MDR-TB [Helen Townsend]

She believes me when
I tell her it isn’t personal.
We explain it’s evidence-based
that we have to watch her
take every dose
that she has to sit alone
in a hotel room we pay for
that she can’t leave
without a mask
that we have to test
all of her friends
at the shelter.
Science says TB floats in the air.
We tell her we don’t test
her for HIV because
she looks the part.
We tell her it is science-based.
We base our tests on science.
It is science-based to say
TB and HIV make each other worse
like lies plus zealotry.
She doesn’t like to be called vulnerable.
She worked
as a rodeo clown
until a bull threw her
into a fence.
She had a dentist
and all of her teeth
until the divorce.
She apologized to the fetus
for the bad luck
of no birth vs. birth into
fists and teeth flying.
She apologized once.
She says she doesn’t feel entitled
to forgiveness or praise.
She considers herself down on her luck.
We explain in our line of work
an entitlement is a promise
to the old ones for a roof
to the young ones for a chance.
For the promises that require money
a promise to provide the money.
We tell her it’s not just the poor.
Even lucky ones
can get TB.
Everyone breathes.
She worries about the
transgender woman
who slept on the cot next to her
worries about what she will do
worries if she will ever see her again.
They held hands
at night to go to sleep.
She tells us about
the diversity of sounds
on the street
how the animals and insects
trade places in the mind
how the wind smells
different in the sun
how boots in the alley
sound like snapping traps
how bathrooms with
room to turn around
and signage that says
whatever feel homey
how hallways
never feel kind
and how it’s been so long
since she had her own stove
that she’s afraid to turn it on.
The time she tried to boil
water for ramen
she meditated
on the flames and bubbles
until the bottom of the pan
crusted over
and the fire alarm went off
in a diversity of profanity
and the hotel manager
cursing the health department
and whores like her.
She asks if hate is science-based
or evidence-based.
She swallows her pills
and I leave
with a fist in my throat.


Helen Townsend, TB Nurse Consultant and poem writer, lives and works in Indianapolis. She tweets at @prsgrlks.
Inspiration: The inspiration for this poem came directly from my work. The woman who inhabits this poem, while fictional, embodies so many of the risk factors and the needs of our clients.

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