A Tough Good bye

I landed in Honolulu two weeks ago, and so far, things have been pleasant. Between workouts and trips to the beach, I scurry about the hospital and the nearby Army installation trying to fulfill all of my in processing requirements before the start of official business on July 1st. That's the day that I become an intern, and start soaking up all of the joy residency has to offer.
Before I left Maryland, I made sure that I shared one last afternoon with Jamal. His 14th Birthday fell about 4 days before I boarded the plane, so an outing for lunch and a movie seemed like the perfect way to say good-bye and Happy Birthday at the same time. I picked him up from the school office (along with his report card) and we headed out to Arundel Mills Mall to get something to eat before catching the Iron Man matinee. I had already seen the movie, but I enjoyed it enough to see it again with him.
During the more dialog heavy parts of the film, my mind drifted a little more than it usually would. I had been concerned for weeks about Jamal's future as he entered a very critical four year period of his adolescence. Tensions between him and grandma had been on the rise, his grades were plummeting, and he had started skipping class more and more frequently. I searched for replacement mentors among the men in the medical school's under three classes, my parents had considered adopting him, and I had even thought about adopting him myself for about three seconds. In the end, none of these were viable options, and I was just going to have to leave him in Baltimore with the hope that he will eventually find his way. What upset me most, as we sat there in the theatre, was that I was unable to reach him in the way that I had hoped. Despite tutoring sessions, visits to his school, talks with his grandmother, and many heart to heart conversations about the importance of academics, Jamal had another report card full of F's for his third quarter.
Amid the previous months of turmoil, I had been learning a tough reality about poverty, and it's effects on young people. I was starting to see that I could not make Jamal want anything badly enough to actually lift a finger. More and more, I understood that mentorship is not an adequate substitute for parenthood. It was never my job to fix everything, I was there to be a friend, to show him that there are options, and to let him decide. I just couldn't understand why he didn't seem to be choosing the road towards opportunity.
Jamal, like me, loves superhero stories. So it occurred to me that I may be able to draw a parallel between his life and that of Tony Stark in one last attempt to drive my point home. As we were getting in the car after the movie, I told him that sometimes life can be like that cave which imprisoned Tony stark. In the movie, Iron Man is born through Mr. Stark's desperation to escape his murderous captors before they can finish him off. In true Marvel fashion, he waxes about a dozen of them as he breaks free of the cave and rockets to safety in the Afghan desert. Just like Tony Stark, I told him, we can harness everything available to us, education, employment, and innate talents to design our own escape vehicles. He seemed to understand the analogy, but I know it takes more than that to make him buy into something.
Before leaving the mall, we stopped by the bookstore and picked out an art book. He likes the Japanese animation style, Manga. So I allowed him to select one of the many instruction books on the topic as my present to him. I made him promise that he would not lend it to anybody else or destroy it. He has consistently lost or destroyed gifts that I've given him in the past. I had been working for months to teach him more responsible stewardship, with little improvement (he kept losing things). But since it was his birthday, I wasn't going to deny him a gift for the sake of one last lesson.

On the way home, I pressed him a little closer about his grades:

"Do you think it is important to get good grades?"
He replied that he did.
"Then why are you not making it happen? I know you're smart enough."
He said that he didn't know.
"Actually, you DO know. But maybe you don't want to tell me."

At the distance of a few weeks, I realize that I probably made a mistake in how I approached him. During my years as an army officer, as a grade school tutor, and as a medical student, I was always taught to ask a little more. To assume that something else might be going on, but I failed to do that, and just moved forward with the assumption that Jamal was not motivated enough to study and do his work. And that may be part of it, but I'm disappointed that I failed to find out why.
I emphasized again that he has the power to remove himself from his current situation, and that it's up to him to create a better life for himself. Finally, I painted a picture of his future on the path that he has started. I told of my childhood acquaintances, cousins, and friends who ignored their academic development at his age and who now have low paying jobs or none at all, have fathered children, and have nothing to contribute to society at large. At this point he became quiet, and glared out the window. It was obvious that he was angry and didn't really want to talk anymore. I kind of wished that I hadn't pushed so hard, and I tried to alleviate the tension. I told him that I did not intend to make him angry, I just want him to take things seriously because four years from now may be too late.
As we stepped into his grandmother's kitchen for the last time, I kissed her good bye and handed Jamal a letter that I had written for him days before. It contained what I considered important, but simple advice for his teen years, my contact information, and a plea for him to call or email if he needs to talk, has a question, wants help, etc. As I said my final good bye and hugged him, I could tell that he was crying, but had turned away so that I wouldn't see. He said 'bye' and I slipped out into the building's hallway and down to the sidewalk.
So what now? What happens to Jamal? Where does he go from here? It's just him and his 74 year old grandmother whose health deteriorates by the week. His father is still addicted to heroine, and his mother died of AIDS complications three years ago. I've tried to be a model of black success, and show him that his color doesn't have to be an obstacle to progress and success. But as I examine the situation from this side of things, I realize that maybe color wasn't what he saw as the greatest obstacle. Poverty, Baltimore, it's pathetic school system, loneliness, frustration and stifling boredom are swallowing him alive. And without relief of some of these things, it's going to be hard for him to change course. I wish there was more that I could do, but my life is about to get very complicated, and he's 5,000 miles away. I will continue to check on him, and share what I know as he grows towards adulthood. Thanks for sharing the Big Brother experience with me.

