Social Work in the Tenderloin Will Kill Something Inside of You
Photo by Kevin Killian
The Tenderloin is widely acknowledged as the most hellish neighborhood in San Francisco. Out of the city's ten most violent crime plots, the Tenderloin is home to seven. Recent stats estimate the neighborhood has an average of three major crimes per hour, including one-third of the city’s drug offenses, with a yearly mean of two crimes per resident. The population is made up of more than 6,000 homeless people and contains one-fourth of the city’s HIV-positive drug users. Filthy sidewalks and vacant buildings peppered with single-occupancy hotel rooms provide a home to all levels of drugs and prostitution.
My friend Lorian has been employed as a social worker in the Tenderloin for several years now. Her tweets about it (things like: “today: 4 dead clients, 1 murdered provider, 1 client defecated in the lobby, 1 dead dog, & 1 facebook friend posted pictures of nachos.”) got me curious as to what her job is like. She was kind enough to answer some of my questions.
VICE: I imagine it varies greatly, but can you describe your average workday?
Lorian: The first thing is getting through the door at 9 AM. We usually have to step over clients or random strangers passed out on the benches from drinking and/or using since God knows when. The smell is the first thing that hits you—a stench of urine, feces, poor hygiene—it's really at its strongest in the morning, but you get used to it throughout the day. Then we check our voicemail. Twenty messages from the same two or three clients who either scream their financial requests over and over, simply sit there and breathe, or tell you that witches are under their beds waiting for the next blood sacrifice. Paranoid clients like to fixate on witches, Satan, etc. Anyway, we get ready to open and hand out checks to the clients who are either on daily budgets, or who make random check requests. The budgeted clients are the most low-functioning, as they can be restricted to as little as $7 per day in order to curb their harm reduction. They'll go and spend that $7 on whatever piece of crack they can find, and then two hours later they're back, begging for more money. Clients will find some really brilliant ways to beg. When we're not dealing with clients out in the lobby, which can involve anything from handing out checks to cleaning up blood to clearing the floor for folks having seizures, we're usually dealing with the government agency assholes over at Social Security. I personally work with around 200 clients, so the paperwork and filing can be extraordinary. My “average day” starts at 9 AM and lasts until 7 or 8 PM.
You're in the Tenderloin, right? What's the deal with that area?
Yeah, the Tenderloin is where the majority of our clients live in residential hotels (SROs). It's one of the two predominately black neighborhoods left in SF (the other is the Western Addition), and it's the center of the crack, heroin, and oxy drug culture, and it hosts the transgendered sex-worker scene. It's an incredible neighborhood. There's a preservation society that works really hard to keep the original buildings in place, so the 'Loin has an impressive architectural history, not to mention random shit like vintage fetish-magazine stores, pot dispensaries, and transgender strip clubs. It's literally located at the bottom of a giant hill (Nob Hill), where the old money sits and looks down on the poor black folk, so the geography of SF's class structure is more blatant than in other cities, I think. It's a fucked place: human shit smeared on the sidewalks, tweakers sitting on the corner dismantling doorknobs for hours, heroin users nodding out in the middle of the streets, drug dealers paying cornerstore owners $20 to sell in their stores, dudes pissing on your doorstep as you leave for work, etc. It's a weird, fascinating, and very hard place to live.
Why do you think so many of your clients are paranoid and/or disturbed?
Why are my clients so fucked up? Traumatic backgrounds, PTSD, and severe mental illness (schizophrenia, bipolar disorder, and dementia are the most frequent cases we see). And whenever you combine a drug habit with compromised mental health, you usually get a mess of a brain. Abuse, rape, murder, suicide, war—you name it, they've experienced it. Most of our clients live with on-site case management and nursing staff, so their medication is monitored, but when they stop taking the meds, that's when psychotic breaks and fixations happen. I've been the “subject” of quite a few of these fixations. And even though our agency pushes the belief that “housing is healthcare,” the shit that goes down inside these residential hotels can be hard to stomach. A lot of our clients feel safer living on the streets.
How does being in the midst of so much mental illness affect you emotionally?
Man, social work is so fucking weird. People think you're a saint. “It takes a certain person to do that kind of work,” is what I hear a lot. Fuck that. When you're young, you can afford to have ideals and believe in stuff, and think that what you're doing matters, but after watching grown men shit themselves and sometimes try to eat their own shit, not to mention the countless number of times I've had to pick people off the floor and put them back in their wheelchairs because they've been drinking since 6 AM and can't even sit up straight, your measly 32K salary starts to matter a helluva lot more than social justice.
I think I got into social work because I had this idea of it somehow “killing” my ego. It seems silly, but it felt very real at the time. There's a sadness to watching your idealism and convictions go to shit. Not to mention that working in such a thankless and fucked system will kill a sacred part of you. I feel tired. For the most part, people do not want help. They want money or they want drugs or they want death.
What you do seems important, though. There must be some goodness in it, too, right? I feel like you tweet sometimes about people bringing you weird things they see as gifts or saying nice, if totally bizarre things. Are there moments that help balance the heavy?
I don't really think of what I do as “important,” because days are days and everyone is dying and who am I to think anything of anything. But yes, there are moments, there is goodness. Today a client brought me a huge drawing he made of a tree in Golden Gate Park. It must've taken him hours. He said he drew every leaf. I told him the line work was amazing, and he said, “An amazing tree for an amazing woman.” And then he asked me, “When is the Fourth of July?” Sometimes moments like that are enough.
Update: This article has been amended and certain images have been omitted in accordance with the requests of certain parties involved.
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