Monday, September 24, 2012

chapter 28 The art of politics

And so the days past.  Sun rises, sun sets, the world turns, I read some books, made some bead jewelry, painted a little, puttered about the library and the clothes closet and I waited.  Great thing about time, sooner or later something almost always happens.  
And something happened.
In a time of budget cuts and health care cost cutting, mad people are easy targets.   We don’t see the mad, we try very very hard not to see them.  We try very very hard not to think about them.  It is the wonderful American conceit that ignored people will politely and properly disappear.  
So  the politicians decided that closing the hospital would save the city some money.  It is a strange genius of our culture that spending money to care for the weak and helpless becomes morally the same as spending money to buy a spiffy new hat.  
Back before I was officially mad,  ( I do take a certain pride in that I have graduated from amateur madness to officially recognized professional)  I enjoyed walking the early dawn streets of San Francisco.  It is a city made for the dawn.  At dawn it is all soft mists and hues of pink pearl a moment of pause a calming intake of breath, the change of tides, the night people curling into their beds, the day people fixing their coffee.  Walking down the middle of the street is a homeless person in the orange vest of community service.  In order to get the great sum of some 200 to 400 hundred a month in aid they must perform such service as picking up trash.  And there is the result, walking down the middle of the street dragging his broken trash bag littering a trail of used condoms and cigarettes behind him, and he is scratching his half naked hairy ass.
The conservative view is that somehow if we were just crappier to him his life would become so bad he would learn better.  Teach a man to fish not feed a man a fish  ( though as I recall Jesus handed out loaves and fishes not fishing poles).  Aid creates dependency goes the thinking ( do wheelchairscreate broken legs I wonder?)  so you force them to work for everything you ‘give’ them.
Look at that man weaving his way down the middle of the street dragging his broken trash bag and ask yourself this; How much crappier do I have to make his life in order to make him behave?  And do I really want to spend any of my time in life thinking up ways to make crappy lives crappier?
My philosophy here is this; The Fucked Up are Always With Us.
It seems to me as a purely practical matter that GIVING Fucked UP people food and shelter at a minimum keeps them from cluttering up the streets and getting in the way of societies more useful and attractive members.  
One of the union reps is in the activity room chatting on his cell phone about the hospital closure.  The call ends and he snaps the phone shut.
“You trying to stop this hospital from closing?  I ask him.
“Yes.” He says.  The sort of yes that says yes, I want to keep the tide from coming in.
“I can tell you how to do that.”  I give him a sly cynical smile.  It’s the smile of one who knows perfectly well nothing she says will be thought of as anything but the ramblings of a mad woman.
“Ohh yes?”  The polite humor the mad person tones.
“You have to get the closure of the hospital off the back pages, the pity the mad letters to the editor, pointless whining.  You need to get this right up in their faces on the front page of the paper.”
“And how would you do that?”
(and for my next trick I explain how to take candy from a baby.)
“Ohh that’s easy.  Do a reverse strike.”
“A reverse strike?”
“Yes.  Look they want the hospital closed.  Don’t do it.  Don’t transfer the patients out, don’t leave your jobs.  Hell keep all the doctors and nurses in the hospital and barricade the doors.  Make them send in the cops to drag the doctors away from their patients.  Now that is a picture that will not only reach the front page of the San Francisco Chronicle but will be on CNN.  That one picture would be seen around the world in less than one hours time.”
“mmm, yes.”  (back away from the mental patient, she may bite) than the cell phone rings and he returns to his safe little world of forms and procedures.
There was a time when unions had balls.  There was a time when they knew how to fight for something important.  Now the leadership of unions are lawyers with cell phones so without balls I don’t even think main lining Viagra would give them a hard on.  Unions these days are like a kid who comes to school wearing a t shirt that says UNCLE.
This is San Francisco for gosh sakes and the union cant think of a way to save a hospital of poor mental patients from being shut down?  The closure date of the hospital just a few scant weeks away and so far the best publicity they have been able to manage is a ‘ohh dear me isn’t this sad’ opinion letter to the editor written by somebody’s mother.  That shop owners in china town sold live frogs for slaughter got more press and comment. Fucking frogs.
Public speaking is one of the most common fears and why is that?  People are afraid of being seen as a crazy person.  So there I was stepping forward to give a little speech to Kevin Newsom in all his Ken doll perfection and rest of city halls talking heads, without a tremor of nerves.  Starting out as a crazy person all I had to do to exceed expectations was to avoid a full of torrettes episode.
Burt had asked me if I could perhaps contribute to the public comment phase of the hospital closure.  If I would feel ‘safe’, leaving the hospital grounds and speaking in city hall.
“Burt, I hardly think Boccie has people posted outside the hospital just in case I should gopher like pop my head out, and to do a Harvey Milk on me right on the steps of city hall?  Yeh that wouldn’t cause any notice or comment at all.  (eye rolling sarcasm).  
Actually by this time I would guess that Boccie has all but given up the idea of killing me.  He got what he wanted, me out of the apartment and after all this time without any official interest in the ramblings of a mad woman.  Yeh, I would say he feels all nice and safe and secure by now.  Course I can’t be one hundred percent sure, but that’s just one of those weird things I shall have to live with.  Never being sure if the sword of Damocles is or is not hanging over hmy head.  But then how is that different from anybody else?
Carl goes first, its politics, it’s city hall, it’s a microphone, he is in heaven.  On and on he goes and I must say amplification does not improve the quality of his voice.  Then Bob, he doesn’t have much to say except ‘don’t take away my home’.  He does a little twirl, he loves his pink tutu and sits.
Then it was my turn.  I am the worlds greatest procrastinator.  I had written the speech on the back of an envelope   while Carl had been speaking.  I knew I could depend on him to be long winded.
I step to the mic. And pull the envelope out of one of the pocket of my yellow submarine coat.
Even a Lunatic deserves respect

