Winning the Lottery - 12. Chapter 12 Losing objectivity. Plus Cass meets....

Don’s report was comprehensive. He quoted statistics (including doctor burnout, depression and suicide rates), surveys, personal interview comments. He wrote about the strengths and weaknesses of the current state of health resources—human, machine and funding—in Honolulu. There was even a chapter dedicated to family dynamics and what sort of support I could expect on the home front (a lot, apparently).

His conclusions were backed up with sound research and tempered with compassion. He focussed on my interest in preventative medicine, and my strong family ties. In the end, his recommendations boiled down to me pursuing a balanced practice, splitting my time equally between a more middle class, suburban, regular appointment clinic and an urban, walk in clinic (two days a week each). The variety, he said would prevent burnout. To augment and compliment existing healthcare services, where there was already strong support for treatment, including addiction and mental health services, he recommended that the Dea-Con Foundation fund a free diagnostic facility: radiology, ultrasound, heart diagnostics, nuclear medicine, MRI, general laboratory, etc. plus a dispensing pharmacy. Often patients didn’t follow through on testing because they had no money (no medical insurance), or there were long waits for ‘free’ existing services such as MRI. They also didn’t have prescriptions filled for the same reason. Bottom line for me was that I would have a rewarding career and fulfilling family time. In other words, I could have my cake and eat it too.

Don had included an appendix, which was a complete business plan for the diagnostic facility/pharmacy. He’d even picked out a downtown office building that had enough space available.

Derrick, Cass, Mom and Dad all thought that the plan was a good one. Deacons being Deacons they were concerned it was right for me. “It’s right for the family,” I insisted.

They also set about to find me a storefront office downtown including renovating, equipping and staffing it. It was large enough that at least two other doctors could work with me there. Hopefully, there would be others willing to participate in a walk-in clinic especially knowing that we had full diagnostic and pharmacy facilities to back us up.

The lab and pharmacy wasn’t restricted to just my patients. It would be available to anyone without medical insurance irrespective of income (how do you police something like income?). There would always be a few ‘cheaters,’ well off people who were too cheap to buy medical insurance and who thought nothing of scamming resources. It comes down to taking peoples’ word sometimes. That, and everybody seemed to know everybody else’s business in Honolulu anyway.

We gave Don and the Foundation the go-ahead the wheels were set in motion. Foundation staff handled everything from space configuration to equipment purchasing to staffing to setting up the not-for-profit entity. The year plus that I had left on my residency gave them ample time to complete the project before I started ‘real’ practice.

As you can imagine, medical training left little time for socializing outside the family. Between Derrick’s and my somewhat erratic working hours we’d barely had time for each other, let alone friends. We vowed that would change. Derrick would bid only mid week, Monday to Thursday, trips, and once my residency finished, I would take three day weekends, Friday through Sunday. In addition, we would try to invite over non-family friends at least once each weekend for casual socializing.

One of my fellow residents, Jordan Applebaum, and I struck up a work friendship. He was born and raised in Hawaii but went to med school over on the mainland. Since coming back home he had met and moved in with one of the Island’s better known morning disc jockeys, Kelly Ka’ena. Taking the opportunity to meet another gay couple, Derrick and I invited them over for a barbeque one weekend. Kelly was a whirlwind on the air. Full of energy, very funny, and talking a mile a minute; he was very popular. I must admit to a little trepidation at entertaining a guy who seemed to be perpetually on speed. But it turned out that Kelly, in person, was nothing like his radio persona. Evidently he left his radio voice and jokes at work because we found him to be fairly unassuming in real life. The four of us really hit it off and our evening together was a lot of fun.

One of the topics that came up was Cass. Kelly and Jordan expressed envy. Jordan went on to say that that they’d been discussing having children, but that they were holding off until their life became a little more settled. That begged the question of whether or not there was ever a ‘right time’ to start a family. Kelly remarked that, in many ways, a ‘surprise’ like Cass would be ideal; it would take all the waffling out of the decision.

Fate sometimes lays down interesting cards, and it wasn’t long after our discussion that an eight year old boy was admitted to the ER with a broken ulna (arm bone). It was instantly obvious to me that he’d been the victim of abuse in spite of his mother adamantly insisting that he’d fallen out of a tree. He had a particular type of torsion fracture that most often occurs when the arm is yanked and twisted violently, along with consistent bruising. Add that to his black eye and the contusions on his face consistent with a hard slap, and it wasn’t difficult to figure out what had happened to this kid. I told the mother that I needed to examine him in a private room with just a nurse present. We needed pictures of the injuries, and I wanted to hear his version of the story. The mother at first objected, but I insisted, telling her we needed a quiet space to examine him for a concussion.

