The Final Hour

A continuing tale of heartbreak

Incriminating evidence.

The suffering never ends.

Every once in a while I try to get inside of my son’s head. He is paranoid schizophrenic, a disabled veteran who was medically discharged from the Navy seven years ago. He is also an alcoholic. He is also my son and I see him as I would see a familiar but run down and haunted house. Until this week, the gate was always open. I could always approach, come inside and see.

Like any father, I have a parade of memories that is the history of my family. I am the photographer and archivist. I have something on the order of 150,000 photos. Right now in the Favorites category, I have it down to under 500.

A child with a crippling disability fails to be a noble cause in American imagination and in practical policy beyond a certain mark. Everyone loves the miracle of the smiling bald child with terminal cancer, who loves and behaves courageously. But after the 29th birthday, most of our generic sympathy falls away. A few sentences is pretty much all I ever bother to talk about in polite company, the rabbit hole goes deep. Jump in with me.

Institutional Personality
What I have recently seen creeping up in my son is what I call an institutional personality. Because of his varying bouts with stability, I have been around enough hospitals, psych wards and managed care facilities to see how their denizens behave. Denizens is kind. They are for the most part prisoners, and prisons have their cultures.

I don’t remember the day, but I remember the final hour. It was the moment when his plastic stare broke me. I could feel the minutes counting down as his eyes followed me and everyone else left the room. His stare was vague, not empty but vaguely blank and vaguely hostile as if he were completely oblivious to the meaning of words I was saying but counting them up in his head. One false word and he would either stand up and walk out or lunge at my throat. If I didn’t know him, I would have been scared.

In fact I did know him. This is his partial, walking catatonia. I call it ‘zombie mode’. On a bad day I can meet him, he will be pleasant and glad to meet me. As long as I am speaking in neutral pleasantries, he will return them in kind. Inevitably I want to talk about his life, and what’s on his mind. His sentences get briefer until they come to one word answers and dribble out like a garden spigot mostly closed. You never know when the last drop of water will break surface tension and fall. Today the last drop defies gravity. Not only is he not speaking, he is not moving at all. He’s not nodding or blinking. It’s the strangest kind of stare, as if he’s looking at a spider on my lip.

I declare my love in a hug. You see today he is getting evicted from the facility where he has lived for over two years, the longest residency anywhere since he left NATTC Pensacola in 2017. The house manager busted him for alcohol, so we came there to make a deal but his was the eye of Sauron. No response. No deal. No hug back. Just the chill of someone not lost, but implacable. As I turned to leave the room, I lost my shit.

I can’t do it. I can’t even talk to him. I can’t do it.

The Downhill
The next day, the manager informs me that as soon as I left, somebody delivered him a bottle of rum. Three days later he was blocking staff members from doing their jobs. The Spousal Unit and I headed over on that Sunday separately. We’re 15 minutes away by car. I call 911 to explain the situation. I don’t know what’s going to happen when I get there. Anything is possible.

In California the number is 5150. Somehow California codes make the popular culture. You probably know 187 as well. The barrier for an involuntary hold of 72 hours is generally gated by some relatively simple questions.

5150 holds occur when peace officers take people into custody and place them in an involuntary treatment facility for a 72-hour hold. For a 5150 hold to apply, one or more of the following requirements must be met:

• You must be considered a danger to yourself due to your mental health condition, which means you must have threatened or attempted to harm yourself or commit suicide.

• You must be diagnosed with a severe mental health condition that makes it difficult or impossible for you to provide your own basic needs. Anyone who cannot provide shelter, food, or clothing may be eligible.

• You must be considered a danger to others or the public due to your mental health condition. In other words, you must have threatened or attempted to cause physical bodily harm or death to others, such as family members or the public.

After the 72-hour hold time limit has been reached, several potential scenarios could play out. These include:

• You could be released from the mental health treatment facility.

• You can agree to accept voluntary treatment for your mental health condition.

• You may need to attend a 5250 Certification Review Hearing to determine whether you will be placed on an extended 14-day involuntary hold.

• You could be referred to the Office of the Public Guardian to determine whether a conservatorship is necessary.

We’ve been through this rodeo at least five times, but the most difficult distance to traverse is that first descent from the peak of a successful home to the dark valley of state action. This is the soul crushing downhill you think you’re strong enough to endure, but then you have to actually do survive it. The scars of tumbling down through the rocks and cacti don’t show up on your face, at first.