When most people think about severe mental illness they tend to think of it in the context of movies they have seen: ‘one flew over the coo coos nest’, ‘Girl Interrupted, ‘K-pax, ‘ Rain man, People walk away from those movies with the feeling the the severely mentally  ill are , quirky but kinda cute and sweet with a childlike innocence.
Reality is a far cry from such sentimental portraiture.
The severely mentally ill arre
Extremely Annoying People.
(This is the point when every single person on the board including the perfectly groomed Mr. Newsom sit up in their seats expressions of polite boredom replaced with shock.  Like I had just reached up and slapped them all in the face.  Nothing is more shocking to a politician than someone speaking the truth.)
Many fo the residents of the MHFR are not able to master the minimum skill sets necessary to function independently in society.  Skills such as bathing, laundry, dressing themselves, some are completely illiterate, can not add 2 and 2 without extreme mental gymnastics.  Some even have difficulty speaking their own name.
On top of all those difficulties, the mentally ill have an inability to understand or to conform to societies norms of behavior.  The laugh for no reason, scream with no warning, they stumble, they drool.
In short, it’s hard to want to help these people.  We want to draw away, to avoid to step around them.
Think for a moment how many you stepped around as you came to work this morning.  How many grubby outstretched hands you pretended not to see.
We feel angry with those laying on the street in their filthy rags.  Angry at them for so nakedly displaying their helpless misery.
Issues are nearly always complex, but choices nearly always simple.
What is to be done with the mentally ill?  Will we as a society do the hard thing and extend to them care and safety?  Or will we ignore their outstretched hands, close our eyes to their pain and need?  Shall we step over the ragged man with a wrinkle of disgust and a sanctimoniously intoned
“Why doesn’t somebody do something?”
The speech came off pretty well.  Some nice reporter lady talked to me for a bit and that was fun.  She wanted to know how I got to the MHRF.
“Well you see it all started when my landlord tried to have me killed.”
My my how quickly the careful face, the ‘don’t scare the mad woman and back away slowly or she may bite, face comes into play.
The predictability of people if both amusing and depressing.  In a world of information people have forgotten how to ask questions.
The speech went over so well that Burt asked me to print up some copies of the speech for the families and others trying to get people to care.
As the thing was written on the back of an envelope and that my handwriting is resentfully bad my spelling, well the less said about that the better, Burt gave me the key to the computer room so I could spin the speech through a word processor and print up a few copies.
“What do you think your doing?”
(Yeh like I didn’t see this coming.  Charles,  I never he wouldn’t be best pleased to find me in his computer room)
Not even glancing up I expain that Burt had asked me to write up the speech I had given.
“You can’t be in here alone.”
“Well I’m not in here alone am I?  You’re here.”
“I can’t stay in here just to watch you.”
“Ok then, I’ll lock up when I’m done.”
(spell check, spell check. Spell check)
“You can’t be in here alone.  You have to leave.
(Oh honestly there I am trying to help save his stupid job, you would think he might give this ‘I hate that fucking bitch,’ thing a rest for that.)
“I will as soon as I get these copies of the speech printed up.”  Spell check done, send to printer number of copies and there you go.
“How many copies are you making?”
“Ohh I figure 25 aught to be enough.  People need more they can  use a copy  machine I guess.”
“Your only allowed to print 10 pieces of paper a day.”
“That’s for personal use, this isn’t personal, this is to help save the MHRF.”  
The last of the 25 copies spits out of the printer I gather them all up and smile to poor seething Charles.
“All done, you want me to lock up or are you going to be staying to work for a bit.”
Another day another board or bored people putting in the necessary time to listen to the mild whimpers of helpless people before they can get back to the important business of counting costs is drops of blood.;
Another speech scribbled on the back of an envelope.

The Cost of Care

A few years back when the Soviet Empire broke apart signaling the official end of an unofficial war, the US Military looked into the idea of closing a number of its smaller military bases in order to save money.  What they found was that in most cases closing the base would in the long run cost more than keeping the bases open.  We have only to look at the money pit the Presidio has become to remind us of that.
(And the board sat up straighter in their seats.  The Presidio was a poke in a tender place.  The former Army base sitting on some of the most valued real estate in the world and no one could figure out what to do with it.  So it sits mostly empty paying no taxes and sucking up money for maintenance while the lawyers argue over competing claims and costs)
Closing the MHRF will likewise cost San Francisco more than it will save.
There are over one hundred forty patients at the MHRF where shall they go in the event of closure?
Psychiatry patients do not ‘get better’ just because there is no funding for their care.
Some will no doupt end up in acute care facilities.  Such facilities are all ready over burdened and under funded.  Acute care is also more expensive per patient than comparable care done at the MHRF.
Some will go to board and care, even though some are unable to care for themselves in even the most basic aspects of independent living.
Some will no doupt end up wandering the streets, homeless and confused.
Some will routinely be seen in overwhelmed emergency rooms.
Some will fail to take their meds that hold their demons in check and end up acting out violently to a world gone mad.  For those, a jail cell may well be their future fate.
The MHRF is currently the most cost effective answer to a difficult problem.  How do we as a society care for those who can not care for themselves.

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