How to Save a Life

On the street, I see someone who looks like my brother, dresses like him, moves like him. For a moment, I suspend the truth and say, “There’s my brother.” The moment passes too soon. But there are many who suffer still, and I try to treat them like brothers, for my brother.

The spirit release ceremony was held on the corner in Richmond where the car hit the writer’s brother, Mario Castillo, Jr.

 

by Janny Castillo

“Where did I go wrong? I lost a friend.

Somewhere along in the bitterness. And

I would have stayed up with you all night

Had I known how to save a life.”

— The Fray

The police report said that my brother’s death was 100 percent his fault. He was 43 when I lost him in April of 2012. The report said that he had broken the law because he was riding a bike irresponsibly while under the influence. He had turned into a moving car and was thrown headfirst into the windshield.

I read that the driver had stopped, called 911 and placed a blanket over my brother. For me, one glaring detail was missing: How fast was the driver going to cause such a catastrophic brain injury?

The results of the police report were disturbing. I had no way to prove it, but I knew there was something ugly about it. My brother was homeless, previously incarcerated, and after a violent attempt on his life at the age of 19, he had suffered from substance abuse and severe mental illness. I believe the system gave him one more kick in the ass for old times sake.

The song, “How to Save A Life” by The Fray, reminds me that I did not do enough to help him. I had failed, as a big sister, to take care of my little brother.

When he was little, it was easy. He was chubby and heavy, but I carried him when Mama told me to, fed him (that was messy), changed him (even messier), and taught him how to walk. Sure, he would fall, but back then, all he needed was a hug and a sucker.

My Dad beamed with pride when Mama presented him with a son. Daughters are OK, but to my father, my brother equaled the continuation of his lineage and HOPE for the future. That’s why he was given the proud name of Mario Castillo, Jr.

We grew up in Richmond on one of those tight, short streets only one car at a time could drive down. Single-story homes were scrunched up together, ten deep on both sides of the street, and walking to the next house felt like walking down the hallway to a spare bedroom.

We knew our neighbors — some of them a little too well. In a world before the Internet or Playstation, for fun, we played for hours in a pocket park in the middle of the block. There was always a bully who picked on the timid kids but we lessened the fear of abuse by becoming absorbed in making creative, individualized tossers for hop scotch and playing Monopoly games that lasted for days.

Our parents used every birthday, holiday, graduation, and new baby to party. The hot Latin beat and stories about Republica Dominicana kept me emotionally connected to a culture I left at the age of two. People came to our house for super-fast Merengue music with splashes of two-step dancing to Dion’s “Runaround Sue” and Tony Orlando’s “Knock Three Times.”

I loved and dreaded dancing with my father. He was very good at leading me but I always found a way to stumble onto his foot. The good days were rich and sustained us through the tough times.

There were Little League baseball games and summer camping trips to Napa County’s Lake Berryessa. We also took long drives to attractions like the Winchester Mystery House where we wandered through a strange old lady’s mansion with stairs that went nowhere and rooms that went on forever.

I remember being mesmerized by a 100-year-old skeleton that lay exposed in a cool, dark crypt beneath one of the many California Missions we toured, and I was changed forever by an unforgettable drive from California to New York. We drove along Route 50, the 3,000-mile highway, in the family station wagon with the fake wood side paneling. On some cold mornings, by the side of the road, we ate breakfast in strange little square containers cereal came in.

My family loved and took care of each other but we did it without using our words. We handled problems with as little effort as possible, which usually meant issues remained unresolved and simmered just below the surface until we could not stand it anymore. Then the dangerous yelling started and hell would break loose.

With my brother, it was different. Past the park, there was an empty lot. My brother and I would squeeze through an opening in the chain-link fence and cross the train tracks into an open field of wild grass and wet marsh. It was these private moments that fused our spirits together and made me fiercely protective of him. We would walk until the real world fell away and all we could see were pieces of the San Francisco skyline and the sun sparkling on the bay. There, my brother and I would contemplate the complexities of our existence and try to come up with reasons why our sister Maria was so damn mean.

Years later, my sister would melt my heart when she defiantly and proudly walked across her graduation stage with a big tummy full of baby. She blew the whole poor teenage mom stereotype out of the water. My sister showed me what real courage was, and her baby grew up to do big things, like manage multiple McDonald’s franchises.

