some thoughts for the holiday

i am home for lunch today.
i just returned from two "home visits". i do a lot of driving for my job as i work with folks living in three different counties. i don't mind the driving; especially on days like today.
i find that the drive helps me to clear my head. often when leaving visits with folks i am overwhelmed with the amount of information gathered, or the staggering barriers to improving outcomes. i spend my time with clients being centered and focused; not revealing the internal chaos of my brain trying to formulate a realistic plan. these folks have more than enough chaos and don't need to worry about mine.
being that it's the holiday season, there's a lot of extra effort and coordination. there are donated gifts from local churches. there are bags of toiletries. our volunteers go out of their way to bring a little festivity to folks who would otherwise be alone and without celebration. we also have food baskets that are put together by the local salvation army.
this is all fantastic, but there is also the logistics of getting these things to the people they were intended for. spread out over three counties and most without their own transportation, this becomes a major headache. an additional paradox is the fact that activities not linked to medical outcomes (i.e. delivering holiday gifts or food baskets) are not approved ways for a medical case manager to spend her time. in other words, it's not something i am supposed to be doing (per the omnipotent folks who run MEDICAID). so i have to "hide" these "deliveries" inside other "true" case management activities.
all of this brings an air of dread to something that should be a heart-warming and humbling activity.
but then you actually meet with your client....
and all of that apprehension goes away.
my first visit was with a gentleman who is currently homeless. he is substance addicted and has been "banned" from the local shelter. he is being sanctioned by the local DSS and cannot receive cash grants, food stamps or emergency housing. he currently has no health insurance. he is completely without. i brought him a new winter jacket and a basket of food and toiletries. he has nowhere to keep these things so i brought him to his sister's home. his sister lives in public housing. this particular public housing development is in a city known for it's rich folks and posh summer sport, Thoroughbred horse racing. the public housing apartments are old and run down. the parking lot is not plowed and there is over a foot of old snow. the concrete steps are all covered in thick ice. it's a hazard, but my client would be eternally grateful to live in a government funded dump like this. it's sure better than the streets.
my second visit was with a woman who is the best example of a survivor i have ever seen. she has been chronically homeless and substance addicted all of her adult life. she has been beaten to near death many times. she's been in and out of multiple rehabs and psychiatric hospitals since being a teenager. she is currently recovering from yet another assault from a former "lover". for the holidays she will have a drain in her scalp from the contusion which is abscessed. she is unstable on her feet and couldn't help me carry her food and gifts because of the concussion she suffered when her head was slammed multiple times against a tile floor.
these are people who are grateful for any shred they are given. they are completely overlooked by most of society; if not discriminated against (did i happen to mention that all of my clients have HIV/AIDS?).
so on my drive back to the office i have a head full of things...
i think how sad it is that there are people who feel they have nothing to celebrate. they are so demoralized they cannot see a way out. i think about the contrast of this richy-rich town and how they treat their poor. i think about how nice it would be if my folks could just have a "day off" from their lives-to just be able to relax and not worry about their next meal.
but most of all i think of the explosion of pure joy that happens when i get to be the one to bring these folks the only gifts they may receive all season (if not all year).
i get the privilege of showing them that not everyone has forgotten about them.
it kind of makes me want to get back to work...

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