Authors: M.D. Randy Christensen
I pictured her sitting up on my exam table, asking in that childlike voice, “Am I healthy, Doctor?” And what had I said in response? “Healthy as a horse.” She had said, “See? I knew I was brave enough to do it.”
Yes, Nicole, I thought, you were brave enough to do it.
By the time I drove to the van I had a handle on myself. Jan met me, wiping her eyes. I spent the day in silence, helping new kids but haunted by remorse, plagued by thoughts of what I could have done for Nicole. Why hadn’t I done more? I should have pressed for mental health care. I should have called members of Congress. I should have yelled from the rooftops. I had done none of those things, and the guilt pressed on me. I was sickened at how our
system had failed Nicole. If only for a piece of identification she might have gotten help. But I was also angry with myself. Maybe I could have done more too.
My thoughts were interrupted when Jan poked her head into the exam room where I was finishing with a girl with diabetes. I was explaining to her how difficult it is to manage diabetes while homeless.
“Randy? There is a detective here that would like to see you.”
I met him outside the van. He was a short man with red hair and very fair skin that had been damaged by the Arizona sun. Red spots of damage showed across his forehead. “Are you Dr. Christensen?”
“Yes.”
“We’re investigating the death of a young Jane Doe. I’ve spoken with some police who suggested she might be a patient of yours.” He described her briefly.
I nodded. “She was our patient.” I took a deep breath. “We never knew who she really was. We called her Nicole.”
“No last name?”
“No last name. No real name,” I answered. “No identification, nothing. The jail had her for a few days. Maybe they have a better idea. She was disturbed. Deeply disturbed …”
He made a few marks in his notebook, more doodles than anything. “I was there when the medical examiner was examining her.” He paused delicately. He raised his red eyebrows to me. “There were scars.”
“Yes,” I said. “There were scars.”
The detective and I held eyes for a moment longer. I wondered if he had children. I saw a wedding band on his hand. “I don’t think there will be any next of kin,” I said. “If you find them, let me know.”
He nodded. He put his notebook away.
“So that’s it?”
He gave me a look of compassion. “No one wants a girl like this to get hurt,” he said softly. “We will do our best. But you probably already know that cases like this are hard.” He paused. “There
are some people who target homeless victims. They’re easy targets. And there is no family to see that justice is done. But I will.”
“I hope you can,” I said. Before he left, he gave me his card in case I heard anything more.
That evening, when I walked through the door, Amy enveloped me in her arms. I had called her in advance to tell her what happened. I was doing better, I hoped, at sharing with Amy.
“What happened, Daddy?” Janie asked, running up to hug my legs. I had recently remarked to Amy that as the kids got older, it was harder for me to keep things to myself; they were like emotional sight dogs, wired into my every emotion. Amy had told me it was a good thing. I wiped my eyes.
“I lost a kid today, from the van.”
Amy nodded to them. She looked as sick and sad as I felt. She herded the kids into the living room to watch a movie.
“Daddy’s sad,” Janie said with worry.
“Daddy will be OK,” Amy told her.
We sat down to a late dinner, Amy pulling lasagna and garlic bread out of the oven while Janie told me fascinating facts about animals, trying to comfort me. Charlotte looked around. “Daddy had a bad day!” she exclaimed.
“Do you guys know why Daddy does his work?” Amy asked them, sitting down at the table.
Reed hesitated. “Because he’s a doctor.” He sounded older than seven.
“That’s right. And what do doctors do?”
This time Charlotte spoke up. “They give people shots.”
Amy smiled at her. “They do that. They also try to help people get better.”
Reed looked at her. “But Daddy said one of them died. On his Big Blue van.”
“She didn’t die on the van,” I told him. “But, yes, she died.”
“How come she died?”
“We don’t know yet,” I said.
Charlotte looked at me. “How come you didn’t save her, Daddy?”
I swallowed my milk. “I tried, honey.”
“Your daddy tried because he is a doctor,” Amy said in her calm, reassuring voice. “He tried because he cares about people and wants to help them. But sometimes it doesn’t work. The hardest part of being a doctor is knowing you can’t help everyone.”
The kids were silent. Reed was staring at me with intensity. Finally Charlotte piped up. “It’s OK, Daddy.”
I rubbed my face with my hands. I tried to protect my kids as much as possible from the sadness of my work. On the other hand, I also wanted them to live a life of courage. Death and loss were part of being a doctor. Risk and pain were part of helping others. The dilemma was how to teach courage without traumatizing them.
We finished eating. I got up to help with the dishes, and as soon as I was done, Reed sidled up next to me. “Daddy, do you want to play with me?” he asked. “I got a cool new game called Cat in the Hat.”
I dried my hands. “Sure. That sounds like fun.”