He was thin, and there were marks all over his body. Red welts and healed scars on his legs, buttocks, stomach and back. Poor little guy had been whipped, caned and belted multiple times. I also discovered several cigarette burn scars on his abdomen. Under gentle questioning by the nurse, a fairly motherly type, he admitted that ‘sometimes’ his mom and dad ‘punished’ him, when he was ‘bad.’

Honestly, it’s hard to remain dispassionate in the face of something like that. I saw red. I felt like going out to the waiting room and slapping the mother into next year. I kept telling myself that I was a doctor, and doctors acted professionally. But I swore an oath that only over my dead body would that child be returned to that abusive home.

We followed protocol, of course. I was able to admit him for ‘observation’ and we called social services and the police. There was enough evidence with my testimony and the photos to charge the parents with first degree assault among other things. The social worker immediately petitioned the court to have the child removed from the home and placed into temporary foster care. Temporary foster care? Lord Almighty, this poor, traumatized little guy was going to be tossed around in the system until maybe he’d land in a permanent home.

Alfy’s father, if you could call the bastard that, didn’t help their case any when he assaulted the police officers sent to arrest him. Luckily, the mother confessed to the abuse, saying that Alfy was a ‘sinful’ child and that he needed to be punished in order to enter God’s grace. How people can twist religion to justify their own deeply sick actions is completely beyond my understanding. Don’t get me wrong, I’m not anti-religion. In fact, I’ve seen faith and prayer work miracles in health care many times.

Alfy was safe from his parents for the time being. Now what?

My doctor objectivity vanished, and my protective father self emerged. The solution was obvious. Derrick and I would adopt the little guy.

Luckily, sensible doctor guy came back. Doctors don’t ‘rescue’ their patients, they help them. But what could I do to ‘help’ this little guy? Then I remembered the conversation we’d had with Jordan and Kelly.

I phoned Jordan.

“Hi Jord, it’s Gabe. Um...were you guys serious about you know, adopting a child if the right circumstances arose?”

“Well, yeah. Kelly and I talked about that later. We’re both up for it. In fact we’ve been researching adoption agencies. I guess you could say we were inspired by you and Derrick. Why are you asking?”

I told him about little Alfy Keauhou. Jordan, who had some Hawaiian blood himself, lunged at the bait; in fact, he took it hook, line and sinker. That Alfy had mixed Hawaiian ancestry had him nearly pissing his pants with excitement. “Kelly’s gonna love this! What do we need to do? When can we meet him? Kelly is asleep right now, but his shift finished at nine tomorrow morning, can we come to the hospital then?”

“I’ll meet you there,” I promised.

There now. That wasn’t ‘rescuing,’ was it? Definitely ‘helping,’ I’d say. Fuck professional boundaries. This kid needed a home. Jordan and Kelly, both good people, seemed ready and willing. This situation had the potential for a win-win.

It took only one look for Jordan and Kelly to fall head over heels in love with Alfy. He was a really cute kid with dark hair and big, soulful brown eyes. Not that they weren’t aware of the negatives. Alfy was likely to have, possibly severe, psychological problems. He was being removed from his parents care and, as abusive as they were, they were still his parents, and he was attached to them. That doesn’t sound logical, I know, but think of it like a child version of the Stockholm syndrome. He’d need a lot of care, but one look at Jordan and Kelly’s faces told me that they were smitten and eager to get going.

Unfortunately, there were the legal aspects to consider. Jordan and Kelly didn’t have a foster parent license. They couldn’t just take him home right away. That would be kidnapping. We’d hit a roadblock.

Wait a minute! Aren’t I a Deacon? Couldn’t I make things happen by merely flicking my wrist?

I phoned Uncle Darius who had pretty much taken over the reins from Gramps. I explained the situation and asked for help. He requested that Jordan and Kelly send copies of their ID and Social Security numbers to his office and give permission for a ‘deep background’ check. Someone was at their home within an hour to digitally capture their finger prints.

