In the old district of downtown Seattle, down a flight of stairs from sidewalk level, around a couple turns and through a door, is a service center. Hispanics who live on the street call it the Hoyo, or the Hole, because of its subterranean location, but it's not a "hole in the wall" or a "pit." As we enter, we see a large, low-ceilinged space filled with tables. Near the front door is a service counter where people can get a pair of shoes, a clean shirt, or a jacket; or they can sign up for a shower in an adjacent room and borrow a towel. Some seventy or eighty people of various races and ages, mostly men, sit around the tables, and there's an ongoing murmur of conversation. One man sleeps, his head cradled in his arms on a tabletop. Several have sleeping bags rolled up or piled next to their chairs. In a corner of the room, a card game is in progress. Before the city banned smoking in public interiors, the place used to be bathed in a gray-brown haze, but otherwise the atmosphere was one of simplicity and warmth, as it still is. The center was, and is, a kind of club, and some of the folks who eventually find a home return to help those who are still left behind. One feels welcome here.
It was here that I first met Jerry, seated on a folding chair at a table and sipping coffee from an old chipped mug. He had on a tattered dress shirt with frayed cuffs under the stained and rumpled sport coat that he had once, long ago, worn to worka sign of a professional man who cared about his appearance, back in the days when he was able to maintain it. He was then, from all accounts, a modest, competent, and thoughtful citizen.
Since then, however, illness had kindled in Jerry and he had developed a reputation of another sort. Service staffers knew him as one of the most difficult individuals on the street. One day he would bluster about the city, claiming to be the commandant of the coast guard; the next, he was the superintendent of construction for all downtown buildings; on another day, he was the Treasurer of the United States. In the midst of these episodes Jerry was impatient and irritable, oblivious of the usual rules and regulations. He would shove to the front of the food line, berate shelter volunteers, and shout at service center staff. When his illness was full blown, he had little or no consciousness of his behavior. The quiet, caring, thoughtful man disappeared behind the symptoms of mania and grandiosity.
At various times Jerry's behavior got him barred from every shelter, drop-in center, and meal program in the city. There were days when he had literally nowhere to go. One morning I encountered him storming up out of the Hoyo. He headed grimly up the sidewalk, shaking and muttering. At first I followed him at a distance, but gradually I caught up with him, giving him berth, until at a corner we stood side by side. Jerry glanced my way, his eyes furious, and continued to stride forward. I stayed with him, and we walked together in silence for many blocks. Finally he slowed, and we turned into a small café. Still agitated, but somewhat calmer, Jerry sat and gazed at me. Eventually, a tear formed in his eye. He shook his head. "Is there anything for me in this world?"
"There is, Jerry," I said. "There's something for each of us. Possibilities, purpose, potential."
On an afternoon a week or so later, the usual collection of people were in the Hoyo, trying on clothing at the service counter, drinking coffee, playing cards. At the rear counter, next to the coffee urn, volunteers were clearing away the pans and bowls from which they had just served a meal. Jerry, sitting across a table from me, began writing on a blank sheet of paper, telling his story: where he was born; how he grew up; where he went to school; where he went to college; when he enlisted in the Navy; and when he worked.
Toward the bottom of the page, the pen moved faster and faster, and Jerry's writing began to sprawl. He pulled the pen back to the top of the sheet and continued his story, filling in the spaces between the lines. Reaching the bottom a second time, he wrote up the side of the paper and around the edges, then up and down the page across everything he had already written. Finally, in a furious rush, he scribbled sentences diagonally from one corner to the other. He spent about half an hour filling the paper with layers of dense, black ink that became impossible to read.
Finished, he shoved the paper across the table.
"That's me," he said.
What I could read of Jerry's narrative revealed a complex pattern. It touched upon core events in his lifehis childhood, his education, his time in the Navybut the basic thread of his story was interrupted by tangents which he had added in bursts of emotion. Some of his story line had a dreamlike quality: he was making deliveries in a truck but then headed off on an imaginary journey that took him nowhere. He was riding a motorcycle along country roads, and then without any transition he was back home again. The pieces of his autobiography didn't fit together in any clear way.
