Haiku (17 page)

“Brewster says he does not need this medication.”

Levi studied my face for a moment. “But you already know that’s not true,” he said.

“Yes,” I admitted, noting again Levi’s habit of asking questions that assumed facts—I was impressed that he could so quickly intuit the truth. “But is there no alternative? Brewster says the medication makes him feel … strange.”

“Tardive dyskinesia,” Levi said, nodding his head. “Those uncontrollable movements you see, like jerking his arms for no reason, or when he rolls his tongue outside his mouth—it’s a known side effect of
any
medication that controls … or even eliminates … the voices. Brewster’s schizophrenia is what we call ‘Undifferentiated.’ He’s not paranoid, he’s not disorganized, and he’s never had a catatonic episode. So Brewster has a real shot at functioning
in the community. But he’s got to achieve
and
maintain a consistent blood-level of his medications before he can participate in our skill-building program.”

“What skills are taught?” I asked, genuinely curious.

“That depends on where we start. For some, it could be as basic as personal hygiene. Brewster actually has a relatively high GAF—” Seeing my obvious confusion, he explained: “Global Assessment of Functioning. The higher the better. Brewster could
already
handle a wide variety of clerical jobs, for example.”

Sensing that Brewster did not resent being spoken of in this manner—indeed, he seemed to regard the information I was being given as praise—I asked, “Who would hire—?”

“That’s another skill we teach,” Levi said. “Job-finding. Handling the interview. How you
keep
a job. We do the same thing with housing, transportation … anything that gives the client a realistic shot at self-maintenance. Truth is, Brewster could have been on his own a long time ago, if he put some effort into it.”

I looked at Brewster.

“I don’t want a job,” the young man finally admitted, blushing furiously. “I just want to work on my library.”

“But you have to come here to get your check,” Levi said. His voice was neutral, not accusatory. “So you show up and go through the motions.”

“I come to every—”

“Yeah. You never miss a session,” Levi said, his voice hardening slightly. “But you never
participate
in them, either.”

“If it wasn’t for my sister’s husband—”

“You’d move in with her,” Levi finished. “But what
would that change? You still wouldn’t be taking care of yourself, Brewster; you’d just be changing caretakers.”

“The meds make me all … fuzzy. I can’t think straight. How could I ever hold a job?” Brewster said.

“I’m not saying it’d be easy,” Levi told him. “I
never
said that, did I?”

“No …” Brewster replied, his attempt to divert the conversation away from his own lack of interest in what Levi had called self-maintenance having failed.

I waited a few moments, then I spoke into the silence: “Can you … can you tell me why Brewster might, most sincerely, believe he does not need this medication?”

“When a schizophrenic goes off medication, there’s a honeymoon period,” Levi told me. “His mood elevates, the kinetic tics occur less frequently, or even stop altogether. Off the meds, he gets all manic. Expansive, grandiose, absolutely convinced he’s in total control of himself. Then comes the … episode.”

“Always?”

“Always. No different than taking a diabetic off insulin and putting him on a diet of hot-fudge sundaes. We try to build in every option possible, and we’re always adding new ones. But the medication, that one’s nonnegotiable.”

“You will reject Brewster if he does not—?”

“It’s not personal,” Levi cut me short. “Everybody here likes Brewster, and he knows it. But he
also
knows that ACT is all about helping folks change their lives, and, for some of our people, they can’t even get
started
unless they commit to taking their medication. This isn’t a Welfare office. Brewster’s got himself a nice, certified diagnosis. He knows he can
stop taking his meds and he’ll still keep right on getting his Disability check. But he won’t be picking it up here.”

I shifted my posture so that I could triangulate Levi and Brewster, although I addressed my words only to Levi. “So Brewster has
chosen
to be in a program where more is required of him than he is willing to give?”

“Yeah,” Levi said, leaning on his forearms. “I wonder about that myself.”

“I like talking to Levi,” Brewster said.

It was as if theater curtains were lifted, and the play was the revelation of a secret. I then understood the true reason why Brewster had asked me to accompany him that day. Despite his claims, some part of him
did
want to self-maintain. He attended the various programs at this place not because that was the only way to get his government stipend, but because it was his only channel to Levi.

