Ana dives into a fictional piece about writing a first person story that connects healing from trauma with the help of the Earth. Ana discusses with Hana how daunting the prompt initially was for her and how the process of writing this piece gave pause to reflect upon codependency, compassion fatigue, and questions who might be our healers.

Originally recorded on August 23, 2020.

Every Little Thing

It’s hot. The air is thick with it. From horizon to horizon the sky drops to a pale blue as if the very sky itself is bleached out by the sun. Being outside however, is better than being in the sterility of that building. Out here there is movement, breath, life, natural sound. Not the beeping of incessant machines or the constant squeaking of soles on polished, reflective floors. 

I breathed in the languid breeze, thankful to be moving in a straight line and out of that oppressive environment. Three more hours and I will be done with my twelve hour shift, the last shift of my week. Three more hours my mind kept repeating. As my feet moved across the bumpy, scalding pavement my circular thoughts stayed back at work. 

What did I miss with that last vital check? Shit, did I give the correct dosage? Person after person had begun to fuse into one needy patient. My compassion had begun to slip. Years ago, in the beginning, I faintly recall an impassioned, empathetic version of myself. Now I could hardly muster a genuine smile or word. Get through my shift. Get home. Lie down. Sleep. Just…sleep. 

Just as my eyes dropped to nearly closed, lost in my reverie of sleeping, I heard a woman’s voice call out. Eyes wide open I whipped my head around to hear which direction the appeal was coming from, my body tense and poised for action. 

The road I had chosen for my daily walking breaks lined the marshy wetlands. Tall grasses, cottonwoods, rose bushes, and vining blackberries fenced the aging pavement. I loved the openness of the marsh and watching the birds flock through the seasons. During mid summer as it is now, the swallows in particular tend to swarm, eating bugs out of the air in their playful, loving dance. Often I would see the perfect trio of swallows sitting evenly spaced on a power line and I would hear in my head “Three little birds, on my doorstep…Cause every little thing will be alright…don’t worry…”

The voice called out again and reminded me of the other not so quaint inhabitants of this place. Modern day nomads living out of run down cars, trailers, or tents had also begun to flock midsummer and rapidly take over the otherwise peaceful nature of the wetlands. I couldn’t help but feel disgust and outrage at the sight of these people and what they are doing to this street, not to mention this town. Coarse, disturbing language, dropping f-bombs, and abusive vitriol floats on the wind mixed with the putrid scents of decaying rot of carelessly discarded litter. I am disgusted. How dare these people litter the beauty of this landscape? All I want is a peaceful place to walk and get away from despair and pain. 

So when this voice began to call out in the direction that I could no longer ignore was mine, I felt that growing seed of resentment that had become a constant companion during countless moments of a single day.

“Ma’m!”

I’m not a Ma’m! 

“Ma’m!”

No! I don’t want this, I don’t need this right now. 

“Excuse me, can you help me?”

Screw you, I wanted to scream at her but my instinct to help when asked was far too engrained and I found myself walking toward the pestering voice. As I got closer to the caller I noticed that it came from a large, white, box van with windows taped over by pieces of cardboard and tapestries for privacy. The back doors of the vehicle were blocked by a makeshift metal rack that held heavy duty, black plastic containers with bright yellow lids. They were stacked three high and were comically balanced askew as if a set designer for a movie created this montage specifically to have a quaint and eccentric vibe. 

There was notably less garbage around this area, yet the unfortunate circumstances of the occupant’s situation clung in the air. Leaning precariously out of the driver’s side of the van sat an extremely heavy-set woman who appeared to be in her mid to late 50’s but could have easily been 10 years younger. Her legs and body faced out toward the street and her left hand held tightly to the van’s inside wall as if terrified the van would spit her out at any given moment. 

Her stringy, unkempt hair was pulled loosely back and her wide, full cheeked face had creases of pain etched in. What caught my eye however, was her feet. One foot was propped on the edge of the van completely normal is sized in a worn out sneaker, while the other foot dangled bare hanging just above the second, empty, worn sneaker. Before I could investigate further the woman spoke again. 

