24. MERSIHA LEAPS

MERSIHA had been waiting for Faris to graduate high school before starting her business, but suddenly, she was more than ready. “Right now, I have all this energy,” she said.

It was 2018: She now had a wider customer base—in Syracuse and Ithaca. “They keep pushing me, ‘When are you going to open your café?’ ”

She felt that rolling the dice was the only way her family was going to get ahead. “Hajrudin recently got a 22 cent raise,” she said, exasperated. “He’s still not up to $15 an hour.”

She felt they were running out of time: She was 43; Hajrudin was 50.

Like everybody in Utica, she had been excited about Governor Cuomo’s plan to make Utica a nanotechnology hub. She thought it would be great for her café.

But the plan fell through: The Austrian chipmaker withdrew after a bid-rigging scheme was revealed. Alain E. Kaloyeros, the president of SUNY Poly, in charge of the nanotechnology program, was indicted for corruption and wire fraud.

Mersiha shrugged off her disappointment.

Other Uticans did, too: “The feeling was, ‘Here we go again,’ ” Mayor Palmieri said. “ ‘Another missed opportunity. Only in Utica!’ ”

But something new was on the horizon: A $480 million hospital—with $300 million coming from New York State—was being planned for downtown. Utica’s two old hospitals—St. Elizabeth in South Utica, and St. Luke’s in New Hartford—were going to be consolidated by the Mohawk Valley Health System.

A modern glass and steel building—set on 25 acres—was going to rise in the middle of the old city.

It was as if a flaming torch were thrown into a crowd: People immediately divided over the hospital.

“It was hugely controversial,” said Jason, co-owner of Bite. “At every table in the café, people were talking about it.”

Supporters felt a state-of-the-art hospital was badly needed—and putting it downtown would make healthcare more accessible for residents, as well as those from the wider region.

They saw it as an economic boon.

The hospital would bring 2,000 daily employees downtown, round the clock, said Mr. Thomas, commissioner of urban and economic development. He saw new businesses springing up around it: pharmacies, medical offices, restaurants, and bars.

Robert Burmaster, a city councilman representing West Utica, a low-income neighborhood with many vacant buildings, was hopeful: “If downtown thrives, the surrounding communities will do well, too.”

But many residents felt that instead of building a new hospital, St. Luke’s, which had ample land, should be expanded. And many were disturbed by the fate of the dozens of small businesses that would be forced to make way for the new hospital. On the fringes, a small but very vocal No Hospital Downtown movement sprang up.

Katie Aiello, owner of Character Coffee, a downtown café, worried about preserving the character of Utica’s small downtown: “It will change the vibe of the neighborhood,” she said. “I don’t want to be in a hospital district.”

Everybody agreed on one thing: The rollout was badly done. Hospital administrators felt they did their part by meeting with the public. But the community felt there was no real consultation.

“Residents should have been more involved,” Mayor Palmieri said. “You can’t shove something down someone’s throat, without letting them have a taste on their own.”

Mersiha—busy with work and family—avoided the controversy. “I don’t know much about it,” she said. Like many residents—no matter which side they started on—she accepted the idea of the new hospital.

But Uticans have been burned before.

And some remained skeptical: “Where is this money coming from?” Mr. Zogby asked. “They’re promised $300 million. Where’s the other $180 million?”

“The hospital people consider it done. But what if the governor ends up needing that money?”

Mersiha was sitting at a desk in an empty classroom. Because of budget cuts, her ESL program had been downsized from 12 teachers to 3 and moved into a BOCES building, off Bleecker. She now taught six-week sessions, preparing her refugee students for jobs in the hospitality industry.

She unwrapped cheese, bread, and an apple. A monk in a sleeveless, saffron-colored robe passed by the doorway.

“My monk!” Mersiha called out. “You want candy?” The Burmese monk, who took ESL classes, liked the hard candies Mersiha kept on her desk.

A small man in his forties, he stood expectantly in the doorway, holding his backpack.

“May I have three?” he asked Mersiha.

“I can only give you one,” she said, handing him a wrapped orange candy.

Thanking her, the monk left.

Things have changed, Mersiha told me.

For years, Hajrudin sat on the ledge: “He’s not a striker,” she explained. “He always plays defense: ‘What if this—and that—happens?’ ”

Then suddenly—out of the blue—Hajrudin jumped.

“He promised me something,” she said, eating her lunch. “In the next year, we can open a business, a real business, outside the home.”

They quickly agreed on a plan: They would start looking for a building to buy. It made more sense than renting a storefront.

Hajrudin would quit his job, though Mersiha would keep hers, so they would have at least one paycheck and her health insurance.

