The mad in our streets
We are neglecting to write new Idleposts, while being drawn into banter in the Comments, & email. See for instance the Comments under “Why why why?” for an illustration of our descent. Still, it is banter with actual readers. We must have a dozen of them, by now! Soon we may catch up with Lady Gaga (thirty million followers on Twitter) & Justin Bieber-Trudeau.
In the olden days, before the invention of all these portable electronic “devices,” we would sometimes sit at some long table in a public library, examining a book. It always seemed that we were sharing this table with what was called in our parents’ generation a “rubby-dubby.” He would not be examining a book, but nevertheless making notes in a soiled cahier, or on scraps of much-folded paper. He would be using a short & extremely blunt pencil, in an advanced state of engnarlment from chewing. Always, the fingernails caught one’s attention; or the hair, unwashed for a very long time. The eyes one seldom met. We would be in wonderment at the amount of paper that could be covered by his remarks, & might compare his exercise with our own, as a journalist.
On one occasion we decided that the brotherly & charitable thing, given the shortness of the poor rubby’s pencil stub, was to give him a much longer one from our pencil case. On another, our ministry required the surrender of a cheap plastic pencil sharpener. A neoconservative might say that we were feeding his habit, but what do neoconservatives know? They don’t understand people who must write.
Sometimes this habit provides a useful service to the economy. In our own case, we look back over years of supplying copy, to fill the spaces between the advertisements in large daily newspapers. Press lords recognized the value of this service, & would pay us handsomely. Too handsomely, we fear: for look what has become of their poor tattered properties. More sensible to pay by the word, use wire services, & encourage letters to the editor. As one press lord famously opined, the letters were his favourite part of the editorial “package,” because he didn’t have to pay for them.
Only a fool would pay, as so many of us journalists, & other graphomaniacs, have discovered to our cost since the invention of the Internet. Soon, those among us who must write to eat, will find ourselves in an acutely embarrassing position. We may have no choice but to become interesting.
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The question of what to do with the (formally diagnosed) insane was raised in the Comments to the post we flagged, above. Perhaps at this point we might drop the masque of humour. Those who have had the honour of working with the insane (a distinctly Christian honour) will know that being (certifiably) crazy is not much fun. They will also know that the genuinely insane often lack social skills; that they can be sometimes quite alarmingly charmless.
We are straying now into a very large topic, in which the tribulations of the mad are compounded by the organized & scrupled insanity of statisticians, policy wonks, & overpaid social workers. We will excuse pharmacists, for the moment, for we are convinced by modest experience that certain powerful anti-psychotic drugs, & even “mood stabilizers,” can be merciful in the relief of real human suffering, & should not be denied. If the condition of the patient requires their use, however, it also implies the folly of self-medication.
We live in Parkdale, a district overflowing with “outpatients” from what was once the largest mental asylum in Ontario (larger even than the Legislature). It has “evolved” into the province’s largest “mental health” processing centre. This means, in practice, that it hoovers in the mad from all over this Fine Province of Ontario — especially Sudbury for some reason — drugs them to the gills & then turns them out on our big city streets. From where they instinctively roll to the lowest accessible point on the socio-economic surface, i.e. Parkdale.
As we mentioned in our Comments banter, there is a huge & rather grave social problem here, known to euphemists as “the homeless.” It has been addressed not mercifully but ideologically, over recent generations. We summarized that history: “Throughout North America we emptied the mental asylums in the 1950s & ’60s, only then to fill up the gaols.” A fiscal problem — the cost of maintaining mental asylums — was solved in the usual way, by a bureaucratic game of cups & marbles, slipping it from one department into another. Meanwhile we, the people, have beggared ourselves with an array of middle-class “entitlements” which make every other fiscal problem irretrievable.
We are not a policy wonk, & while we are also not much of a democrat, we do wish sometimes there were a mechanism for voting the existing policy wonks out of power. For they are there ensconced, commanding all departments, whatever politicians we might happen to vote in or out. They even write the politicians’ legislation for them, when not by-passing “democracy” entirely with daily rafts of new & very petty regulations.
The wonk comes in two flavours: cause-&-effect specialist, or “technocrat” as it is called; & ideological “progressive,” in comparison to which your common garden lunatic is so much easier to endure. And to make the mess the more intractable, they are not two camps — for then we could just eliminate the progressives. The average policy wonk is instead a hybrid. That different wonks defer to slightly different ideologies might go without saying. There are, by analogy, many different kinds of mental illness, & in truth each patient is his own little universe of trouble.
It should be obvious that the Nanny State’s spic-&-spanking, upbeat, “mental health” approach, prettied up & tarted out in smileyface niceness, has failed, utterly. Look at the streets. To our mind it should therefore be abandoned, utterly. The tax-flesh consumed by these wolves in smileyface stickers is anyway needed elsewhere. It would indeed cost plenty to rebuild the network of old-fashioned, essentially incarcerative, mental asylums.
