Prior to meeting Gideon a week ago, I’d read in his chart that he was 79 years old, his address was a shelter, and he had no known contacts.  He’d been hospitalized for pneumonia, and he’d begun to respond to treatment.  When I entered his room that day, he welcomed me and muted the TV, but continued to gaze at it throughout our conversation, looking at me only briefly.  Still, he was courteous in an old-school way, and he spoke thoughtfully of growing up in the deep South, his tour of duty in Vietnam just before things heated up, and going to college on the GI Bill.  But he did not offer anything about the 55 years since then leading up to his present situation.

Yesterday Gideon was referred for spiritual care by a provider concerned by his despondency over being discharged back to the shelter.  Gideon had asked her about eligibility for Oregon’s Death With Dignity Act; she’d told him he does not qualify, having no terminal illness.  In response to her follow up, however, he denied suicidal ideation.  Unable to offer Gideon better options, the provider hoped a chaplain could somehow help lift his spirits.

When I enter Gideon’s room, he is dressed in rumpled street clothes, sitting in his bedside chair, holding a small, grimy knapsack containing all his worldly belongings in his lap.  At first he doesn’t recognize me, then recalls our time together.  I pull up a chair and sit facing him.

“They’re telling me I’m well enough to leave now,” he begins.

“Are you feeling better?” I ask.

“Couldn’t feel worse,” he replies.  “The minute I walk out onto those streets I’m a dead man.  It’s cold and raining and I can just now barely walk.  I’m an old man, I won’t last long.  I wish they’d just off me here and now.”

“I’m so sorry, Gideon.”

“They tell me they’ll pay for a ride back to the shelter.  They don’t get what it’s like to live there.  There, I’m just a rat among rats, living like vermin.”

“I saw the social worker’s note about all the places they’ve looked for you, but nothing’s come through.”

“So why are you here?  What have you got to offer me?”

I draw in my breath.  “All I have to offer you is compassion and prayers … but I realize that might not seem like much help in your situation.”

“Not your fault.  I just can’t believe there’s nothing better out there for a person like me.”

“Honestly, I can’t believe there isn’t either.  I’m so sorry.”

I extend my hand, and he takes it.  We hold hands together for a moment of silence.

“I appreciate your coming by to see me,” Gideon says in closing.  “I appreciate all you are doing to show kindness to us humans out there.  It means a lot.”

An hour later Gideon’s name is erased from the board at the nursing station, and his room is empty …

◊

It is the morning of Easter Sunday as I write this.  For most Christians, Easter represents the triumph of hope over despair.  At this very moment, I’m not feeling it.  Elder Chaplain is committed to the notion of practicing hope amid loss.  Today, practice feels hard.  Today, instead of hope, I mostly feel anger.

I’m angry at the multiplicity of factors causing homelessness crises all across our nation.  I’m angry at the economic polarization that makes the comfortable more comfortable (and I count myself among those) while increasing numbers are pushed farther to the margins, out of even the most basic housing.  Homelessness is caused by more than simple economics, but it’s a powerful contributing factor.

I’m angry at the collapse of our mental health system. Like many my age, I was appalled by the depiction of institutional mental health care in One Flew Over the Cuckoo’s Nest, but I believe we have over-corrected.  My brother-in-law suffered a head injury in his 20s that caused lifelong mental health problems; without a supportive family keeping him connected to care, and ultimately getting him committed to a safe, caring locked group home, he surely would have spent his last decades living like Gideon.  Oregon, like many other states, has far too few institutional settings that can provide the care and housing my brother-in-law received in Pennsylvania.  We must find a better balance.

I’m angry at the scourge of drugs, especially meth and opioids, that I see destroying the lives of so many patients—rich and poor, urban and rural.  Two weeks ago I visited with Charles, a patient who had been living on the streets with “polysubstance abuse.”  Chart notes stated he was abusive to staff early in his stay, but he’d been off drugs a few days when I saw him.  “You know,” Charles began, “I’m actually a good person when I’m clean”—and you could see that he was.  “But,” he continued, “I can’t find a place to live where I can stay clean—I can’t do it on the streets or in a shelter.”  Charles was likely discharged just as Gideon was, and is back to being a less good person than he is capable of.  This scourge has many sources—the Sacklers and McKinsey peddling Oxycontin, the drug cartels peddling everything, American moralism pushing criminal punishment for the illness of addiction—but we need to do better.

I’m angry at our political system and the people it puts in power.  I’m angry at the states that refuse to expand Medicaid, which at least gives low-income folks a fighting chance.  The voters in Oregon passed well-intentioned legislation to fund addiction services and supportive housing, but the bureaucrats in charge of these programs have failed to put most of this money to use.  Now our legislature is considering a bill to require hospitals to domicile any patients who cannot be discharged to housing, as if the hospitals have a place to house all of the Gideons passing through their doors.  I would love for any legislator in favor of this bill to spend a day in our shoes and then explain how this would work.  Hospitals must play a key role in this crisis, but we need better ideas than this.

Perhaps more than anything, I’m angry at those who fail to see the humanity in people like Gideon and Charles—while owning that I often fail at this myself.  Many of those we see living under bridges and in tents have made, and continue to make, poor choices, to be sure, but almost all come from deeply traumatized upbringings that remind me of the privileges I carry into the world.  These are the people Jesus found worthy of his time and care, but not his judgment; that was reserved for those who crossed to the other side of the road to avoid them.  I am grateful to work for a hospital named Good Samaritan, and people like Gideon remind me of the work I need to do to live up to that name.

As Holy Week comes to an end, I take note that the first thing Jesus did after entering Jerusalem on a donkey was go to the temple and overturn the tables of the money changers.  This angry outburst likely hastened his execution, but the gospels tell us it gave hope to the blind, the lame, and the children.  I conclude that, in order to celebrate the triumph of hope over despair, it may be necessary to first give vent to anger at the injustices causing that despair.  I am grateful to Gideon for getting me in touch with that anger, and for encouraging me to keep trying to show kindness to all the humans out there.  And I am grateful to you, my readers, for accompanying me through it all.