And they would eventually sell their beloved house. They hoped to find a café space that had an apartment above it; they would live there. That way they could run upstairs to see their kids, instead of driving back and forth to Blandina Street.

They would use the profit from the house as a cushion.

First, they went to their local bank, where they had gotten their home mortgage. Mersiha loved the loan officer, an ambitious woman in her twenties, who gave them a lot of time. She estimated they would need at least a $250,000 loan for their business.

She steered them to Utica’s small business bureau; gave them a list of lawyers; and told them to go to city hall to find out about grants for women and minorities. Before consulting anyone, Mersiha planned to do research. “We want to be able to ask good questions.”

Mersiha knew that opening a business would involve financial sacrifices. She was not fazed: Laughing, she said, “We don’t smoke. We don’t drink. We cook at home. We have old cars.”

“Our kids don’t request things.”

Ismar and Faris already said they would work at the café for free.

It was almost 1 p.m.: Mersiha packed up her crumbs and the cheese wrapping and went down the hall to her class.

When I first met Mersiha in 2013, she hurried past the signs at the refugee center: This school is betel nut free. Nose picking is gross, use a tissue.

And past the poster, put up after New York State won its court case against the Utica school district: You have the right to an education! Do you live in Utica, NY? Are you younger than 21? Enroll in Proctor High School now!

And past the world map that pinpointed the nations her students had fled.

For a moment, Mersiha stood looking into her classroom. Some of her students, tired, had put their heads down on their desks. All wore traditional clothing; they came from a dozen different countries.

“This is my Disney,” she said. “My students are so appreciative. When I open that door, I’m in another world.”

Then she entered: Almost 20 years ago, she had been in one of those seats.

Mersiha put on a doctor’s white coat. Her students were delighted.

“Hello, are we ready?” Mersiha asked. Her goal was to familiarize them with the process of going to the doctor—and to sharpen their language skills.

They leaned forward. Some had never had a medical exam before applying for refugee status.

“Physicals are necessary!” she said. “We need to see a doctor at least once a year. And women—after a certain age, we need breast exams, Pap smears!”

She put four wooden chairs together to make an examination table. “You know your body best. If you notice any changes in your body, speak up!”

Mersiha knows “speaking up” is difficult for refugees: Back home, calling attention to yourself meant asking for trouble. Keeping your head down kept you alive.

“If you don’t tell the doctor, he can’t help you,” she warned them.

The students listened, riveted.

“Before I go, I write my questions on paper,” Mersiha said. “I have headaches every day. But if I don’t write them down, I forget to tell the doctor.”

“Let’s say, I’m drinking a lot of water,” she added. “That may be a problem! I write it down. My doctor might do a blood test for diabetes.”

Putting a stethoscope around her neck, she said, “The doctor works very quick. Five minutes—done!” She clapped her hands.

“I need a volunteer patient.”

Ahmet, an intense-looking man in his forties wearing glasses, came forward, then sat on the pretend examination table. He faced the window. “Turn around,” Mersiha said.

“Ahhh,” he said, looking confused. Then he looked up at her.

“Raise your arm,” she said. He looked puzzled until she touched his arm.

“Raise your left leg.” Springing up, he stamped his right foot.

“You have a problem with left and right,” Mersiha said. “We’ll work on this!”

Then, putting the stethoscope against his chest, she told the class, “Everybody, breathe in—breathe out! This is so the doctor can check your heart.”

There was a bit of chaos. Chairs were moved away from desks.

“Breathe in!” Mersiha said, taking a deep breath. “Breathe out!” And as her chest rose and fell, the whole class followed her.

There was silence, except for breathing. “Turn your head!” she said. “Move your right leg.”

“Cough!” Students tried this; discreet coughs spread across the room.

“Cover your right eye.” This was a favorite; students smiled at each other.

“Now bend over, touch your toes.” There was a rustle of saris, long dresses, and caftans. “Come up, slow.”

“Make a fist!” Mersiha said, clenching her right hand, strong from baking. “What do we do every day when you go home?”

She bumped fists with Ahmet.

“Teacher,” a young woman raised her hand. “My daughter, no sleep.” “You give her milk, juice before going to bed?” “No juice.”

“You give her candy, sugar?”

The young woman seemed unsure.

“Call your doctor and schedule an appointment,” Mersiha said. “But if you give your children a lot of sugar—no good!”

A young woman, her long hair in a bun, asked, “We have insurance?”

“Everybody here have insurance,” Mersiha said, firmly. Refugees get short-term health insurance for up to eight months.

“You get one free appointment per year. They will charge you nothing for that.”

She glanced at her watch, suddenly exhausted. She had been up till 6 a.m. baking.

“Ladies, always check yourself!” she said, touching her breast. “Tomorrow, I will show you how it feels if you find a lump!”