This is how it ended (2004-06)

This is a memorial sort of slide show that I made for Steve back in 2006. It's a compilation of some of the photos that appear here on the blog and some others that were taken the last few months of his life.

It's been a long time since he died but I still miss his great stories and that optimistic charm. Sometimes I take my dog over to the cemetery and we have lunch there and I fill him in on all the fun stuff he's been missing. Stella reclines at his grave like a beauty queen and I'm always sorry they never got a chance to be friends. I know he would've fallen for her, much the same way I did. He had a soft spot for dogs.

Thanks for visiting this page and thanks again to Guy Clark for letting me use his song, Homeless. If drugs or alcohol have stolen your life, please get some help today.

Crutches

This is one of the first pictures I ever made of Steve. He's the one in the wheelchair. There are more, buried somewhere in a file cabinet downstairs. I haven't seen them in a while. According to Barney (also pictured), Steve was doing pretty well until he got hit by the car that broke his leg. Prior to that, he was working regularly and for the first time in years, paying forty dollars a month rent for his apartment.

When the accident happened, his status as an alcoholic meant they couldn't send him home with anything to kill the pain. So naturally, he used vodka and that worked pretty good except that he had the cast on for ten months.

The culprit

How would you rate your pain?

"I've been reading about cirrhosis of the liver."

"Did it say on there that it'll kill you?"

"Yes."

"Did it say it was a long, slow, painful death?"

"Yes."

"Nothing that a length of rope and one of them tree limbs out there wouldn't fix."

"You better be careful with those tree limbs. They're rotted. You'll hit the ground and that tree limb will follow you right down."

"Then I'll wake up and somebody'll be saying:
'Mr. Grady, on a scale of one to ten, how would you rate your pain?'"

Sitting

When we all get up to Heaven, St. Peter is going to be on a lunch break. Instead, there's going to be a guy there, that goes by the name of Shorty. He's gonna' be kicked back in one of those collapsible nylon chairs you get at Wal- Mart, with a 40 oz. Natural Ice in one hand and a cigarette in the other. I think a lot of people are going to be very surprised.

My apologies for leaving you all sitting. Lots of things have been happening and first I should say thanks for the kind words and e-mails of late from a wide variety of people. Your thoughts and comments are not only appreciated but many times thought-provoking and educational.

The last three weeks have been something of a blur. There are too many stories to tell and not enough time to sit and write but eventually, I'll have to tell them because there is beauty and humor, even in the worst of it. Also because there are a couple of people who will hound me like a dog, if I don't.

To answer the pressing question of my last post... Yes.

Steve dialed his family from my cellphone that day and although it was an emotional experience for everyone, I believe it went very well. The good thing (and with someone else it might have been very different) was that they were happy to hear from him. It allowed him the chance to reconnect in his own way and it spared them the phone call that for years, they believed would eventually reach them.

Yesterday, Steve returned to the hospital and was admitted once again with another round of complications. At the moment however, he is resting comfortably, in the care of some good nurses on the fifth floor.

A few days back, he saw this photo on my computer screen and announced:

"I know that's in a rich neighborhood."

"Really," I answered, "how can you tell?"

"Well" he said, "them chairs ain't chained together. If they were in my neighborhood, they'd be chained together."

Blinders

He sat in the chair reading the contraindication pages given to him with four different prescriptions. He laughed and read aloud:

Tell your doctor immediately if you become thirsty or confused. Hell, he said, that's my whole problem.

The doctor always prescribes a few things that aren't covered by his limited insurance. It's a nice gesture, wasted; a cookbook version of treatment. I don't know why it doesn't occur to them that the only money he's got is the bus fare they're going to give him when he leaves. Even then, sometimes people act like they're doing him a favor. Like, hey here's a dollar forty-five so you can get back over to that bridge you've been living on for the last few years. Don't forget to weigh yourself regularly and have your blood pressure checked and oh, by the way, stop drinking.