When I was 22, I left home for stupid reasons. I ran all the way to Los Angeles for L.O.V.E. I didn’t know what love was and LA beat me up just to make sure I knew what love wasn’t, but that’s another story for another time.

Back home, my brother had started drinking. He was Mr. Instant Alcoholic. Practically everyone in my family was in denial and could not figure out how to help him. We were dysfunctional before dysfunctional became a thing.

On the phone, my mother would cry, “Jenny, tiene que venir, te necesito, ayudarme con tu hermano.” I need you to come home and help with your brother.

After the birth of my brother, my mother was diagnosed with diabetes. She had a hard time following doctor’s orders so her symptoms quickly got out of control. I would come home from school to find her unconscious on the couch. When I could not wake her, I would call an ambulance, hoping they could save her from falling into a diabetic coma.

Living on the edge, with my mother’s health spiraling out of control, I learned to shut down my emotions and respond to crisis with a disconnected, surreal calm.

My sassy, stubborn Dominican mother never received what she needed from Kaiser, from Dad, from her children. She lived several countries away from her culture and her sisters, and we didn’t know enough to tell her she was really suffering from grief. “Get Mom to stop eating sugar.” That was our failed and only plan.

But my brother’s story cannot be told without Mom. She was his codependent champion. She always forgave him, no matter what he did. And he did some crazy things, like steal Dad’s car again and again for joy rides. Just so you know, all you have to do is saw off a small piece of the steering wheel to take The Club off. Dad found that out one very angry night.

Mom hated it when Dad and my brother fought. She was a master at making me feel guilty for not being there, so I came home from LA with a husband and fresh new emotional baggage.

At the age of 19, my brother fathered a baby girl, a little dark-haired beauty that looked like him. One night, after spending the morning with her and her mom, and walking to a party several blocks from home, he was almost murdered. One of the attackers held a bottle of alcohol to his throat while others beat him. He was in a coma for nine days until the swelling in his brain went down.

I was numb looking down at him in the hospital bed with tubes running everywhere, his head three sizes bigger than it should be and deep purple bruises covering his face. The metallic scent of blood that hung in the air made his injuries seem that much worse.

I had become very good at pushing uncomfortable feelings deep into the blackness of my subconscious. Detached and just a little crazy with phantom pain, I tried to be there for him and my parents, but before the attack, I had been silently falling apart and self-medicating just to get through the abuse at home.

My messed-up, sensitive brother was never the same. He had suffered a traumatic brain injury. He needed quality, long-term mental health care but we didn’t know enough to insist on it. Instead he received a couple of months of rehab to make sure he could pick up a fork and eat by himself, and string words together in halfway coherent sentences.

Over the next two decades, his life resembled a lethal pendulum, swinging between being the best father he could be to his five beautiful children, and the deep despair of prison, drugs and homelessness.

And there was the recurring dream that I was sure was a memory. The one where I walk out the door of my house, stand at the curb and watch my brother get hit by a car. Every five or six years I would anxiously ask my mother, “Mom, did Jr. get hit by a car? Because I remember him being hit by a car.” She would deny it but I could never shake the dream that eventually turned into a premonition.

Over the years, I came every time my frustrated and scared parents called. I came to get the drug dealers out of the house, to stop the fighting, to talk some sense into him, which never worked. One day, in front of my parent’s house, he was so out of his mind he walked right by me and kicked me. I couldn’t tell whether he recognized me or not.

My brother had stretches of clean time which gave us all hope. Unfortunately, most of it happened when he was behind bars. In 2011, after another 18 months in prison, he was released to a San Francisco re-entry program. It seemed to help him more than any other program. He told me the worst thing about the program was his job. He had to clean bathrooms for a fast food restaurant. It was nasty and emotionally degrading, how he described the filth he had to deal with. To this day, I can’t walk into a public bathroom without thinking of my brother.

I also find it hard to drive my car around a person riding a bike. Sometimes I follow along behind them for blocks, at a safe, slow distance until one of us turns.

