Two drug-related incidents in the shelter today. Around 10 a.m. a middle-aged client tried to pick up a chair, lost his balance, and fell hard to the ground. Staff came to his side and tried to talk to him, but he only mumbled incoherently. A woman sitting nearby reported that the fallen client had said he had suffered a seizure the day before. Perhaps. His incoherence did mimic a post-seizure haze. But we know this client too well to take this apparent explanation at face value, for he is perhaps the shelter’s premier heroin addict. He never shoots up in the shelter, but he comes in high about three-quarters of the time. (His addiction has left him so malnourished he has scurvy rashes.) He has mastered the art of stumbling about the shelter in a state of semiconsciousness, like a sleepwalker who never wakes.
He usually doesn’t fall down, however, and today he had another symptom: a slow rolling of the lips. This is a Parkinsonian symptom that often appears as a side effect of anti-psychotic medication. The client does take an anti-psychotic for schizophrenia, but he takes one of the newer generation—developed in the mid-’90s—which trigger those side effects at a much lower rate than the older generation. (They appear in 0.5 percent of patients per year, as opposed to 5 percent per year.) Our nurse examined him and decided to call an ambulance. Did this client have a seizure yesterday? Did a brief seizure trigger the fall this morning? It’s possible, the nurse told me, but he’s never been diagnosed with epilepsy. More likely, a heroin overdose or withdrawal triggered a seizure. Or maybe he just took too much smack and slipped briefly from semiconsciousness to unconsciousness. The medics propped him up in a stretcher and took him to the hospital for tests.
After lunch I did a routine bathroom sweep and found a client in front of a urinal slipping something to the guy next to him. They spied me, stuffed their paraphernalia into their pockets, and pretended to piss. I smelled crack smoke—for the uninitiated, it smells like an electrical fire—and ordered them to do a self-search, which turned up nothing. Without evidence, I couldn’t bar them. I warned them to leave their habit outside and logged the incident on the shelter computer. To take a hit of crack you need to expose the lighter and pipe for only several seconds, so catching clients in the act is hard. What’s sad, though, is the lengths clients go to for a fix. Several weeks ago I had a long conversation with a new client despairing over his crack addiction. He’s a skilled worker, but he can’t pay rent or hold a job because of his habit. His “girlfriend” provides him with crack but also sells herself to get it. We strategized ways to stay away from the girlfriend, and while we both knew the odds were against him, he thanked me, and I believed I had earned his trust. Several days later he begged me to let him use a locked bathroom so that he could piss. I let him. He was in and out in 15 seconds, and the bathroom smelled like an electrical fire.
I want to end this diary by talking about equality, as a matter of both policy and philosophy. An annual one-night count of Seattle’s homeless found nearly 1,500 people on the streets last October. Some of these folks want to sleep outside, but most don’t. The solution isn’t just to throw more money at the problem, though that would certainly help. Research indicates homelessness persists partly because of a misallocation of resources. This occurs in two ways: 1) Most chronic homeless people are single men, yet most human-service charities target women and children. 2) Chronic homeless people do not receive enough mainstream social services, such as welfare, health care, and addiction treatment. As a result, they consume a disproportionate amount of emergency social services, such as shelter beds. This pushes many of the temporary homeless—who constitute the vast majority of the population—onto the street. (Welfare-reform wonks sometimes call the mentally ill and drug addicted the “hard cases,” partly because they don’t respond to monetary incentives as effectively as the more functional population. They are hard to treat but vital to the larger solution.)
The Morrison Hotel’s history as a destination for the rich provides a daily study in wealth and the lack thereof. The shelter’s walls are actually mahogany paneled with engraved cornices near the top. But decades of retrofitting have shrouded the building’s turn-of-the-century opulence with a floor of cheap tile and a drop ceiling. Add to this the rows of cheap plastic chairs, the piles of ugly gray mats, and the constant stench of urine, B.O., and bleach, and you have a thoroughly decrepit space. (A DESC client-confidentiality policy prevented me from photographing it.) When I first entered the shelter, I was reminded of the scene in Dr. Zhivago when Zhivago comes home to find his mansion being commandeered by angry Red soldiers and stripped by hungry peasant squatters. “There was living space for 13 families in this one house!” one of the commissars barks. Zhivago replies, “Yes, this is a better arrangement, comrades. More just.” His wife begins to titter, but Zhivago, that bleeding heart, protests: “Well, it is more just, Tonya. Why did it sound so funny?”