The Psych Ward

The Shuffle
We left to meet the paramedics to Harbor General, which was literally six blocks away. We sat and waited to get the go-ahead to push through to the Psych ward. They didn’t show up for 30 minutes. Next the four of us, my wife and I, the main paramedic and my son in his gurney sat outside the doors of the Psych ward for another hour. I have in my Documents folder as you might imagine me writing in detail, dozens of pages of the history of events. This year has been the most intense. My mind took me back in time, to a more innocent time when we were merely confused and afraid, unsure about his diagnosis and hopeful that we could work things out.

Now we know better. We know the system’s faults. We know our son’s limitations. We can figure out how he skirts the guardrails and works his deceptions amidst his delusions. We know how he spends all of his money in a burst and is broke within a week of getting paid his disability stipend. We know how he vegetates with video games and anime for hours. We know how he takes liberties with curfew. We know how he winds up drunk in the gutter at two in the morning picked up by police and delivered back to Harbor General. We know how many facilities he has bounced in and out of over the years. We know how Harbor General forgets everything about him each time he is readmitted.

It’s tiresome, exhausting, pitiful. When the crisis hits, it’s affecting everything I do. I have lost the ability to focus except for during the emergent moment. I am like a midnight sentry, ever alert to any and every possibility without prejudice. My mind has to be empty and ready to drop everything and respond to the merest inconsistency. I have to take every proper action against every chaotic incident. I have to triage everything between myself and his abyss. It sounds heroic, it doesn’t feel that way. It feels like an entirely dubious mission that I may not survive. I embrace the suck and somehow don’t hate myself for doing so.

The doctor finally steps out of the Psych ward. I have a piece of paper with doctor-like scribbles that I got from the head of the managed care facility. It has his regimen on it. I don’t recognize the drugs. I try explain recent this and historical that. The paramedic periodically interrupts in code. His RPQ is non-encabulated. It’s twelve-B7. The doctor nods at the cryptic babble and responds in kind. I’m just trying to get him over to the Long BeachVA hospital where the record-keeping is better, where his actual doctor and his social worker have offices. In the end he is admitted at Harbor, and me, my wife and the professionals at Long Beach are kept out of the loop.

After a week or so, his social worker calls me indicating that he has been transferred to Hawthorne. He is in a small nursing care building of sorts. He has a second residential placement worker who is trying to find a new spot for him when he is released. Next we hear that he’s not eating, so he is transferred to a teaching hospital in Long Beach. OK can we visit? It has been three weeks since the final hour. We are HIPAA’d out of details. At the teaching hospital we walk through the horror movie industrial corridors towards the inpatient wing. We are transferred through a series of minders whose smiles are disconnected from their eyes. The institutional personalities are in random shuffling clumps; they give us that look of semi-interest, semi-resentful attention. Ooh, look, somebody’s got a loving family that cares, as if chocolate bars were going to drop from our pockets.

He is comatose but not really. Sleeping on his cot, he is motionless and unresponsive when we jiggle his arm and call his name. He looks pale. We stare for a moment, turn and leave. At least he’s not out on the street. The week before the 911 call, I showed him a picture of my cousin who got jumped and pistol whipped two years ago not far from this neighborhood. I thought it might help him not get kicked out, but he went for the booze anyway.

We tried another couple times to get information from the teaching hospital, but his condition and trajectory were ringfenced away from us. I sent my 20 page dossier to his doctor. Somehow I learned that they didn’t know he was a veteran. So it is likely they had him on all the wrong medications. His social worker told me that they said he said he wanted to die of starvation. All of the second-hand and third-hand information I had to process would be unnerving if I had any nerves left. All I want is for him to crawl out of the hole for the fifth time, or is it the sixth? Then they told me that they discharged him at midnight on Halloween, on the day after Halloween.

We saw that he pulled $1600 out of an ATM in Hollywood. What a surprise. My son, who is a Life Scout who had been a counselor specializing in teaching orienteering is, like me, an inveterate hiker. I know he would think nothing of walking 15 miles, even with his bad leg. When we lived in Redondo Beach he would have walked to Long Beach. One time he showed up in a hospital in Glendale. He could be anywhere, but he still prefers the beach. We are up to the point at which a week without knowing where he is located is weirdly acceptable. After that point, I schedule an appointment with the LASD to file a missing persons report; just another damned thing to do. That very morning I am informed that he’s back at Hawthorne.