Jerry's problems began while he was at sea with what he characterized as a nervous breakdown following an incident in a storm off the Alaska coast. A radioman, he had been the only contact between his ship and a fishing vessel that was sinking. He relayed the messages coming from the distressed boatits location, the condition of the crew, the calls for helpto the rescue command center. He stood in the gap, maintaining communication, receiving reports from the field, passing along the information for processing, and sending back action updates and encouragement. It was an exhausting and draining task, and Jerry gave his all.
Shortly after that ordeal, he experienced the first great storm of confusion in his mind. Jerry's brain, like yours and mine, is an intricate command and control system that had been called upon for complex tasks of information gathering, calculating, evaluating and making fast decisions, strategizing, three-way communicating, and giving moral support. All of these activities took place quickly and in an environment of intensified mood and emotion. Jerry's brain got him through the crisis, but then it malfunctioned. He slipped into repeated cycles of manic highs and miserable lows. When he first left the service, he was able to function professionally on the staff of a nonprofit organization, but eventually his illness overwhelmed him and drove him out of his career and into the streets.
For years, Jerry resisted any suggestion that he might be suffering from a mental disorder. Most of the people who crossed his path saw him only as a man who had lost touch with reality and couldn't control his anger. Few saw the process that had led to the full-blown presentation of Jerry's disorder. For those who wanted to help himthe service center staff, the well-intentioned volunteersthe best they could do was to contain Jerry's chaos, or confront it, or, in the end, give up trying to restrain him and ask him to leave. It's not that they were mean-spirited; they had difficulty understanding his illness and little training in how to help people like him.
What do people need when their brain chemistry is out of balance, when their thoughts and feelings are in disarray? They need a fellow human being who understands that what they are experiencing is serious, but treatable. They need both acceptance and honest responses, both sensitivity and clear, appropriate limits. They need someone who can help them get appropriate care from skilled practitioners who are trained to treat their particular form of illness. They need open doors to treatment and a continuum of care for long-term healing. Above all, they need the compassion and support of our communities, including especially our communities of faith.
Our society, our communities, and our culture are not adequately equipped for the scope of the task. Our congregations have not been prepared to care effectively for the multitude of brothers and sisters in our midst who suffer from mental illness. We haven't realized our potential for care, and we have created far too few possibilities for healing and growth.
* * *
We have only begun to grasp the wonderful complexity of the brain and to understand what is happening in the course of a brain disorder. The Bible offers a basic framework for appreciating the delicate and involved nature of our bodies and brains, but it doesn't begin to explain the actual composition and functioning of the cells and systems that make up the human being.
Each of us is a small universe of astonishing depth and richness, each of us a world worthy of exploration. The Psalmist reminds us that we are "intricately wrought," even before we emerge at birth (Ps. 139:15, RSV). Psalm 8:5 proclaims that we have been "created little less than God" and are "crowned with glory and honor." Thus the Psalmist, composing more than two millennia ago, sensed the outlines of the complexities and the potential in us. But of our specific physical, biological, and biochemical makeup, the Psalmist says little. It wasn't until more than two thousand years later that science began to identify the intricate molecular structures that constitute the human body.
And by far the most intricate part of our body is the brain, a crowning glory giving us the capacities to sense and feel, think, become unique persons in relation to others, and share together. It is the brain that enables us to have faith: to delve into life's mysteries and seek its deepest meanings.
Now, in the early years of the twenty-first century, science is just on the threshold of more fully understanding the complexityand, indeed, the miracle of lifethat is the human brain. Weighing less than three pounds, the brain contains hundreds of billions of cells, no two of which actually touch each other. Each cell is its own constantly shaping center of process and activity, joined in a surrounding sea as ships in a fleet, microscopic flotillas organizing to hold memory, give rise to mood and emotion, process sensations, carry language, create ideas and speech, imagine, choose, act and decide, write, draw, paint, sing and dance, believe, pray, and celebrate. In the mystery and complexity of the human brain lie the most mundane activities of monitoring our breathing and the beat of our heart, as well as our capacity to experience the holy, what is ultimate and sacred. Each of the hundreds of billions of cells in our brain is its own small miracle ship in a biochemical ocean. Every individual neuron has its own information-receiving systemup to ten thousand dendrites, receptor sites available to chemical messengers sent specifically from nearby cells, and a semipermeable cell wall open to the changing, local waters, which bathe whole clusters of neighboring cells in common biochemical waves of informational activation, intensity, and modulation. Each individual brain cell also contains its own nucleus of activity, its own internal processing center, up to ten thousand protein molecules organizing and shaping and pulsing forth a unique contribution to our overall personal and human experience at any moment.
