Observations

Yesterday, my Very Sick client was really struggling. Since he had been picked up by an ambulance at his apartment, he was at Bronxcare, the nearest hospital. Like many hospitals in the Bronx, Bronxcare is short on resources. Unlike NYU, where there is one social worker for every floor, when you call the social work office there you get a recording that instructs you to leave a message which will be returned in 24-48 hours. Staffing shortages mean long waits for pain and diarrhea meds, or to be cleaned up after an episode of fecal incontinence. Overworked staff mean less patience for our client's challenging behaviors, and a tendency to respond to him with anger, which only makes his behavior worse. It also means that attending to details like his skin gets overlooked. "I'm white like a ghost," he said, referring to his very dry skin. We have known each other for a long time and I know what will make him laugh. "So am I," I say and he starts crackin...

Getting ready for my infusion this morning, I had just found two matching socks when an email alert flashed on my phone. It was from Kyle, my newish neighbor, the one who introduced himself to me for the first time by saying “I know we look like a hetero couple, but we’re both bisexual.” Now he was writing to tell me that in today’s warmer, thawing weather a pipe burst in my basement, sending water into theirs. I didn’t think they could get in to shut off the water so I threw on my shoes and took off for Bay Ridge, trying to shut up the inner voice that was saying, “you’re never going to be able to move back home.” I had barely left when I got a message from H. “She’s gone and I want to kill myself because I walked out of the room to do something.” On the phone, I told her “That’s common. People often wait for someone to leave before they die.” “I wanted to be there, holding her hand.” “You were there, you got yourself and E there,” I told her. “Her last word was E’s n...

H’s mother is dying. She has been on oxygen for a long time because she damaged her lungs by smoking, just like my mother. After her last hospitalization, she was discharged on high concentration oxygen and she fell through a crack – really a canyon in the system. Nobody followed up to adjust the oxygen, and sustained use of that high a concentration caused carbon dioxide to build up in her blood and it wasn’t until she began having periods of altered mental status and wound up back in the hospital that they realized what was happening. By then enough damage had been done that she could not recover. H. has been getting increasingly frantic as her mother became less able to answer the phone. “Who am I going to text at 3am?” she kept asking. Monday afternoon, I was on hold with social security and could not answer when she called, so she texted me. “It’s time for hospice,” and a crying emoji. “Her body is just done at this point.” She desperately started searching for ...

In a dark mood, I went to bed early. Figured I’d sleep it off or at least get some sleep before my double header of hematology and rheumatology tomorrow. I didn’t realize my phone ringer was off, I’ve been leaving it on in case of hospital calls, but I must have turned it off for the Rise and Resist meeting. At five past midnight, I woke up suddenly for no particular reason. The cats were all snoozing quietly in their spots, the heater was humming along softly, making a hopeless effort to keep up with the night’s bitter cold. It felt like I had been awakened by an invisible disturbance in the energy. Confused, I reached for my phone and saw a missed call from my Very Sick client. I called him back and found him distressed. “I want to go home, I’m tired,” he said, with no understanding that his life literally depends on the heart and blood pressure medications flowing into his veins. I tried to explain, “your heart needs the medicine.” “They already gave it to me,” he said,...

Today was a march, but I needed to spend the day tracking down and sealing off drafts because the temperatures are supposed to drop into the teens tonight and stay very low most of the week. Before I started on that, I had to set everything up for a cold weather overnight at work – assign staff, notify the church, get the word out to clients. When the weather is below 20, one of our staff members opens the space at 8pm so that clients with nowhere to go don’t freeze to death on the street. It’s nothing fancy, sleeping bags on the floor, but it’s warm and safe and even our clients who will not stay anyplace else trust us enough to come inside for the night. I was just finishing up the overnight preparations when the Very Sick client’s uncle called. “We’ve decided to have them try extubating him,” he said, “and maybe lower the heart medicine.” I’m glad this is the direction they have chosen, but then he says, “we’re worried that his father might try to block this. If that happens, ...

It’s an overcast medium-cold drippy day. Everything - the sky, the slightly choppy water in the Narrows, the Verrazano disappearing into the fog - is so persistently grey you wouldn’t know if I had taken a picture in black and white or color. This kind of weather makes me feel like one of those storybook princesses who pricks her finger and falls asleep for months. I work today, so I shove aside the boulder of inertia and start getting ready. Jeff B, the volunteer who works with our Very Sick client calls. He says the client’s father has asked him for a ride to the hospital. He’s a little confused about why the father is asking for a ride from Harlem instead of taking the train. “Maybe this is his way of asking for support,” I say, and this rings true for Jeff. “I told him I could get him after church,” he says. “And he said to me ‘you’re a man of God, we can pray over my son together.” Jeff is nervous about this, because he is a liberal Christian and he doesn’t know ...