The Litany.

This is a post that I have been thinking about for a long time.  That isn't because the subject requires great thought, it is simply a list.  I have been thinking about this post because the subject matter is something that I would prefer not to think about but cannot prevent myself from doing so.  I hope this post is therapeutic for me, that is my intention.  Of all the posts that I will write this is probably the only one in which to a very large extent I wish people would not read.  That particularly goes for my wife Christina, there isn't really anything new here for you and you have already been such a massive help to me with this.

On Sunday night I found myself unable to sleep.  I snatched a few moments here and there when complete exhaustion overcame me.  I had memories and feelings and visions of things that have damaged me, one after the other, and I sobbed in pain through the night.  This used to happen very often to me.  For a while it happened at least weekly, and often in public.  It hasn't happened in many months, long enough that I can't remember when.

I don't know if these memories are especially hard.  I suspect they are, at least among our modern Western culture.  It may well be that, as my sister said to me this summer, I am simply too sensitive to the world.  Here is what I call The Litany.

I remember the sound my mother made when her rib was broken.  A deep "Whhoooff" of surprised pain.  But not surprised enough not to try and keep the sound inside, to keep it away from her children.  I found out what had happened and how years later, but somehow I had always remembered the sound.

I worked at a rehabilitation center for children in Michigan.  The Saint Louis Center.  There was a child of fourteen who lived there, among a small group of young children with brain illnesses, or damage.  This child of fourteen was the size of a six year old, unable to talk, who spent much of his time on the floor like an infant who could not walk yet.  He was physically unable to tell when he was full, when his hunger was satisfied, and so he was constantly desperate for food.  When this hunger became too much he would smash his head into the ground, over and over again, in order to get what his body told him it needed.  The protocol was to ignore this behavior as to reward it with food would be to reinforce it.  So, I had to stand in the room while this child smashed his head repeatedly into the floor and screamed.

Another child in this facility could not talk.  Or perhaps would not talk, I always suspected he was intelligent enough to do so.  He was in a group of six children, but he wanted the emotional attention and love of an only child.  To get this attention he would destroy his room, throwing his feces at the walls.  There was a small window in the door to his room, so that we could check on the children.  When in one of his tantrums he would stare through the window at me.  Every few seconds he would smash his head against the window, look me straight in the eyes with the most beautiful blue eyes I have ever seen, and if there was no reaction he would do it again.  he would do this until there was a large lump on his forehead.  He also would bite people, because then he would be restrained by an adult.  Restraint consisted of being held, enveloped in the arms and legs of an adult.  I am certain that he worked for this, that being held in restraint was the most like love he felt there.  I learned that when he would bite me, if I looked at him in those amazing blue eyes and pushed my arm into his mouth a bit, offering it to him in a gesture of trust, he would not bite.

There was third child there, a creature kept alive through religious dogma and a lack of courage.  This child was a late teenager, but had an IQ just about adequate to stand, and push food into his mouth with his hands.  He understood no words but could grunt with desire or moan in distress.  One of my tasks was to bathe him, stripping him naked and soaking him in water and scrubbing and drying him.  Throughout this procedure (and it was a procedure, medical in its necessity and manner) he would moan and turn away, flinching, frightened and confused by it all.  Frightened and confused by being bathed every day for his entire life.

When I first came to Portland I got a job with United Cerebral Palsy.  Generally the only trauma here consisted of intense workloads, rushing around Portland to serve the needs of the disabled in the most respectful way possible, understaffed and with a schedule down to fifteen minutes all day, every day.  On one occasion I was on emergency call and in the evening went to the house of Kasumi.  Kasumi was nearly a quadriplegic,  born with legs that simply flopped, and hands that moved so slowly and imprcisely that they were nearly useless.  She had a grip like iron.  She could barely speak, you could see her strain like a weightlifter to get out each monosyllable.  She was a seventy year old woman, born into a Japanese family within a culture that held the disabled as a cause of shame within a family.  I have never met any person who laughed so much in my life.  She was, without doubt, the person with the strongest will I have ever met.  the call was to her house because she had been ill with bronchitis and she seemed in great distress.  I carried her into the emergency room, with her coughing and wincing, and they asked her to point to the rainbow chart with numbers to describe her pain.  "Ten" was her reply, the highest number.  I remember the x-ray technician trying to force her twisted body into a position from which a useful x-ray could be taken.  The look on her face was what I remember, such pain.  She had broken her rib by coughing over and over in her bed, unable to move, unable to do anything but endure.