Ground And Pound
I love watching pro football and UFC. These are two of the things on the tube that are categorically not fake. I also enjoy reading military history and spy books, either historical or fictional. I am entertainingly distracted by testimonies of destruction and deception. You might say that I’m on an emotional rollercoaster, but I hate that metaphor. I’m on my back against the cage fighting against elbows to the face. The thing is, I’ve been trained for this, now. I’m anti-fragile to it, within certain limits. I know how to counter the blows. I can take way more hits than the average Joe. But I’m not kidding myself. It takes a lot out of me. One of these days I’m going to stop caring to get into the Octagon.

I am today just before Christmas Eve, 12 weeks out of the cascade of immediate and delayed suffering. Boy has been placed in a halfway house out in Bellflower. It’s not as nice as the one he had in Torrance, but larger than the one he had before in Long Beach three years ago right after COVID. He’s not locked down like he was in Mid-City or Echo Park before that. He has lost weight and his hair is still filthy. I think he’s on the verge of falling back through the safety net where he’s not on lockdown. I’m neither optimistic nor pessimistic. The reality is that he’s not downtown in the more roughneck shelters, or out on lawn at the VA in Westwood, or missing altogether, or dead. So I’m off my back and shuffling in the middle of the ring. It’s a normal standup fight. Year seven.

The other day he texted me his Amazon wishlist for Christmas, including hair clippers, bless his dear heart. The odd thing is that he has so many boxes of trophies, papers, clothings, instruments in our storage, that he could fill two walk-in closets. But we’ll get him new stuff.

He hasn’t been in his new place a month and has gone AWOL twice already. There is no legal way to stop this unless and until he commits a crime. Crimes against self-respect and dignity are insufficient despite all the talk we do about being a caring society. The simple fact of the matter is that our capability in this arena is rather like favela construction. It is what it is, and it keeps them out of the rain. Why would anyone of substance intentionally move to East St Louis and build what it obviously needs? The sharpest minds in the country would rather we go to Mars. The only thing Americans expect is compassionate rhetoric, we’re eternally counting pin dancing demons and angels. As for actual construction, staffing and funding at the national industrial level, who do you think we are, China?

Maybe if you got Bill Maher to talk about it, a mob of journalists could make it a thing. Then again, it’s not as important to America’s movers and shakers as controlling AI and the ‘proper’ limits of free speech. Besides, it’s the holiday season and mellow vibes are not to be harshed. Maybe next year. After all, the chatting classes are not in the Octogon. It’s much more noble to cure cancer, like we’ve been doing all this time, right? We can live with the homeless. We can live with the crippled and crazy. ‘We’. When you get elbowed in the face for a few years, then you’ll know what I know.

What Do I Know
I’m a peasant survivor. I lost my high flying job in mid-October. I’m living on my rainy day fund in the meantime and I’m nowhere close to anything like desperation. For a few weeks now, I have been able to think clearly and independent of my sentry duty. I’m off the rotation until the next crisis. The labor market has changed, I’m dealing with people who are dealing with AIs, so there’s not a lot of high quality human communication in that arena. I sense a lack of sense and sensibility in the realms of dealing with social dysfunction and disruption considering how we are now asking midwit commissars and robot assisted clerks to keep our bureaucracies going. Not that I expect some comprehensive safety net or even consistent attention to the problems with drug addictions and mental health. Remember travel agents? Remember secretaries? Remember etiquette?

I have a kind of inherent faith in the capacities of the human mind, body and spirit, rather like I assume people did before anyone understood cell theory or germ theory. I don’t know what to call it, there’s just something in me that can get me through all of this. In me. Not abstracted to some algorithmic policy unit outside of me. In the man.

That’s the difference between me and how I believe most Americans think. We Americans believe institutional fixes can come around under the right Administration or following the right brain trust, funded by the right funds, and supported by the right political majority coalition. That all sounds very hopeful without being reassuring, and yet people continue to believe in all that snake handling. Listen for the passive voice. I hope you’ll never hear ‘systemic’ again without thinking about it.

I am paying close attention to Niall Ferguson. I think he knows something from experience that we still haven’t grasped in the main, and what I’m thinking about I should learn by studying The Troubles. They don’t even call it a civil war, and the overwhelming majority of us have no idea of the names of the leaders. I sure don’t. But the people who lived through it know the heartbreak and the elbows and the sentry duty. Maybe that’s coming, maybe one day you’ll have to be your own sentry. Governments do go broke you know.

In the meantime it’s almost Christmas, so have a laugh.