Loose Change

Moving from Italy to New York City has been an emotional chemical peel. Here is a big reason why.

Times Square, New York. PHOTO CREDIT: Stacey Eskelin

His name was Cesare, and he’d lived his whole life in the hinterlands of Lazio, Italy. Italians call such persons ritardato mentale. Americans refer to them as intellectually disabled. Almost every Italian village has a Cesare, usually the son of a family with deep roots in the community. In a very real way, the village and all who live there raise their Cesares. They belong to everyone.

Consequently, Cesare was a regular fixture in our borgo, a grinning, affable, and yes, inebriated presence at the local restaurant that sold him cheap red wine or at one of the many local festas up the hill in Calcata Nuova. At a public barbecue in the piazza, one of the Calcatese thought it might be funny to prank Cesare by grilling the insole of his own shoe and offering it to him to eat. Poor Cesare gnawed at the thing for a full ten minutes, complaining in his semi-indecipherable Italian that the meat was “troppo duro,” too hard, while everyone laughed.

Was it a heartless thing to do to an intellectually disabled person? Of course.

But there were also moments of grace. One night when John was driving home from a late-night gig, he saw Cesare passed out in the middle of the road and yanked the wheel to the right, worried about how to get Cesare back to the house he shared with his sister. Cesare outweighed him by at least seventy pounds.

By some miracle, John saw some guys he knew on the road up ahead. One of them owned a truck. Together, they hauled Cesare into the bed of the truck, a necessary precaution since Cesare had peed himself, and took him safely to his sister’s.

No police were called. No reports were filed. No fuss was made. Cesare had been saved from being run over like a dead raccoon. He got up the next morning, cheerful as always, and trundled off to find a fresh bottle of wine.

It’s unfair to compare how a small Italian village treats its poor/broken/intoxicated/mentally ill/developmentally delayed denizens with the way we treat them in the U.S., but the differences are too stark to ignore. I get that we’re talking about a bee-hive metropolis like New York City versus a sleepy Mediterranean village of only a few hundred souls, but the scale of the problem alone doesn’t explain why we in the U.S. are unequal to addressing it. It’s a multi-pronged issue, homelessness, a combination of mental illness, substance abuse, trauma, violence, lack of affordable housing, and the inability to either get or maintain employment.

In a city of 8.4 million people, nearly one in every twenty New Yorkers is homeless. That’s 70,000 people. 3,400 of them are living in the subways. Know what else lives in subways? Rats. So you can imagine what a hellish existance this is for any human, regardless of his level of awareness.

The overwhelming number of homeless people was the first thing I noticed after returning from Italy. They’re everywhere: passed out in front of buildings, hustling for change in front of banks, grocery stores, and Dunkin Donut franchises, sprawled out across hard plastic seats in subway cars. According to government reports, there are fewer homeless now than there were ten years ago, and perhaps that’s even true, but they are far more visible than they were before, especially those with obvious mental conditions and/or drug problems.

There are reasons for this.

When the Covid-19 pandemic hit New York, then-governor Andrew Cuomo suspended Certificate of Need applications, which required hospitals to undergo a rigorous and public-facing process before closing and/or changing the services they provide. At the time, it made sense. Bureaucracy is schlerotic, and hospitals needed the authority to make their own decisions based on rapidly-changing conditions.

What happened, of course, is that long after the emergency was over, hospitals kept shedding inpatient psychiatric beds. Public, private, it didn’t matter. In a for-profit healthcare system like the one we have in the U.S., psychiatric services for the poor are a financial loss whose elimination is easy to justify. The city’s public hospital system is chronically underfunded and can only handle so much overflow, especially after Covid. Where else do people with mental instability and drug issues go besides the streets?

What can we do for people who cannot do for themselves? How do we solve a problem that will not go away, is in fact getting worse, and impacts all of us, whether we want to admit it or not? PHOTO CREDIT: John Arnold

Often, you are forced to step over people in NYC in order to enter or exit a building. This poor soul couldn’t be more than thirty years old. Here he is, one shoe on, one shoe off, covered in lesions, a dollar bill crumpled next to his leg. PHOTO CREDIT: John Arnold

Sadder still, not all of New York’s homeless are drug addled or mentally ill. John and I were on a bus to the New York Public Library a few weeks ago, and I got into an indepth conversation with a guy wearing a dirty sleeping bag in 90-degree heat. There was nothing ostensibly “wrong” with him; in fact, rarely have I met anyone better spoken, more widely read, or easier to talk to.

Last week, I watched in sadness and horror as a young man did the “heroin nod” in front of me on the L train. The week before that, a homeless guy vomited three feet away from John. I will never forget the time John and I rushed into the only available car on a crowded subway only to discover some poor soul, reeking of necrosis, literally rotting in one of the seats. We couldn’t bear the stench. It made my gorge rise, and we hastily decamped to the next car, watching the smell hit other hapless commuters who then scrabbled, like cats caught in an aquarium, to save themselves.

Their discomfort may have been amusing, but the source of it wasn’t. The source was clearly in serious trouble, and there wasn’t one thing I could do to save him.

It’s the helplessness that I find so daunting. As a woman walking the streets of New York City, I find it necessary to avert my eyes from such scenes. For my own protection, I do this. Most of these men are harmless, but not all of them are, and as tough as I like to think I am, a fight might not always go my way. And yet, that doesn’t mean I don’t see the bleakness of their situation or don’t lay awake wondering what can be done.

I do not turn my eyes away because I believe it to be somebody else’s problem. It’s not. It’s our problem, and there is no guarantee in life that I might not one day join their ranks.

My compassion doesn’t exonerate me from blame or responsibility. We are all to blame.

I also find myself asking: Are some people beyond hope of redemption? Does hardcore drug addiction actually consume a human soul? If so, is there any point in trying to save an addict? If not, do we leave him to his awful fate? How many times have the well-intentioned intervened and made an even bigger mess of things?

Too many to count.

My compassion seems like a trifling and insubstantial thing to give to those who are lost to poverty, drugs, disease. The need to take action is great. And yet what action?

There is a Buddhist tale that illustrates this dilemma.

The Jakartan king, Sibi, was out walking when a pigeon flew down to him and cried, “Save me, please! There’s a hawk that’s about to kill me.” Two seconds later, the hawk flew down and said, “Please give me the pigeon. Without it, I will starve and so will all my family.”

King Sibi considered his choices. If he acceded to the hawk, the pigeon would die; if he acceded to the pigeon, the hawk and his family would die. In order to save them both, the king decided to give his own flesh to the hawk in an amount equal to the weight of the pigeon. And so, the king’s servants produced a scale and a knife, which the king used to achieve his purpose.

No matter how much flesh he added, the scale would not balance. Out of sheer desperation, the king threw his entire body over the scale. Only then did it balance. At this moment he realized one of the greatest of the Buddhist teachings: On a soul level, all life is of equal value. On a more practical one, how do we remind someone who is possibly too far gone to care anymore that he actually has value?

On this issue, like an ourourboros, I am the snake that is forever eating its tail.

New York City reminds me every single day that we are one economic collapse, terrorist attack, or pandemic away from losing what we have.

We ignore that possibility at our peril.

Copyright © 2023 Stacey Eskelin

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