They are needed at many locations & in many different kinds. None need be “mediaeval dungeons,” need not even be as spiritually & aesthetically numbing as the asylums in which we now warehouse our old. For the point is not to serve our own convenience, exclusively; it is also to serve the real & often desperate needs of the mad. And, their needs are not served any better than our own by housing them on the streets.
A vast issue: on which we journalized in the past at some length, & on which we have since accumulated bags of additional fact & anecdote. Gentle reader must not assume we are overlooking the more obvious objections; that we are not for instance prepared to wrestle with the whole vexed issue of human freedom, which comes directly into play because the mad are not inhuman. Their instinct to seek freedom — & thus avoid incarceration regardless of consequences — is something we have encountered more than once firsthand.
This yields a spectrum wherein we find grey areas, which the determined may employ to confuse the larger issue. But that grey elides into darker on the one side, & lighter on the other. Some street person may turn out to be Diogenes, & by all means let him sit in the sun, as a constructive example to the rest of us. We are surely not opposed to mere public loitering, or invigorating eccentricity. We are talking mad here — visibly nuts — & as the jurisprudes have said, “hard cases make bad law.”
One must read back into the 1950s — the golden age of “liberalism” it could be argued, from which the ‘sixties & forward might be considered mere radioactive fallout — to see why sane, effective, & even affordable remedies will not soon be found. In the cause of emptying out the old, clearly labelled mental asylums, the progressive forces of that day set up a huge propaganda, demonizing the asylums & those who worked often selflessly to sustain them. They depicted these places as “mediaeval dungeons” — when they were not. Most reflected more than a century of tireless & sometimes heroic if also somewhat unimaginative work to improve living conditions for the inmates. (And incidentally, few mediaeval dungeons were like “mediaeval dungeons,” either. Victorian dungeons were probably much worse. This propaganda had in turn the usual Reformation ancestry.)
In retrospect, it is fairly easy to see that the propagandists were rather more concerned with some abstract idea of perpetual “progress” than with the actual fate of the inmates they were “liberating.” Not that they wished the mad ill, for the indifference was more akin to bullshit than to lying: they didn’t really care what happened to the actual, as opposed to the statistical, mad — as tended to show in their cost/benefit analyses. They only pretended to care, for the purposes of their propaganda.
(We might refer gentle reader on this point to the learned Prof. Harry G. Frankfurt’s useful little tome, On Bullshit, for light on this phenomenon, including a passing explanation of why bullshit may do more harm than lies, & bullshitting be morally lower than lying, since the liar at least knows that he is lying & therefore retains some appreciation for the truth.)
A good way to start felling this thicket of false consciousness might therefore be to put all money questions likewise on one side. Should gentle reader hesitate, he need only ask himself: “If we couldn’t afford to keep all these asylums for the mentally ill, how do we afford to keep all these asylums for our vastly more numerous unwanted oldies?”
Anyone who wishes to do something comprehensive for the mad in our streets must first help overcome this legacy of progressive bullshit. That, much more than the usual shortage of money, stands between the individual sufferer from a serious mental illness & a huge improvement in his conditions of life.
The even bigger thing is Love. Paid doctors, nurses, strong-armed orderlies, & basic service staff are not replaceable, & may need to be paid. On the other hand, we spy an immense bureaucratic infrastructure for which we might propose a Carthaginian reduction. Far too many “push paper,” or push people as if they were paper; it takes years to realize on how great a scale. The whole machinery might simply be unplugged, but would then require arduous recycling efforts. For we must never entirely withdraw our sympathy from the bureaucrats themselves, while wrecking their bureaucracy.
But the point here is that they have replaced the unpaid & perfectly voluntary endeavours of that host of people, both secular & monastic, who once filled the gaps. Who, to be plain, rendered their services out of Love — & for Christ alone in those moments when the mad become too much for anyone to bear. As Mother Teresa of Calcutta used to say, “I wouldn’t touch a leper for a million dollars.” Yet for the love of God, she touched them every day.
The same Mother Teresa who spontaneously observed, in a California hospital where the forms were being filled for a little baby who urgently needed to be operated upon: “Such a lot of signatures for such a little heart!”
One may see, every day in the nursing homes that have proliferated through our urban landscape, that money can’t buy Love; that, where we do see love, in all this galaxy of professionally smiling government agents, it is an intangible, unpaid, even provocative “extra.” (And if it were tangible, the government would find a way to claw it back through taxes.) Mental asylums, like nursing homes, like prisons & public schools for that matter, could be made far more humane. But we would have to spend a lot less money in order to achieve this result, & build them around the very notion that without Love they are lost.
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Which takes us back to those Commonplace Books. … Item: “Let us do something beautiful for God.” … Item: “If you can’t feed a hundred people, then feed just one.” … Item: “To keep a lamp burning, we must keep putting oil in it.” … Item: “Love does not measure, but just gives.”
Item: “Our life of poverty is as necessary as the work itself.”
Item: “When a poor person dies of hunger, it is not because God failed to take care of him. It is because He told you & I to take care of him, & we forgot.”
Item: “The miracle is not that we do this work, but that it makes us so happy.”
Item: “Suffering in itself is a waste of time. But suffering in the passion of Christ is the most beautiful gift: His love token.”