The last year of my brother’s life was wonderful and devastating. He came to live with me after his time ended in the recovery program. We spent time together like we used to when we were young. All three of my boys were home, so he had family, which always brought out the best in him.

But he would spend hours just sitting, watching TV. I mean long hours, like my eyes would fall out of my head if I watched TV that long. I finally asked him about it. He responded with something profound.

“Inside (meaning prison), that’s all you do is sit in one place. You get used to it.”

And sometimes he scared me, because the medications for his mental illness caused serious side effects. He would wake up screaming from horrific nightmares. He told me once he thought someone was stabbing him.

He did get stabbed once, and he was rushed by helicopter to John Muir Hospital in Walnut Creek. Another anxious drive to another little brother crisis, another bout with overworked, emotionally detached doctors, another incompetent recovery period, and back to the streets he went.

That fall, my oldest son got my brother involved in the Occupy protest in downtown Oakland. They would man the donation tent and help provide security to a large gathering of peaceful occupiers and homeless people who lived in tents at Frank Ogawa Plaza. I went a couple of times and witnessed the magic of a community living off the grid under the shadow of City Hall.

My son organized an alternative healing event where I gave energy treatments. I was humbled and amazed. People were growing edible plants in wooden boxes and supporting each other in ways that housed people should, but don’t.

The cross at the spirit release ceremony held for the writer’s brother says “R.I.P. Mario Castillo, Jr.”

 

After several weeks, my brother sat me down and asked me to explain the Occupy Movement because he wanted to know what the hell he was fighting for. We talked about Wall Street mobsters, the foreclosure crisis, poor people and homelessness.

He couldn’t stay with us at our home for very long. The tension with my husband, who didn’t want him there, and my brother’s inability to follow basic safety rules — like, “Please stop letting homeless drug addicts sleep over!” — forced him back out into the streets.

This time, I had learned so much, or so I thought, after my personal recovery and after working for years with people who suffer like my brother, so I treated him with tough love, urging him to get help, hoping he would find his way back out of hell again.

But time runs out without giving notice.

I was at work when I got the call. My sister had gotten to the hospital first, and the doctor had already talked to her. I was told to come right away, because a car had hit Jr. She sounded deeply disturbed. On my way, there, I was thinking, “OK, we’ve been here before.”

I wondered how long he would have to stay in the hospital. I wondered what he would need. I didn’t think for one moment that I was losing him forever.

In his final days, my brother received the best medical care of his life. Specialist after specialist ran tests, and then there were tests to double-check and triple-check the first tests. We piled into the hospital room and were told the same thing by three different doctors — that he was brain dead and the only thing keeping him alive was a machine.

It was confusing to his children who were gathered around his bedside. He was warm when we held his hand and if you ignored the bandages wrapped around his head, and the dry, crusted blood that poked out from behind his ear, he looked like he would wake at any moment.

 

The first time my brother held his granddaughter, a year before his death.

 

After the third time, I got the message loud and clear: there was no hope of recovery. I was ready to take control and make decisions. I was ready to help my family through his transition. But I was in for a rude awakening: I wasn’t put in charge.

His adult children were designated his next of kin, at the tender ages of 18 and 20. They knew their Dad would not have wanted to be kept on life support, and because he had been so generous with family, friends and especially strangers, they decided that absolutely he would be an organ donor. “That’s what Daddy would have wanted,” said teary-eyed, strong Ariel.

After a three-day vigil where my family gathered to comfort each other and talk about his life and loves, my brother was taken off life support and his organs were harvested. Months later, I got a letter from the donor network that made me burst out crying; he had saved or improved the quality of life of nine people.

My brother’s life ended several blocks away from where he was attacked when he was 19, and three blocks from our childhood home. Over the years, like an irresistible force, the neighborhood had pulled him back in, representing the best and the worst of times for him and for me. My father had lost my childhood home in the recession, and now, the same neighborhood had callously taken my brother.

We held a spirit release ceremony for him. I did not want to leave my brother’s spirit trapped on a street where he had suffered so. We met a woman who lived nearby who heard the crash. She told us that she ran to my brother and held him until the ambulance came. I was so grateful that he did not spend those moments alone.

