He had dark, sinewy arms that spoke of greater strength and speed than his wiry frame revealed. Warnings of his lifestyle were tattooed across his arms, shoulders, neck, and torso… symbols of power, fear, violence, and religion. The skin on his arms was smooth yet his hands were calloused, twisted to early aging by poverty. He wore a “wifebeater” white sleeveless tank top and baggy navy blue work pants pulled high. In the communities in and around East LA, these are warnings, the uniform of a gang member. His baggy pants held another secret, one even his family did not seem to understand.
The network of marks covered his legs, feet, even between his toes, mapping out the young man's struggle with heroin. Dotted with scabs, the infection had affected many injection sites, each a dime-sized scab interrupting the landscape of tattooed art. All sites except one... this dime had become an oozing, throbbing mass, the cellulitis that converged our paths. But antibiotics, methadone, and his sister’s pleas were not enough to keep him in the hospital. He insisted, “I have things to do, people to see.” I tried to convince him to stay, but even my best effort is not as strong as the pull of smack on his veins. I somberly read the AMA form to him, reciting the hospital policy on leaving against medical advice, knowing he faced a daily fight for survival that held more immediate consequences than dying of an infection. He eagerly signed it.
I understood his decision… I knew where he was headed and what his plan was. Knowing I only had a split second, I poured all the forgiveness and respect I could into just one simple statement; I looked deep into his eyes and softly said, “Take care of yourself.” For a second our eyes locked and his agitation to return to the street was quelled as he stopped to greedily absorb the kind words, revealing how few he ever heard in life. Then he and his family were gone as quickly as he was assigned to me and imprinted on my memory forever.