*Disclaimer: client name changed out of respect and confidentiality*

When you are an employee of AIDS Community Services, you acquire an aversion to ECMC for a number of reasons. ECMC’s Immunodeficiency Clinic, also known as “The Tunnel” (due to it’s unbecoming and borderline politically incorrect location in the basement) is the other HIV specialty care provider in town, besides our own Evergreen Health Services. Needless to say, there is no love lost between the two competing providers, and the world of HIV care in Western NY can sometimes feel like the Cold War. EHS/ Immuno Clinic beef aside, ECMC is where fucked up people go to get better or to die, plain and simple. I’m hard pressed to think of a reason why I was ever happy to visit ECMC; each horror I’ve witnessed has steadily been trumped by something even worse. Examples include: my best friend from childhood in a coma in the ICU after a car accident; speaking with a client’s family about hospice options as he lay unconscious and dying of liver failure; going to see a client only to be informed that he died a couple of hours ago and then paying my respects to his still- present corpse; witnessing a client in the Intensive Care Burn Unit because of a freak reaction from chemotherapy and HIV meds that caused his skin to peel off in sheets as he babbled and whimpered deliriously from pain and sedatives; those were the worst of the worst. The experience I want to talk about in this story deals with one of the first times I was ever exposed to something emotionally traumatic at that hospital. I randomly thought about this client today and realized that I’d forgotten all about him and this story; I wanted to write it down before I forgot completely because he’s since passed away and I feel I owe him something for making an impact on me.

We’ll call the main character in this story Phan; I met him while I was still an assistant case manager at ACS. Phan was a diminutive Laotian immigrant; tiny in stature, long wispy hair, heavily accented English, very soft spoken and effeminate. His mental state was a bit…fluid. Sometimes he would present as competent and able to care for himself, but others he was forgetful or confused. He constantly called the case manager that I worked with “Sherry” instead of “Cheryl,” no matter how many times we corrected him. Phan was also an alcoholic, which definitely contributed to a lot of these issues and was a major reason why he needed us in his life, to help him make positive decisions for himself.

The three of us who worked on the caseload: me, the case manager Cheryl, and the other assistant Roz, took turns assisting Phan with his service plan goals. This included badgering him about starting and staying on his HIV medications, occasionally getting him to his check-ups at ECMC, or making sure that his payee (the person who had control over his government checks, due to his diminished mental capacity) kept giving him enough money to pay the rent at the rooming house he lived in. Phan was always happy to see or hear from us and it was not an uncommon occurrence to walk into our waiting room and see him sitting there (most likely without an appointment because he NEVER showed up on the days we actually scheduled to meet with him), wanting to show us some mail or ask a question about his Medicaid. Phan was a little tiresome to deal with at times because of his high level of need but I knew that he honestly required it to stay on track, and he always made sure to thank me for anything I helped him with.

In a city’s poverty culture, Phan unfortunately presented a great target for predation: he was friendly, foreign, and blissfully ignorant to subtle nuances that might indicate trouble to a street-savvy person. The three of us on the CM Team had always feared that with his propensity to drink, Phan would end up putting himself in a vulnerable situation where he ended up getting hurt. One morning, I was in the office by myself when Cheryl came in, visibly flustered, carrying the newspaper. She showed me an article she just read about a robbery/ assault that had taken place the night before, in the same rooming house that Phan stayed in. It stated that during the night, one resident had broken into another’s room and attempted to burglarize it. The person woke up and when they tried to stop the intruder, they were overpowered and had their throat slashed with a box cutter. When the police and ambulances arrived, the victim was rushed to ECMC in critical condition. The article didn’t give any further details. The victim ended up being Phan.

