August 2011 Editor's Note
Monday, August 1, 2011 at 02:00PM I was walking to my car near the greyhound station on 19th and Curtis when he stopped me. He muttered something about being cast out and did I have 50 cents. I didn’t, but I made a firm stop to hear him out—not the turn-your-head-over-your-shoulder-and-say-no-as-you-walk-past routine. I think he liked that, so he walked with me for a bit.
It was cloudy and cool and I welcomed the strange company. He chattered on relentlessly. Something about getting anchored in hell; some strange mixed metaphor about getting married. Beneath a patchy beard I noticed a pinky-wide smooth patch of skin that ran horizontally across the left side of his throat, right down to his Adam’s apple. A thought raced through my brain before I could stop it. The thought was that he must have spent some time doing that. It wasn’t a nice, neat cut. It was wide, like he worked at idet with a plastic knife or something, desperately trying to cut something out.
I don’t know if he noticed me notice this about him, but a minute or so later in his stream of consciousness monologue, he just out of the blue said, “See, this is where I tried to kill myself because I hear voices.” A short pause, then he continued his monologue.
A month ago I would have assumed he had schizophrenia, but just as we were parting a different thought started to take shape in my brain. Speculation. The way you inevitably start to build a story for the people you meet, filling in the empty spaces to make a cleaner, or at least more complete, picture. This thought taking shape went back to an issue that Street Roots (the Portland, Oregon street paper) wrote about in June, and that we’re exploring again in this edition of the Denver VOICE—Traumatic Brain Injury.
Nick Patton, the person interviewed for their story, had a severe brain injury. He was homeless, and for years was passed off as schizophrenic. He heard voices and was given anti-psychotic medication to no avail. Only after several years did a doctor discover that small seizures, stemming from an old traumatic blow to the head, were causing the hallucinatory effects. He is now being treated with anti-seizure medication that is helping to control the voices and hallucinations.
Researchers and caseworkers are beginning to see brain injury as a more prevalent diagnosis for many homeless individuals. On the extreme end, one study in Ontario said 98 percent of homeless participants had experience traumatic brain injuries. Several other studies (cited at length in “Getting Ahead of Homelessness” on page 7) demonstrated significant correlation as well.
While well short of preventing homelessness, being aware of this potential diagnosis can create a clearer picture of what people are going through. Brain injuries can cause victims to appear drunk, drugged or mentally unstable. They can cause people to become irrationally aggressive or loud. The things that generally make up negative stereotypes of homelessness might really be symptoms of a severe injury, and if we can start to identify those symptoms, we might be able to help people recover.
Like Nick Patton, the man I met the other day might not be “crazy.” I can’t say and personally can’t do much about his individual case, but as a community of homeless service providers, we should coordinate our efforts and improve our ability to identify these cases. The evidence for how pervasive brain injuries are among the homeless is irrefutable, and we’ll have far better outcomes for the people we serve if we’re treating the right problems.
August 2011, Tim Covi in Editor's Note
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