Tuesday, June 29, 2010

Peace be with you, S.

While I try, in this blog, to focus on the positive things that I see in my clients, I feel moved to share a somewhat negative thing that happened last week. One of our clients, S, killed himself. This was his third attempt. I don't know how; one of my co-workers found him when she went to take his medication to him.

While this, in itself, is tragic and devastating (there were many tears flowing around the office that day), out of respect for S, I would like to talk a little bit about him, remembering him.

S first came into my day program after months of outreach from the mobile team establishing a rapport with him on the street. He came to us extremely delusional with symptoms untreated before he came into my center. For the first several weeks, he wouldn't communicate with any people but the mobile outreach team. He actively conversed, however, with the voices in his head, in all volumes. He frightened a number of the clients, and even offended one or two of them when he imagine himself to be God, as he did pretty regularly. Most of the clients, however, could see that he was not well, and they treated him gently. It was really sweet to see them, as tough as they tried to pretend they were, treat someone who was hurting with a kind of quiet care and respect.

When S became extremely loud, one of the workers would go to him, point out his volume, and ask him to lower his voice. When I first began doing this, as soon as I approached him, he would avert his eyes. He would lower his voice, but only for a minute. The longer I knew him, however, the more comfortable he became, and he began to look me in the eye and smile. After a little longer, he began to hold small conversations with me.

He became of client of our Assertive Community Treatment team, which houses chronically homeless and severaly ill clients and then follows them every day or so, making sure they take their meds and go to the doctor. S had only been with them a few months, and then this happened. My agency has a number of burial plots for clients who do not have family so they can be buried with dignity, and S will receive one of those.

When I think about his passing, I'm a little sad, of course, because his was such a simple and sweet spirit. But it was also tortured, and I like to think of him now completely and finally at peace.

Tuesday, June 15, 2010

Reverend Bobo and Bubblegum

Today I saw one of the more colorful characters I’ve known from my day program. He’s working with our intensive community treatment team, which is the only way the wonder of his current stability is possible – he’s been housed through my agency for over a year. He takes medication regularly, he bathes regularly, and when one asks him a question, he answers in a way that makes sense. This is a far cry from the years he spent on the "hobo trail." He was rarely clean and a hopeless hoarder, saving papers and food, empty cups and trinkets in an old backpack. The only clothes he owned were those on his back - and he had several outfits on his back.

His very name is truly unique. I won't give the actual name here to protect his identity (in the small chance that you'd know him) but it's akin to Empee. As a testament to his then untreated mental illness, however, some days he wanted to be called Earl, and sometimes he wanted to be called Reverend Bobo. Unfortunately, one couldn't tell who he was on which day, and he got very angry when we called him incorrectly.

Not only did he adjust his own name, but also other people's names. He frequently called people Bubblegum, particularly when he was frustrated. "I put that there for a reason, bubblegum.." He had trouble with my name for awhile, and so he just called me Gracie. I don’t know how he got Gracie or why, but I was sad when he stopped. Whether this was due to his personality or mental illness, I don't know.

One thing that I do believe is a testament to his mental illness is that when one asked him a question about how he was or the status of his meetings, he would answer a different question. Very frequently, the answer was to remind us that Darth Vader was his father. Sometimes, though, the answer was an angry outburst, and no amount of soothing voices or corrected names could fix it - he was excused for the day.

The first time that he revealed to me how sweet and gentle person he is was when one of our staff members was leaving. This made him very nervous and anxious, but he really didn't have the words to communicate how he was feeling. Instead, like a frightened child staying near their parents, he hung close to different staff members throughout the day. My turn was during lunch. He hovered around me, almost wringing his hands, and frequently reminded me that she was leaving. Though he was sad, his reaction was touching. He was handling it the best way he knew how.

I remember the day that President Obama was inaugurated – my center has a big screen TV and we let people stay after lunch to watch it. The whole center was darkened, and all of the clients were arranged in a half circle around the TV to watch. Despite the unusually large number of people in the room, they were hushed to hear the television commentator announce the different parts of the ceremony. When they announced a performance by Yoyo Ma, Empee’s voice piped up from the quiet darkness to announce, “Yoyo Ma’s my cousin!”

While I miss Reverend Bobo and Bubblegum, it was nice to be able to hug him hello today and to really be with Empee.

Epilogue: When I was working on a project in my practicum, I was working with prominent members of the faith community, and did, in fact, meet a Reverend Bobo. I spoke with other people about Empee, and they suggested that he knew Reverend Bobo, who is extremely involved in his community. And all this time, I thought it was a delusion...