By Cynthia Ryan
Homeless With Cancer
On the streets, cancer has a different face
By Cynthia Ryan
Sanders told me that she had first felt a painful lump six years ago but had ignored the sensation because “I thought it was just gas pains.” Finally, in June 2009, a friend persuaded her to see a doctor at Cooper Green Mercy Hospital, the facility serving most of Birmingham’s homeless. By then, “It was 11 centimeters! They took out half of it and got me started on chemo to make it go down. It’s up under my arm now,” Sanders said, directing my eye to her right side.
As we talked about the doctor’s reasons for wanting to perform a mastectomy—to remove the remainder of the tumor and any further disease that might be lurking—Sanders nodded with skepticism.
“When they cut it open, that’s when it spreads,” she said, repeating a commonly held myth. “Plus, I’m scared, Miss Ryan. They might put me to sleep and I might not wake up again.” Given Sanders’ reputation as somebody to be reckoned with on the streets, a woman who had survived cocaine addiction, a stint in prison, and plenty of scrapes and bruises from fighting off anyone who got in her way, her fear of surgery was telling.
When it came to her health, Sanders seemed to oscillate between wanting to be taken care of and not wanting to be told what to do. She lit up when she spoke of the nurses in Cooper Green’s oncology clinic, who “treat me like one of their children” and “give me the money to take the bus back on home after chemo.” Yet she quarreled with any instructions from her doctor, asking, “Why she tell me that, Miss Ryan? That don’t make no sense.”
According to Kertesz, black Americans like Sanders “are disproportionately more likely to experience homelessness, and on average have fewer safety nets to catch them when things go wrong in their economic life.” As I got to know Sanders—becoming close enough to her over the subsequent months to accompany her on medical visits and to catch up regularly at Church of the Reconciler about her most recent medical report—I came to understand that this lack of a safety net contributed to her sense that whatever could go wrong, probably would.
And, I learned, she was not alone in her distrust of the medical system.
Ervin Miles, who was diagnosed with colon cancer in his 20s and underwent a colostomy, is equally anxious about seeking medical care, but for different reasons. When a black, tarry liquid began seeping into his colostomy bag some 25 years after his initial diagnosis, Miles, now in his mid-50s, delayed a visit to the doctor for more than six months.
For Miles, living alone in a dilapidated row house, just two doors down from where a homeless friend froze to death, is preferable to putting himself in someone else’s hands. Greater than Miles’ fear of cancer is his fear of being sent to a mental institution.
(photos: © Sylvia Plachy)