Behind the Deadbolts

I arrived early at the clinic for my 5 p.m. group, but all ten women were already waiting for me, most of them holding Christmas cards and plastic dishes covered in aluminum foil.

“Hello, Doctor,” Mrs. L said, “Feliz Navidad.” A chorus of greetings followed as the others took their cue from Mrs. L, who liked to think of herself as the group’s co-leader. In fact, she, like all the others, was a patient for whom I prescribed medications for depression and anxiety. But instead of seeing each of them individually, I was managing them all in a 1-hour group, the brainstorm of the clinic director, who had too many patients and an overwhelmed staff.

The group was remarkably homogeneous: all the women were immigrants from the Dominican Republic in their 30s and 40s, and all were single mothers abandoned by the men in their lives. We had met each month since the summer, and the group had become somewhat of a social event for them.

“You’re too skinny, Doctor,” Mrs. L said, “So we brought some things to fatten you up.” She and all the others always addressed me formally, but they continuously mothered me. I smiled, slightly embarrassed, and waited for the next inevitable line. “You need to find yourself a nice girl to cook for you,” she added on cue.

Mrs. L and the others in the group all lived in the streets around New York’s Presbyterian Hospital in Washington Heights. The neighborhood had its grit: abandoned buildings, boarded-up windows, and colorful graffiti, not unlike other parts of New York. But in that year of 1994, Washington Heights was also the epicenter of the city’s ongoing crack epidemic, with the city’s highest murder rate.

Yet here in our group, I saw only the mothers and young grandmothers who held the neighborhood together tenuously. Many of them raised several generations under one roof, trying to keep the younger ones from the violence just outside the door. Each time we met, I got a glimpse of what went on behind the deadbolts: their pride in cooking sancocho, their off-color gossip, their love of dancing merengue.

Most of the women were now stable on their various medications, so in recent months I tried to use some of the group time to discuss therapeutic issues. That week the neighborhood had made the headlines: large letters described how a child had been caught in the crossfire of rival drug gangs. She was in our hospital in critical condition. I knew the story was the talk on the street, so I asked how these women, all mothers themselves, were dealing with the tragedy.

One of the women said that she had heard the gunshots from her apartment. Not to be outdone, Mrs. L, sitting next to me, cleared her throat. “I saw a boy shot on my street,” she said in a matter-of-fact way. “He was bleeding and crying for help, but no one came out because he still had a gun in his hand.”

Her story opened up the others’ memories.

“Last year, we heard guns and lay on the floor. A bullet came through the window and hit the wall.”

“They put a gun to my nephew’s head and stole his sneakers.”

The stories kept coming, striking me with their violence and their resigned delivery. I had opened up a discussion that was beginning to get out of control as their descriptions grew progressively more gruesome.

“I saw a man burn a lady in the subway with lighter fluid. He took her bag.”

“They threw a man from a moving car in front of the emergency room. I think he was already dead.”

Only one woman was quiet, but I could see tears streaming down her face. Younger than the others, Alma (a pseudonym) was also the newest immigrant, having arrived one year earlier with a husband who had quickly left her and her three children. I knew from her chart that she lived in a well-known building run by drug dealers. They controlled the building like an army, a teenage soldier always out front, armed with a menacing look and an obvious bulge at his side.

“Do you want to say something?” I asked her.

Alma didn’t nod or shake her head, but just continued crying. I didn’t know if she cried from all the stories of violence she was hearing, from her own experiences over the past year, or from the broken promise of a better life in New York.

“It was yesterday,” she began in a whisper. “I went to my cousin’s for a party with my children. We got home late. When I got off the elevator, I saw that my door was open and two men from my building were coming out of my apartment. They were carrying all of our Christmas presents. They laughed when they saw us. My little girl asked me why the men were taking her presents. I said they were taking them to kids who didn’t have money. I know she didn’t believe me, and it just made the men laugh louder. They laughed until the elevator closed.”

Alma wasn’t crying anymore. She looked angry. “Doctor,” she said, turning now toward me, “You know psychology. You’re a man who understands how men think.” Her voice got louder. “Why then, Doctor?” she asked. “Why do men do these things to us?” For the first time the room was completely quiet and all eyes looked at me.

I knew before I spoke that I didn’t have an answer—that I was just a young doctor who couldn’t provide the insight she needed or the comfort she deserved.

“I’m sorry,” I said. “I just don’t know.”

The room stayed silent for a long moment. “Enough of this talk,” Mrs. L said, taking over. “It’s too depressing. Besides, it’s time to go.”

The mood immediately lifted, and the women began their chatter as they gathered their things. One by one, they thanked me as they left, many handing me a holiday card or a plate of homemade food.

Alma lingered and was the last to leave. As she walked by me at the door, she smiled and touched my arm.

“Thank you, Doctor,” she said. I could see that she meant it, but I wasn’t sure why. I hadn’t done anything to help her. I hadn’t answered her question. Perhaps I was a just a man who hadn’t hurt her.