A Case Manager’s Tale

by Colin Bosio-Cady on July 12, 2004

The front page of the Chronicle, the Daily News, Washington Post or any other news daily in the country most typically depicts homeless people as derelicts, bums, unclean, “crazy” and undeserving of sympathy. Why? Well, the common wisdom is that they have had their chance and have obviously not made the best of it. So goes the American casino mentality: “I’ve got mine and if you haven’t got yours it must be your fault.” No luck, or no drive.

More realistically and more commonly, homeless and marginally housed people are not nearly so colorful, so news grabbing or formulaic. I work with 108 clients, none of whom would easily fit the stereotype major news sources create for mass consumption.

I work with a 63-year-old man, an alcoholic who struggles with depression. In keeping with the common wisdom, the image conjured up is a disheveled man, oily hair, ripped clothes, a grainy voice unable to get out more than syllable or two at a time.

My client, unlike this image sold so expensively to all of us, is few of these things. Dressing almost solely in white, he exudes an air of respect. Walking around the welfare hotel he lives in he seems more apparition than man, as if a member of the British gentry had somehow found himself on 6th street. He rarely curses, has a Masters degree in Speech with an emphasis in Theater, he is a devout Catholic and Green Party member.

He has fulfilled part of his stereotypical role, and has very successfully attempted to drink himself to death, living more off Royal Gate than anything else; food or water for that matter rarely find their way to this man’s mouth. Having attempted detox several times, the man has recently been content to state, “I’m drinking because I’m an alcoholic,” and to leave it at that. He recently landed himself in the hospital with walking pneumonia, anemia, and severe dehydration, ill enough that he does not recall the last three weeks of his life.

If you looked at the situation in purely economic terms, it could be said that this man has taken up a disproportionate amount of resources – a point that the Newsom administration likes to make about certain groups of people when talking about the effort to revamp the city’s welfare system. In line with this is the simple-minded logic that having had several chances, failure now must be an indication of malice or ignorance. Amongst the city elite there seems to be a split over the logical conclusion to this malady. There are those, no doubt, who would rather this man die than consume any more tax dollars; while others more well versed in the niceties of social etiquette are content to not have to witness this man’s pain. Each of these divergent camps, though, would be much happier if Bank of America continued to consume their tax dollars instead of this senior.

In the case of the failure of accepted dogmas where do we turn? When crafting city and national policy that affects people like this, how is it best to summarize their lives, their future possibilities and their place in society? For those most intent on limiting government’s responsibility to society it is most efficient to label men like this malingerers, drunks or criminals. Labels that allow people a measure of comfort and supposed moral and intellectual superiority.

Knowing him, though, I know that all of these labels fail him by a far sight. Highly educated, having marched with Harvey Milk and acted Shakespeare, lectured on Einstein, and traveled Europe; in old age, he is stubborn, a poor judge of his own strength, a poor historian and obviously not making very good decisions for himself while he struggles with alcoholism. Too proud to join a recovery group, he has made horrible decisions about his health. He easily defies any label that city officials and an under-aware public would like to put on him; he is uncomfortably like many of our own grandparents.

Another convenience of simplistic labels is that they prohibit any deeper analysis of the root cause of people’s troubles. Accomplished as this man is, he did not provide for himself in old age and relies on SSI now, federal money which comes to $872 a month or about $10,000 a year, less than twice his rent payment. He lives in a room that barely measures 12×12, with a door so thin that everything that happens in the hall might as well be happening in his room; in the hall, men and women half his age yell through the night, they buy and sell drugs and occasionally they beat each other. Many others simply go about the business of getting by amongst the craziness, but their quiet presence must be a cold comfort to a man who can hear all of the sounds of aggression and violence but cannot protect himself from them.

With more than half his money going to rent, what is left for this man for the rest of his life? Surviving in San Francisco on $10,000 a year leaves a person with few choices and less mobility. How many readers could say that facing a reality like this man’s they would not poison themselves slowly and fade into old age less than aware of their situation?

While crushing poverty exists, it serves as a reminder of potential consequences for the rest of us. When people can become malnourished and on the edge of death from curable disease in a major city like San Francisco; the rest of us are that much less likely to take the kind of risk that could put us in that same place. We are less likely to go on strike for better wages, demand greater civil rights, fight for police accountability or social and racial justice. We are all that much more content in our current situations because we have such a stark reminder of what waits after chances are taken. Working people have not analyzed the fact that our wages have decreased proportionately over the last 50 years because there has been concurrent lessening of federal relief money. So, since we are still the same distance from the bottom, we must be doing OK.

This is the real strength in the barriers created when labels are cast upon people living in poverty; that the rest of us are blinded to the fact that all of our fates are tied together. That contrary to trickle down logic, wages historically go up when welfare money goes up, that people can struggle for greater social rights when they are guaranteed to be able to eat. That, in fact, the most strategic move for working people is to ally with people living at the lowest social level because when wages go up at the bottom they go up everywhere else, and when human rights improve at the bottom they improve everywhere else. This realization is the great fear of the people who spend millions of dollars to convince us of the simplicity of poverty. Their interest is to convince us that poverty is the sole domain of malingerers, drunks and crazies, of weak people who could not make it in the world the rest of us travel in – because as long as we cannot relate to them we cannot work collectively.

My client gets out of the hospital in two weeks and will find himself in the same circumstance that he left. He tells me now though that “63 isn’t that old these days” and that he still thinks that he could play a part in Richard III if he got the chance. He says that he knows that his next drink may well be his last and that he’s not ready for that yet. A Green Party member, he wants get more active in local politics.

I have no idea whether or not this last attempt at detox will work, I don’t know if I will visit him for a meeting and have him collapse again next week. What I do know is that attempting sobriety in an environment so hostile and in a city so hostile takes a lot more strength than most people could imagine.

This is the case of almost all of my clients, incredibly strong people full of contradictions and far from the realm of simple labels. People who are experiencing just how much harder it is to try to get by than it is to get by.



Colin Bosio-Cady is a Case Manager at the Seneca Hotel in San Francisco.

Filed under: Bay Area / California