With so much activity going on all the time, it's no wonder that the brain can malfunction. Some of us are more fragile and vulnerable than others to subtle shifts in brain biochemistry, but under extremely violent or stressful conditions, any of us can be at risk for a breakdown in our ability to manage our emotions, think clearly, make decisions, communicate with others, or relate to even our dearest family members and friends.
Even in our daily lives, almost all of us have some experience of the extraordinary states of which the human brain is capable. Consider our dreams, the unusual, even bizarre, scenarios created in the midst of sleep; how we may awake and find ourselves unsure of where we are, disoriented in time and space and sense of self by the power of a nightmare or a dream. Consider our capacity for daydreams and fantasy, the power of the imagination. Consider the different interpretations we each can put on the same event.
Artists regularly demonstrate our capacity for experiencing and communicating the unusual, sometimes in quite strange and disturbing terms. The fluidity of the brain is an amazing gift.
When our friend Jerry was most ill, the disturbances within made it almost impossible for him to explore or even acknowledge his disorder. The very capacities we use to consider our situation, receive and process feedback from others, and choose a new directionthese are precisely what were impaired for Jerry. Nevertheless, something of Jerry's basic self, the self he and others knew when he was healthywhat I call his familiar self, as distinct from his illness selfremained available and always potentially at hand, even in the worst moments of his internal storm and its external fury. We might walk miles together, Jerry fuming, I in silence, as the whirlwind spent itself and finally subsided. Sometimes the gusts and squallscame steadily and lasted for days, or dropped Jerry into extended depressions.
And for periods, he functioned with a relative wellness. He could be a model volunteer, a cooperative client at the shelter, a thoughtful and caring brother to others who were homeless. Jerry dearly wished to get off the street, but to do it on his own terms, not as a psychiatric patient. Such is the stigma associated with mental illness that few of us willingly embrace a diagnosis or readily accept treatment. Jerry was no exception. People from the service center staff had suggested treatment possibilities and attempted to get him into care. When his symptoms were full blown, he belligerently denied any need for help. When he was more coherent and available for conversation, he was wary and ambivalent about seeking mental healthcare. He questioned whether a doctor or drugs would do any good and dredged up scenes from the movie One Flew Over the Cuckoo's Nest, saying that he didn't want to end up somewhere with a Nurse Ratched, the cruel head nurse of the mental hospital portrayed in the film.
Jerry had a particularly intractable illness. He and I shared the journey together for seven lean years, building trust and understanding and making gradual connections with care. He loved people and genuinely enjoyed being with others. Eventually, he opened to the help of a young caseworker from the local office of the national organization Health Care for the Homeless, Graydon, who began seeing him at a shelter he frequented. Graydon became a part of Jerry's team, and the three of us would meet over coffee or a sandwich. Graydon focused on practical issues and needs, helping Jerry negotiate reentry to the shelter when he faced a week's banishment, obtaining food stamps for him, helping him set up some basic routines, increasing his access to a clothing bank and showers, and assisting him when he eventually began applying for housing and benefits.
One day when he was feeling exhausted, Jerry agreed to go with us to the hospital. He saw it as a well-deserved R R, rest and recuperation after his long struggle on the street. It was the right prescription for his battle fatigue, and he accepted it as such. Once on the inpatient unit, he watched carefully as others went about the healing process. The psychiatrist explored with him the possibility of medications. Jerry talked about his illness and paths to recovery with his hospital roommate, in group meetings, with other staff members, and on our visits together.