“You are a young man to have acquired so much wisdom,” I said to the therapist.

“I’m a good listener,” he said, flashing a quick, thin smile.

“Ranger doesn’t have to …” Brewster muttered sullenly.

Before I could act to protect Ranger’s privacy, Levi had already stepped on Brewster’s childish sulkiness: “The ACT Team works with the most high-need cases, but that’s the
only
thing our clients have in common. You want to be treated as an individual, right, Brewster?”

“Sure. I mean—”

“I don’t want to hear anything like that again, okay?”

“Levi,” Brewster pleaded, “I didn’t mean to—”

“Sure,” Levi said. “Just let it go. Any decisions you make, you make them about
you
, okay?”

“Okay.”

“Your expectations, they, too, vary with the individual?” I asked, sensing Brewster’s anxiety at having trespassed across a known barrier.

“Right,” Levi answered, his voice back to neutral, the very sound soothing to Brewster. “Let’s say, hypothetically, there was a man with PTSD—Post-Traumatic Stress Disorder—as a result of a long period during which he was fighting for his own survival … like a soldier in combat. If his problem
was
due to military service, he’d be entitled to treatment at the VA. But we see a lot of guys who blame the government for whatever’s going on in their heads. They end up here, because you couldn’t ask for a less military outfit than this one.”

How Levi assumed I knew Ranger, I did not know. But it was clear he was offering me the “hypothetical” information for a purpose. I immediately seized the opportunity to test the limits of my access.

“And if a person had, say, an addiction to gambling?”

“If that was his
real
problem, we’d probably never see him,” Levi said. “Depending on his resources, he could get anything from celebrity spa ‘rehab’ to a bed in a detox facility, only it wouldn’t be dope they were trying to get out of his system. Most of them end up in one of the self-help programs. Like AA.”

“That contract you had me sign …?”

“Yeah?”

“Could not Brewster sign one as well?”

“I’m not a lawyer,” Levi said.

“Ah. Forgive my poor English,” I said. “What I meant
was, you said each individual has a different level of … functioning, is it?”

“Uh-huh.”

“And Brewster’s is quite high?”

“It is.”

“So I am not asking you a question about whether he could sign a contract to buy a house. My question is: Could Brewster sign the contract every man signs when he gives his word? Is he … functioning enough to do that?”

Levi gave me a hard, searching look. Then he said, “I wasn’t lying when I told you I was a good listener.”

I bowed.

He quickly turned to Brewster. “How many days, Brewster? No games. How many?”

“Five,” the young man repeated, without hesitation.

“Counting today’s?”

“Yes. But, Levi—”

“Which means we can cut that down to four. Understand? You come
here
to get your meds from now on, Brewster. Every day. We’ll trust you over the weekends, give you three days’ worth on Fridays. Same day you let us draw some blood.”

“That’s not—”

“Yeah, it’s fair,” Levi said. I could now detect a vein of well-controlled anger in his voice. “This is a place where we help people help themselves, Brewster. We’re a therapeutic team, not a fucking pharmacy, got it?”

“I never said—”

“Your behavior said it for you. So that’s the deal. You give
us one solid month without missing a day, we go back to giving you a week’s supply at a time. You come to the programs and you do more than just sit there, understand?
That’s
our contract. You want to be a man, stand up and we’ll shake on it. You don’t, there’s plenty of other places where you can go and pick up your check.”

None of us moved for a long minute. Then Brewster stood up. He stuck out his hand. “I promise, Levi,” he said.

“Good enough for me,” Levi told him. He hit a button on his desk. “How can I—?” came through the telephone speaker.

“Pull one day’s med package for Brewster,” Levi said. “He’ll be in once a day from now on, until I tell you different.”

“Dr. Pkhafatsh’s orders—”

“He doesn’t work here, okay? He’s just a rubber stamp,” Levi interrupted. “If he’s got a problem, he knows where to find me.”

Levi pushed a button, and the speaker went silent.

I got to my feet, faced the therapist—I now knew the true meaning of the word—bowed, and said, “Would a true friend of Brewster’s allow him to sell his medication?”

“Never,” Levi said, holding my eyes with his own.