After she showed me the article, Cheryl immediately called ECMC to find out the details; at this point, we didn’t even know if Phan was alive or dead. After a few frantic minutes, Cheryl learned that Phan had been in surgery that night and he was stabilized, but obviously in no condition to talk on the phone. Since I was in the office and Roz was out on another appointment, Cheryl asked if I could go to ECMC that afternoon and get some updates. I was terrified; this guy had literally JUST had his throat cut wide open and put back together! I knew that Phan was fond of me though, and visiting would show that he had the support of his case management team. I knew it was in my job description to do things like this. It was time to see if I had the fortitude to follow through for some one in need of a supporter in the face of a traumatic ordeal.

Armed with Phan’s room number, I rode ECMC’s elevator to the upper floors. The sterile, white walls of a hospital may as well be made of brick and mortar, lit by torches and smeared with human blood because when you step past the nurses station and down the hallway towards the room you’re looking for, you never know what you’ll see or hear from the others you pass. I decided that seeing my own attempted murder victim was enough and kept my eyes facing forward until I got to Phan’s room. I double checked, then triple checked (possibly quadruple checked) the room number and slowly entered. Phan’s small shape lay on the hospital bed, attached to a whirring breathing machine. He looked at me and smiled and waved. Of course, my eyes were immediately drawn to his neck, which for the most part was bandaged up. I peered in closer and realized that he hadn’t been so much stitched back together as clamped shut. A row of surgical staples marched out from beneath the gauze, around Phan’s throat, and up towards his ear; they looked positively savage as they held together pink, shredded pieces of flesh that didn’t quite make it under the wound dressing. I was more enthralled than repulsed, but Phan had another surprise for me. As he tried to greet me, wind whistled through a newly constructed hole in his neck; he grimaced and gently plugged the tracheotomy with his hand and said “hi, good to see you!” As I tried to keep my mind from exploding, I realized the surgeons had given Phan a tracheotomy as an easier way to breath while he was healing, and that in order for his vocal chords to work, he had to physically plug the hole in his neck. We talked slowly and haltingly so as not to tire him out, and I started to piece together what had happened that night: Phan apparently knew his attacker, he was a “friend” that Phan lent money to earlier. Phan then went to bed, but forgot to lock his door. The acquaintance turned out to be a drug addict with significant mental health issues; he barged back into Phan’s room, looking for more money. Phan barely had time to react before he was jumped on by his assailant and stabbed in the neck. I listened to Phan’s tale with morbid curiosity, then tried my best to encourage him and ask if he was comfortable. It was obvious he wasn’t leaving ECMC anytime soon, and I told him that Cheryl or Roz would be back up to see him within a few days. I wasn’t sure what else I could do and frankly, I needed to get out of there so I could process the whole experience. Phan was grateful that some one had come to check up on him; I told him I would see him soon and that I would let him rest. As I walked out of the hospital, I couldn’t keep a sardonic smile off of my face as I thought about what a truly bizarre chain of events had occurred that day.

Phan eventually recovered from his ordeal, but then moved into an assisted living facility that required he drop our case management services to pick up their nursing ones, seeing as though his injuries and HIV would keep him relatively bed-ridden for a good while. We learned through the grape vine over the course of a year that he’d been able to move out of the facility and into his own place on the west side. He surprised us by coming into the building once after that, but I don’t think he ever re-linked with case management . Phan died of a heart attack in winter 2009. He was in his early 50s. I’m glad I was reminded of him because he was a character that I never want to forget. He had a hard life and surely deserves more than a case closure file buried somewhere in a stack of cabinets; I can at least give him this story. I think it helps people who choose this profession to talk about clients who have died; it keeps their memories alive and it makes you reflect on how you made an actual, tangible difference in the life of another human being.