Within 48 hours Jordan and Kelly were vetted thoroughly. (A very anxious 48 hours for them!) And I mean vetted thoroughly. School records, financial records, property records, criminal records (none found). Family, teachers, neighbors and acquaintances were interviewed. No stone was left unturned. Luckily they turned out to be as pure as clean driven snow and were given the Deacon Security stamp of approval.

Then, as only Deacons can do, Darius contacted the authorities—probably some high up politicians—in Hawaii. Twenty four hours after that a family court judge rearranged his schedule for a special hearing. Reviewing the evidence of the assaults, he issued a removal order as well as a restraining order against the parents. Jordan and Kelly were granted a foster parent license. With the removal order in place they were given a temporary custody of Alfy.

Alfy remained in the hospital’s children’s ward for several days while Jordan and Kelly began the process of getting to know him. They both took ‘family’ leave and worked through a graduated get-to-know process. Each day they’d spend a little more time with him. At first in the company of the social worker, then on their own with him. After that they took him on some simple outings like going across the street to the park and having an ice cream cone. Gradually they spent more time away from the hospital including supervised then unsupervised visits to their home. Eventually, the big day came when they took him home for his first overnight visit. Jordan and Kelly were so excited you’d have thought that Alfy was visiting royalty. Luckily, the social worker had advised them not overwhelm Alfy by going overboard with toys and gifts. They laughed and said that restraining themselves from buying every toy in Toys ‘R’ Us was the hardest thing they’d ever done. That overnight visit was a success. Alfy only woke up once and Kelly was able to quickly calm him and get him back to sleep. After that, Alfy didn’t want to go back to the hospital any more. He kicked up a fuss when they dropped him off. He wanted to stay with Jordan and Kelly. Mission accomplished!

Working in health care sometimes gives one access to ‘priority’ care. When word got around about Alfy, the head pediatric psychiatrist assigned one of his best interns to work with him. I’d met her several times and was always impressed with her compassion and insight. Alfy was in good hands.

Hawaiian culture is all about the four F’s: family, friends, food and fun. So when the Applebaums and Ka’enas found out they had a new ‘grandson’ they pulled out all the stops. This called for a huge family celebration. The weather was perfect for a luau. Derrick and I volunteered our compound and beach. Over one hundred people showed up. The place was overrun. It was our security guys’ worst nightmare. They didn’t stand a chance, it was like herding cats. (Relax, we told them, everybody there knows everybody else, so it wasn’t like some stranger was going to sneak in and cause trouble.) It was an incredible afternoon and evening. They roasted three pigs in stone pits on the beach. All kinds of other traditional Hawaiian foods were served—including everyone’s favorite, macaroni salad. The meal was pot luck. People arrived with dishes upon dishes brimming with food. There were dance performances, both war themed and hula. Lucy was running around barking, having the time of her life, as were several other dogs that arrived with the guests. Kids were everywhere: in and out of the ocean, swarming up and down the beach, in and out of the swimming pools, running through the garden, racing in and out of the houses. Thank God we had ten bathrooms on the property! People were playing volleyball and soccer on the beach. Alfy was passed from one aunt to another until he escaped to run wild with the rest of the kids. His arm cast was a badge of honor. He had no qualms about saying exactly what had happened to him, and the kids came up with some very colorful ways of seeking revenge against his birth parents. The kids gorged themselves, and more than a few of them were so excited they puked. It was pandemonium, but I think it was, hands down, the best party I’d ever been to.

Jordan and Kelly, were crowned kings for the evening and were given special thrones from which to watch over the proceedings.

As the evening wore down I noticed Cass and a very attractive young lady sitting off to the side, in an out-of-the-way spot, quietly talking. I nudged Derrick and discretely pointed. We looked at each other with raised eyebrows.

After the last guests departed, the yard, beach and houses were a mess. Many people volunteered to help clean up, but we shooed them away. We’d already arranged for a cleanup crew to come in the next morning. They cleaned and raked the beach, repaired the lawn and gardens, cleaned the sand and debris out of the pools, touched up paint, unblocked a toilet. They polished and scrubbed. By dinner time you’d never know there’d been a party. (Sometimes, I must admit, it’s damn nice to be wealthy.)

Cass seemed a little preoccupied that next day. He spent a lot of time in the shade by the pool talking to someone on the phone. Lucy, exhausted by the previous day’s activities—she was getting on in years—lay resting at his feet.

