Socks

By Dr. Jim Ferguson

As I crossed the dark parking lot it happened again. This time I was not threatened, because the disheveled woman who approached me for alms was pitiable and obviously only harmful to herself. And in my heart and mind the conundrum replayed. Should I follow the Master’s directive (Matthew 25:40) or should reason dictate, knowing full well that enabling panhandlers just perpetuates their problems?

We’ve all been scammed at one time or another, and this feeds our skepticism. A large man once approached me on the street and asked for money, telling me he was hungry. I offered to take him in my car to a nearby restaurant for a meal. He hesitated, obviously perplexed by my offer. He quickly recovered and said, “No, I don’t ride with strangers,” and walked away. The absurdity of that situation still resonates with me years later. His “caution” reminded me of the “stranger-danger” precautions we taught our children.

In Jesus’ time there were no social support networks as we have in America today.  Our taxes and other charitable donations go to support the common good and the lost. And it is painful that so many are lost. The lady who approached me in the dark, was like so many street people who are in the thrall of drugs or mental illness. She said she needed money to buy some socks and her need was obvious. I asked her about KARM (Knoxville Area Rescue Ministries), a wonderful organization in our community that helps the dispossessed. Unfortunately, she had been banished from KARM for using violent and abusive language.

You never know who you’ll run into in a parking lot or waiting in line for a flu shot. I had not seen my colleague in years, though we live in the same community. We grew up in the same neighborhood and were in the same class in medical school. Apparently, his recent pneumonia moved this retired surgeon into the realm of preventive care and vaccinations, a realm more in the purview of internal medicine. He asked me if I had received a pneumonia shot, a vaccination against the most common type of adult pneumonia. I said yes and I was making sure that my wife received the “pneumonia shot” along with this year’s flu shot.

I knew health problems had forced him into early retirement from his surgical profession, but I learned that more devastating was the story of his schizophrenic son who was once lost to the street. Only his constant vigilance prevented his son from again slipping out the backdoor to live under a bridge with the lost people.

Like so many other things, we do not know what causes schizophrenia. I am not an expert on this terrible psychiatric illness so my research and several quotes come from expert sources like Up To Date and WebMD. Schizophrenia most often begins in adolescence, and the lifetime risk of this scourge is 1%. The World Health Organization says that schizophrenia is on the top 10 list of “disabling and economically catastrophic disorders.”

The current theory is that schizophrenia is a “syndrome of multiple diseases with similar signs and symptoms.” It is thought to be a polygenetic illness with contributing environmental factors, because it is known that the “environment can influence gene expression and genes influence the response to environmental stress.”

Schizophrenia is associated with a number of so-called positive and negative symptoms. The former consist of hallucinations, such as hearing voices, or delusions, best described as false beliefs. People with schizophrenia also have disorganized speech and lose track of their train of thought. They sometimes make up words (neologisms) or organize words in a non-meaningful way (word salad).

Negative symptoms include a flat affect, poverty of speech, and decreased energy. There is also impaired thinking with decreased attention, decreased memory and decreased ability to “manage time and pay attention to get things done.” Collectively these are known as executive functions. The symptoms lead to impaired social and work function. If you want some notion of what it’s like to be a paranoid schizophrenic, you should watch the movie, A Beautiful Mind.

I believe the greatest tragedy that can befall a parent is for something terrible to happen to their child. My heart goes out to my friend who shepherds his son who will never be normal. In recent years, with the help of antipsychotic medications and psychosocial intervention, some schizophrenics may become functional enough to live and work independently.

My heart also went out to the disheveled poor woman in the darkened parking lot with disordered speech and other stigmata of schizophrenia. I don’t believe my money will fix her problems, nor was this a time for intervention. I just hoped my money would do more good than harm, and at least buy her some socks rather than drugs. And perhaps a few gentle words of encouragement and nonjudgmental kindness might influence her to return to KARM or similar social agencies for more definitive care.

Our country made a decision decades ago to close most of the institutions where today’s street people were once cared for. Our local example is the Lakeshore Mental Asylum. I believe closing these institutions was done out of compassion, but misguided and the wrong decision. Now, people like the lady in the parking lot, who may not have the support network like my colleague who cares for his son, is left to wander the streets. Yes, she is free from institutional restraints, but as a result she won’t have a roof over her head, three meals a day and protection from winter just around the corner or those who prey upon the weak.

Some liberals claim the moral high ground because they “feel” and have compassion. I maintain that this conservative driven by reason also has a heart and soul. These days the two perspectives are segregated into camps where they’re assigned the philosophical labels of either having  feelings or reason.

Rodney King once asked, “Why can’t we all just get along”? Yes, and why can’t we all use our God given talents rather than just one or the other?

 

 

 

 

 

 

 

 

 

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