One time I drove to a bar to meet a girl. Today’s methods of communication: the internet, smart phones, texting- have drastically changed how we interact with each other. As it was, I don’t think I’d ever spoken to this girl in real life; we did a lot of online chatting and at one point I must have gotten her phone number too because we also texted. It’s kind of strange thinking back because now I’m not even sure how I “met” her; friends of friends through a social networking site seems like the most likely culprit. Regardless, I thought she was pretty and nice and based on her internet persona, her interests were a lot like mine. There were times that I dropped hints that I was interested in her but I was never quite sure that she reciprocated; my gut feeling was that I was friend zone material. A lot of us guys, even when we know that we’ve been relegated to the “just friends” category, still labor under the romantic delusion that the girl in question will rethink her position and decide that they want to give us a try. I’d been drawn into that before and by this point, my cynicism was outweighing my naivety. Still, there was a little part of me that wanted to see what this girl was all about; after all, we’d still never met in person. One night I decided to see what would happen.

I don’t remember the specifics of the night in question, only that we were texting back and forth and I must have said I was bored and didn’t have any plans. She told me she was going out to a bar she liked and that I should come out. At first I laughed it off; bar culture was and still is not my thing. Besides, it was getting a little late and the place was roughly an hour away. Then I started thinking…..you know, why not? What else am I going to do tonight? Just go and see what happens. If I looked at the whole situation intellectually, like I was only going as a subject in my own social experiment, then I had some emotional barriers already set in place to deflect any embarrassment if things were awkward. Fuck it.

The drive southward was long and dark and gave the two warring factions of my brain plenty of time to debate on whether or not I believed my own bullshit; one arguing that I was expanding my horizons by taking a chance, and the other smugly insinuating that I thought I had a chance with this girl and I was getting my hopes up for no reason. Neither side won and it really didn’t matter because within the hour, I was sitting in the parking lot. I stared long and hard at the steering wheel before I got out, wondering why something like this was so hard for me to do. I walked slowly down the opposite side of the street to try and gauge the situation but when I saw the bar and the crowd, I still got that first-day-of-school feeling of trepidation. I self-consciously bumped my way through the buzzing throng of smokers and fresh-air-getters, tried to muster up a half cocky, half bemused expression, and ventured in.

It was around 10:45, the bar was packed, and I wanted to run. Luckily, the girl was near the door and waved me over. She gave me a hug and I told her it was nice to finally meet her; we chatted a bit but it quickly turned awkward because A.) we JUST MET and B.) my abstinence from alcohol at the time and her knowledge of it prevented the natural line of conversation in a bar, “so, you want to get a drink?” Again, I lucked out that she was with a friend who was also nice and we were able to strike up a conversation, too. I met a couple of their other friends and slid into their social circle amidst the music, clinking glasses, and boisterous voices. The two girls then wandered off and left me standing with two guys whom I’d just met. The smug side of my brain shrieked in triumph, AH HA, YOU FUCKING IDIOT! THERE SHE GOES, ALONG WITH HER CUTE FRIEND, LEAVING YOU STANDING HERE WITH TWO ESSENTIAL STRANGERS, LOOKING LIKE A COMPLETE ASSHOLE! The rational side attempted damage control, and I was able to get a bit of conversation going with the two guys, who weren’t jerks or anything, I was just WAY out of my fucking element and sinking quickly. This wasn’t a social experiment and I wasn’t some quirky character in a movie that could throw around a couple of witty one liners and win everybody over with his charm. I tried to keep a smile on my face but truth be told, I was nervous, tired, and perturbed at myself for having the personality that I did. I found the girls again and after a little while, said my goodbyes. I couldn’t have been in the bar longer than an hour.

There isn’t a moral to this story. I never did decide if I went for fun/ excitement, if I thought I had a chance with the girl, or if it was a mistake. I’ll tell you one thing, on that ride back it sure felt like a fucking mistake. All I wanted was to be home and in bed, not psychoanalyzing the night or going over the ‘hows’ and ‘whys’ for miles upon miles of dark highway. I honestly can’t say I wish it didn’t happen because you have to learn about yourself somehow. If you over think every single situation preemptively and talk yourself out of things, are you really learning anything? I mean yeah, it could definitely suck. You just read a story that laid out a blow by blow ass-whipping of my confidence. I just said there isn’t a moral here; what I meant was there isn’t a right or a wrong. Just remember that regardless of the lesson, you need to be a good student.

