Twelve Patients: Life and Death at Bellevue Hospital (5 page)

Tanisha was sixteen, pretty, with braided hair that hung to her mid-back. She had bundled herself in several T-shirts, a sweater, and an extra-large Yankees sweatshirt along with jeans layered over pajamas. She headed toward Myrtle Avenue a few blocks away, carefully scanning the streets. A few lone cars drove past her as she made her way, her breath turned white. She was glad it was freezing, unlikely anyone would be hanging outside.

She had stayed too long at this foster family’s apartment. She knew it from her placement there exactly four weeks ago. The caseworker from the Administration for Children’s Services had taken her in a car
with another worker. It had been her twelfth foster care placement, almost one a year since she was born in Kings County Hospital sixteen years earlier. They had arrived in the late morning and a middle-aged woman opened the door, smiled, and welcomed them inside. Tanisha had dropped her guard slightly when the woman, Letitia, spoke with a Spanish accent. It had brought her back momentarily to the one foster placement that had been a home to her several years earlier.

The warmth of the apartment—the radiators that had no controls—and the steamed windows made it seem almost friendly. The caseworkers had stayed for over an hour, talking with Letitia, introducing Tanisha, and helping unpack the small backpack of what remained of her worldly items. She had a few changes of clothes and a small zipped bag for her toothbrush and hairbrush. The senior caseworker Anna had given
la puertoriqueña
Letitia two plastic pillboxes and gone over the instructions for the timing of the medications and possible side effects. There was a sheaf of papers she had in a plastic binder. She gave Letitia a copy of some documents and asked her to sign and date a form. The workers turned to Tanisha, who was sitting quietly at the dining room table, came over to give her a hug, and told her she would be fine here and they would be by to visit in a few days.

The problem started that night. In the late afternoon, Letitia’s daughter had come home with her boyfriend. They put on the television and ate pizza while talking and ignored Tanisha after a perfunctory introduction by Letitia, who promptly left to do some errands. The boy was around twenty and lived upstairs and didn’t appear to notice that Tanisha was even in the room.

It was after midnight when Tanisha was in bed. She had left the window open a few inches since the only way to control the temperature was to let in some cold air. She heard the window scraping against the frame and saw a sneaker and leg enter the room, followed by the young man from the afternoon. The light from the street made it clear who he was even in the shadows. He slid the window down, looked over at her, and took out a switchblade.

This wasn’t the first time Tanisha had been raped, violated, or abused in foster care, but she had decided it would be the last time.
She said nothing to the family the next morning after they banged on the door to the bathroom as she showered under near-boiling water for fifteen minutes to cleanse her mind and body. The window didn’t have a lock. She jammed it shut that morning and rigged a wooden bar so that it could not be opened. She also took a knife from the kitchen and kept it at the side of the bed. She heard rattling at the window a few nights later, again after midnight. The young man came over several days a week, and one night she noticed that the piece of broomstick keeping the window secure was gone. It was time to get out.

When she got to Myrtle Avenue, she turned right under the elevated train. She had gotten directions on the walk to Manhattan from a friendly counterperson at the White Castle all-night diner. “You go to Myrtle,” he’d said, pointing out the window, “and make a right turn. It is another fifteen minutes until you hit Broadway. There is another elevated train there and you make another right turn. You just walk the length of Broadway and stay under the elevated train. It runs right into the Williamsburg Bridge. You can’t miss it. You are practically in the East River. It is another world there. You are in another country.” He smiled enigmatically while handing over two hamburgers and french fries “on the house,
chica
.
Suerte
, good luck.”

By the time she got to the hundred-year-old bridge it was past five a.m. and the streets were starting to fill up. At first she was anxious, but she could hear the trains squealing overhead. The early-morning risers were going to work. Bundled up against the cold, they barely gave Tanisha a glance, walking quickly to the steep stairs to the M train platform or ducking into the coffee and donut shops that lined Broadway in a shadowy sunless netherworld. She knew she was near the bridge when several men walked along the early-morning streets of Williamsburg in long black coats and round brown fur hats with white socks. She had heard about this group of Hasidic Jews, the Satmars. They ignored her and spoke among themselves in a guttural foreign language. An orange school bus idled at the corner, plumes of white exhaust exiting the rear like a surreal post-apocalyptic beast. The door opened and long black coats and fur hats got inside.