On the other side, and there is another side. There are some health care professionals who actually get it. They're hard-working, bright compassionate people who'd do just about anything for anybody they could. Their only limitation is the broken system. The one that discharges you on a Sunday knowing you can't get any medicine until Tuesday. The one that says we heard you say you'd like to try rehab so why don't you make an appointment for a month from now.

Three days ago, the Tennessean printed an article with a headline, General Hospital needs image transplant. Straight from the mouth of the Metro Hospital Authority's chief executive:

"We want to get the public to perceive us differently," Coopwood said.

How? The hospital has made some low-budget strides with a television commercial. They have a new slogan: "Experience the new General. Get to know us."

Does anyone actually believe that a new slogan is going to fix General's problems? That's the mentality that probably drove it into the ground in the first place. General Hospital needs a staff transplant. Again, let me make it perfectly clear, I believe there are competent, well-trained people working there. Unfortunately, they're surrounded by a cloud of complacent, irritable, employees drowning in bureaucracy and underfunding. By all means, spend tens of thousands of dollars on a commercial. When the ambulance driver asks Dr. Coopwood what hospital he'd like to be taken to, what do we think he's going to say?

Emergency room

Down the hall there was a little boy screaming. It lasted the better part of four hours. I stared at the pattern on the linoleum floor while Steve nodded off on the gurney. He'd sleep in two minute intervals for a while then wake up for fifteen or twenty and we'd have another conversation. He was hurting all over this time. Grouchy, but apologetic.

On the way to the emergency room, a girl crossed Eighth Avenue in front of us and after she'd almost gone, he said,

"I wish I could still walk like that."

There was a long silence and then he added, "but it's too late for me."

My arm instinctively turned off the radio and we crossed over the train yard, surrounded on all sides, by the lunch time traffic.

"If they drain this fluid off when I'm there," he said, "maybe you could take a picture of that. Maybe it would stop some motherfucker from drinking himself to death."

The next light came and I studied a familiar profile, sleeping on the bus stop bench by the offices of our daily newspaper. It was seventy-four degrees and the man on the bench couldn't take off his winter coat because someone would've stolen it, in a matter of minutes.

I tried to relax my jaw and said, "Maybe ".

The message on my answering machine the day before was cryptic. Could I come by sometime tomorrow? He didn't say Hey I need a ride to the hospital. Or hey, my liver is about to make my stomach explode.

He said "Hey, Sue could you come by tomorrow if you've got time? "

In the message, he was very drunk. He didn't know how to hang up the cell phone and the ensuing conversation between he and another man gave me great pause. It was a five-minute dialogue that I could have gone my whole life without hearing. I couldn't begin to describe it here.

His voice has changed dramatically over the last two months. Sometimes it heaves like the old garbage disposal under my sink. Rocking gently between homelessness and alcoholism, death and now a subtle form of hopeless regret, he would talk for the next nine hours, seven of which were spent in the emergency room, waiting patiently for a double shot of arrogant indifference. I foolishly believed it wouldn't happen but Steve knew better. He laid it all out beautifully, before we even got there.


(In memory of Wayne E. Frampton, who died in an abandoned car, on the morning of Saturday, February 25, 2006. He was fifty-five years old.)

Paperwork

The follow up

At the end of last week, Steve did his follow-up visit at the hospital. I was going to take a picture of his chart (it's eight inches thick; going back only to 2001) but it made the doctor nervous and I didn't blame her. We'd never met before that moment. I wouldn't have let me do it either but the fact is the thing was eight inches thick.

He predicted that he'd be examined and then lectured about drinking, which is more or less, what happened. Two different doctors each took a turn (he's never had the same doctor twice). Both were painfully honest with him, about his condition. There was also the (somewhat) vague offer of inpatient treatment. If he had expressed an interest in sobriety, I believe they would've kept him there but then, he isn't the one running the show (where his options are concerned), alcohol is.

So, I might ask the question, of people who know more than I do about it...why do so many of us continue to believe that alcoholics are capable of making rational decisions? If alcoholism is a disease, then why isn't that the symptom we treat first? Why not a pill or a shot that releases the grip of alcohol long enough for a person to want treatment? Steve's been dependent on alcohol since he was eighteen years old. That's twenty-six years (of the same well-intentioned approach).

