It was an unfortunate set of circumstances that led to me doing some of the best social work I have ever done. As the director of a large program serving adults with mental illness, I always carried a small caseload. It gave me my "fix" of client contact (a key ingredient to my professional happiness) and kept my clinical skills sharp. No matter how busy my director duties kept me, it was something I insisted on doing.
"Nancy" was one of the clients on my caseload, but she was not our typical client. She arrived precisely on time every Thursday morning at 10:00 a.m. and her punctuality was so sharp I am pretty sure you could set the atomic clock in Boulder, Colorado by her arrival. She would wait for me in the waiting room, her hair perfectly coiffed, lipstick carefully applied, hands patiently folded in her lap. When I would go to retrieve her, the look of recognition on her face offered only a distant warmth.
Nancy never really required much from me or from anyone, really. She was remarkably self-reliant and only stayed in mental health services to ensure she never repeated the horrors of her distant past. She would sit with me and independently set up her medication tray for the next week. She would indulge me by reassuring me that she was happy with her housing, she had followed through on all of her necessary medical and dental appointments, and that she had swallowed every pill prescribed to her in the preceding week. She would take a quick social detour to talk about movies with me - a common hobby we shared - and tell me what movie she planned to see that upcoming weekend. Every Saturday afternoon, rain or shine, she saw a matinee. This was part of the routine, a routine that never allowed for deviation. After our quick and perfunctory visit, Nancy would leave and make her way to the local clubhouse - another thing she did each and every day.
It was a sad and shocking Wednesday when I got a call from the staff at Nancy's clubhouse that Nancy had passed away. She had not shown up there for a day, and then two, when they called her landlord to do a wellness check. Sure enough, she had passed away peacefully in her sleep. They were calling to give me the information for the medical examiner and to ask for my help with funeral plans. It wasn't the first time I ever had to do this, sadly, as for many of our clients we are the family making the arrangements. I knew what to do.
In the days that followed, however, I learned that I had my work cut out for me. I went straight to the funeral home I had used for years. They were situated in a neighborhood familiar to many of the people we serve, and as a small, independent funeral home they had a lot of heart and compassion. I worked with the staff to make the difficult decisions without any input - this was one of the many things Nancy and I had never thought to discuss. The staff at the funeral home and I bonded, and on the way out the door the director gave me his business card. It was a card that on the front had the funeral home logo, and on the back said "Thank You for Smoking." I needed that laugh.
The complicating factor was that Nancy had a fair amount of money saved up in her bank account. Of course she did; I am telling you this woman had her life put together better than most people I know. This money was going to be needed to proceed with the funeral arrangements, but the bank told me it could not be accessed without a signature from her next of kin. This, I knew, was going to be no small feat. And no small feat it was, indeed.
Nancy had been estranged from her family for decades. She, of course, was far too guarded to share the details of the story. But my guess is that like many of the people we serve, her symptoms and her illness got in the way of her relationships. I had to do some digging, but I did find her brother's name buried deep in some old records. I took a deep breath and I picked up the phone. When her brother answered, I stumbled through trying to explain who I was. There was no remorse at the other end of the line, no sadness for the news of a loss. There was, instead, anger. Lots and lots of anger. Anger that this person he once fiercely loved in his youth had not been in his family's life for years upon years. Anger about the things that had transpired and had led to the relationship's demise. Anger that now he was supposed to do something, however small, to help.
It took several hours of conversation over a couple of days to get the brother to come around. He needed validation - the one thing that almost every angry person ever needs - and he got a lot of it. He was validated that his experience, heart-breaking as it was, was not all that uncommon. He was validated that mental illness is cruel and sometimes takes no prisoners. He was validated that it was okay he was mad, for most people in his circumstance would be. And slowly, ever so slowly, he came around. He agreed to go to the bank, "but that's all I'm doing." Fair enough.
It was really all I needed, because I had a funeral to plan and that had been the only thing holding me back. The day of the funeral arrived, and the funeral home was packed with all of Nancy's friends and colleagues from the clubhouse. It was quite moving, actually, to juxtapose this scene with the images I had formed over the past few days of her family estrangement. Shortly before the services started, I saw a man standing at the back of the room. It's funny how sometimes a face perfectly matches a voice, and I knew in an instant who it was - it was Nancy's brother. I gingerly approached and introduced myself to this curmudgeonly man who seemed to have found some love in that heart of his. He thanked me for reaching out and quickly set his limits again. "I'm not staying." I assured him it was beautiful that he showed up at all. What I could see in his eyes was a little bit of mourning and a little bit of peace. What he had lost over the years with his sister, clearly a lot of other people had found.
The service was lovely and included all kinds of funny stories that few people knew about our private, guarded Nancy. I left that day and I thought I had finally been able to do something for Nancy - if nothing else, I gave her a good send off. This was good enough for me.
A couple months later, I was at my desk when my phone rang. I recognized the voice, but it took me a couple of minutes to orient to who it was. It was Nancy's brother, this time reaching out to me. There was a warmth in his voice that I hadn't heard before. He told me that he wanted to call and thank me for doing what he would have not been able to do by planning Nancy's funeral, and I assured him it was my privilege and honor. But mostly, he said, he was calling to let me know that he had taken Nancy's ashes a few days prior and placed them in his family's mausoleum. After decades of being on her own, Nancy was right back where she belonged - with her family. I hung up the phone, and wiped away some tears. It's never too late, I thought, and the world felt a little more right in that moment.