It took Tanisha awhile to find the pedestrian walkway across the
bridge. She waited until a group of middle-aged workers, black metal lunch pails in hand, started across and trailed them by fifty feet. They would be her safety net to the other side. The morning was sparkling clear and very cold. The wind whipped through her layers. She tucked the hood tightly around her head and put her hands underneath her armpits. Traffic was picking up. Red taillights zipped by. Tugboat lights headed north up the East River toward Roosevelt Island. Sparkling yellow lights from Manhattan stretched as far to the north as you could see. Once she was across the bridge, she was in known territory. She had been “placed” on the Lower East Side two years earlier. There wasn’t a block, bodega, or pizza shop she didn’t know in the area, from Delancey Street to 14th Street. Avenue C in Alphabet City had been her home base. It would be good to be out of a Brooklyn she was unfamiliar with—each neighborhood a crazy quilt of angled streets, different languages, street gangs, drug dealers, hustlers, hipsters, and old folks sitting on their stoops. You had to have your wits about you and stay in your safe zone or it was a game park.

As Tanisha wound her way past the midpoint of the bridge and began the downward slope into Manhattan, her thoughts changed into Spanish. She was back in the house of her
abuelita
. Mama Lola as her family called her and
abuelita
(little grandmother) as the six young girls called her, wards of the state in foster care in a group home run by Mama Lola and her adoring husband, Hugo. He drove a livery car or gypsy cab fifteen hours a day, as the price of gasoline had inched its way up and cut into his weekly take-home pay.
Abuela
always said her husband “was an exception to Dominican men. He has one wife and one family, and he is a loving man. I found the one in my town.”

As her legs carried her down the slope, she ran through in her mind the families and group homes she had lived with over the years since she had a memory. Of her mother she had no recollection, and there virtually no information was shared with her or perhaps known. All Tanisha knew about her mother was that she was a Latina drug addict; crack was her drug of choice. She had several other children all in foster care removed by ACS. She had left Tanisha when she was a child with some “crack sisters,” and a neighbor called 911. After
the police arrived and found a six-month-old girl in a filthy rug, they brought the baby to St. Barnabas hospital in the Bronx. ACS was notified and traced the mother to the Rose M. Singer women’s prison at Rikers Island. They worked through the legal system to have Tanisha removed permanently from the mother’s custody given her long record of drugs, abandonment, and prostitution. Tanisha’s mother had been a victim herself of a mother who had been a gang member, drug user, and petty dealer who didn’t actively abuse her children so much as neglect them.
Feral
was the term ACS used in a report that had been shared with Tanisha by a social worker when she was a young teenager. Tanisha had no idea what feral was. She had thought it was an animal, a pet tiger.

The Smiths were the first family Tanisha remembered. They were a black Jamaican couple with six youngsters under their care. Tanisha was four years old. They were benign with the children. There was food on the table, and the kids were bathed and kept clean, dry, and warm. They slept in one large dormitory room with the door open. The husband came home from driving a city bus and sat in front of the television and slipped a bottle of rum out from a brown paper bag. His personality went from quiet and calm to an animal growl with a few sips of the brownish liquid. Tanisha could still hear his voice penetrating the walls and the open door, “Get your fucking ass in here, bitch. Get your fucking ass right in here.” The yelling, cursing, screaming, door banging, and throwing would cease around midnight, when he could be heard snoring. The thunderous snores were punctuated by long apneic pauses when he ceased to breathe altogether. And then the rumble would begin again after some horse-like snorts. The kids would finally get to sleep between nightmares and bed-wetting. One day a dozen ACS workers showed up at the apartment with several official white vehicles idling in the street. The children were all packed up and taken away. Two workers accompanied each child. Mrs. Smith was nowhere in sight. Mr. Smith was driving his bus. They were all taken to a large shelter somewhere in Brooklyn.

