Slipping through the Cracks

flood under canalWe listen to stories, personal biographies, all day long.  We sit on porches, stoops, flea-infested couches, under bridges, inside cardboard boxes, next to bucket toilets, and listen.  It’s what we do.  Sometimes what we are listening to is psychotic ramblings and sometimes they are stories of hard luck, bum raps and tough breaks.   Every story we hear is the most important and is saddest you’ve ever heard because, despite the thousands of clients we know, there is only one sitting across from you now. These stories are important because they’re being told, really confessed, to you as a trusted party.  Sitting in an abandoned house at 2 in the morning, the quiet of the streets unfolding around us, our clients express where they have been and how they got to where they are.  They confess to us where they want to be: housed.   Sometimes, you meet a client that doesn’t have a story to tell.  That’s when we become truly worried. 

I fully recognize that life happens. There are events inside and outside of our control that can have a dramatic effect on our future.  Most people can articulate some coherent and linear progression of events that account for their immediate situation.  The man we met under the interstate bridge could not.  

It was obvious that this man had put his time in on the street.  He had the classic shopping cart, the receipts from the aluminum can deposits, the weathered look of the absolutely chronically homeless.  When you meet dozens of sick homeless people a week you begin to think in degrees.  There’s a difference between a man with nicotine stained teeth and a man without a smile.  There’s a difference between dirt under the fingernails and fungus attacking your digits. This was the man and he didn’t want to talk.

“Hi sir.  How are you? I’m Mike.  This is Shamus.”  as we squat over his tattered piece of card board, the buzz of the interstate over our heads.  “We work with the homeless.”

Our conversation was abruptly interrupted by him expressing that he is fine and that he has been homeless for 20 years.  His mother put him in the hospital and kicked him out.  He didn’t know what year that was, but he has been homeless ever since.  Looking at this man, I believed it.  He said no one could help him.  No one has.

Now, partly through clinical training and partly through my dumb pride, I coerced him into giving us a shot.  I validated his concerns. I empathized with his situation.  I redirected his frustration.  I expressed that I wasn’t standing under a bridge at 2 AM next to an over flowing porta-John for my own health.   Funny, he decided it was worth a shot.

Maybe it was his interrupted sleep or maybe a lapse in his organic paranoia, but we got his assessment completed.  Surprisingly, he signed the paperwork we need to get a disability determination.  I got back to my cluttered desk to see if I could sort out this man’s last two decades on the streets through hospital visits, clinic appointments, and incarcerations; through “system contacts.”

Picture 1191The records I was able to pull up were very simple.  In 1984 he was taken to Charity Hospital on a Physician’s Emergency Certificate procured through his mother because he was acting bizarre.  He was sent to the psychiatric ward and it was noted that it was in all probability a first psychotic break, probably schizophrenia.  His discharge papers explain he should follow-up at the mental health clinic.  He doesn’t.  He goes to the street.

The story ends and begins there.  Twenty-five years later, sitting under a bridge at 2 AM, we’ll see if we can make the connections that should have been made decades ago.  We’ll see if we can fill the crack for this man that was really a valley.

– Mike

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