Tuesday, April 20, 2010

Case Study #1

A bit of a backgrounder on barf-bag guy.*

Dude was a hard rocker in his younger days. Played sports, partied hard. Drank a lot, used marijuana and coke. As an adult got a decent job driving a forklift, and enjoyed watched football with his drinking buddies. He’s a big guy who loves beer and greasy food. His parents both died fairly young of cancer, leaving him extremely broken, a feeling he drowned in about a weeks worth of tequila after the second funeral.

Eventually, he got married to a woman with a young daughter whom he loved like his own. A couple years in, his wife comes out as a lesbian and says that she and the daughter will be leaving.

This is just too much for him, and so he slits his wrists, getting himself an all-expenses-paid five day trip to the hospital. He comes home to find that his family has indeed left with most of the couples belongings, including several pets. They kindly left a pile of debt in their wake. So, here comes the second suicide attempt, the wrists again. Hospital stay, take 2.

Long story short, the guy lived, but did a number on his wrists, leaving him with limited feeling and movement in his hands. Years of sports and hard living have taken their toll too, resulting in bad knees, back, shoulder, and carrying around an extra 200 pounds or so. He wasn’t able to work after the separation and the suicide attempts due to his rapid decline of physical and mental health. So he winds up on welfare, then gets disability support, still hardly paying enough to look after himself in a healthy way.

He’s doing reasonably well now since he got a government subsidized apartment. He meets with his counselor, has a few friends, and is good with is money.

But this man is only 45, and looks at least 20 years older. He can now barely walk, is in all kinds of pain, has a myriad of GI problems (ick) and still deals with depression.

He’s a smart and nice guy with a good sense of humour, but I often feel at a loss of how to support him. How do I work with him to accept that he is basically like a senior citizen? That he may need some in-home care, a pass for the wheel chair bus, and some serious medical interventions?

Really, he knows all this. But he also does not want to give in, and has sort of resigned himself to suffering. I totally believe in a client’s right to self-determination, but it doesn’t make it any easier to watch. I’m trained to cope with and offer support to people in all kinds of mental and emotional distress, with whatever social factors working against them. But physical deterioration? Out of my scope. We’re meeting with his GP this week, and I’m anxious to see how it goes.

*and no, he didn’t end up puking in my car. We had to pull over for him to get some air, but fortunately it didn’t get any grosser.


  1. Hey, just started a social work blog myself, spelunking around the internets looking for others to link. So howdy.

  2. Howdy yerself. I'll be sure to check you out!