Situational ethics are the only kind

He was the worst of the worst.  Wrecked.  Disgusting.  Mental.  Aggressive and so far beyond filthy as to redefine the word.  Robert had thick matted hair that stuck like a large brown bag on his head falling down to mid back, and covering his face.  He had no shoes, only several pairs of rotting socks.  They stunk.  He stunk.  The air around him stunk.  He had several layers of clothing all of which was in tatters, the crotch rotted out through the layers because he relieved himself without removing them.  His skin was pock-marked with dirt and it felt like bugs and fleas were coming off him if you even came near.  He was hunched over and he dragged his feet when he walked.  He was so bad that the lowest of the low detoured around him.  Robert was the craziest, most filthy, most repulsive person I had ever seen.

Robert was also angry, insane and volatile.  If you spoke to him he began spitting and waving his arms and making aggressive gestures.  The fear one felt stemmed mostly from being so near the filth and the disease.  And the spray of germs and slime that projected from him was worse than a weapon.  He was like a walking plague.  He was a human sewer rat.

No one went near Robert.

Our policy at the clinic was to ‘accept’ the weirdos and to offer assistance.  Part of the definition of ‘weirdo’ was repulsive, dirty and way too often, addicted and crazy.  Robert was all of that and so much more.  But our staff did what they could without getting too close.  In fact, Robert came to the clinic about once a week and went to the small food store we ran.  The staff would open a free can of sardines, give it to him with a plastic spoon and he would scurry off to a corner and protect his meal from anyone approaching within ten feet.  Usually he ate undisturbed.  No one ever approached on purpose.

One day, I asked the street nurses about him. “Robert?  Are you kidding.  None of us will go near him.  I’d quit before I had to attend to him.”

“Seems kinda chicken not to try.  You guys are the toughest, most street savvy skid row workers going.  If you can’t do it, who can?”

“Robert’s so crazy that you need to commit him.  That requires two doctor’s signatures. From different offices.  And both doctors have to examine him and agree on the decision to commit.  Then the paddy wagon comes when only all the paperwork is done.  They take the real crazies to Crease Clinic.  No doctor is going to see Robert because  no one can get Robert to do anything or go anywhere.  Getting two of them to see him is impossible. Never gonna happen.”

I went to all our doctors and explained the situation.  No go.  I went to the other street clinic miles away and explained the situation to them.  No go.  So I went back to my group and asked them to examine him on the fly if they could.  In the hallway, in the washroom, on the street, whatever.  They agreed to do that if the opportunity arose.  I got the other clinic doctors to agree, too.  Any kind of exam anywhere would do. Then, after months of futile waiting for an opportunistic encounter, I asked one of my doctors to sign a committal form in advance so that I would NOT have to chase paper if any of the others had the chance encounter but he/she did not.  They would not do that.  But, eventually one did on the promise that at least one of the other doctors in our clinic saw him and, of course, the other clinic doctor also saw him.

Then I asked the other clinic to do the same and with the same promise.  I now had two signed committal forms and I was determined to wrestle Robert into seeing at least one of my group doctors when I could.  The second impossible bridge would have to be crossed after that.

To make a long story short, it never happened.  Robert was too erratic.  When he did show, the staff were busy with other patients.  And the second clinic doctor was going to be even harder to satisfy.  After a few months, I gave up doing it the right way.  I gave up my promise.  When I next saw Robert I called the paddy wagon and I gave them the two signed committal forms and they took him away.

In effect, I broke every rule in the book.  I not only put myself in danger of being charged with a long list of crimes, but I jeopardized the doctor’s and their professional standing.  In hospital administration terms, I was the worst felon possible.  And, I felt that way.

For about a week.

Skid Row is busy.  We had over 800 people a day come through the clinic on a busy day and all days were pretty much busy.  That kind of ocean of sickness tends to erase any one day.  After a week, I forgot about Robert.

Until about a year later when a tall distinguished guy wearing a three piece tailored suit and carrying a briefcase asked to meet with me.  He had such a professional bearing and elegance, the receptionist made the only exception I have ever seen to her rule of never coming out from behind the Plexiglas.  She escorted him to my office.

“Are you David Cox?”

“Yes.  How can I help you?”

Getting some papers out of his briefcase, he continued, “Do you recall Robert Smith, a patient at this clinic?”