Item: “We can cure physical diseases with medicine, but it will not cure loneliness, hopelessness, despair. Many in this world are dying for a piece of bread, but so many more are dying for a little love. This is the poverty I have seen in the West, & it is so much more terrible than what I have seen in the slums of Calcutta.”
Item: “People are often unreasonable, illogical, & self-centred. Forgive them anyway. If you are kind, people may accuse you of selfish, ulterior motives. Be kind anyway. If you are successful, you will win false friends & true enemies. Succeed anyway. If you are honest & frank, people may cheat you. Be honest & frank anyway. What you spend years building, someone could destroy overnight. Build anyway. If you find serenity & happiness, they may be jealous. Be happy anyway. The good you do today, people will often forget tomorrow. Do good anyway. Give the world the best you have, & it may never be enough. Give it the best you have anyway. You see, in the final analysis, it is between you & God. It was never between you & them anyway.”
Item: “I know God won’t give me anything I can’t handle. I just wish he didn’t trust me so much.”
Dear Mr. Warren,
This is so beautifully put, and so absolutely true and correct.
As a physician, I have nearly forty years of work with the mentally ill, in every setting, academic, state hospital (northern California), county mental health, private practice, and large “H.M.O.”
The last has worked out best, I think, both for me and my patients, but it is not well designed to care for the most severely ill (those you describe here), and is probably going to be destroyed over time by the handiwork of Mr. Obama.
It seems odd to me that the “progressives” haven’t taken up the recreation of the old state hospital system as a project — in many ways, it was a system which naturally fit the “progressive” model — huge, cumbersome, a child of “big government,” but, in some ways at least, not an entirely bad alternative.
Coming to work every day I see more and more “homeless” (some of them even have homes of a sort), but very little is said of them or written about them. Thirty years ago, during the Reagan administration, in the exact same place, a much lesser number of homeless people excited infinitely more comment, though precious little effective action.
Jamie Irons
What a beautiful essay, David. I think it best for me to take some time to savor and digest it! My wife, a nurse for over 30 years now, will much appreciate your words.
Your essay brought tears to my eyes. Tears of guilt, unfortunately, as I shoved my mother into one of those nursing homes as fast as I could shove her. She slid into dementia fairly quickly when I brought her into my home for what I thought was going to be a wonderful “mother-daughter caring for her in her last years adventure.”
Turned out to be so awful as we did not recognize what was happening and just assumed she was her horrible old self. So much for seeing the face of Christ in my poor mother. Mother Theresa I’m not.
I often wonder what people did in the really olden days. Did every family have a crazy grandma in a back room somewhere chained to the bed? I don’t mean to be flip. I really would like to know. Or do we simply have an epidemic of dementia now that becomes so unmanageable that we are forced to house our elderly in nursing homes?
It becomes impossible to keep them at home, to my mind, when they can’t be trusted with stoves, or when they simply wander off, and refuse to take needed meds. When they are nasty to boot it is doubly hard.
As for the mentally ill on our streets, this is a scandal of misplaced charity. I see it as akin to leaving pagans and heretics in ignorance because we ‘love’ them, or don’t want to offend them.
I don’t have any answers. I wish I had the courage to invite a street person to my home for Christmas dinner. But I don’t. Where would I find such a person when here in my town they are all down at Project Share picking up their baskets? Or having a basket delivered to their homes?
If I sound churlish, I’m sorry. This is a bad time for many of us who don’t have happy memories of Christmases past.
Dear honest Barbara — thank you for your frank comment. I too wonder about elder care in the past. I would imagine that it ranged from devoted to cruel depending on the people involved. Certainly there was nowhere to dump the old — some child or near relative would be responsible in previous centuries in most countries. The mad were put in mad houses; the indigent in workhouses or county poorhouses in the U.S. Many are still housed in the county homes when they are too disabled to be cared for by a family member (or unwanted).
David, if there’s any way you could make shorter comments — which you sometimes do — I’d be deeply appreciative.
We working people just don’t have the time to read such lengthy articles on a daily basis, as worthy as they may be.
I hear you, Barbara. We’re human after all. Mother Teresa was asked in an interview by Joyce Davidson, of all people — how many of you remember her of CBC and married-to-David-Susskind fame? — how she and her sisters were able to do so much with only 24 hours in a day. Mother Teresa answered that they received Jesus every morning (at Mass).
I learned an important lesson a few years ago from a street person I was on conversational terms with. I bought him some Thinsulate gloves that allowed fingers to be exposed by flipping a piece of material back. Seeing as “Gil” smoked, and was out in the elements in a doorway on Bloor Street a lot, I figured my choice of gift was ingenious.
When I gave them to him, he looked at me more in pity than anger and said, “I can’t use these.” When I asked why not, he pointed out that if he was drinking and smoking, the gloves would simply go up in flames.
The next year, I asked him what he would like. He asked for tools with which to grow things in the tree wells adjacent to the doorway he inhabited. So, that’s what I got him.
I haven’t seen him for years. I hope he’s OK or that he’s now in Paradise.