“Hey, can you look at my foot?”

Finally resigned to my reality that I was stuck in this conversation I took a deep breath and replied. “Hi, do you need help?” The woman nodded and adjusted herself slightly then pointed with her free hand toward her naked foot. 

“Yeah can you look at my foot?”

My God, I thought, she doesn’t expect me to touch it? I recoiled at the thought wanting simply to walk away and continue on. “I mean I can try to take a look. I’m not sure what you need or how much I am able to help but it looks pretty bad. Did you injure it in some way?”

Even from eight feet away I could tell that this was no “injury”. The foot looked grotesque. Two, no, three times its normal size, the swelling was significant and appeared to be missing the big toe. Scaly skin, red and white patches obviously incredibly inflamed and terribly unhappy. The size of the woman, her unhealthy lifestyle, and missing toe all pointed toward a metabolic disease. Diabetes - probably type two. 

“My foot,” the woman slurred, “it really is bad and it hurts. Do you think I should put my foot in that shoe?” 

“That shoe there?” I could barely keep the incredulousness out of my voice. The woman again nodded in answer and readjusted, clearly uncomfortable in her perched position. “No, no I don’t think that would be a good idea to try and put your foot in that shoe. It looks very swollen!”

The woman chuckled and then grimaced. “It’s a real bitch I got it looked at but they didn’t really do nothing - just sent me back - keeps me up at night. Can’t take pain meds cause of me being an old addict.” 

Because this was the most she had spoken at once, I hadn’t noticed before that she was missing all four upper front and lower front teeth. Her speech was slurred and muddled. Definitely a user or a former one. 

“I can’t get to the clinic or hospital - can’t walk - it’s not far but they don’t help me anyway. Not like my husband can carry me.” She laughed ironically at this. In that moment I noticed two black and white paws poking out beneath the van. In the shadows a pair of cocked ears and two shining eyes looked out back at me wary yet relaxed. The woman had continued to speak in her haphazard way as I began to lose track of the conversation. Half her words were lost to my ears as her lack of teeth inhibited her pronunciation…living on streets…trying to be legal…allowed to live…can’t sleep at night…in pain…foot needs surgery…

“Us people on the streets, we’re nothing. You know, we’re trying to live but l got disabilities. My husband and me we’ve got insurance but they can’t do nothing for my foot. I go in they take off the wraps and hurt me and tell me to go.”

I was at a loss of words. I’ve had plenty of patients in similar situations that I simply could do nothing for. I asked her if she could get to the clinic or hospital but their van is broken down and obviously she can’t walk. Somewhere deep in my chest I felt a twinge. If it wasn’t for the dog beneath the van snapping at a fly and taking my attention off of the woman I would have missed it. I felt sympathy. I still felt annoyed and disgusted by the scene before me but the feeling stopped me. I didn’t like it. I worked so hard to build my callousness so that I could work, do my job, function. This won’t do. 

“Do you have the numbers to the local charities who can help?”

The woman scoffed. “They can’t do nothing. If they pick me up they just leave me there and I have to pay for a taxi home and I don’t got the money for that shit.” My feelings ofhelplessness swelled - this woman truly was in need of help and I was a medical professional for God sakes. I decided I had to do something, anything, even just the relieve the guilt that was building.

“Look I know people, I do medical work. I am going to get a hold of some people I know who work with disadvantaged populations in the area. I will try and get you some sort of transport or maybe medical supplies? You really shouldn’t have to suffer especially if you do have insurance.” The woman smiled a toothless grin. Her eyes shown with such gratitude that I felt guilt creep in futher.   

“Thank you Ma’m. Thank you. You have no idea what this means, your help.”

“Oh, I forgot to ask. Can you feel much in your foot?”

She laughed which turned into a phlegm filled cough. “No I got diabetes. That’s why they took my damn toe.”