By the time Tanisha was seven, she had been in seven different residential homes and foster families, plus a few shelters and ACS
distribution facilities. She remembered her first hospitalization as she reached the bottom of the bridge and kept walking down Delancey Street. She stopped in a Dunkin’ Donuts on the north side of the street. This was an old hangout, and she was glad it was still here after so many years. There was already a line in front of the counter where some Indian women presided over the coffee and donuts. She settled in a window seat warming up for a few minutes. At age seven she had become unmanageable. The foster family had called 911 when she attacked another foster child who hit Tanisha and called her a bitch. Something had flipped and continued to flip without any warning signs.

She would be fine—then suddenly hypervigilant. Something would snap, and later she had no recognition of what had happened. Except that some adults were holding her down, sitting on her, injecting her buttock with Haldol that put her to sleep or left her extremely dopey, in a dream-like state. She had once been taken to an emergency room at the local hospital. After hours of sitting on a stretcher with a bored woman in light brown scrubs looking at her, reading the paper, and talking to her boyfriend on her cell phone, she was admitted to the inpatient pediatric unit. The other kids had diabetes, pneumonia, influenza, epilepsy, asthma, and mental retardation. Tanisha remembered the doctor who talked to her two days after she was admitted. He took her into a quiet room, with a social worker taking notes at his side. There were toys in the room. Tanisha was asked if she wanted to play with the toys or draw. She refused to talk to the man, who looked bored and tired. She was hungry and asked for food. They said after she drew them a picture. She sat and waited them out. After a month on the unit, visited by social workers, psychologists and the occasional psychiatrist, and ACS workers, she was transferred to another foster family.

A succession of families followed, interrupted by shelter stays when the families disintegrated in a shower of police calls, domestic violence, drug dealing, and ACS investigations. As Tanisha pushed out the door of Dunkin’ Donuts and headed north, she thought she glimpsed a man she had pushed to the back of her mind but could never forget.
She kept an eye out for him instinctively. A habitual roving third eye. There were many times when she thought she saw him in a crowd, on the subway, on a bus, or across the street. She was always prepared to lose herself, make herself disappear, or if necessary take her own life.

The Brown family had been gregarious and welcoming. The children, all four of them, were teenagers, well dressed and well behaved. The house was spotlessly clean, with old but well-maintained furniture that shone after being polished every week. The children did their homework in the evenings and then were allowed some television time before going to bed. Chores were divided up evenly and listed in rotation on a board in the small kitchen: garbage, dishes, laundry, bed making, tidying up, washing the kitchen floor. It all seemed too perfect. Tanisha’s symptoms had been better, and she didn’t have a “flipout” more than a couple of times. Lester Brown liked to read to the children at night. After a few months he had asked Tanisha if he could read her a special story. His wife was in the bedroom with a migraine and had taken a sleeping pill. He and Tanisha were in the living room alone with a reading light on, a blanket covering them. He placed Tanisha on his lap and opened Dr. Seuss. He whispered in her ear and she felt something hard between her legs as his breathing accelerated and he moved rhythmically. She had sat totally still as the large man panted in her ear then clutched her to him in a spasm that seemed to last forever. He made her change her pajamas before he put her into bed, whispering, “You are my favorite, Tanisha. We will read together again, just the two of us. Let’s keep this our secret.”

Tanisha pushed open the doors to the ACS intake building just off First Avenue at six thirty a.m. The building was just north of the main entrance to Bellevue Hospital and part of the original sprawling hospital complex. The morning shift was starting to stream in through front doors. The rectangular silver food carts were jockeying for position on both sides of the avenue. Delivery trucks were triple-parked, and an FDNY ambulance hung a hard right turn down to the main emergency room entrance. She was patted down for drugs and weapons and then fed and bathed. The senior administrator knew her well and stopped
by to welcome her. After six hours of evaluation and innumerable phone calls, two workers took her to the Bellevue emergency room.