My client was a middle-aged, single woman living in a squalid New York City Housing Authority apartment with two kids, a boyfriend, a degenerate brother who’d been sexually abusing her for 35 years, and a wacky old aunt who checked out every morning at 5 and returned home from a hard day’s panhandling with a heaping bag of fresh garbage. The kids were acting out at school, the client’s boyfriend was jobless and staying that way, and, for a topper, the client had just been diagnosed with Stage 4 breast cancer.
And not one of these dreadful realities had anything to do with why I, as a case manager for New York City Adult Protective Services, was in the home. I was there strictly to prevent this dysfunctional menagerie from being evicted for non-payment of rent, which I was fortunately able to do by obtaining a one-shot grant from the city to pay a year’s worth of arrears.
Via what APS pompously calls its “financial management unit,” we began receiving the client’s supplemental security income (SSI) check and paying all her essential bills. Each month, I would deliver whatever money was left over to the client in her home.
On one hot summer afternoon in 2006, I arrived at the apartment with the client’s $200 monthly cash allowance. She led me to a back bedroom where we could attend to the transaction out of the brother’s watchful, evil eye. The dark bedroom smelled like the inside of a bowling shoe on league night. I sat on the edge of the bed where a million dust mites had made their camp.
Suddenly, I began to feel woozy, most likely from having skipped breakfast and lunch rather than the unpleasant surroundings. After several years at APS, I was used to much, much worse.
“Are you OK?” the client inquired, looking very concerned.
“I think so,” I said. “Can I get a glass of water?”
The client quickly returned with a helping of NY’s finest tap water and sat down beside me. She was no longer a pathetic victim of horrendous circumstances. She was Florence Nightingale, and the part suited her well.
“Are you sure you’re OK?” she asked again.
After a few solid gulps, I started regaining my sea legs.
“Thanks, I really needed that,” I said. “I’m fine now.”
Just this brief, elemental human exchange was all it took to erode the boundaries in our relationship. No longer pitiful client and noble caseworker, victim and savior — just two ordinary people helping each other make it through another tough day. Her day was infinitely tougher than mine, but we were still two lost souls doing a slow dance in the big city.
We sat for a while after I slipped her the cash. She began to cry, softly, and I held her hand. Nothing more was, or needed to be, said on that home visit. Seeing me out the door, the client smiled. I hadn’t seen her do that before, which is probably why I remember it as one of the most beautiful smiles I’ve ever seen.
Ultimately, with the assistance of other social service agencies, we managed to clean out the filthy apartment, boot out the despicable brother, place auntie in an adult home, bring in Child Protective Services for the kids and get the client into appropriate cancer treatment. All the king’s horses couldn’t cure her, but she died knowing her kids would be safe in their own home. I was on vacation the week of her funeral. I heard it was very moving.
In the end, when I look back on this case — one of about 500 in my APS tenure — all those essential services fade away. What’s left is a glass of cool water on a hot day, delivered by a caring friend.