When Opportunity Knocks: In the Bronx, a Little Bit of Therapy Can Go a Long Way

Article excerpt

Monday, 8:20 a.m. It is a cool, sunny, early-October morning. I park on a side street and walk a block to Montefiore Family Health Center at 193nd Street and Decatur Avenue in the Bronx. At my back is the roar of Fordham Road, one of the Bronx's major commercial arteries--several miles of department stores, drugstores, supermarkets and bodegas, offices, record shops, restaurants and sidewalk vendors facing one another across four lanes of constant traffic. Down the block, the lofty spire of an old brick church rises, its soaring architecture bearing testimony to the grand dreams of the immigrant parishioners who built it.

As I glance back in the early-morning sunlight, Fordham Road looks as prosperous as the Bronx's new slogan--"The Bronx Is Bouncing Back." People of different ethnicities and races are still working here to make their dreams come true for themselves and their children. Many of the abandoned buildings that dotted the landscape when I first came to work in the Bronx 10 years ago have been rehabilitated. But businesses still struggle to survive and they cannot provide jobs for the thousands of people--including many of my clients--who need them.

My walk to work takes me past large brick apartment buildings, built during the boom after World War II. Vietnamese, Latino and African American children straggle out the door to school, and adults rush by me on their way to work. I pass the trimmed hedges and well-raked lawns of older, proudly maintained, single-family homes that openly speak of families working hard to keep the standards of the neighborhood high.

This is what I focus on. Not the abandoned buildings up the block that have yet to be rehabilitated--the places with gaping holes that once were windows, where boards and concrete blocks seal doorways. Not the places where the homeless and the addicts creep through crevices at night to use inner rooms. Not the spent cartridges I see on the sidewalk in front of the health center every month or so or the empty crack vials in the doorway that our janitorial staff washes away nearly every week. Denial--or rather conscious, selective hope--is part of what keeps me going.

For the last five years, I've worked at Montefiore Family Health Center--a nondescript, three-story, brick office building housing 36 doctors, 5 nurse-practitioners, 4 social workers and other staff. We serve about 20,000 people a year here in the Bronx, a place as poor as, and far more devastated than, the neighborhood in Kingston, Jamaica, where I grew up. My official title is AIDS social work supervisor. Each day, I see about 10 clients, 3 to 5 of whom are people who are about to get HIV tests or who have returned for the results. Before the day ends, I may tell a young, gay, college student that he is HIV positive; work with a woman who struggles to tell her AIDS secret to her sexual partner; and get frustrated by someone who plans to continue having unprotected sex without telling his numerous partners that he is HIV positive.

This is not where my responsibilities end: I am also the only male therapist at the health center, the only social worker of African descent and the only family therapist. I see the families of single mothers who are struggling to protect and raise their children and get off public assistance, along with teenage fathers working to stay alive and connected to their children. I am sometimes one of the few black men they know who grew up in a poor neighborhood and did not succumb to its numerous risks: gunfire, alcoholism, unemployment, despair.

This sort of work is supposed to burn people out. It's the kind of work people are supposed to do for a year or two before they can get off the front lines and work with clients who make more money, have more options and face fewer life risks. …