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(The first in a series of client profiles for a book collaboration on city planning).


Last June I went exploring crackhouses, hoping to find my client Chicken Man in a flooded garage with half the roof gone, only to have him point me to someone even sicker.

Miss Gloria was tiny, incontinent, partially paralyzed, speech slurred from a recent stroke, beloved by homeless and neighbors everywhere she went due to her extremely popular son, who operated out of a ground floor unit in the hotel across from Dekalb County jail (I have a story about another homeless family we placed in that hotel, it ends in prison for the baby daddy and a Catholic group home for everyone else). She'd lost seventy pounds living on the street. I asked the sex workers who looked after her why she was so skinny and they replied, "The church only comes to feed once a week now. She can't walk farther than that."

She'd die under that bridge.  Too sick to function, too big a liability for her son, a boarding house, or the assisted living facility, but not crazy enough to be institutionalized against her will. Our last ditch option was to wait for the sex workers to call an ambulance and have Grady place her in a rural nursing home.

(As a side note, none of the three options listed earlier would have been a good fit anyway. The son shared a tiny room with his girlfriend and infant child. The boarding house room was a second-floor unit owned by a fastidious retiree who kept everything Open Casket neat and was not interested in being a live-in nurse. And the ALF was a haven for smokers in wheelchairs with Good Insurance, where Miss Gloria might have been happy if she were marginally more independent or could afford a maid.)

Rural nursing homes wouldn't take her without ID, proof of income, and Medicaid, so for the next month I laid a painter's tarp on the backseat of my car to drive Miss Gloria to various government agencies. Every morning I prepped her with cigarettes, Cheeze-Its, and a clean dress, teasing the poopy diaper off her ankles with a coat hanger. Sometimes the sex workers helped me change her clothes under the bridge, other times I got lucky and led her inside a restroom. The funniest time was when she peed on her way through the metal detector at the Social Security headquarters and the guards kept exchanging glances like "do we...use a paper towel? Maybe a lot of paper towels?" (pro tip: drive the extra fifteen miles to suburban offices, where the wait is shorter and nobody makes you turn out your pockets).

We ordered the birth certificate online. We had a social worker draft a note so she'd qualify for a photo ID bus card. Her son held onto her Green Express debit card, which meant driving to a six-story hotel where fifty young men all stepped out of their doors at once to see who I'd come to visit (pro tip: wear nurse scrubs so they don't mistake you for police).

Sure enough, I arrived at the bridge one morning only to learn Miss Gloria was in Grady for heart palpitations, so I made Xeroxes of all her documents, put them in the hands of her social workers, and snuck her some menthols in a box of crackers (she wasn't allowed to smoke in her room but she could break them apart and chew the tobacco).  Medicaid meant she could keep her bed for weeks until they placed her somewhere. After a week of no crack and clean sheets, she began to look sane.

When the nursing home offer came in, we didn't tell her it was ninety miles away, far from the beloved son who continually put her to the curb. I brought her a bag of new clothes, two packs of smokes, soft candy, and left just before the nursing home van pulled up.  Her medical record shows that she gave verbal consent but not signed consent to live in the new facility, so there is only the doctor's X for Miss Gloria's signature.

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