“Well you don’t want to lose your whole foot if you don’t…” She interrupted my admonishment 

“I know! I’m not an idiot. All the doctors say that, that’s why I’m asking for help!”

I flushed in embarrassment. My comment made her feel bad, terrible bed side manners. I needed to move on and get out of this conversation but I vowed to call my contacts and find out what services she could receive. As I waved goodbye I thought to ask her name. 

“Sheila. Just Sheila.” She said as she shifted once again with a grunt looking sadly out across the marshy grass. 

I did my Christian duty as I was taught. I tried to get a hold of my colleagues but no one answered. I felt angry and I wasn’t sure why. My job is to help and heal people and I did absolutely nothing for this woman. I can’t even get a hold of my so called friends for guidance I thought bitterly. Walking down one of the hallways of the hospital a colleague and occasional friend stopped me. He grabbed my arm in passing and said. 

“Hey Zara! Saw you making some friends with those homeless people down the road.” His smile wasn’t particularly kind. “Starting to do some street work?” He laughed. I felt defensive but tried to ignore is jabs. 

“No just a woman asking for my help as I walked by. Nothing I could do really they’re hopeless.” I added for affect and immediately felt yet another pang of guilt. 

“You know I walk there all the time even wearing my scrubs sometimes and she has never once stopped me for help.” He shrugged and walked off letting his last words ring down the hall. That is strange I thought. I wasn’t wearing anything signifying that I was a medical professional nor was I making any indication at all that I was willing or wanting to help. Just my unlucky day I decided and moved on to finish out my shift. 

A few hours later however, as I was walking to my car the woman, Sheila, floated into my thoughts. Annoyed that she had managed to wriggle into my thick exterior I decided that I may as well just drive by her van. The compulsion surprised me. As I turned onto the road I noticed flashing lights up ahead. A firetruck and several EMT’s were outside the van and I as I slowed to a stop to turn around and watch I noticed Sheila sitting in the grass outside the van being spoken to by the medics. A man in dressed in a baggy t-shirt and shorts that I hadn’t noticed before, (her husband?) stood awkwardly aside. He was short for a man, maybe 5’8, but then I noticed he stood a bit hunched, head bowed and to the side. The leash of the dog I had noticed earlier, a Border Collie now that I could see it in the open, was wrapped firmly around his hand holding the incensed barking dog back. The man must have sensed my observation because he turned and faced my car and looked directly at me. His grizzled dark brown beard covered his mouth but his eyes drilled into mine. Kind, sad, resigned. I turned back forward and drove home. 

The next day I took my walk. The vehicles of filth still lined the road and I could see the white box van up ahead. As I neared it I saw the man again. Still hunched, slowly shifting objects around on the ground. Before I could stop myself I called out.

“Hello! My name is Zara I was helping Sheila yesterday and then I saw the medics later. Is she ok - did she get help.” The man stopped and stood up. He smiled as he saw me, recognition in his dark brown eyes. I was struck by the kindness in them. His eyes did not hold my gaze long, as they dropped down and up, anywhere but on me. 

“Oh, she’s asleep.” He jerked his thumb indicating the van. It was pushing 90 degrees outside - it had to be sweltering in the there. “Medics took her last evening. Didn’t get her back till midnight or so. She’s sleeping. Real tired.” He repeated. As if feeling the conversation was through he turned and began picking up the sacks of garbage. 

“What did they do to her foot? Did they clean it or bandage it or offer any medical advice for long-term care?” 

The man stopped again but instead of turning towards me stayed facing the van.

“Oh, uh they brought her home too late. Haven’t talked to her.” 

“I see. Well I guess I mean I walk here all the time so if you need anything my name is Zara. May I ask your name?”

At this he turned fully around and smiled broadly with brightness in his eyes. “David.” He nodded and shuffled away ending the engagement. 

The summer dragged on with bursts of heat waves and my daily walks found more and more people converging with tents, RV’s, campers, and trash. On the 100 degree days the stench of the rotting garbage sent me into gagging fits and yet I couldn’t keep away. Sometimes I’d pass by the box van and Sheila or David were out and I’d wave and exchange pleasantries. 