My last job was at Park Tower Apartments in downtown Portland.  An apartment block funded by HUD (Housing and Urban Development) for those classed as "very low income" with priority given to the disabled and seniors.  One of my jobs was to check on the well being of people we hadn't seen for a while.  I would head up through the elevator, down identical hallways with the same carpet and walls, like a scene from a David Lynch movie.  I would knock on the door, call loudly, and if I received no answer I would unlock the door with my master key and look within.

Some time in my first few months I walked down such a hallway and smelled a distinctive smell.  Somehow sweet and sour, the smell of rot.  I opened the door and there was the old gentleman face down in front of me, wearing just his underwear, unmoving.  His flesh was mottled and blackened by the rot beginning in his skin and pooling, dried blood.  The stench was intense and deeply disgusting, and it somehow inspired an animal fear.  Something far below my unconscious prevented me from moving closer.  I now know the root from which all our feelings of disgust originate.  He was a gentleman.  A quiet, soft-spoken man, who always treated me kindly and had a ready smile.  I had never really thought that death would affect me so, but it shook me powerfully.

After this I performed a good number of "well checks" as they were known, at least once a week.  Usually the person was home and well, or simply out and about, but I never knew this before my check.  Sometimes I was greeted with smiles and gratitude and sometimes by irritation and abuse.  A few weeks after my first death I opened a door to see a man apparently asleep in his bed, lying on his back in the dark.  I called to him repeatedly but with no response.  I looked closer and it seemed that breath was coming from his nose in little bubbles.  I went over and placed my hand on his shoulder, felt the chill of it, and realized that the bubbles was the gas from his decomposing lungs.  When the light came on I saw his face in an expression of shock, the face of someone right before the car accident.  He also was a gentleman, self-sufficient and understanding of my job.  He never wanted to cause anyone any trouble.

The third death was a mean old bastard, who wore a stinking lumberjack's shirt and showed contempt for all around him.  He would see the Raam a janitor and then deliberately spit on the floor and smile.  To get into his room the maintenance supervisor Harold had to take the door of it's frame.  We looked at each other, both knowing what was next.  I said, "It's my job" went in and did the formality of touching his shoulder to see if he could be jarred awake.  He was stiff, a heavy weight, lying alone in his filthy apartment, in that filthy shirt, in a filthy bed.  I felt empty, not devoid of feeling, but as if who I was had been poured out through a hole in my chest, leaving just a shell.

The fourth death I heard about from Raam, in a panic.  He said that he thought a resident had killed himself, thrown himself out a window.  He was one of the very few married people in the building, someone with schizophrenia and his wife had been in the hospital for a week with her own issues.  We went to his apartment and rushed in.  He wasn't there and I saw the broken window screen.  I looked out of the window, six floors down and saw him lying on the concrete roof of the neighboring building.  He was lying in the classic position you see in television shows of the chalk outline, his body smashed.  The force of the blow had broken the concrete around his body.  Raam said that he heard him as he fell yelling, "Oh no!"  His delusions had got him without his wife around to help.  The hardest part for me was calling her to give her the news.

Telling people the news might be the hardest part, because it takes an act of will, you must decide to do it.  The person is dead whether you check on them or not, you don't cause their death.  But when you tell someone that a loved one is dead you have shattered their heart with a few words, and their life will never be the same again.  There is nothing you can say to make things better, nothing you can do to try to help, and they cry, and cry.

The first time I told a mother that her child was dead I walked up the stairs in dread, hoping that she would not be home.  I told her as simply as I could, completely without any idea of how to soften the blow.  Her face crumbled and she asked me what had happened.  I could tell she was searching for an error, some mistake.  I told her about an accident that a sheriff in another town had related to me on the telephone, not knowing the sheriff, the town, the daughter, or the mother.  The mother told me, a nearly anonymous stranger bringing this news, "Thank you, you have been very kind."

The second time was somehow worse because I knew what it was like.  I have felt that the more times you experience something tragically sad it gets harder, not easier.  It's as if you only have a certain amount of protection, or resources, and they get used up.  I believe I developed essentially a phobia towards these experiences.  Knocking on doors became harder and harder.  When I returned to visit after I had left the job, it took me three times to walk in to the lobby.  The sight of the carpet made my heart race, and I felt the urge to run, and I did run.