Some Progress

Whenever I travel to Baltimore, it is not uncommon for me to park some distance away from the hospital to save money, and to take a short cut through the seedier parts in the interest of time. When I do venture away from what many might consider 'safe zones,' I typically come across young Baltimoreans who cause me much frustration and disappointment.
Often, I will encounter a group of teenagers trying (or maybe not) to look as menacing as possible while flaunting their thuggish gait. As our distance closes, I overhear the latest rap single being recited (sometimes in unison, but not always). Upon examining their faces, there is usually one or more among with a mouthful of gaudy jewelry. I imagine that my reaction is similar to what a physical trainer experiences when he sees a severely obese person inhaling a double quarter pounder with bacon.
Time and time again I am overcome with a desire to snatch one of them up by the throat and scream into the recesses of their minds, I want to force them to understand the nature of the world in which we live. I want to tell them that if they're not aggressively educating themselves, they can expect a future that will probably be a lot bleaker than anything they're living through right now. I want to instill the futility and emptiness of their elaborate ghetto gestures, rituals, and values. I want them to know that they have no business fathering a child as long they cherish ignorance and disorder. But of course, I always stop myself short of anything more than a head nod, and an occasional 'what's up.' I'm typically greeted with the same, but periodically, the young ruffians may shoot me a look of contempt, or ignore me all together.
In the beginning, I looked to Big Brothers Big Sisters as an avenue to reach young menin a meaningful way. Knowledge alone is unlikely to inspire the needed change. I knew that I could only be effective if I built rapport with Jamal and let him know that he meant more to me than some kind of project or endeavor of goodwill. Otherwise, I might come off as some lunatic on the sidewalk spitting random advice.
So after more than a year of building our relationship, I have intentionally hardened my warnings to Jamal over the past month or so (no I haven't grabbed him by the throat). I have slowly progressed from gentle encouragement to harsh admonition about his future. After all, he is almost fourteen. He has only four years to establish effective study habits and discipline if he is to educate himself after high school.
With more time off I have been able to share a few weekday afternoons with him working on his math homework (his weakest subject) and we are actually getting somewhere. I have been rather surprised how quickly he progressed in a single week. It seems to me that all this time, he has probably just needed someone to sit down with him, encourage him, and let him know that they care about his performance. As usual, I will not know exactly how much he's improving until the end of the quarter. But the smile on his grandmother's face the last time I stopped in let's me know that something must be getting better.

Stare down

A stand off between Louis and Jamal during a recent game of tag. Jamal still hasn't managed to catch him yet.

The Birds and the Bees

Teenage and unwed pregnancy in Baltimore is a pretty serious problem among African Americans. During my time on a maternity ward in a city hospital, I noticed that almost every Black woman that I cared for was both unmarried and was currently, or had been pregnant as a teenager. An analysis of birthrates in 2003 demonstrated that Baltimore City is consistently among the highest in the nation with teen pregnancy comprising 18% of all births. I see this as one of the greatest problems to progress among impoverished black communities.

Generation after generation is having children before they have the means to offer that child a life better than their own. If I had unlimited power and influence, I would first make sure that every hospital in America was outfitted with Xbox 360 consoles in their bathrooms. Number two, I would revoke reproductive privilege in some of the hardest hit areas, and re-instate it on a case by case basis. However, I am but a mere mortal, so I'll have to settle for making sure that my little brother, Jamal, understands exactly how important it is that he keep his weapon holstered.