He held my hand as we walked together into the living room. Amy, Janie, and Charlotte looked up at us. They all smiled. Reed sat down and set up the game. It required pulling cards that instructed us to take turns dancing around with a tiny cardboard hat and crawling under spindly canes or balancing pretend cakes on our head. Soon the whole family was playing. The kids laughed, and while the weight of Nicole’s death was still a stone in my heart, somehow I felt closer to them than I ever had. That night I kissed the children as I tucked them in, murmuring my innermost feelings for them, and when I went to bed, Amy was waiting for me.
A few days later we held a little sunset service for Nicole. The whole team lit a candle for her outside the van. We had parked in the downtown area where we so often saw her. It was getting dark, and the sound of the freeway could be heard in the distance. We
were alone, standing outside the van. It seemed like a small gesture for the end of a real person. Is this all? I thought. A girl has died at the end of years of torment and
this is it?
No one will ever know her. No justice will probably ever be done. There would be no headlines, no eulogies, no public record or memory that this was a missing child. Nicole had died and it was as if she had never existed. In our country some kids are lost forever.
I felt I had to say something. Jan passed me the candle. “I keep thinking about who Nicole was when she died,” I said to the stars. “I keep wondering if she was Becca, or the young man, or one of her other personalities.” I took a breath and continued. “All those people were pieces of Nicole she had to splinter apart just to survive. But now I’m thinking it doesn’t matter who Nicole was when she died in that parking lot. Because now she’s in a place where she can be whole.”
I passed the candle to Jan. Tears were streaming down her face. She passed it to Wendy. Wendy took the candle and blew it out. We watched the wisp of smoke float up into the scarlet sky.
“Good-bye, Nicole,” we said.
“Jan, what do you think of this letter?” I asked a month later. “It’s to the governor.”
“The who?” She was immediately interested.
“I’m asking for change with the Medicaid insurance,” I said. “I’m telling the governor we are saving the state money by taking care of these kids for free. I’ve shown with these statistics how much money we are saving them. But we need to revamp the system. We need to make it easier for homeless kids to get help, especially the ones with mental health problems.” There was insistence in my voice. “We need to make it easier for kids like Nicole to get help.”
Jan looked up from the letter. Her eyes were somber. “You’re taking this pretty seriously.”
“I’m mad.”
She cocked her red hair to one side. The sun coming through the van’s windshield showed the freckles on her face. “Usually you preach patience, at least with administrations,” she told me.
“You’ve rubbed off on me. There’s a time to fight too.”
“Good luck. You’ll probably get a form letter in reply.”
“The voice of experience.”
Later I ran into my boss at the hospital, Jeff Weiss. I told him about the letter and Jan’s comment. “Oh, I’ve seen you get mad,” he said. “Usually it isn’t with governors, though. Other doctors, maybe. Come to think of it, I haven’t seen an angry e-mail from you in ages,” he said.
“I guess I’m learning to channel my passions,” I said.
He stared at me. “This one is really bothering you.”
“Yes. This is one of the ones.”
“OK.” He nodded. “That’s good you’re learning to talk about it.”
“Was I bottling it before?” I asked, surprised.
“Oh, Randy, you are the
king
of bottling. All these years you’ve been so worried we’d think you weren’t up to the job you never complained once. Let it out.”
A few weeks later the FBI appeared. The agent waited patiently for the van to clear before he stepped aboard, showing me his identification. “We are investigating prostitution and sex rings in the area. The local police suggested I pay you a visit.” He had brought photographs. “I’d like to see if you recognize any of these girls. We suspect they were kidnapped or sold into the sex trade.”
I thumbed through the photographs. Young faces stared out at me. Brown faces, white faces, plain faces, pretty faces. Some were very young, while others were teenagers. “We’re getting a lot of reports in the area,” he said. “We busted one house last month. The girls had been locked up for months.” He had deep brown eyes
that looked as if they had seen far too much. His hair was receding, and lines were etched in his forehead.
“Where do they get the girls?” I asked.
“A lot of them are from Mexico. They’re illegal, they’re scared, and they don’t know where they are. It’s easier to keep them in a state of fear that way. But we’ve had plenty from around here too. Phoenix is turning into a hot spot. Some might have been homeless. No one notices they are missing.”
I nodded. I had many girls tell me about being prostituted even as toddlers and young children. By the time they came on the van some had been in the sex trade for a decade, and they were only teenagers. Beyond getting them in shelters, I felt there was little I could do for them. They needed intensive, specialized counseling and a safe place to stay, and such places didn’t seem to exist.
I thought about Nicole as I thumbed through the pictures. Some of the photographs were blurry. Others were grainy reproductions, many years old. Part of me was hoping, if only for a sense of closure, that I would see her in one. But a larger part of me dreaded it. None looked like Nicole. I handed them back. “We see hundreds of kids a week on this van,” I said. “Thousands over the years.”
“I’ll be back in touch.” He looked around the antiseptic walls of the van. “This is a nice outfit you got going. There are some people who work with child sex victims, in case some of your patients need help. There are a few safe houses opening up.”