While Jerry was in the hospital, he asked me to bring him Communion. I arrived at his room with my kit, a box containing a wafer of bread and a small bottle of grape juice. I opened the box and set it on the bedside table. I broke the wafer in two and poured juice into two small Communion cups. I offered a prayer of blessing, and we shared the bread and the cup together. "Would you bless the medicine if I took it?" he said.
"Sure," I said.
We celebrated two Communions that day, one of bread and juice, one of healing medicinetwo sacred moments, two occasions of restoration, two moments of God's gift and grace.
* * *
About a year before Jerry got off the street, our community suffered a loss. Eddie, a staff member at the Hoyo, died of cancer. We set up the day center for a memorial service. Someone brought in flowers in small bottles to set on each of the round tables, and we fashioned an altar from a table at one end of the room. Refreshments were prepared. During the half-hour before the service was to begin, people gathered. Eddie had worked at the center for a long time, and those who came to pay him tribute spanned several generations. There were ex-cons who had been among the first to populate the service center two and three decades earlier. There were middle-aged women who had fled, years ago, from abusive relationships. There were youthful runaways who were trying to escape violent home lives.
At the last moment, Jerry rushed in. Out of breath, he told me he wanted to say something at the memorial and then sing the "Bugle Song." I wasn't sure what he had in mind, but I told him there would be a time for people to share their thoughts and memories. I invited him to speak if and when he felt ready. I didn't encourage the Bugle Song; the only thing that came to my mind was the Andrews Sisters, singing their jazzy World War II tune, "The Boogie Woogie Bugle Boy."
The memorial service started with someone playing a Native American flute solo, a quiet, haunting, soothing sound. One of the regulars at the center read a poem she had written for the occasion, a tribute to Eddie and his many kindnesses to folks over the years. Elderly men, women long accustomed to life on the street, transients, persons struggling with mental illness and addictionsa roomful of the forgotten and troubled and barely-making-itshared their stories of Eddie's steady presence and encouragement. Staff members, volunteers, board members, and people from the wider community offered their special remembrances.
We had almost reached the end of the service. It was time for a final prayer of commendation, a last hymn, and a benediction, and Jerry had not spoken. I glanced at him and said, "Are there any others who would like to share with us their memories or thoughts about Eddie?"
No one spoke or moved. I started toward the center of the little altar to offer the closing prayer.
Then, finally, Jerry rose from his seat. I waited. He shook his head as if to clear his mind, and brought his hands to his eyes, as if clearing his vision. He gathered focus and spoke.
"Eddie was my friend," he said, "sometimes my only friend. Eddie always had a smile and a hello for me. There were times when I couldn't come in here, times when I couldn't go in anywhere. I didn't have any place to stay. I didn't have any place to eat. But Eddie always made sure when I came to the back door. He couldn't let me in, but he made sure to give me a blanket and a sandwich. I'm alive because Eddie cared. That's all I have to say. And now I want to sing the Bugle Song."
In a clear baritone, he began to sing:
Day is done, gone the sun,
From the lake, from the hills, from the sky;
Safely rest, all is well,
God is nigh.
The words to taps, the day's last call.
The room was quiet. This oft-rejected, broken pilgrim of the streets sat down, and the flute picked up the tune. The melody of reassurance circled and sounded to us all.
In our hardest moments come the toughest questions. And the deepest answers. No matter what we have been, no matter who we are, no matter how little we have at the end of the day, home and safety are our ultimate destination, healing and wholeness our ultimate abode. Stronger than any illness or evil, able to overcome death itself is the nearness of God, an infinite gentleness able to bear with us our worst, and bring forth in us our fullest and best.
Jerry entered and left the life of the Hoyo community numerous times over the years as he aged. A small circle of care wove itself around him. In his sixties, he was placed in care on a geriatric psychiatry unit, along with others who had had lifelong journeys with mental illness. Among these veterans of the struggle, Jerry was welcomed as a valued comrade. Frail after many years on the street, he transitioned from the hospital to a small nursing home. There he rested, safe and well cared for.
The tenderness of God takes up every moment and aspect of our lives, with care especially to what is most difficult and fearsome and painful. Holding the whole of who we are in an invincible grace, God constantly offers back to us new life, a place in an infinite and abiding circle of care.