Closing Shop

     You know what it's like to move.  We simply have too many things in America!  Scads of stuff show up in closets and cabinets--so much that you wonder how you ever managed to breathe in your own quarters.  You find stashed-away items you don't even remember buying;  you pile it in hallways and on tables;  you package it in boxes;  and the whole while you wish it would all just disappear so you could sit down with a cold beer and heave a sigh of relief.
     Since I'm giving everything away, at least I won't need to rent a storage unit--which I consider a sure sign that people have too many things for their own good.
     The eighteen-wheelers are arriving in two days, and we're just about ready to fill them with medical and office supplies.  A local dentist, Jay Garlitz, made donations of dental equipment, and the U-Haul dealership down the road donated a truck for a day, making it easy to get the dental items from his office to ours. 
     The waiting room looks like a warehouse for an auction company.  Patients arriving to pick up their medical records have to tread a narrow path between boxes stacked to the ceiling and weird-looking instruments lying on their sides like unclothed mannikins.
     We're almost finished  with the task of calling every single patient, urging each to stop by the clinic to claim his or her chart.  This has amounted to thousands of calls, but at least I'll have peace of mind, knowing that patients won't have their records confiscated again.
     Taking a break from the monotony of the phone calls, I started emptying cabinets in the front office.  So much junk! 
     "That's not junk," said Celeste Segrest, my long-time nurse-practitioner and the impetus behind donating all this equipment to Paramedics for Children.
     Celeste has been volunteering with this organization for five years, making regular trips to Central America with supplies donated by my office to do pediatric and gynecologic care.
     Paramedics for Children is a charitable organization funded solely by private donors, including a bed-and-breakfast in Copan Ruinas, Honduras.  The non-profit provides free--or nearly-free-- (vegetables can be used for payment) medical care to women and children in rural Honduras and Guatemala.
     Whenever Celeste makes these philanthropic trips, she does Pap tests on women who may have borne twelve children, but never had a Pap.  The women who line up for medical help are often those who know from their symptoms that they have a serious problem;  therefore, many of the tests come back positive for cancer.  At that point, the women might qualify for referral to a specialist in the city.  It is basic medical care that is lacking in these countries, as well as health education, for mountain dwellers who have subsistence-level farming lives.  These people need immunizations, blood pressure and diabetes screening, nutrition counseling, eye exams, Pap smears, and TB tests.
     I was throwing out lots of things--such as half-used post-it notepads, and scratched-up, plastic in- and out-boxes, of the type used in offices before electronic records.
     "Don't throw that out!" Celeste kept reprimanding me, and then she'd retrieve the item from the trash bin.
     She was putting together boxes of supplies for schoolteachers in the mountains.
     "People in America don't realize what nothing is," she said.  "Nothing really is nothing."
     Then she recounted the times she had seen teachers who were doing their jobs without pay, because the government had stopped issuing paychecks.  The reasons were political and, as usual, senseless--but that didn't stop the teachers. Without money, space or materials, they continued their commitment to teaching.  Children gathered at their feet, extremely polite, aware that education, for them, was more important than anything else.
     Getting donations of reams of paper, file folders, hole-punchers, post-it notes, pens and pencils, Sharpies, envelopes, labels, staplers, Scotch tape--even buckets--will mean a lot to these teachers, Celeste explained.  I know she's right.  I've spent enough time in developing countries to know that small things can make a big difference.
     "What about this?" I asked, holding up a box of plastic page-protectors. "Do they have any use for these flimsy things?"
     "Definitely, she said.  "They'll take them."
     "How about these paper clips I swept off the floor and picked off the charts?"
     "Oh, yes," she said.
     "Okay, but not these bottles of White-Out, or the chart-holders, right?"
     "They can use them!" she said, taking the White-Out.  Then she told Kathryn, our CNA, to find a drill in our tool box, and unscrew all twenty-four wooden chart-holders from the walls.
     The rooms don't seem like exam rooms any more.  They have the look, oddly, of prison cells.  No color, no bulletin boards, no laughter, no light, no spirit.  I don't know whether the experience is sad or liberating. 
     "These three-ring binders are too ratty to send," I said, schlepping to the dumpster with a tower of them in my arms .  These notebooks used to hold the clinic's "policies and procedures," test logs, calibration measurements, refrigerator temperatures, maintenance reports, lab results, CLIA, HIPAA and OSHA manuals, patient education materials, and copies of our documentation forms.
     "Stop!" said Celeste, blocking my path.  "They can use those notebooks in Guatemala--and I've got the perfect box for them!"  She even took one that was broken, the metal rings having separated from their vinyl spine
     After awhile, I got tired of checking in with her, so I made pyramids of all kinds of doodads, and watched them disappear into boxes, which she labelled carefully in Spanish.
     Finally, as I was cleaning out a front-desk drawer, I found a leather-bound copy of The Book of Mormon.   
     How on earth had we acquired that?
     Inside was the inscription:  To all of you, that you may know the truth and become believers.
     I handed it to Celeste, but she ignored me.
     "Don't you want this?" I asked.
     Still, no answer.
     "Celeste," I prodded her.  "I'm giving this to you."
     "Okay," she said, inhaling deeply as though the decision took will-power.  "We've got to draw the line somewhere.  And I'm drawing it here."