Work also shifted. Some of my calloused exterior began to melt away and I began to “see” my patients once again. The hardness in my chest that sometimes threatened to suffocate me as I lie awake at night, had began slowly to subside. Every once in awhile I even felt the smallest indications of joy. 

The last time I saw Sheila she was using a walker waiting outside the van. I immediately walked up to her and called out. 

“Hi Sheila!”  She immediately lit up and said hello back. She looked very pretty. Her usually unwashed hair was combed back and wetted into a pony tail. It even looked like she had put on make-up. 

“I’m waiting for my ride. Going to go to the hospital and get surgery on my foot soon! They gotta take an infected bone out. Sucks. I hate them hacking at my foot but it should stop the pain and I might be able to walk normally again.”

I was thrilled and told her so. I commented on how nicely she looked today and she smiled bashfully. 

“You know Zara, I really want to thank you for helping me.” 

“Sheila, I did nothing!” 

“No you did more than you know. You’re a kind woman.”

My heart swelled and tears formed in my eyes. I couldn’t believe how much honor I felt toward this woman’s gratitude. I honestly didn’t do anything. I couldn’t even get a hold of my friends to help! 

“I am so sorry I couldn’t do more. I know your situation is difficult and I can only imagine. You’ve been through so much.”

Sheila laughed toothlessly. “Still got life in me yet! David and I are fine. We are getting a new camper! We will have a real bed and everything!”

I walked away that day back to yet another shift with a lightness in my step. If I had only known that would be the last time I would see her maybe I would have said something more. 

The seasons began shifting from the stifling heat of late summer to the last hurrah of early Autumn. It was a cloudy day and threatened to rain. Many of the inhabitants of the road had moved on with the seasons. Sheila and David’s white box van had transformed into a 1970’s camper, tan with darker stripes. The metal rack from behind the box van and been refashioned to the back of the camper, still comically piled with the black boxed, yellow lidded containers tied down with bright orange straps. 

David stood at the back of the camper, his dog loyally sitting heeled next to him. He looked more stooped than usual, something about his body language alarmed me. 

“Hi David!” I called. 

He didn’t look up. Just stared out at the tall waving grass watching red winged black birds flit and call “Pumkin eater!” in the now increasingly wet marsh. 

I kept a respectful distance not sure if I was going to scare him. I called softly again. His overly baggy t-shirt hung loosely over stained denims that looked about as forlorn as he. The Border Collie turned to stared at me but decided I wasn’t a threat and turned back to look at the marsh along with his master. 

“Hello.” He managed. His head bobbed down and up not making eye contact. 

“Are you ok? How is Sheila?” 

David turned his head down firmly and hunched even further over. A tight knot began to form in my abdomen. I knew that look all too well. 

“Did she…is she here?” I stuttered. 

“Sheila, she uh, she didn’t make it.” He choked out. He cleared his throat and began shifting his weight nervously. “I’m sorry to tell you.” 

I couldn’t speak. The heaviness of this news slammed into me and a wave of emotion threatened to crash over me. 

“David I am so, so sorry. I just..don’t know what to say. I am going to miss her.” I added lamely. 

He nodded slowly. “She was my companion. She took care of me. Always knew how.”  At this he turned and looked at me. “Thank you for helping her.”

I was about to argue that I hadn’t but he stopped me with a raised hand. 

“Sheila was a very kind soul. She liked you.” 

“David, I never asked her and you probably don’t even know, but why did she ask me for help?” A ripple of a smile moved across his face. Distant, nostalgic, loving. 

“She saws things. Saw people. She saw you.” 

I was confused, what did that have to do with anything? She was the one who needed help. I frowned in confusion, “David what do you mean she saw me?”. 

He turned away and I watched his eyes follow a sudden swoop of swallows fly through in front of us. His eyes twitched watching each one...