DESPAIR

There is something both pathetic and disturbing about what I heard yesterday while sitting in the emergency room at a local hospital. The story is an old one. It has been written about many times. It has been at the heart of a continuing controversy over civil rights. It is one of our perhaps insoluble social problems. What do you do with the lost and fallen, the destitute and hopeless, the addicted and the forlorn? The city is full of the jetsam of society and we won’t or can’t do anything about it.

The emergency beds are separated by curtains to provide some privacy. But curtains are not soundproof. You are aware of almost everything. Sometimes it is not for the squeamish.

“Open your eyes. Do you know where you are?”
Groans and unintelligible response.
“You were found unconscious in a courtyard with your pants at your ankles.”
More groans.
“What did you take?”
Muffled response.
What we heard was a very patient nurse trying to quiet, comfort, and perhaps treat what sounded like a woman who had been beaten or raped or drugged or all three. It went on for the better part of half an hour, the nurse calling for security to help, I inferred from the yelling and struggling, and the woman shouting that she wanted to get up and leave, that the hospital had as much as it could handle. She was in no condition to leave.

In another cubicle a male voice, perhaps a doctor was heard: “Did you take your methadone?” The man was obviously a druggie and in urgent need of medical care. An exhausted-looking policewoman was sitting outside the cubicle. She had, I presume, brought the man into emergency.

Later I commented to a nurse: “All you can do is to treat them, get them back to some kind of normalcy, and then let them return to the street. That is what happens, unless the person was brought in by police which suggests that some crime had been committed. But even in those cases, the person is released into the public stream once the condition has been treated, and the jail term, if there is one, has been served.

The nurse responded with a kind of “I know I know” despair. But she said the hospital has a great social worker. That simply doesn’t go far enough, and their hands are tied by the double-barreled issues of civil liberty, and government failure. If a patient in emergency, someone who often has made similar visits, wants to leave, he/she is entitled to do so. Unless a crime has been committed or the patient is deemed to be a danger, she can not be apprehended. Such is the nature of civil liberty.

But there is a much larger issue here. It speaks to the problem of the homeless, the crisis of drug and alcohol abuse, the even more profound problem of mental illness. It reflects on our inability to contain these problems, both for the good of society and the needless pressure on the health system, and the overriding reality of the dregs of our society.

It has been many years since different jurisdictions began closing mental institutions, either because it was deemed a violation of civil rights to incarcerate the unwilling, or that the government decided that people would be better off in the community where they could be treated. For the latter we have, in Ontario, to thank the Harris government for their blindness. They claimed that the community services could treat these people. So mental institutions were closed but no community service was in place.

I understand that civil liberties groups oppose apprehension and detention of these people on the grounds that such action could be used to incarcerate anyone you didn’t like as long as a court or medical service, agreed that they constituted a danger. That is the thin edge of the wedge of dictatorship.
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But what are we to do? I have enough trust in our court system and our medical people, to believe that the only way these chronic social problems can be dealt with, is to confine these people for their own good. By “confine” I don’t mean held behind bars. I simply mean that they should be treated as humanely and generously as possible, while at the same time removing them until such time as they can be put back into the mainstream. In many cases, there are virtually incurable people whose only hope is to be put into some kind of permanent care. Civil liberties be damned. We simply can’t have people curled up drunk on the sidewalk at noon, or found unconscious in a courtyard, and carted off to a hospital where upon recovery, are sent back out again. It simply makes no sense.