The second mother was a one-legged woman wrapped so deeply into her faith that it was a part of every moment of her speech.  She was obsessed with the color red, and wore it at all times, and wrapped it around her crutch.  Red and the crucifix were with her at all times.  I told her that her daughter had died from a very sudden illness.  I had not been told which illness, and simply had a telephone number written on a scrap of paper.  She cried, "My baby, my baby, my baby's gone!"  It turned out that this was her second child to have died before her.  She thanked me profusely, and worried about how hard it had been for me.  She said I had been so good to have done this.  Apparently I have a knack for breaking this news.  It seems the best method is to stand there witless, broken apart, with nothing to say but "I'm sorry" from time-to-time.

There was a woman who lived high up in the building.  Her color was purple, and she had a strange way about her and spoke with an oddly formal manner.  She had an aura of something like a Harvard educated witch.  She called me up from my office in the basement bowels of the building, a place with no natural light, no weather, no trace of the world outside.  She apologized but she needed to be taken to the hospital.  This wasn't my job, I didn't provide services but connected people to them.  There were over four hundred people for whom I had responsibility.  She said that she had no-one else to take her, and that it was an emergency.  It turned out that her son, a charming young man, was serving time for a plea-bargained count of sexual child abuse.  It transpired that this woman had gone blind over the course of a few hours in the morning and so I led her as she held my arm so tightly, with a running commentary of where she was and where we were stepping next. 

I led her into the hospital where she sat, straight backed and calm.  So dignified.  She asked me to remain in the consulting room with the specialist, who after a brief examination informed her that a blood vessel feeding her optical nerve had burst, killing it.  In one morning she had been struck irrevocably blind, out of nowhere.  In her total darkness she took this like a slap, but immediately gathered herself, calmly thanked the doctor and asked me to take her home.  To my knowledge she never left that apartment again.  Never learned how to get around, or where to get books on tape, or tried to be a part of any community.  She rejected all help but someone to clean her apartment and get her groceries.  She just waited there in the dark, waiting to die.

I remember sitting in another filthy apartment watching a man cry.  He was a Vietnam veteran, a patient using the VA.  He was a heroin addict, and had been since he returned from Vietnam.  He wasn't a stupid man, not someone trying to wallow in decadence.  He said that he used heroin because it was "the only thing that stopped him remembering what he had done."  He had tried medication, other drugs, drinking, but nothing had worked.  More than thirty years had passed and still his memories were intolerable.  Only now was he faced with a choice.  The VA had implemented a policy of drug testing, and if you failed the drug tests you could not receive medical treatment from the VA.  If you were covered by the VA you could not receive other government health assistance.  He was faced with the choice between no healthcare for his damaged organs, or living with his intolerable memories.  He briefly thought of a third way out, suicide.   I was there because he was asking for help, for another way out.  I was helpless.  I had nothing to give but understanding.  It hurts so badly to see a man weeping because he is haunted, agonizingly haunted and with no way out.

That is The Litany.  My list of things that keeps me awake in the night, that had me sobbing in public at times, that broke my heart.  It is the reason that my wife convinced me to leave my job, my career, even though I knew that I was good at it, that I did great good, that there are people dead because I have left.  I take a small measure of pride that this list is not a list of those who have done me wrong, of those who lied, cheated, and wronged me.  I have had those experiences too, but they have faded into the backdrop of the past.  The Litany is a list of tragedy, nothing more.

In an explanation given by someone who had been a friend who no longer was as to why we were not friend was included the words, "There is a darkness in you Dan."  I would cry, rage, castigate, and demand the right to live my pain.  This is all true.  I was never asked why I was like that.  In fact I don't think anyone has ever asked me about it, although I have been asked how I was doing, and people have been sympathetic when I would tell them.  My darkness came through the uncontrollable scourge of depression, coloring everything grey and painting everything in hopelessness.  But it also came from the grinding pain of helpless tragedy, that caused me to howl into the uncaring world.

Maybe these aren't anything special.  Maybe I am just sensitive, or self-involved.  Maybe these are experiences we all have in our lives, I am certain there are people who have worse.  It's what I have to deal with in the darkness of the night, and although it is getting better, it is still there.