Observations

                       I was at the check-in desk, multitasking as clients arrived for Sunday dinner, when I noticed a distressed post from a long ago client.     I hit the “care” reaction and turned by attention back to the room. Then the first message arrived, “Sorry for the doom post.     I just feel like shit.     Someone triggered me bad,” he wrote.     “I’m struggling for $20 for my dogs since I don’t get paid til Wednesday and this man offered me $20 to sleep with him.     It just took me back to 20 years ago in my brain and made me not ok,” he said, referring to his homeless days.     “I can see how that could happen,” I wrote back.     “Try using your senses to remind your brain that you are not there anymore.     Find some things you can touch, smell, etc.”     It’s an abbreviated version of a c...

8/14/25       The cats had just woken me up when a message from a long ago client showed up.  “I need your help.  It’s an emergency. So I just got the news that Manny unfortunately passed away this morning,” he wrote, including a picture of another long ago client.  “How do I go about finding his body?” Over the years, I have dealt with enough of these situations that I have a strategy. “Start with the person who told you,” I wrote back.  “Do they know where he died? How do they know he died?”  Once in a while, rumors of a death turn out to be inaccurate so I always start with the source.  “The police came to Angelica’s house and told her,” he said, naming another long ago client.  He explained that the police woke her up at 4am and she froze from the shock and didn’t get much information. “She thinks it was in Manhattan,” he added.  “Start with the Manhattan Medical Examiner then,” ...

  One of the many ways our healthcare system is broken is the difficulty of finding a psychiatrist who takes insurance.  The combination of low reimbursement rates and burdensome paperwork makes many of them opt out.  With such limited options, I wound up at a training clinic, where the doctors are residents.  Once they finish their two years of residency, they move on.  They finish up in June, and I don’t meet the new one until September, which would have been fine except that the leaving doctor only gave me two refills, not the three I needed to cover the gap.   I didn’t realize this until I ran out and my assistant called the pharmacy to request a delivery.  The training clinic, like so many hospital systems, is impossible to reach by phone, and since I have not yet met the new resident, I can’t message her on the portal.  My assistant and the pharmacy went back and forth trying to figure out this conundrum, but in the meantime days were goin...

  I was waiting for the elevator in the blast furnace heat of the 95 th   St station next to an older woman in denim shorts and brightly painted nails.     She was closer to the elevator when the doors opened, releasing a blast of even hotter air, like it was coming from hell itself.     She cringed but got on and I followed.     “You’d think they could air condition these elevators,” I said. “This is the worst station for heat,” she replied. “I moved here from Bensonhurst.” Before I could joke that I wouldn’t be able to leave the cannoli, she added“little Chinatown.” I know many older people miss the days when Bensonhurst was all Italian, but there aren’t many new immigrants coming from Italy, and many of the second generation ones have moved to Staten Island or New Jersey. The same thing happened to Carroll Gardens. But you can’t blame the new immigrants for that.     “And now look what’s happening here,” she says.     I’m no...

8/6/27       I came home after a truly marathon day - 11 walk-ins, one intake, and an absent social worker - with my brain feeling like warm jello, not fully set.     I was gathering cardboard to put out for recycling when I suddenly noticed a large hole in one of the terrace side first floor windows. I can’t really imagine what would take out almost half of an 6” by 8” window pane. There is no tell tale pattern of a rock impact or a bullet. I’m familiar with bullet holes in glass because I grew up in Red Hook in the 80s when gangs were battling it out for drug territory. There was often shooting, and a stray bullet hit our bathroom window, luckily while nobody was in there.     Since I went to the school 8 blocks to the north in the entirely different world of Carroll gardens, my 5th grade teacher was alarmed by the phrase “bullets in the night” in one of my classroom poems and dragged my mom into it who confirmed that it...

        Another new intake today made four in two days. Today it’s a trans man in his twenties who happened to meet one of our staff. Our staff member heard he was having trouble getting Medicaid and food stamps and told him to come see me.  It sounded like he got denied because of the work requirements that are part of Trump’s Big Ugly Bill. They assigned him to one of the workfare agencies, but when he showed up they told him his appointment was cancelled but then the City considered him out of compliance. I told him that if he had something he was interested in I could find him a much better training program than the workfare ones, but he told me he doesn’t feel up to it right now and his story came spilling out. He is grieving the loss of his younger brother, who at 21 was murdered by his on again off again g irlfriend. His grief about his brother’s loss is being complicated by the memories of his father, who was also murdered, years ago.  I t...