by Still, lawmakers and citizens who shy away from the cost of ending homelessness today would do well to consider the cost of maintaining it: eight and a half billion a year in the emergency room alone, according to Culhane’s research (based on 2015 data), or about twenty-seven thousand dollars per bed per year—eleven billion and thirty-six thousand in today’s dollars. That eleven billion dollar cost does not include, as Culhane reminded me, “overuse of health care, emergency rooms, EMTs, long hospital stays. Not counting the impacts on parks, sanitation, police, libraries, education. . . . There is rarely a public sector program out there that is not affected by homelessness. ” In a landmark study from 2002, Culhane calculated the cost of chronic street homelessness. another A mentally ill person would be forty thousand dollars a year – about seventy thousand dollars in today’s money. That’s a lot of money to spend in a terrible situation.
“Nobody wants to face the sight of human suffering every time you walk out the door with your kids,” David Giffen, executive director of New York’s Coalition for the Homeless, told me. “I hate to sound pretentious, but if you don’t want someone sleeping on your subway then let’s put in a system that provides four walls, a roof and a bed for that person.” In a country with skyrocketing housing costs and inadequate mental health care, everyone can end up in that situation. “It’s not a question these people,” Giffen said. “These people are us.”
In late July, Iishea’s case manager emailed that there appeared to be some activity on her EBT card, or food-stamp account. I went back to West Harlem that afternoon to look for Iishea again, and this time I was able to find a hair salon on West 116th Street that I thought was where she got her hair done. Of course, the woman braiding the customer’s hair at the salon knew who I was talking about. “Ah, Ishea. A wheelchair,” he said in stern English. He added, sadly, “He’s dying. Long time ago. Dose abuse.” That news came from Ishea’s boyfriend, who used to pay for appointments.
Not satisfied, I went to the buildings where I had left the letters to the Ishea’s two months earlier. I searched all the rooms on the ground floor and found another tenant who described himself as a former user of iicrack and said he knew about Ishea’s overdose death “through the grapevine.” She told me in which house her boyfriend lived, and I left a letter in Spanish asking her to call me, so I could find out exactly what had happened. I never heard of him. Kelly was finally able to confirm with the morgue that Iishea died on April 6th, the day before our scheduled photo session.
In a broad sense, I know what happened to Iishea Stone: a bright and extraordinary woman has failed repeatedly – with the pathologies of her family, with poverty, and with the social security net that did not seem to catch her. If Ishea grew up with the advantages I had, she might have achieved anything. Instead, he suffered so much and went so invisible that, to this day, Kelly doesn’t know what was done to his body. How many Americans are we losing this way? How can we bear that loss—the richest country in human history? The fact that we can, and do, even though we know it’s wrong, speaks to the moral cost of homelessness.
For Jessica, April brought the unthinkable: her aunt Mary, the woman she called her mother and listed as a relative in her 90 Sands rental, died unexpectedly on the operating table during a lung exam. When I visited Jessica a few days later, she had not stopped shaking. He had talked to Mary the night before the biopsy, trying to ease her fears about the procedure. He said: “I woke up at four o’clock, wide awake, and I had terrible feelings. “I waited, because I knew he wouldn’t wake up at four o’clock. I texted her at seven o’clock, and I was like, I love you so much. I knew he wasn’t going home, I knew that.” He wept openly as he spoke.
Jessica’s aunt didn’t know that she had relapsed into heroin after using methadone a few years ago. Jessica told me: “He’s the only person I’ve ever lied to about that in my life. I couldn’t break his heart like that. But Mary knew about Jessica’s homelessness and was very relieved when she moved to 90 Sands. “My cousin said, ‘You told me you were proud of you.’ I was like, I don’t know what I was doing.”
Jessica’s cousin had put up a lot of money for a plane ticket to the funeral, which was the next afternoon. He had planned to leave before dawn for the subway to LaGuardia, but he had a problem with how to do things: he didn’t want to carry heroin on the plane and he needed some way to stop himself while he was gone. The obvious answer was to carry a sealed dose of methadone, but Troy, his former friend at 90 Sands, wanted sixty dollars for one of his take-home doses. “I’d be like, ‘Are you lying now? I’ve given you money all the time, I’ve given you dope, I’ve given you cigarettes, you’re trying to charge me with methadone. Really?’ When I come back here, shit will change,” he concluded. “I don’t talk to any of them anymore. I will change my number if necessary.” He went off the methadone, and came back, sick, within twenty-four hours.
Changing her life wasn’t as quick or clean as Jessica had promised herself it would be. After fighting with his dealer’s daughter he went on to fight the dealer himself, and stopped buying heroin. His withdrawal was manageable at first; he had subsided enough that the sickness was bearable. But he got sick again; he vomited for days, and had infected areas on his legs that resulted in deep wounds. When they began to recover, he was so exhausted that he could no longer leave his house. In mid-June he stopped responding to texts, which was so out of character for him that I panicked and went to 90 Sands, where I asked security to call upstairs from the internal phone in his room. He was there; her cell phone service had been turned off because she was too tired to work and hadn’t paid the bill.
I found him lying on his bed next to the plastic shelves, which had been cleared of all the drug paraphernalia. He was remarkably thin. I asked him if he thought he would recover from heroin this time, when he hadn’t before. He reminded me that, when he got out of prison using methadone, he returned to New York with nowhere to go: “It was winter, I had no clothes, nothing.” Medley was not his case manager yet, and no organization he contacted could get him a bed. Inevitably, he rejoined the shelter of homeless drug users he knew and, after a short catch, turned to heroin. Now, where he lives, the situation is different: “I am not close to anyone.” He had spoken to his salesman on the phone several times. “He asked me, ‘Are you coming again, Jessica?’ ” He muttered, “Uh-uh, I’m sorry, I love you, but I can’t do that. I can’t be in the middle of that right now.”
Unfortunately, he it was even now heroin, and the death ravages of individuals have encouraged joint use. When I saw Jessica two months later, in August, she was using again (albeit to a lesser extent) and had new wounds caused by the xylazine-adated doses that she had bought from the seller who lives in the building. Still, at the stop of the opioid recovery spell of sobriety is perfection – even if, as he emphasized back in June, it was due to the lack of fatigue, and depression, after his loss. “I didn’t have the energy to get out of bed and go out and try to make money—that’s exactly what it was,” he said. I was struck by the fact that what Jessica was describing was pain. Here, inside his clean, quiet and fragrant house, he indulged in luxury. “My cousins said, ‘You have to get up and do something.’ No I do not. You don’t understand. I was homeless on the streets. They cannot understand how difficult it is. I was always outside. I walked ten miles a day, maybe. Like, I don’t need to wake up.
Jessica hopes to enroll in a culinary arts program next semester, and is trying to get bone grafts to replace teeth. He has started working with his boss at 90 Sands, and is receiving treatment for his wounds from a doctor on site. You still intend to get off heroin.
“Winning can be small sometimes,” Lipsky reminded me at our last meeting, when I expressed my dismay at Jessica’s failing health, without identifying her. “You meet people and see where they are at this stage, and where they can be. It takes time. And it takes investment, and it takes consistency. It takes trust and belief in that person to that point when five, ten years down the line you look back and think, Wow! Look where that person is coming from.” ♦
#Journey #Homelessness #Room
