What's inside

Some of my favorite patients at the hospital are hard-bitten blue-collar guys on their first psych hospitalization.  They haven't processed their childhoods or their issues or anything - it's all been stored up in there, and when they finally start to talk, it's so raw.

Last week I worked with a man who moved to this country as a child.  As a young man he joined a gang and served prison time for shooting someone.  Now he's middle-aged and the stay-at-home dad of young kids.  More than anything, he wants a paying job.  He kept telling me, "I want to support my kids and my wife. I want to be a good father."

Today I sat with a working-class man whose decades-long depression finally got noticed.  He hasn't told his grandmother he's in the hospital, and that's the part he dreads most: "I just can't stand to do anything that would worry her."  Most people in hospitals get teary when they think of how hard their life has been.  These guys tear up when they talk about the harm they might have caused others.

I once saw an unemployed carpenter calmly discuss his plans for suicide and then break down when he told me how terrible he felt that he'd left his dog with a friend and hadn't provided money to buy dog food.  My ex-gangster showed the most emotion when he talked about his mother, who had flown across the country to see him in the hospital.  He hated to think of the money she had spent on the ticket.  "I want her to move out here so I can support her. I want to repay her for everything she done for me."

If I had gone into some other field, I wouldn't sit around talking with murderers, child abusers, addicts.  And I wouldn't get to be there when someone finally speaks about how much he loves the woman who raised him, or about the pain he doesn't show to anyone.  And every time I think, Holy shit, I can't believe you've been carrying that inside you.

"...the Devil hardly ever made anyone do anything. He didn't have to. That was what some humans found hard to understand. Hell wasn't a major reservoir of evil, any more than Heaven, in Crowley's opinion, was a fountain of goodness; they were just sides in the great cosmic chess game. Where you found the real McCoy, the real grace and the real heart-stopping evil, was right inside the human mind."

- Good Omens, Neil Gaiman and Terry Pratchett

What your hat says about you

Last night I was at a discussion where someone claimed to be surprised that anyone picks a car based on what "message" it sends about them. He felt it was very materialistic to do so, and said he would never think of buying a car in order to make a personal statement.

I doubt this is true. Several years ago Jeff's parents were buying a car and had the problem that one of the reasonably-priced and reliable cars they were considering was from a company with a reputation for luxury cars. This is a family that darns its socks, and they would be embarrassed to drive such a car.

I have the same dilemma buying clothes at the thrift store. I hate wearing something with a visible high-price logo, even though I know I paid $4.99 for it. I don't want other people to think I'm the kind of person who paid $70 for a sweater (whatever that "kind of person" is).

I think of it as the John Woolman Hat Problem. John Woolman was a Quaker abolitionist in the 1700s (before abolition was a thing, even among Quakers). At one point Woolman refused to wear dyed clothes, because indigo and other dyes were produced by slave labor. So he wore an undyed hat, but he had the problem that such hats were popular among young dandies. His pale hat made him look like someone who cared about fashion, which was not the image he wanted. In the end, he wore the hat and suffered a principled embarrassment.

Economist Robin Hanson calls this signaling. We all care what other people think of us, and we do lots of things to project certain messages about ourselves. Companies have an economic interest in getting us to signal "I am rich and have good taste" by buying expensive cars or whatever. But those of us who scoff at such things are trying to indicate "I don't care about such shallow things as brand names - I'm not materialistic like that." Which is, of course, its own signal.

Two love songs

One of my favorite love songs is the Roches' "Home Away From Home", about two vulnerable people finding each other.

She was twenty-six when she came to the 'burbs
Where the family secrets stop at the curb
I was nine when she moved next door
She had married a Republican, he was for the war

Over at my house, things were sad
Because my folks were always fighting - that made me feel bad
I went to her door with a cookie tin
I said I am your neighbor, would you let me in
She was big, having a baby
She asked me are you hungry and I said maybe
She gave me soup, a piece of toast
She gave me what I needed the most

Thank you for the love you gave
To me as a child
There must have been so much pain
That you never cried
In my home away from home.

Our society stresses romantic love, but sometimes it's the other kinds we need most. Love can be soup, love can be listening, love can be encouragement.

Another song that never fails to swell my heart is Dar Williams' "You're Aging Well".

Why is it that as we grow older and stronger
The road signs point us adrift and make us afraid
Saying, "You never can win,"
"Watch your back," "Where's your husband?"
Oh, I don't like the signs that the signmakers made.

So I'm gonna steal out with my paint and my brushes
I'll change the directions, I'll hit every street
It's the Tinseltown scandal, the Robin Hood vandal
She goes out and steals the King's English
In the morning you wake up and the signs point to you

They say,
"I'm so glad that you finally made it here,"
"You thought nobody cared, but I did, I could tell,"
And "This is your year," and "It always starts here,"
And oh, "You're aging well."

May you have a year of growing older and stronger, a year of love in unexpected places, a year of the signs pointing to you (wherever you are).

Something wrong

This week on the psych ward one of the patients was telling me why she came into the hospital.  "Sunday afternoon I was at church helping out with the coffee, and I started hearing voices. I was scared."

This woman is unremarkable by psych ward standards.  She's middle-aged and has been living with schizophrenia for years.  She wears the same clothes every day.  Her face shows no expression (possibly an effect of her medications).  Her conversation is polite, but it seems to take effort.

As she talked, I had a mental image of her behind the coffee table in a church parish hall, staring blankly, distracted by the voices.  I wondered what other people at her church thought, and instantly I knew - the same thing I would think if I saw her outside the hospital. "That woman is not normal.  Something is wrong with her."

And yet in the hospital, I notice the things that are right with her.  I expect to see someone with mental illness, so her slightly bizarre presentation doesn't surprise me.  What's noteworthy are the things that are going well - she's not suicidal, she recognizes her hallucinations as such, she has an apartment, she has a boyfriend, she knows how to get help.

In most of my life, I expect people to be whole and I take note when they break. In social work, I expect people to be broken and I take note of the ways they heal.

In reality, most of us develop "something wrong with us."  I and just about everyone I love have one thing or another - depression, diabetes, learning disabilities, overweight, chronic pain.  Some of us can hide it better than others. 

Let's be kind in each other's moments of pain.  Let's celebrate the ways we rise above.