When he spilled the story of his first cheek kiss with girlfriend, Bonquelda (only in Baltimore), he mentioned that 'positive' peer pressure had a lot to do with it. And as innocent an encounter as that was, it wasn't hard for me to imagine him taking things further in the years to come as his hormones rage, and his buddies cheer him on.

Me: So what do you know about serious things between boys and girls? (Trying to be as vague as possible)

Jamal: I know all about the birds and the bees.

Me: Well do you know why it is so important that you not have sex?

He had a few of the answers I was looking for. Jamal is aware of diseases and the unwanted consequences of a pregnancy at this age. There's a girl in his middle school class who is with child. But still, he casually mentioned that "a condom can take care of all that." As true as that is, I reminded him of the possibility of failure or misuse, and the likelihood that someone his age would not use one everytime.

I am an ardent advocate of abstinence, but I am not naive enough to think that someone who has not been properly indoctrinated will actually adopt that as their primary birth control method. Jamal's family does not have a strong tradition of marriage, and I am among the few married adults that he knows.

My parents started working on me and my brothers very early. I can remember being sat down for lessons about lust, irresponsibility, and consequences of Biblical proportions at the age of seven. There was some overkill at times, but their technique has been proven effective:

"..according to data from the National Longitudinal Survey of Youth, 1997 cohort, even after taking account of characteristics such as race/ethnicity, mother’s education, and family structure. Teenagers whose parents have strong religious beliefs, who have higher levels of attendance at religious services, who participate in more family religious activities, and whose parents are affiliated with a religious denomination are less likely to have sex before age 18 than are teens without these characteristics."

I can see that the next generation of our family is reaping the benefits of this approach. My nephews and nieces are being born into stable homes where they will be very well provided for emotionally and financially.

Before putting the subject to rest, I told Jamal that abstinence is his best bet for many reasons. I tried to include his faith, and the potential heartache involved when young girls misinterpret a thrill-seeking boy's emotional investment. Some part of me doubts that any of that is really sticking. Puberty has begun, and reprogramming a young male with his eyes on the prize may be next to impossible.

Me: Just promise me that if you can't wait until marriage, you'll always use a condom

Jamal: okay

I'll be sure to revisit the issue.

"Report to the office immediately or you will be arrested"

That's what I heard being announced over the school intercom as I approached the Middle School's main office to pick up Jamal's report card Monday afternoon. Upon entering, I was treated to a snapshot of his school's administrative faculty in action. A uniformed Baltimore Police officer was reading off a list of children who had been spotted loitering in the hallway, while the secretary was announcing their names. The principal was beside them both barking her disapproval with their technique. Minutes later, the first of the delinquents started to appear at the doorway.

"Are they serious? Arrested?" I asked the lady helping me with the report card.
"Yes, they will be taken to Baltimore Juvenile detention until their parents or whoever picks them up."

I had visited the office once about a year ago and didn't notice so much chaos. I wonder what the deal was today.

As each of students arrived, the Principal began yelling at them individually, raising her voice even louder to drown out their objections. Occasionally, she would glare over her shoulder and give an unresponsive member of her faculty the same treatment. I was a little embarrassed for everyone involved. It was a bit reminiscent of an early basic training experience, but a lot meaner.

Anyway, after about 10 minutes, the office administrator produced Jamal's report card and printed it. "You know, he's one of the good ones. He just needs some help caring about his school work" she tells me.

I'll say. I was stunned when I saw that he is carrying a D minus average (61%) over the first two quarters and is failing 3 out of his 5 classes halfway through the current quarter. His worst grades were in math where he has received F's (55% and 57%) for the first two quarters. Grandma told me that he wasn't doing well, but I didn't expect it to be this bad. Only a year ago he had a 78% average for all of his classes. How is it that things have fallen so dramatically so quickly?

It sounds a bit presumptuous, but I have considered that my dwindling involvement with him this academic year may have played some role in it. Well, it was more than obvious that there is work to be done. I asked her if she would summon Jamal to the office before dismissal so that I could take him home with me. She very kindly cooperated and had him pulled from class.