“Yes.  Yes I do.” And I started to think about my pending arrest at that very instant.

“Are you aware that you violated the legal procedures for committal?  I have already spoken with the doctors involved and they claim that the entire committal was executed by you in violation of their specific instructions and that they are claiming no responsibility in the matter whatsoever.  Is that true?”

“Yes.  I broke the agreement.  I felt I needed to.  It was an accident.  They did nothing wrong except to trust that I would keep my word and I did not.”  I almost extended my wrists together for him to handcuff.  I hung my head.

“Are you aware of what happened to Robert Smith?”

“Not a clue.  He went to the hospital.  That’s all I know.  It was a long time ago.”

He stood there looking down at me.  He was over six feet, average build, about fifty, with lawyer-style greying temples and he was wearing a very stern expression.  I could feel my life coming apart.

He extended his hand and smiled. “Don’t worry about a thing.  I am Robert.  Your actions saved my life.  I came to thank you.  If you hadn’t done what you did, I would surely be dead by now.”

Seems Robert had been on meds for a form of schizophrenia.  He has no idea what caused him to come off the meds but, at the time, he was living in Kelowna and had a family.  Wife and kids.  He was an accountant of some kind.  He had subsequently lost seven years of his life to the madness that was his condition and he estimated that almost all of it was spent in the Downtown Eastside.  His memory of the time was hazy but he remembered the building, the sardines and Oppenheimer Park.

After he had been at the hospital for a month or so, they had him stabilized. New meds. He contacted his wife.  She was overjoyed and went immeditely to retrieve him and the last year was spent putting his life together.  He looked great and we spent a half hour grinning and sharing what we knew about the old Robert.

Once he was together enough, he had investigated how he had been saved.  He unraveled the mystery on his own.  No formal inquiry, just conversations.  The secret was safe.

Robert left.  I told the doctors what I had learned.  Robert had not told him that he was, in fact, the man that had briefly asked them a question or two recently.  They, too, thought that it was a lawyer making inquiries.  They were as relieved as I was.  We all spent much of the time together saying things like. “I never should have agreed to do that”.  “After all is said and done, it was still a violation of ethics and blah, blah, blah.”  “I am sorry.  I really am.” (I really was when I was saying that but a week or so later when the dust had cleared and I had time to think about it, I was not.  I was pleased about it.) 

Situational ethics.  Not uncommon for anyone working in skid row but rarely as dramatic as Robert.

12 thoughts on “Situational ethics are the only kind

  1. Thank You. I lost my sister to the Downtown Eastside. It’s wonderful that you shared this feel good story. This is all I can type as I seem to have gotten some dust in my eye.


    • Yeah. Robt. was one of the stories that justified a lot. Sadly, most people down there were NOT saved. Way,way too much humanity wasted. It was overwhelming then, it seems even worse now. A job for the young, brave, good and still it would burn them out.


  2. Wow! Very moving. I thought I was going to dislike where this was going, until I found out. Revises one’s perspective of the DTES people. If only all their stories were this happy.


    • Sadly, JG, I can count all the happy ending stories on both hands but I do not have enough digits for all the heroic efforts. I may do a few of those…..


  3. ‘Thanks for helping me but you broke some rules to do so.’ Profound really. Even in his manic state his sense of injustice remained and once he was functioning more appropriately he needed to set the record straight. Nice reminder of one’s humanity even in the face of adversity and conflict. George Orwell tells the story of prisoner on his way to the gallows who stepped around a puddle rather than lose his dignity by being dragged through it.


    • It wasn’t Robert who was concerned with the rules. It was the doctors. Which made sense….they literally had no skin in the game nor had they ever really seen him. To them, he only represented a professional paper problem that MIGHT bring them involuntarily to the issue. But everyone was pleased in the end. They were good doctors.


    • The worst part was seven years! Took me about three months of dithering. That guy was an obvious emergency and we went by the rulebook. And THIS was a ‘fringe-street’ clinic. We were the most flexible and he was still missed. Can you imagine the numbers missed?


  4. Don’t mean to name drop, or get pedantic on your blog, any readers here read ‘the couch of willingness’,,? fwiw it’s a memoire by a former Okanogan social worker, male, just a tad younger then we old guys.
    To get a sense of the power of booze over some souls, his in this story, this is good as it gets for the genre ,,, endless suffering, yet a real page turner just the same.


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