cutters
Tonight at work I looked up from the computer and noticed one of the clients was doing something weird. For anyone who doesn't know, I work in a transitional housing facility for the homeless mentally ill. It's in a big, old building downtown and the part of the building I work in is a wide open, high-ceilinged space we call the drop in center (DIC). There are tables and chairs for eating in the DIC and on one side there's a sitting area with four couches, all in a friendly, conversational little square.
At night, some of the people who don't have beds in the building (either in the shelter or in the rooms upstairs), but who still have 24-hour drop in center access, are allowed to sleep on the couches and it was one of those guys I noticed when I glanced up from the billing I was working on. Usually friendly, funny and helpful, he's been really depressed since losing his girlfriend and the housing he'd only had a few weeks and tonight was his first night on our couch, though he's been a visitor for awhile now. He's the kind of guy who jokes around and does nice stuff for everybody because he feels completely worthless and shitty on the inside.
So I looked up and saw him on the couch in a weird sort of daze, poking at his forearm and staring blankly. I watched him for a minute from the desk across the room, then my coworker, Mohawk, noticed him too and walked over to check-in with him. I sat at the desk and watched. I couldn't really hear what she was saying, but I watched him closely and it became clear that he was jabbing something into his skin over and over. Right. Because he's a cutter. She talked to him -- turns out it was a thumb-tack -- and convinced him to hand it over to her. She threw it away, talked to him awhile, got him to cry a little and really impacted his mood in the moment. Meanwhile, I just sat behind the desk and watched.
Three years ago, I would've been so worried about him. I would've jumped up immediately when I noticed he was acting funny and I would've done all the things Mohawk had done. As I sat and watched them, I remembered another cutter I knew a few years ago. She was HIV positive and would scrape cheap razors sideways down her arms to draw blood, which she would leave carelessly spattered on the counters and floors of the common restrooms in our building. Obviously, this was a problem.
One night, when she'd only been in our program for a short while, before any of us knew her very well, someone came and reported blood in a bathroom. I cleaned the blood up and went sleuthing around to try and figure out who had done it. Eventually I got around to this client, (we'll call her Wilma) who had put paper towels on the cuts, which were on her forearms, then pulled down long sleeves to cover them. I convinced her to come into a private room with me and I started gently prying. At first she wouldn't admit that she'd been cutting, but eventually I managed to gain her trust and before long she was gingerly pushing up her sleeves to show me the cuts.
Obviously they weren't life threatening, just superficial slices into the shallow layers, but they were plentiful and unsanitary. Worse, the paper towels she'd laid over them had dried to the cuts and stuck and she found she couldn't pull them off without a lot of pain. I put on gloves and helped her use soap and warm water to wash the cuts and get the paper towels off, then I did some basic first aid and bandaged her up, thinking all the while: "If there is a heaven, I will go there when I die just for this." Performing first aid, believe it or not, is not in my job description, let alone first aid on a person with HIV. But, more than that, there was something so heartfelt, so sincere and meaningful to me about that level of intervention with that client on that night. She was in so much pain, she was so vulnerable and self-destructive, yet she was looking for help and I was giving it to her. My heart was so, so in it. That's the best way to describe it. My heart was completely in it.
Tonight, I sat and watched that guy on the couch with the push-pin and even before Mohawk intervened, when I knew he was probably cutting himself and when I knew I should probably talk to him, I didn't. I hate to think my heart's not in it anymore, because if anything is still in it, it's my heart. It's just... I know too much now. After five years at this job, I know too well the trajectory of this guy's behavior -- not because I know *him* so well, but because I know our clients. I knew from the way he chose to lay himself out on a couch in full view of the staff desk and poke himself with something so small it didn't draw blood that he wasn't hell-bent on *really* hurting himself. I knew he was suffering inside and the only way he could express it was by hurting himself in a way we could see. But I also felt a little jaded. A little unsympathetic. I didn't want to go talk to him tonight because I knew what it would be like, I knew what it would take out of me and I knew where it would get him -- all well mapped, charted territory -- and I just didn't feel like engaging in it.
