Lord of the Flies

Not William Golding's novel, but certainly an example of something the book hinted at; culture created by man is doomed to fail because of man's desire to control everything. Sometimes holding on too tight can break things. Sometimes things get so out of control there is no stopping, no steering, no hope. Sometimes culture steps in to help after all. Cue the bells and Medic 99 is out the door.

THE EMERGENCY

Police have a woman for an involuntary psych eval.

THE ACTION

I remember from the psych emergencies section of my pre-med classes that the...um...there was none as I recall. Call me crazy, but I'm no expert in crazy. I will tie her down and take her to an Emergency Room where a general practice physician will hold her for 72 hours. That's all I can do.

The ambulance pulls up in front of the most rundown house on the block and is the first hint at what we will find inside. On the steps outside are 3 police officers and a woman with a clipboard. She identifies herself as a representative from the local adult services organization and is the one who activated the police.
The agency is forcibly removing the woman from her home of 56 years. Not being one to stand in the way of personal rights I try to get more information.
"Just go inside, but be warned." She says.

I already knew it would be bad since everyone was outside talking, not inside. She isn't a physical threat we were told and upstairs into the house we go.

The odor is faint at first, but is almost like a curtain in the doorway. As we cross the threshold and enter the rundown house the floors are the first thing to catch our eyes. The old plank floor, likely installed when the house was built 70 some-odd years ago is visibly worn down in a small two lane pattern just wide enough for a small pair of legs to shuffle along in. Everywhere else is covered either in shredded paper, random trash or feces.
Movement in the back of the far room turns out to be a large swarm of flies of all sizes. They hover over the center of the room which appears to have been a chair at one time, but is covered in almost a glaze of feces and clothing, appearing almost like a mountain 5 feet tall. The swarm doesn't even scatter when we try to walk by.

The adjoining rooms are behind closed doors and the shuffle tracks don't lead there. It appears they haven't for some time. Maybe decades.

Our patient is in the room commonly used to prepare food. The items in the sink have a film on them, a fuzzy one, that seems to touch your skin from arms distance. the air is heavy and we're trying hard not to breathe too much. The stovetop has rotting bones of some kind and pots and pans with crusted leftovers from when I was in diapers.

The walls are caked with fly larva and their constant flying from feces to the wall has left certain areas with a brown tint. I see the refrigerator and am too frightened to look. If this is how she keeps the open areas, I honestly fear what that little area hides.

"Hello. Are you here to take me away in hand cuffs?"
She's standing in the corner in a clean nightgown, maybe in her late 70s, alert, oriented and...clean.
"We were told you needed some help getting this started. Are you in any pain or discomfort? Anything you would call an ambulance for?" I ask, wondering where she keeps the soap.
"Oh no. I called a friend who called the adult services. She came over and nearly cried. I know this place is a mess, has been for years, but there's just no way I can clean it on my own. I eat out a lot and dry clean all my clothes."

She's fine physically and mentally, as far as I can tell, but clearly can't thrive in this environment.

"This is going to sound insincere and I know we've only just met, but where do you use the facilities?" My partner asks.
"I go down to the deli on the corner for that. That's where I wash my hair too." That explains that.
"The toilet doesn't work, hasn't for awhile." she tells us looking at the sink.

We spend another 5 minutes letting her change into some clothes for the ride to the ER, she agrees to a 72 hour evaluation, if nothing else than for a proper shower and for the wheels to begin to turn to get her help in cleaning up.
When she's changed she moves a large sheet of plywood over a window to "lock it up" and walks with us, vigorously wiping her shoes on the welcome mat on the way...out.

I can only imagine what the house looked like before this happened and if there was a trigger of some kind, a death in the family, a job loss, something that caused this woman to simply stop tending to her home.

As we left and she went downstairs, I took one last scan of the house and something on the mantle caught my eye. It was a grouping of heavily dust covered christmas knick knacks and one of them appeared to have a date on it. I could barely lean over the pile of rotting trash and clothing to read it, our occupant would never have been able to reach it.

Merry Christmas, 1987.