A change of scenery

Staying in a car isn't that bad. The bad thing is waking up at four-thirty in the morning knowing you got to go to the bathroom. If you've got gas in the tank, you can turn on the heat for awhile and get warm again. Then, all you have to worry about is not falling asleep with it running. -Steve

He can't lay down because I'm storing shit for every hobo in the city, in the back of my truck. -the friendgirl

As far as I've been able to determine, Saturday was the first time Steve found a place to physically lie down in the six days since he'd left Barney's apartment. I found him stretched out on a blanket, lying face down, but not on his stomach. The weather was windy and mild (after two nights of twenty degree weather). For those who are unfamiliar with Nashville, the weather patterns along with the temperatures fluctuate wildly between seasons. It's an area where tropical moisture in the morning can lead to sleet that afternoon. The only predictable thing about it is that it will most likely occur during rush hour. Anyway, Steve planned to sleep outside Saturday night, if possible. He and the girl changed their location because the parking lot where they'd been staying became excessively rowdy over the weekend. It was a brilliant move I thought, since the arrest of either one could lead to some new disaster. Things change very quickly on the block though so just about everything I write is old news.

Here's a story written last week by my friend, John Spragens. (Sorry it's late, I thought I linked to it days ago) I'd just written the first post of Steve's story when John and I went to Lewisburg to meet with people there, who lost their TennCare coverage. It was a troubling day. Reports of tornadoes followed us all the way home and it seemed perfectly appropriate.

Form(s) and function

Steve received two applications yesterday in the mail (his mail is directed to Barney's), from the Social Security Disabilities office. Combined, there were eight pages of medical and employment questions for him to answer, beginning with the question: Where is your pain located? He has fourteen days to return the papers. He is required to list the names and addresses of his employers for the past fifteen years and I'm curious to know, why doesn't Social Security already have this information?

We spoke briefly again yesterday about the loss of his TennCare coverage and again, I'd like to stress the fact that he isn't bitter and has never held anyone accountable for his problems. But, this is the conclusion, as he sees it:

It wasn't the sick people that ruined TennCare. It was the doctors and the hospitals and the pharmaceutical companies. They're the ones who ruined TennCare.

Here is today's opposing viewpoint, from Glen Dean. Mr. Dean notes that Tennesseans take more prescription drugs than any other state. If Tennesseans are over-medicated (and I believe they are) how exactly does a blanket rule of five prescriptions help? For example, if I'm abusing the system in order to receive Oxycontin, that's going to be my number one, name brand choice. Meanwhile, those individuals who require seven or eight prescriptions, sacrifice either their lives or their (already compromised) quality of life, based on the abuses of others.

This is a book of religious poems that Steve's girlfriend used to read from. The photo was taken a couple of years ago. The poem, her favorite, reads:

FORGIVENESS
So Little and So Much

In that I have so greatly failed thee, Lord,
Have grace!
A place!
So little of fair work for thee have I
To show;
So much of what I might have done, I did not do.
Yet thou hast seen in me at times the will
For good.
Although so oft I did not do all that
I would.
Thou knowest me through and through, and yet thou canst,
Forgive.
Only in hope of thy redeeming grace
I live.
-John Oxenham

The choices

When Steve left the hospital yesterday, he was instructed to go to the second floor pharmacy and pick up medications that the doctor had ordered. Wait, let me back up for a minute. The day he arrived, he explained to the staff that he could go without alcohol for two days. On the third day, he told them, it would begin to get bad. On the first and second days he was given librium, two capsules per day. On the third day, by his account, he was given eight. Not surprisingly, there were no DT's beyond some very minor confusion and a slight tremor which could have also been from the liver dysfuntion. He was awake as late as ten o'clock that night, I know this because he called me that night, for the first time in three years. He asked if I had an old pair of pants that he could wear home.