As it was, Mohawk came along and did a really great job and when it was all over I told her what a great job she'd done. She did everything I would've done three years ago. Her heart is very much still in it and her behavior is not yet hindered by a jaded mind. It's not that I don't *care* anymore, it's just that I no longer feel uniquely responsible for something. And that is an interesting feeling to notice.
At night, some of the people who don't have beds in the building (either in the shelter or in the rooms upstairs), but who still have 24-hour drop in center access, are allowed to sleep on the couches and it was one of those guys I noticed when I glanced up from the billing I was working on. Usually friendly, funny and helpful, he's been really depressed since losing his girlfriend and the housing he'd only had a few weeks and tonight was his first night on our couch, though he's been a visitor for awhile now. He's the kind of guy who jokes around and does nice stuff for everybody because he feels completely worthless and shitty on the inside.
So I looked up and saw him on the couch in a weird sort of daze, poking at his forearm and staring blankly. I watched him for a minute from the desk across the room, then my coworker, Mohawk, noticed him too and walked over to check-in with him. I sat at the desk and watched. I couldn't really hear what she was saying, but I watched him closely and it became clear that he was jabbing something into his skin over and over. Right. Because he's a cutter. She talked to him -- turns out it was a thumb-tack -- and convinced him to hand it over to her. She threw it away, talked to him awhile, got him to cry a little and really impacted his mood in the moment. Meanwhile, I just sat behind the desk and watched.
Three years ago, I would've been so worried about him. I would've jumped up immediately when I noticed he was acting funny and I would've done all the things Mohawk had done. As I sat and watched them, I remembered another cutter I knew a few years ago. She was HIV positive and would scrape cheap razors sideways down her arms to draw blood, which she would leave carelessly spattered on the counters and floors of the common restrooms in our building. Obviously, this was a problem.
One night, when she'd only been in our program for a short while, before any of us knew her very well, someone came and reported blood in a bathroom. I cleaned the blood up and went sleuthing around to try and figure out who had done it. Eventually I got around to this client, (we'll call her Wilma) who had put paper towels on the cuts, which were on her forearms, then pulled down long sleeves to cover them. I convinced her to come into a private room with me and I started gently prying. At first she wouldn't admit that she'd been cutting, but eventually I managed to gain her trust and before long she was gingerly pushing up her sleeves to show me the cuts.
Obviously they weren't life threatening, just superficial slices into the shallow layers, but they were plentiful and unsanitary. Worse, the paper towels she'd laid over them had dried to the cuts and stuck and she found she couldn't pull them off without a lot of pain. I put on gloves and helped her use soap and warm water to wash the cuts and get the paper towels off, then I did some basic first aid and bandaged her up, thinking all the while: "If there is a heaven, I will go there when I die just for this." Performing first aid, believe it or not, is not in my job description, let alone first aid on a person with HIV. But, more than that, there was something so heartfelt, so sincere and meaningful to me about that level of intervention with that client on that night. She was in so much pain, she was so vulnerable and self-destructive, yet she was looking for help and I was giving it to her. My heart was so, so in it. That's the best way to describe it. My heart was completely in it.
Tonight, I sat and watched that guy on the couch with the push-pin and even before Mohawk intervened, when I knew he was probably cutting himself and when I knew I should probably talk to him, I didn't. I hate to think my heart's not in it anymore, because if anything is still in it, it's my heart. It's just... I know too much now. After five years at this job, I know too well the trajectory of this guy's behavior -- not because I know *him* so well, but because I know our clients. I knew from the way he chose to lay himself out on a couch in full view of the staff desk and poke himself with something so small it didn't draw blood that he wasn't hell-bent on *really* hurting himself. I knew he was suffering inside and the only way he could express it was by hurting himself in a way we could see. But I also felt a little jaded. A little unsympathetic. I didn't want to go talk to him tonight because I knew what it would be like, I knew what it would take out of me and I knew where it would get him -- all well mapped, charted territory -- and I just didn't feel like engaging in it.
As it was, Mohawk came along and did a really great job and when it was all over I told her what a great job she'd done. She did everything I would've done three years ago. Her heart is very much still in it and her behavior is not yet hindered by a jaded mind. It's not that I don't *care* anymore, it's just that I no longer feel uniquely responsible for something. And that is an interesting feeling to notice.
posted by reasonably prudent poet at 1:07 AM
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