be trained as a Medic like her father. My heart skipped a beat because the world was a volatile and hostile place.

I remembered the excitement of striking out on my own and supported her decision to enlist. Aiyana hugged me tightly and I knew she was happy to please her father. She received her Medic training at Fort Sam Houston.

Aiyana flourished in the Army where she learned discipline, goal-setting, and was able to work and live amongst a diverse group of soldiers. I was relieved to learn she would be stationed at the Army medical facility in Landstuhl, Germany for the duration of her tour. I settled into the routine of training future surgeons. I had a few dates but nothing serious ever developed. I was still in love with Cat. Whenever one of my blind dates suggested we meet at the Oak Room, I politely suggested another establishment. The Oak Room would always be for me and Chloe.

Aiyana finished her tour of duty, returned home, and told me she was pregnant. The father deserted her.  Aiyana wanted to become a nurse like her mother. I told her she could have it all and we would work it out. She gave birth to a healthy baby girl we named Catie. Aiyana was a wonderful mother and I couldn’t help but see my beloved Cat in her face, gestures, and multitasking abilities. Often times I would tear up and Aiyana would put her loving arm around me saying, “There you go again, dad. I miss her too. Mom’s still with us. I can feel her presence.”

When Catie stopped breast feeding, Aiyana began her nursing studies at my medical college affording us the opportunity to be together. We had a wonderful group of devoted nursing students who were paid to provide daycare for Catie. Aiyana graduated nursing school and accepted a position within the family medicine practice at the university hospital. Catie was growing like a weed and already enrolled in preschool near campus.

My parents didn’t age well and each was afflicted with dementia. Towards the end of their lives, they didn’t recognize me. It didn’t hurt me because I’m not certain they ever recognized me for who I was. With Chloe’s advice, I forgave them many years previously. As Redbird said, they were on their own journey and I was on my own. They received the best at home-care money could buy surrounded by their art collection. My father died first and the next day, my mother drank the “cocktail” of prescription medications she had stashed for the appropriate time so she could join her husband on their journey together.

As I was gathering their personal effects, I came across a framed photo of Cat, Aiyana and myself I had sent them years before. I opened the drawer to the night stand adjacent to their bed. Inside the drawer, I found the hand carved little boy Redbird had given me many years before and a collection of my photographs paper clipped to a stack of heartfelt letters they had written to me in Vietnam years ago marked, “Unable to Deliver. Return to Sender” by the Post Office. I opened one of the letters at random revealing their genuine depth of concern for my well being and heartfelt apologies for the love they regretted never providing me at home. In one poignant sentence they wrote, “We gave all of our emotional energy to our patients. We were emotionally bankrupt at the end of each day. Please forgive us.”

As a surgeon, I could now relate to the emotional investment necessary to care for the sick and wounded and I too returned many a day “emotionally bankrupt”. Chloe knew she was fortunate to receive the “emotional energies” my parents provided her because she said years before to me they “left it all on the field”.  I apologized to my parents for resenting them and told them I love you.  I knelt beside their bed, buried my head in the mattress and cried like a baby.

Their memorial service was held at a beautiful synagogue on East 65th Street. It’s a large synagogue with high ceilings and seats hundreds. As the Rabbi spoke of my parents, I turned my head to see that only me, Aiyana, and Catie were sitting in the synagogue except for a distinguished older gentleman sitting alone in the back of the synagogue. Given all the illustrious guests my parents entertained in their home over the decades, nobody showed up at their funeral. I concluded many were likely dead but it really didn’t matter in the end. A squeaky wheel echoed through the synagogue and momentarily interrupted the Rabbi. I turned to see an elderly man being pushed along in a rusty beat-up wheel chair to the pew behind us by an old woman who appeared to be his wife. As the Rabbi concluded his eulogy and the prayers were finished, I turned to the old man in the wheelchair and recognized him as Ace Rodriguez because he was wearing his old door man uniform sans the epaulets. I said hello, Ace. I’m Abby. It’s so nice of you to come. He raised his frail arm and I held his hand. Ace managed a smile, whispered “shalom”, and was wheeled from the synagogue.

As we left the synagogue, the distinguished gentleman approached us and extended his hand to shake saying, “Hello Abby. It's Fisk. Please accept my condolences. I read about your parents’ amazing lives in the Times. Would you join me for a drink? I have some advice to impart to you.” Aiyana said, “Go ahead Dad. We'll meet you at home. It was nice to meet you Dr, Fisk.”  Aiyana and Catie departed with stroller in tow. Dr. Fisk was aging well. The Arizona desert was good to him. He was dressed like an investment banker and suggested we have a drink at the Oak Bar.

