Sun, Moon, and Stars

Sunset, the Napali Coast.

Sunset over the Napali Coast.

Her dark brown pupils searched mine deep, like she dove into the ocean, scoured for answers, but resurfaced empty handed. She blinked twice; said nothing.

Knowing she could not understand nor read English, I translated her doctor’s instructions again. “Start this new medicine, one tablet a day. Stop this other medicine. Increase this here from one to two pills. Okay?”

“Yes,” she replied, a faint quiver in her voice.

“So which pill are you going to stop?”

Her wrinkled hands fidgeted with the handles of her purse. “I don’t know.”

Hmmm… “Can you read in Khmer?”

She shook her head. “In the countryside [in Cambodia], there was no school,” she answered.

How do you survive, illiterate, in a literate world?

Like the signal that triggers the rooster crow every dawn, inviting farmers to the fertile fields,
like the reflection that bounces off the sharp sickles cutting into tall rice stalks,
like the sweat that trickles down a laborer’s temples, saturating their plaid scarves…

I drew the sun. A circle with lines emerging outwards from its perimeter, drawn directly onto the pill bottle.

“This, take one in the morning….” I repeated. Then I called her pharmacy and her daughter, to reinforce the instructions two more times.

Expressing her gratitude, she pressed her palms together, raised them towards her face, and bowed her head.

~ ~ ~

She paused at the door. “Nurse?”

“Yes?” I swiveled my chair to face her.

It was a different patient, a different day. Her black, soft curls masked her gray rooted hair. She handed me her pills. “The doctor wants me to take this at night, right?”

“Yes,” I grabbed my pen. “Can you read Khmer or English?”

Her eyes shifted, avoiding mine.

I knew what that meant. 

Like the light after sunset, that shined its silver smile onto dark lotus ponds,
Like the lantern in the dark, that directed survivors escaping terror of the Killing Fields,
Like the respite from the heat, that carried the coolness of evening…

I was ready to draw a crescent moon onto the label, but she snatched the bottle out of my hands.

She drew triangles, half circles, and squiggles on the label. It was her own hieroglyphics she had invented, that she could read herself.

“See? I wrote it here, take one at night. I’ll remember now.”

~ ~ ~

His young, strong arms propelled him in the wheelchair.

“Can you tell me how to get downtown? I was dropped off, and I don’t really know the way back.”

“Sure. I’ll even give you a map.” I searched for his destination and printed directions. “Turn right at Smith, then left…”

“But.. uhh….” He looked up at me, his dark bangs blocking his eyes.

I continued explaining the route on the map.

“Uhhh…the truth is….I can’t read,” he finally confessed.

I froze.

He was American, born in America and couldn’t read as an adult?

“Oh.. uhh… that’s okay.”

But it’s not okay.

Like the constellations that navigate the sky, beyond the flashing police sirens,
like the detailed works of art that speckle blue ink upon his skin,
like the progress marks on the board of his hospital room, one for every milestone after his debilitating injury…

I drew stars.  “At the gas station [this star], turn left…”

“Thanks,” he grinned, and he wheeled himself through the open door.
~ ~ ~

How do you survive, illiterate, in a literate world?

One small step at a time.




16 thoughts on “Sun, Moon, and Stars

  1. As someone who works with children with disabilities, I know how difficult it is to function in the world without being able to read. I am glad you are there to help!

  2. Your use of the phrases that start “like the. . .” added a this-happens-every-day-in-my-life feel to the piece, in a respectful way. I thought it balanced perfectly. Also, my father graduated from high school almost to the point of illiteracy. When i asked him how he passed the driving test, he said that was an easier one to fake it through. “The answers on the tests were all signs and symbols. All I had to do was ask someone about the ones I didn’t know beforehand and I passed.” Your post reminded me of that conversation, so thanks for that!

    • whoa. your father sounds pretty amazing. indeed.. to be illiterate can pose as an obstacle but it sounds like he managed to overcome his obstacles in different ways.

      thanks so much for your thoughtful comment. its a tough issue to tackle but i wanted to portray it in the many ways and circumstances in which we as a people are faced with it.

  3. I work in a primary care office in Maine. A significant number of our older patients are illiterate, and yet we shove forms at them every time they visit. Many of them have learned to “leave [their] glasses in the car” so they will not have to suffer the indignity of being ‘found out’. I wish there was more consideration put into personnel training and policy making so we could better accommodate these patients, rather than making them accommodate us.

    • you work in primary care? very cool! =D

      as you mentioned, i wish that there could be more dialogue and consideration on the issue of illiteracy and how to tackle it… rather than people feeling shame and then hiding that they cannot read.

      i wonder what are some other small ways that in a healthcare setting we can make those positive changes…

  4. I’ve been in 3 different community health clinic settings over the past few years and have found myself drawing the sun and the moon on top of medicine bottles. I ask those patients to bring ALL their medicine bottles to every visit in order to be seen because at some point you don’t even know if the med isn’t working or they just don’t understand how to take it.

    In order to serve the patients better, what we need is time. The more time we have, the more we can actually spend on doing these extra things to tailor care to the patient rather than rushng them through the system. I’ve found social workers/case managers to be incredibly helpful as they make home visits and can find out what’s really going on behind the scenes which we don’t see when they come to the clinic or in the hospital.

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