The things that stay with you tend to be important

Here is a story I remember from my childhood, one that must have been significant to me considering how clearly I recall it when it seems so trivial. The story begins on Easter of my thirteenth year. I received a pair of sunglasses as a present in my Easter basket; round, mirrored lenses with a skull printed on the outside of them. I thought they were great; photographic evidence of my perceived coolness exists in one of my parents’ photo albums: me that morning, wearing them in my pajamas, grinning like an idiot. Now, as hard as it is to believe after I just revealed my taste in sunglasses, this was the beginning of the age when I became aware and conscious of how I looked. I started to develop a preference for certain clothes, I liked my hair combed a particular way, my sneakers had to be the right brand. I don’t think I was conscious of this process occurring, I was being stretched between the world of a kid and the world of an adolescent and at that age, you don’t discuss and plan different changes going on with your mind and body, they just happen.

One of the biggest enemies of my budding sense of physical appearance was the bicycle helmet. It was truly a multi-faceted enemy; it made my head look gigantically bulbous, messed up my hair, and definitely didn’t convey a grown up look of style to my peers. I abhorred this helmet and rode off without it whenever I could, but the threat of grounding from my doting mother if I was caught always loomed in my mind. Many epic parent vs. puberty battles were waged over the donning of that stupid fucking bike helmet. Little did I know that a helmet and sunglasses would set the stage for a seemingly minuscule interaction that I still remember vividly, roughly fifteen years later.


My main (only) source of income at this age was mowing the lawn of some family friends, the Klockes. Mark and Constance owned a big house on East Ave and in the summertime, they paid me $20 to come and mow the grass. Even though the work was easy and the Klockes were really nice people, it was far from my favorite outside activity. The bike entered the equation as my mode of transportation to the job and with it came the dreaded helmet. My mom’s badgering to make sure I got to the Klockes every week ALWAYS came with this infamous line shouted from the kitchen window, “…AND DON’T FORGET TO WEAR YOUR HELMET!” I would grit my teeth as I opened the garage and practice every new, colorful curse word I picked up in the hallowed halls of Springville Middle School.


In early summer I rode up Main St to East Ave to the Klocke residence, to fulfill my obligation and earn my “paycheck.” That particular day I was wearing both the helmet and the skull sunglasses. Now, cliques were being born and deviant behavior was escalating as I moved through grade seven and into eighth. As I rounded the corner of Franklin and Main and proceeded up the hill, a group of kids that personified both were coming down the other side of the street. This fledgling “stoner clique” didn’t so much scare me physically as they did emotionally. For some reason, I had a fascination with acceptance from this social group and I didn’t know why. I was as straight-laced as they came at that age; great grades, loved reading, the D.A.R.E. program poster child. Why I wanted kids like this to think I was cool is something I still wonder about. As soon as I saw them, I immediately scrambled to grab the sunglasses off of my face, almost falling off my bright yellow ten-speed in the process. I was TERRIFIED of ridicule for the glasses that, just three short months ago, I had been so proud of. I couldn’t do anything about the helmet and I silently cursed my parents again for caring about my physical well-being so much. As I pumped my way up one side of Main St and they sauntered down the other, I heard cat calls; the clearest one I remember in all of it‘s juvenile, creativity-lacking glory: “Heeyyyyy, Haag-it faggot!” I pretended I didn‘t hear but I’m sure my burning face belayed my embarrassment. I overheard some one in the group I was apparently cool with tell the heckler ‘no man, Haag is cool…,” but the damage was already done to my puberty- distorted psyche, as evidenced by the fact that I’m writing about it as a 27 year old.