“So it shall be,” I said, signing my own contract.

I followed Brewster to a window where he picked up a packet. After a moment’s hesitation, he took a proffered plastic cup of water, and swallowed the pills he had poured into his hand.

We left the building together.

“You can’t rush these things.” Lamont spoke out of the side of his mouth as he continued to scan the street from a “fishing spot” we had claimed earlier that day.

Darkness had fallen. Thus, we had fewer competitors. And considerably less fish. But our presence would not be seen as remarkable; this city’s streets are so thoroughly covered with those seeking money from strangers that only their absence would attract attention.

Although they all seek alms, few would regard themselves as beggars. Some stalk the subway cars, virtually
demanding
money as they loom over seated citizens. Some prefer the street, putting on “performances,” such as singing or dancing or playing an instrument, an open receptacle nearby for passersby to reward their efforts. Some spend all day in front of hand-lettered signs that explain their plight. “Disabled Vet” was highly favored until recently, but has now largely been replaced by references to lost employment. Some stagger about, holding an empty cup, mumbling incoherently, glassy-eyed and drooling. Some reek of cheap wine. Some wander aimlessly, others have rigidly established routes. Occasionally, there are even physical battles over a particularly desirable location.

According to Michael, the city’s homeless shelters are so overcrowded that people are often turned away. Lamont told me that today’s shelters were just like the “dorms” he had been sentenced to as a youth. His description of those dorms was horrifying, but Lamont said they were considered a rite of passage for those who sought high status among youth gangs.

Silence fell between us, as it does when Lamont and I both need to search ourselves.

I thought of adaptation. Here, winter kills by its very presence. Some who cannot find shelter fall asleep and do not awaken. Were it not for our dugouts, desperate measures would have been required years ago.

“Watch that one,” Lamont suddenly intruded, his chin tilted toward a dark-haired young woman in a shimmering red skirt that barely concealed her sex, and a matching band of the same material in lieu of a blouse. She was expertly navigating on extraordinarily high heels, weaving between the cars driving closest to the curb. The ones driving very slowly.

Perhaps ten minutes later, one of those cars came to a stop. The young woman walked over to it as its window slid down. She put her head and upper body inside the car, creating an exaggerated display of her buttocks. A moment later, she withdrew, and the car pulled off.

“Too rich for the boy’s blood,” Lamont said.

Before I could ask him to explain, another car had stopped. The young woman repeated the same gestures. But, this time, a bargain must have been struck, because she walked around to the far side of the car and climbed in.

“They’re going to the Cheshire,” Lamont said. “That’s a trick hotel. Rooms by the hour. Girl like that, she won’t be doing you in the front seat. You want that kind of action, you go over to the West Side. Cheaper meal, smaller menu.”

I said nothing, watching similar choreography repeated by other young women.

“This is one of the best strolls in the city,” Lamont told me. “At least, it is today. They move ’em around.”

The young woman in the red outfit returned in less than an hour. She held a brief conversation with a blond woman, each of them smoking a cigarette. The blonde took a small cell phone from her purse and opened it, apparently answering a call. I could not hear whatever she said, but she seemed to be remonstrating with whoever the caller was.

Both women returned to their work. The girl in the red outfit was more consistent, but all succeeded in attracting customers.

It was getting quite late when a black sedan with lavish gold trim and oversized wheels of the same color pulled to the curb. It gleamed as if polished with oil.

Both girls scurried over to the car. They seemed to be competing for the attention of the driver, but the exchange was short, and the black sedan pulled away without either one inside.

“His game is weak,” Lamont said. “That’s old-style, checking your traps like that. A player who’s got his game down, he don’t need to be checking; he knows his ho’s gonna bring him
his
money.”

“So he is not the one we want?”

“He’s just
what we want, bro. Lightweight like him, he’s gotta carry his flash with him. We’re not gonna find some major-leaguer out here. A pimp on that level, his ass is parked in some club right this minute, snorting lines off a platinum spoon one of his women bought for him. What
we
want is a man who
wants
all that, but he’s still dialing longdistance. Maybe he’s too young, maybe he’s new to the game—I don’t know. But you saw his play, right? See how easy he’d be?”