It was a short cab ride to the Plaza Hotel and Oak Bar. It hadn’t changed and we were seated in the same booth Chloe and I celebrated her birthday decades ago. Angelo was no longer tending bar but Mantovani was still the music of choice. Dr. Fisk ordered a dry martini saying, “The Oak Bar and the Plaza Hotel are my home base when I'm in town.” The waiter was patiently awaiting my order and I said: “Bring a pitcher of martinis.” My fond memories of Chloe we're turning melancholy and I needed a drink, fast.

Dr. Fisk got right to the point. “Apparently your parents left you a sizable estate. We docs aren't trained in the art of money management and I want you to speak to my tax and legal experts located here in the city. I made my money unexpectedly and without their guidance, I would have unnecessarily lost much of it to taxes and bad investments.”

The pitcher of martinis arrived and the waiter poured our first drink. I asked: “where’s Angelo the bartender?” The waiter replied, “I've been here ten years Sir and never knew an Angelo.” Dr. Fisk raised his glass and toasted, “To Doctor's Singer. May they rest in peace” He took a long sip, placed the glass down, and continued, “Time slips away from us quickly, Abby.” I raised my glass and said, “Here’s to Chloe”. My hand was noticeably trembling. Dr. Fisk said, “If you think you're losing the edge, I want to tell you about a paradise I found and loved. Afterwards, we'll call my financial advisors.”

It was the “go-go” late eighties and the city was flush with cash. With the assistance of Dr. Fisk’s financial and legal experts, I came to learn my parents estate was formidable including the sizable collection of modern artwork whose painters had become all the rage and both Christie’s and Sotheby’s competed for the right to auction the prize art collection. Their expansive penthouse was in one of the choicest buildings in the Upper East Side and would command dozens of cash offers. We were advised that Aiyana, Catie, and I would never want for anything and had the financial means to spend the rest of our lives traveling the world first class. I was also provided with a method of lessening the estate taxes. They advised me to consult my family before the estate was liquidated.

Aiyana and I had a long talk about how we should spend our fortune while providing for Catie’s future. It didn’t take us long to devise our plan. With the assistance of Dr. Fisk’s legal and tax specialists, we liquidated my parent’s estate and established the “The Cat Medical Education Scholarship Fund” for Hopi youth which Aiyana oversees full time from an office in Dr. Fisk’s new reservation hospital and clinic.  I opened the “Redbird and Ace Rodriquez Homeless Shelter and Free Clinic” in New York City and traveled to Mississippi to open the “The Doctor Reginald Abner Clinic and Hospital.”

The evening I sat with Dr. Fisk in the Oak Room, he expressed concern to me about early indications of Parkinson’s disease and urged me to obtain a neurological follow-up which later confirmed the progression of the disease. Dr. Fisk reminded me that I led a full life and to consider what I would want to do if unable to perform surgery. My answer was to awake each day in paradise, be useful, and appreciated.  He told me about a beautiful island in French Polynesia where he practiced surgery and was loved by the island inhabitants. 

With Aiyana and Catie’s lives settled, I spent a year traveling the many islands of Polynesia settling on the same island Dr. Fisk recommended years before. I was welcomed by the gracious island inhabitants and treated like a returning family member. I set up a general practice clinic from my home which was an oceanfront beach cottage. As the demand for medical services increased, I built the “Chloe Clinic and Hospital” which became a highly sought out destination for brilliant medical residents from throughout the world because of its beautiful setting, welcoming population, and state of the art facility. I know Chloe would have been pleased.

Parkinson’s disease is quickly depriving me of a quality life and the end of my journey is in sight.  I’m prepared with my own prescription “cocktail”.  I have no regrets, just many fond memories of the wonderful people I’ve encountered along the winding road I’ve traveled through life. I’ve learned that everybody you meet is on their own journey and you can’t win every war whether it’s healing Chloe’s emotional traumas, beating Cat’s cancer, or forcing my parents to provide me with love and attention. The lesson I learned is to accept everybody you meet along the journey for whom they are, appreciate their company while you travel through life together however brief, and remember them fondly when your journeys take separate paths. I reach for my cognac and lift the glass in toast, “Thank you to everybody I have met along the way. I love you.”

I hope your journey will take you to exciting places and you’ll achieve an understanding of who you are. I bid you peace.