This story is relevant in my life today because I finally wised up and started wearing a helmet while riding my bike. I no longer find romantic the possibility of splattering my brains all over a City of Buffalo street because some driver neglected his blind spots. Without realizing the apparent significance at first, I also coupled my old arch nemesis with sunglasses mainly because squinting my way through a long ride tends to ruin the experience. On the day that I combined the two, I involuntarily flashed back to that moment of reckoning, when I received one of my first lessons in what it’s like to be the brunt of a joke. I’m not going to lie; for a second, I felt a flash of apprehension in my chest. That feeling was quickly burned away by anger and bitterness. I can’t believe I let some one intimidate me into being embarrassed of something so stupid; my sensitivity was preyed upon and I was ushered into the initial stages of an angry, depressed state of mind that I struggle with to this day. I look for any silver linings, thinking “well, maybe these experiences made me into a person who is more sensitive towards others feelings. Maybe this is why I’m a social worker, helping others who need it and defending them against unfair treatment.” Whichever way I look at it, one thing is for sure; it opened my eyes. It stole the blinders of childhood from me and life’s innocence along with it.

Hustlin the hustler

This story takes place in a Dunkin Donuts on Fulton Ave in Brooklyn NY. The area is slowly but surely becoming gentrified, but it doesn't seem to be quite as there as other, hipper parts of Brooklyn. The street was bustling @ about 1:00pm, but most of the white people I saw were college-age kids on their bikes obviously just passing through the neighborhood, not residents. I was the only white person in this particular dunkin donuts. I like the contrast of this neighborhood because having spent a fair amount of time in Manhattan over the past few days, I'd been getting a steady dose of the rich and the famous-type NYC lifestyle. I'm getting off a tangent though, this story doesn't have to do with race, it has to do with the hustle.

I see the hustle quite a bit considering the line of work I'm in, and I'm getting good at spotting all different types, right off the bat. It's how a lot of people in poorer communities get by, and it's inherent in the welfare culture. In this instance, the hustle involved the selling of goods of a questionable origin. You've seen this before if you've lived in a city atmosphere; it brought me back to the days of going to shows @ Showplace Theater on Grant St. After these shows it was customary to walk to Mighty Taco at the corner of Grant/ Amherst. A small group of white kids out @ night looks like a really easy mark, and if you made the mistake of standing outside too long, you were inevitably hit up with the offer of jewelry or other various goods. Being teenagers from the 'burbs, it was easy to get fast-talked by these hustlers and even if you didn't buy what they were peddling, it was intimidating and a little scary.

This was roughly the situation today; man comes in and walks up to a table of middle-aged black girls. "Hey you wanna look at these crosses? Real nice stuff." The game begins as I drink coffee and tune in to the encounter directly behind me. "Where'd these come from," asked one of the women.
"Long Island."
"Long Island, like where Long Island?"
"Long ISLAND...."

The woman drops it and the man can already tell he's got something going on. He tells her $30 for the cross. They talk a bit more and I can't hear them for a minute, I think they're just bullshitting with the other women at the table. Another piece of jewelry is then brought into the equation; the hustler wants $80 for this one. The woman scoffs, "Oh hell no I ain't paying no 80 bucks for that, that ain't worth no $80." The hustler I can tell is a bit taken aback, I think he thought he had her biting on the first cross. He says "Hey, that's just what I was told to sell it for, that's all I know. Eighty bucks, it's a nice one, beautiful. A cop then walks in and the conversation doesn't stop but it does quiet down a little. They then talk about how many police are out and about in the neighborhood today, wondering what's going on (I'd noticed this too; I'd seen at least four groups of two cops each since I'd walked the two blocks and sat in the window for 20 min) The cop leaves and the women continue to bust on the hustler, giving him a hard time, stringing him along. It was funny to me to hear some one give him some of his own medicine, make him feel self-conscious but not wanting to fuck up the sale. Another man walked in that the hustler apparently knew and they all starting talking, which is when I got up and left. I never did find out if he unloaded any of the jewelry, I just got a kick out of the whole encounter; the set up, the exchanges, the haggling. Street life never stops and it's consistent from city to city.