Patch Work

Trigger warning: While fictional, this story contains an occurrence of sexual abuse, which happens all too frequently around the world. My hope is that in reading, victims will begin or continue their paths to healing.

*

My older brother, Scott, and I were raised by our southern granny after mama died of an overdose. I was five. I never met my father.

Granny Walker was the smartest person I ever knew. She didn't have much schooling, but she was worldly wise. Every day, she would sit us down after school and impart upon us her "black granny words of wisdom" while she continued working on her latest patchwork quilt. The first thing I recall her saying is:

You livin' under my roof now. Y'all work hard and y'all will git what's comin' to ya. These patches don' stitch theyself. I's hard-workin'. I 'spect the same of y'all.

The second I remember is:

Mind yous manners, for a hard head makes for a right sore behind.

Granny made good on that threat more than once, but mostly, she pampered us with love, good ol' southern eatin', and homemade clothing. If we were lucky, we could pick something out at a thrift store. If we complained that classmates made fun of our clothes, she'd say,

I don' give a care what other childs do or what they git. People gonna talk 'bout ya, whether y'all done good or bad. You let 'em talk and have a mind what's right.

For me, Granny Walker's most impressionable words were:

These here patches are same as people. They don' amount to much without a bit o' stitchin', care, an' love. Y'all gonna need patchin' on occasion. Don' you be a-feared a askin' your dear ol' granny when that time be a-comin'.

At that moment, I knew that I wanted to spend my life helping others.

Just after my junior year at Lincoln High School, my brother became the first person in our family to earn a college degree. He majored in history, with a minor in education. He got a job teaching at my school. I was glad I didn't have a history class my senior year, but he did have lunch with me a few times, and he slipped me a bit of money for store-bought clothes.

The following 12 years were the most difficult of my life. With great effort, I managed to earn my doctorate in psychiatry, but shortly thereafter, Granny Walker passed away from a heart attack. I'm certain that she held on just to see me get my diploma.

*

Fourteen-year-old Sarah Martin is my first patient. As she walks in, she slouches on the nearest couch, not bothering to make eye contact. As I look down at her chart, I can feel her looking me over through the blond hair hanging over her eyes. She was referred by the family doctor at the parents' insistence, for changes in behavior. The instant I look back at her, her gaze falls to the floor.

It don' cost nothin' to pay a compliment. You never know what folks is goin' through.

"Sarah," I begin, "I like your sneakers. I'm fond of a bit of bling myself." Silence. "My name is Dr. Williams, but you can call me Dr. Anne, or just Anne if you prefer." Silence. "I've been asked to speak with you today because you've had some changes in behavior. Would you care to elaborate?" Silence. "Have you been doing drugs?" Silence. "Have you been hanging out with different friends?" Silence. "Often, something happens that triggers a change in behavior. Did something bad happen to you?" Silence, but her eyes flicked up at me and then back to the floor. I promise her, "This conversation is confidential and nothing you say here will be repeated to anyone without your permission. So please, speak freely." Silence. I kept on like this for the remainder of the session. Not a great start, but I have some ideas about how to proceed.

Nothin' beats failure like a try.

The following week, Sarah comes in with streaks of black in her hair. She's wearing all black and I notice that a pair of black leather boots have replaced the bling sneakers. I smile warmly and say, "Good afternoon, Sarah. I like what you've done to your hair." Silence. I reiterate, "This is a safe place. You can say anything you want here without anyone knowing but me. I won't tell anyone without your permission." Silence. "I talked with your mom briefly last week. She told me that you've been getting into fights at school." Silence. As I get both of us a bottle of water out of my small refrigerator, I say, "I've been thinking about you this week."

Sarah responds instinctively, "You have?" I almost drop the water bottles in surprise. She's so amazed that someone would think about her that she would break her silence? Interesting.

Have a good attitude and be watchin' for miracles. They be happenin' all 'round y'all.

I hand her the water bottle, saying, "Yes, I was thinking how great it would be to hear your voice. You've just given me my first miracle of the day."

"That's not a miracle. There's no such thing as miracles."

"I think it's sad that you don't believe in miracles. They're everywhere, you know. All you have to do is look for them. Not all miracles are big, like someone coming back to life. Some are small, like the opening of a flower, or the smell of rain."

"Whatever." She folds her arms and crosses her legs, leaning back on the couch. She doesn't say another word during that session.

All love ain't good love. Have a mind how you git it and who you gives it to. [Granny said the same of money.]

I begin the next session by assuring her, "Sarah, asking for help isn't a sign of weakness. It takes courage and strength to reach out."

"Well then, I'm a coward. I don't care." No eye contact again. As she turns away slightly, I notice evidence of cutting on her arm. People who self harm often have trouble expressing psychological pain.

Softly, I say, "I'm going to go out on a limb here and guess that something bad happened. You don't have to say anything yet. I'm going to make some guesses. If I guess right, I'd like you to move your foot a bit." No response. "Did someone hurt your feelings?" No movement. "Did someone hurt your body?" Pause. The top foot twitched just a bit. "Was it someone you know?" Another twitch. "Did the person hit you?" No movement. "Was it a classmate?" No movement. "Is the person a relative?" Twitch. "Is it a parent?" No. "Cousin?" No. "Uncle?" Twitch. I decide to be forward, "Sarah, did your uncle touch you inappropriately?"

Sarah put both hands on her face and started sobbing. I immediately sit by her side and put my hand on her shoulder. She leans into me, continuing to bawl.

Ain't no hurt so big can't be a-fixed with plenty a lovin' and a bit o' time.

I wrap my arms around Sarah and let her cry. This is the breakthrough she has needed. When the sobbing subsides, I say, "Sarah, what happened wasn't your fault. However he touched you is most likely considered rape. We'll get into specifics another time. It isn't an easy thing to talk about."

"I...I...I should have said no." She begins crying again.

Don' apologize where you come from. It won't your choice. An' don' apologize for who you is.

I hold her at arm's length and look her in the eyes. "Sarah, this wasn't your choice. Your uncle is the one to blame. When this happened, your brain and your body went into shock. You shouldn't have had to say no." She falls back into my arms. I continue, "I will help you get through this, but don't you think it would be a good idea to make sure he doesn't do this to anyone else? I can help you with that too." Sarah nods on my shoulder. "First, I'd like to help you with a breathing exercise. I call it '3-4-5.' Whenever you get stressed, you can try this instead of cutting. Sound like a plan?"

Sarah pulls away slowly and I hand her several tissues. After wiping her eyes and blowing her nose, she asks, "Dr. Anne, what's 3-4-5?"

I say, "First, you put one hand on your stomach and the other on your chest. Then, you're going to breath in, counting slowly to three. Hold for a four count and exhale for five. You should feel the hand on your stomach move but not the other one. I'll demonstrate." After showing her, I ask, "Will you do it will me?" She nods and we practice together several times.

If you don' stand for nothin', ya'll fall for anything.

My last words to Sarah that session were, "I'm proud of you for being brave. You have made good progress which we can now build on. I’m going to insist that you take care of yourself now. No more cutting, eat right, exercise, and try the 3-4-5 breathing every day."

When I got home, I collapsed on my patchwork quilt and cried for Sarah. Then, I got up and followed my own advice. I took care of myself.

Don't let nobody or nothin' steal your joy.