When he strolled into the office, he didn't seem the least bit surprised to see me. He actually appeared a little bothered. I didn't understand why, but I probed him a bit once we got outside. After a little more prodding, and poking, I finally got him to tell me that he has a girlfriend he was expecting to meet after school. Can you believe that? And on top of that, he had given her a gift earlier in the day (by way of a mutual friend) and he had been looking forward to their walk home from school so that he could see her response. I offered to take him back, but he said he would just catch up with her later. As we drove to my house, he told me all about his young lady friend. He described the excitement of his first kiss (cheek), and how disappointed he was that he had not yet received a reciprocal peck. How cute. Eventually, we got into serious territory with the whole kissing and girlfriend issue. I'll tell you about that a bit later.

Rebellion

It's March! And the light at the end of the long, dark, and smelly sewage tunnel that has been my quest for the M.D. is brighter than ever. This month I am finishing my final course, Radiology. After that, I am free to do what I please until graduation in May. During this current month, my instructors have already made it clear that they only expect me to be present for about 2-3 hours daily. Never one to disappoint, I've managed to whittle that down to about and hour and a half on average . For the time being, I'm on easy street, and I have a lot of extra time on my hands. It's the perfect time to step things up a notch with Jamal since I'm departing shortly after graduation.

Since I have a bit more energy for the fight, I decided that once again, I would look into Jamal's grades. Around noon yesterday I gave Grandma a call to get permission to go to the middle school to pick up his report card. Before I could even get to that, she unleashed a half hour of grievances of her grandson's most recent behavior. He has been growing bolder, and more rebellious in recent months. As her health continues to fail, she is finding that he defies her more frequently on matters of school work, television, video games, and clandestine exploits with his buddies during school hours. She has also grown quite uncomfortable with his accelerated interest in females. As I listened, I tried my best to empathize with her, but I couldn't help but feel that some of it was probably a natural response to being young, under the influence of volatile hormones, and wanting to be one of the guys. I can't imagine what it must be like to live alone with a 72 year old disciplinarian when you're only 13.
Anyway, she's been through this before (she raised 10 children, and a few grandchildren) and feels as if she no longer has the energy to go through adolescence all over again with Jamal. She is open to moving him out of the house, and he has expressed a desire to leave, but all of the potential destinations would offer living conditions that are the same or worse than Grandma's. It's a difficult situation to say the least.

Before I left for the school, I told her that I would take Jamal home with me and spend some time with him. It won't fix everything, but it might allow him to let off some steam. Her narrative on Jamal's rebellion kind of reminded me of my 5 month-old beagle, Louis. He has a way of acting out if he doesn't burn off his extra energy each day. He's chewed into walls, humped legs and arms, bit, ran in circles, and whined incessantly as a response to neglect. The two met a few weeks ago and really hit it off, so I thought it might be mutually beneficial to get them together again.

I was fortunate to have a number of lively conversations with Jamal (for a change), and even had the chance to counsel him on some major issues during the course of our afternoon and evening. I'll cover some of that in other posts over the next week.

Losing Ground

I saw a disturbing article in the New York times last week (I blog in slow motion), and felt compelled to bring it to the attention of anyone who might care. It comments on the findings of the Brookings institute's research regarding economic mobility in black and white families. Some of the most jarring statistics were those which demonstrated a downward trend among black families' economic success over the last generation.

"..almost half (45 percent) of black children whose parents were solidly middle class end up falling to the bottom of the income distribution, compared to only 16 percent of white children. Achieving middle-income status does not appear to protect black children from future economic adversity the same way it protects white children."

I have always taken a strong stance on black under achievement, some may even say that I am too harsh. But I find it difficult to interpret these statistics in a manner which does not implicate black parents in their own children's' failure. If we know that racism is a less potent inhibitor of academic and economic progress today than it was in the past, and the older generation is capable of attaining middle class status. Then it would only make sense that each generation should be doing better than the previous one. Black children losing academic and economic ground gained by their parents is an indication that parents are not instilling the discipline and work ethic that they relied on to achieve their own success. The Brookings Institute demonstrates that the major difference between white and black middle class families of equal income are lower black male incomes, and the high rate of single parenthood in the black family. In other words, the black family is unraveling. And despite middle class incomes in some families, money alone is not enough to ensure that children will remain on the straight and narrow. I've made it known in the past, that I don't believe that we as a people will ever reverse this negative trend, and I see this study as strong support of my beliefs. If a sizable portion of the legitimately successful among us are not passing it along to their children, then what does the future hold? I am confident that there will continue to be individual black children from all classes and family structures who will succeed (both with and without the help of mentors), but as a whole, I'm afraid that the downward spiral will claim far more than it allows to escape. Of course, I will never see this as a reason to stop reaching out to children in need.