I mentioned before that Steve lost his TennCare when the cuts came and according to him, it's his fault he isn't covered. He was told that he would need to reapply on a certain date, if he wanted his coverage to be reinstated.

It was during that week that it rained six days, he said. I'd been staying under the bridge and when the time came to go downtown, I was sick and wet and I was gonna' have to have to go up on the bridge and make bus fare, I just decided I couldn't do it so it was my own fault.

At the moment, he is enrolled in Bridges to Care. Thankfully, that covered the cost of his medication and presumably, the three and a half days of hospital care. When he got to the pharmacy though (after being handed a piece of paper that instructed him to stop drinking and smoking, cut back on his salt intake, and weigh himself regularly) there was not prescription for librium or any other type of sedative. There is a rationale behind this of course. Librium can be sold on the street for example, or blatantly misused. Regardless, at that very moment, he knew he had two choices. Delirium Tremens. No Delirium Tremens.

There had been three choices, one of them ideal. The Campus for Human Development. When Steve's social worker (at the hospital) failed to arrange this option, someone else did it for her. If she had walked in the room that morning and said, we've arranged for you to stay at CHD and you can only leave if you go there, he would have done it. Perhaps it would have been a failed attempt but I know he would have gone under those circumstances. Steve chose not to go there on his own because in his mind, he has always associated it with the Rescue Mission and other, similar places. There was little time to educate him about the vast differences between the two and besides that, when it came time for him to *hobble out of the hospital, he'd been twelve hours without a librium, ninety hours without a drink. The choice was clear.

(*Note: When his last visit ended, a month ago, someone put Steve in a wheel chair and rolled him all the way to the bus stop. I suspect it might have happened this time if it weren't for the fact he had a photographer tagging along. As he shuffled down the hall leaving though, I noticed an unusual number of people stopped what they were doing and watched him go. I wondered silently, if I was the only one who wanted to scream. He quietly expressed his thanks to a couple of the nurses and made a point of telling me how well they'd treated him over the last few days.)

The final breathing treatment

Before Steve was discharged from the hospital, he was read a list of numbers he could call for medical assistance. I found myself having to resist the urge to snatch the paper and start dialing the phone. Is this really the face of a man that's well enough to go home (as they referred to it)?

The reason I went as early as I did was to speak to his doctor, the doctor who never showed up; the same doctor who didn't return my phone call yesterday. I wanted to ask him if he felt anything, letting this man leave the hospital. I wanted to know if he was sorry that the rules are what they are. I wanted to know if he ever thinks of breaking those rules simply because they are immoral and unjust. I wondered if he understood that this patient of his planned to spend the night, passed out on a concrete floor (which is, so far as I know now) exactly what happened. When I finally left him, he'd been offered that same floor (there's a blind assumption that he'll stay there) for the next three days only, then it's anyone's guess.

An update

Update on the previous entry: Today Steve is able to walk. He's slow and he's bent, but able. More later.

I got to the hospital this morning at 7am. Steve's walking papers were pretty much ready to go. His social worker filed an application for his Bridges to Care extension. I'm not exactly sure what it is that covers but she added that where he went from here, is pretty much up to him. She was offering him bus fare to the mission, which tells me she's totally unfamiliar with the mission but then, I am not a social worker.

As a postscript, I put this image here because of the swelling in Steve's midsection. He'll give me some hell about that but it's important to note. This toxic spare tire is what's left after three and a half liters of fluid were drained. Without it, he'd weigh (probably) less than a hundred pounds.

Along the time I was making this post, Steve's breakfast came and he offered to share it with me. Twice. I thought things were pretty surreal yesterday, and the day before, but this morning, this morning started on a whole new level.

Should've knowns

I should have known that Steve was let go from the hospital because he (and 200,000 other needy people) lost his TennCare coverage. He can't remember exactly when it stopped but, it's been a while. I found him and Brandy yesterday, sitting near the interstate bridge where they've spend so much time these last few months. The temperature dipped Friday night so I was happy to learn that he'd spent the night at a friends house.