Late night

Last night ran late. The very sick client is struggling at the ER, which is not at his preferred hospital. He has diarrhea and he can’t stand and he says they took an hour to come clean him up. He takes this very personally and there’s no point in telling him it’s the system, the hospitals are so understaffed they can’t keep up with patients' needs. Someone finally shows up and we get off the phone and I start to get the crew ready for bed, pouring chow and water and dabbing Connor’s prednisolone on the inside of his ears. And then the phone rings again and I can hear that things have gotten chaotic. "They put this woman in my room, a one to one, and she says not to ask for anything and I told her I need the doctor because my chest hurts and she did nothing," he says agitatedly. I know something must have happened - they don’t just give people a one to one for no reason so I ask. "I tried to hang myself he says," "At the ER?" I ask, surprised because not only is hanging yourself quite difficult but it would be even more difficult with limited mobility in a crowded ER. "Yes," he says, his agitation giving way to a quiet sadness. "I’m tired, I’m just tired." "That’s understandable," I tell him, "it’s been a long struggle." It’s only been a week since he got home from his last hospital stay. And the past few years have been like a revolving door. "They have me locked in a room," he says, "and they put the bed in front of the door. And this security guard is staring at me." If there’s a security guard and a one to one the situation has gotten really out of control, I think. "Let her in! Let her in!" he starts shouting, and I hear a new calm voice. She starts talking to him and he is pouring out his grievances, security and diarrhea and dialysis and AIDS. Finally she interrupts him, "I’m just covering for your nurse" she says, "I don’t know about all this, but let’s start over, ok?" I thank goodness for someone who is willing to talk to him respectfully. She starts gathering supplies, changing the bed, cleaning him up, talking him through it. Then comes the medicine and he starts to get upset again. "What’s that!!" "Midazolam," she says. "It's OK," I say before he can start yelling. It’s kind of like Xanax, it’s going to help you rest." "It’s going to make me sleepy," he says. I don’t want to fall asleep with him here .I don’t feel safe." "He’s not staying," she tells him, "he’s just here for my safety, he’ll leave when I go." I don’t know how true this is but I don’t interfere. Someone else comes in and says “we have to put in a new IV, the other one blew and we have to give you medicine, your potassium is 9." I don’t know if this means anything to him but I know it’s dangerously high and they have to give calcium to bring it down. He hates needles and starts whimpering but the medicine keeps him from being able to resist much. She goes to put the IV in and he starts to scream. "It’s ok," she says "you can scream, just don’t move so I don’t stick you in the wrong place". At the end she praises him, "you did so well, you didn’t move." He is still talking to me but exhausted and medicated he’s not making sense. I listen until he falls asleep and put down the phone. I remember the nights when DK was fighting his losing battle with KS, how he was so frail that I would stay on the line all night so that the sound would wake me if he fell. Even though I worked my AIDS contacts, got him a specialist at Sloan Kettering, he was diagnosd so late the see-saw would never balance. HIV meds would start to let his immmne system recover and then the chemo necessary for his internal KS would wipe it out and he would get an infection. Back and forth we went, with me sitting next to his chemo chair while he asked me questions about the old ACT UP. One day he surprised me, he had been in Manhattan for a medical appointment and told me to meet him at the Center, he was going to the ACT UP meetig. Faced with this severely ill person, like a ghost of the activists of years passed, certain members of ACT UP did not react well. They attacked me, even though it wasn’t my choice for him to come. I was heartbroken, it felt like my family had turned against me. but also like ACT UP had turned on its own. Since when was it a problem for a PWA to come to an ACT UP meeting? But his frail, coughing body had harshly broken through the affluent gay bubble, reminding them that not everybody was getting the treatment and services we fought so hard for. In the end, Jim Eigo with his quiet strength, stood up for me and shut them down, but it would be a long time before I went back. DK needed a ride home, but I had no money as usual, so Eric Sawyer took him in a cab and I took solace in his meeting one of the legends of the early ACT UP he had learned so much about through films and stories. The other day, a new client DK's artwork on my office wall, so I pointed out his photo, one among 40, clients we have lost but not forgotten. Today’s intake is an 18 year old nonbinary queer high school graduate who was living at home with their family until two weeks ago. They said it was never great, but two weeks ago their mother started throwing ceramics at them and so they defended themselves, hitting her. When the police were called, they arrested the young person and now she has court in queens, a borough where we don’t have any lawyer friends. She’s been staying with a friend so we talked over the options, and then she told me the most painful part- when her grandmother retrieved her computer and her property both her hard drives and her diary were gone, taken by her hostile mother. Walking through the port authority on my way home after going through the Santa requests and rejecting people we never heard of and people we haven't seem in years, which make me feel like a grinch, I notice homeless adults scattered around in nooks and crannies, trying to stay warm. The homeless get kicked out of Port Authority a lot more than they used to. At this hour, though, when it’s slow, and so cold out, the police are turning a blind eye to people who are not disruptive. There is so much unused space in the Port Authority- empty store after store, it would be so easy to create a space for the homeless. It wouldn’t have to be on the main concourse, it could be tucked away upstairs to give them some privacy. It wouldn’t need to be fancy- even a basic drop in with recliners and sandwiches and a bathroom would be better than the nothing they have now. Of course, you could do a lot more if you wanted to- social work and medical and all the rest. There used to be a homeless drop in across 9th Ave but the port authority repurposed it for their own uses. If they were hoping that would disperse the homeless in the area it didn’t work, it just left them lying on cardboard or bare concrete or roaming around. As I finish writing this, the train pulls into the tunnel right outside the 95th st station and there's a thud as the brakes go on. This happens sometimes when there's already a train on both sides, and it's usually a short wait until one leaves, but we sit and sit. Finally they announce a signal problem, which doesn't make the wait any less annoying. As soon as I step out of the train, I start to have a troubling thought - I reach in my coat pockets, no keys. I check around my neck, no keys. Sweatshirt pockets - no keys. Pants pockets- no keys. I sit on a bench and go through everything in my bag - no keys. I text Misty and we start brainstorming. Andrea, the cat lady in the next block had my key, but she has moved to London. I'm not bendy enough anymore to climb in the window I used to go through in these situations. Robin lives near the office but he only has a key to the front doors. That would be fine if I left the keys in the sanctuary, but if they are in my locked office, that would be a problem. In the end, there's nothing to do but head up to Misty, who lives in the Bronx to retrieve a spare key. The number of things I lose is directly correlated with my stress level and things have been disappearing like I'm in a magic show lately.