Cass had matured into a fine young man. After his Monkey Incident rebellion (all kids rebel at some point, and thank goodness Cass’s rebellion was a lot milder some we’ve heard about), it was like a switch had been thrown. He went from child to adult in the blink of an eye. We were no longer dads, but rather friends. Of course, Derrick and I were scrupulous about observing proper boundaries, but our interaction with Cass had taken on an adult-adult pattern. We knew he’d been sexually active for some time. It was pretty obvious from the morning after swaggers and smirks we’d noticed on several occasions. But we didn’t lecture. We’d already done that and trusted that he’d be sensible and safe. I have to say, though, that we were sometimes scared shitless.

He was unusually quiet that evening at dinner. Derrick and I were exchanging furtive looks. Finally, Cass let out a huge sigh and said, “How did you guys know when you were in love?”

I nodded at Derrick to take the lead. “Well, Cass, Gabe and I had just met. Gabe had been showing me around Waikiki and we were having a lot of fun and getting along really well. Then we sat on a low wall at the beach and just looked out over the water. Suddenly it just hit me; I guess I didn’t define it as ‘love’ right then and there, but I knew that something profound had happened.”

“It was the same for me,” I continued. “Oddly, I didn’t really know anything about your dad. I’d made some assumptions that were totally wrong, but I felt something pretty much at the same time he did.”

“Yeah, from then on we became sort of lost in each other,” added Derrick.

“Any particular reason why you’re asking?” I asked innocently.

“Don’t be coy,” said Cass. “I saw you guys sneaking looks at Khala and me last night. And you know perfectly well who I was talking to on the phone today. You both know damn well why I’m asking.”

“Busted,” laughed Derrick.

“Cass,” I said, “As a parent, I want to give you all kinds of cautionary advice. I want to say ‘take it slow, wait until you’ve finished vet school.’ But how can I give that advice when your dad and I completely threw caution to the wind? You’ve seen us balance the demands of work and school; it hasn’t always been easy. The odds were stacked against us in some ways, but look at us. Two very happy guys who followed their hearts.”

“But we had a lot of support along the way from Mom and Dad, and you,” added Derrick. “We couldn’t have done it without that support. So I guess what I’m saying is that you have our support, whatever you decided to do, however you decided to follow you heart and dreams. Right Gabe?”

“Absolutely.”

“I guess the only thing I’d add is that I know Hawaiians have strong family values, so try not to disrespect her parent’s wishes. Who knows what they’ll think of you dating Khala. For our part, we’ll try to reassure them that you’re not a cad who’s just out to steal their daughter’s virtue.”

“Khala’s at the U too,” said Cass. “She’s majoring in psychology. She’d like to be a clinical psychologist. We were thinking she could do her masters and PhD at UC Davis while I’m there for vet school. Or maybe she’d do her PhD at Berkeley, which isn’t all that far from Davis anyway.”

Later Derrick and I talked about the situation. It wasn’t like Cass and Khala were making vague, pie-in-the-sky plans, they were making concrete, sensible plans. All we could do was to offer them our unconditional love and support, and hope for the best.

As it turned out, Cass and Khala dated regularly their sophmore year. Her parents seemed to take to Cass. And why not? He was a sensible, respectful guy with a lot of potential (not to mention good looking and rich as sin). And we adored Khala. She was soft spoken but radiated a graceful self-confidence. People seemed naturally drawn to her; she was going to be a crackerjack psychologist.

Both were still planning on going to UC Davis, and both sets of parents commiserated that it was going to be hell to see their children move away from the Island for several years.

Nothing was mentioned about marriage, but they did have plans to eventually live together in Davis. Khala’s parents had ‘modern’ views and agreed with Derrick and me that a marriage certificate wasn’t the be-all and end-all. And it was crystal clear to everyone that Cass and Khala were deeply in love.

******

Alfy’s parents received stiff jail sentences.

At the next custody hearing, a grandmother and aunt came forward to claim Alfy—trying to keep him away from Jordan and Kelly—saying he should be with “family.” Fortunately for Jordan and Kelly, neither woman was of good character. One was elderly and lived on a meagre pension in a very poor part of the island. Sorry if I sound snobby, but she really didn’t have much to offer Alfy. She also had a shoplifting charge on her record. The other had two of DUI’s on her record, and her whole demeanor screamed ‘drug user!’ The judge, with a supporting recommendation from the social worker, therefore awarded provisional custody to Jordan and Kelly with a proviso that it would become permanent in a year upon the approval of a court appointed social worker. Jordan and Kelly had plans to move ahead with full adoption at that time.