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By Elissa Ely
Boston Globe - OpEd (June 1, 2008)
It was a day of minor miseries. There was a new eight-page form that replaced an old one-page form. Two pharmacies called about patients whose medications had run out but could not be renewed without prior authorization. An SSI application required more documentation. We live in a mad land where helping people rests on faxing paperwork.
That night I went to the shelter. I have always thought of it as the last outpost where forms have not taken hold yet. But they had introduced a new form there, too. It involved arrows, decision trees, and subparagraphs. It was dispiriting.
The staff members were in their usual perpetual motion. They work long shifts, turnover is high, and many of them also work second jobs in other shelters, other outposts. The evening supervisor is African and tall as a tree. He wears loose cotton shirts, bone dry in the absence of the African sun, a gold wedding band, a baseball cap. Drunken clients misunderstand his accent, and he has experienced the casual racism of those who, with nothing else to their names, feel entitled to claim the United States as their exclusive property.
The shelter wheels turn smoothly under him. But that night the wheels were falling off. Plumbing had broken in the men's dorm, there was a fight in the dinner line, something was going on with the ventilation, someone was being taken away to detox. The supervisor was running like a madman with his notebook in his hand.
In the middle of the shift, a woman arrived, in tears, but not for psychiatric reasons. She had been living in the shelter a few months, valiantly sober, managing a full-time job. She was slogging through the necessary steps to self-financing and getting an apartment: paycheck, bank account, first and last month's rent.
A few days earlier, she thought she had found a place outside of the shelter to stay while accomplishing all this. She had handed in her notice, returned her locker key, and packed her stuff. This meant giving her bed up to someone else.
But her housing situation fell through. Now she had lost her bed and locker. Without a locker, she had no place to keep her uniform; without a uniform, she could not keep her job; without her job, she could not keep her bank account. Entropy was rising all around her.
We clucked helplessly and passed tissues. The bed belonged to someone else now; the shelter was full. At this hour of the night, other shelters were probably also full. She held up her hands in defeat.
The case manager decided to consult the evening supervisor. There was not much anyone could do - numbers were numbers - but it seemed like a supervisor should know the situation. Besides, productive feelings come from sharing a problem without a solution, even though the feelings are usually illusory. As a former boss once said, never suffer alone, and always kick it upstairs. The case manager left, and we sat in silence, listening to noise from the other side of the door.
There was nothing therapeutic to say.
It took a long time to track the supervisor down. That tall, treelike man was in Heisenbergian motion, disappearing between plumbing repairs and ambulances. At last he was located.
His response was prompt. No problem, he said. He would find a bed for her on the floor. This was an executive decision. He would use his authority and arrange the details.
The whole sobriety-saving, future-saving transaction occurred quickly, efficiently, and without a single fax (though there must have been some form to fill out afterward - if it wasn't recorded, how could it exist?).
Comparisons are irresistible. Paper is self-important and often unhelpful. The supervisor was humble and promptly able to accomplish the necessary. I regret I know nothing of the details of this man's life - what country in Africa he is from, how many children he has, what second or third job he works. I only know he is flesh instead of paginated sheets or self-addressed stamped envelopes, an unsung hero of whom I sing.
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Elissa Ely is a psychiatrist.
© Copyright 2008 Globe Newspaper Company.
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