She was the caretaker of an urban garden on the corner in front of where he was hit, so she offered to let us plant a tree in his name. I drive by every couple of months to see how it is doing. It never looks healthy to me, but still it is very strong. I didn’t even know what kind of tree it was until I saw a hard, tiny green apple hanging from its bare branches.

The whispers beneath my brother’s story scream of a health care system that fails poor people miserably, and a dehumanizing, revolving door of a prison system that works perfectly. How he was forced to live his life fuels my unyielding belief that in the name of justice, my brother’s death was NOT 100 percent his fault.

I see my brother on the street. I see someone who looks like him, dresses like him, moves like him, and for a moment, I suspend the truth and say, “There’s my brother.” The moment passes too soon. But there are many who suffer still, and I try to treat them like brothers, for my brother.

“I would have stayed up with you all night had I known how to save a life.”

***   ***   ***   ***   ***   ***   ***   ***   ***

The Mental Health Needs of People on the Streets

by Janny Castillo

Under the underpass at West Grand Avenue and 27th in Oakland, volunteers had set up a table with brown bags full of toiletries to give to the forty-plus campers who live in tents and makeshift dwellings.

A homeless youth stops in the middle of the street with his head down, wearing a dirty baseball hat and over-sized clothing that reeked of urine. I could tell that he did not want to make eye contact with me. The anxiety he felt was visibly disabling as he tried to gather enough courage to walk to the table. I had to go to him and coax him gently to take the bag. I could tell that being this close to people was excruciating for him.

Compassionately, I wondered where does this young man go for the mental health help he so desperately needs?

According to the May 2017 EveryOne homeless count, Alameda County is experiencing a record number of temporarily sheltered and unsheltered people: 5,629, according to the report. That’s a 40 percent increase in two years. The National Alliance for Mental Illness reports that 26 percent of homeless adults staying in shelters live with serious mental illness and an estimated 46 percent live with severe mental illness and/or substance use disorders.

Adults suffering from homelessness and mental illness suffer from insurmountable challenges. “It’s very hard for a person who is homeless with a mental disorder to achieve stability,” says Shirley Cheney, St. Mary’s Center Homeless Services Program Director.

“Homelessness is the definition of instability,” Cheney adds. “You have to take most medications two to three times a day. When you are roaming the streets all day with no way to tell time, it’s very difficult to take them as prescribed.”

But that’s just one of the issues. Public health insurance with small prescription co-pays are still a barrier to people with no money; and getting enough bus fare to pick up prescriptions, then get to the pharmacy, is daunting. Some walk instead of taking the bus, but they also have to take care of basic needs like taking a shower at the local drop-in center, and then getting to the free lunch spots on time, activities that could take hours.

Frequently, unsheltered people are subject to losing their belongings and medications by theft or police confiscation. Replacing medications is not a priority when you are back to searching for blankets, food and a safe place to sleep.

Alameda County Behavioral Health Care Services has a street medicine project that is helping a little. They have doctors who go to people living in the encampments and provide urgent care and support services for physical ailments. They provide little psychiatric care, and the need is greater than the resources that they can refer people to, since a growing number of homeless people suffer from abuse, trauma, depression and anxiety.

For those that qualify, referrals can be made to the Trust Clinic in downtown Oakland where short-term help is available, but for the young person whose social anxiety is so extreme that it blocks him from entering public places, the Trust Clinic is not an option.

Professional outreach workers with expansive, comprehensive skills are a solution worth looking into. What is needed are teams made up of psychiatrists, physicians, social workers, and housing and income specialists dedicated to working with unsheltered people for as long as it takes to develop trust and bridge people to resources.

Cheney has another good idea. “Right now we send people with substance abuse problems to one facility then send that same person to another facility for mental health issues. What we need is co-location of services. Facilities with easy access residential beds scattered across Alameda County that multi-layer services to address substance abuse and provide long-term mental health stabilization.”

Right now, if a homeless person in the middle of the street is shouting at the invisible voices in his head, he is likely to end up in jail where he is re-traumatized — and then sent back to homelessness. We need to do better.

*** *** *** *** ***

For Mental Health or Substance Use help call: ACCESS 1-800-491-9099

For Walk-in Urgent Care Help go to Sausal Creek Outpatient Clinic: 2620 26th Avenue at Fruitvale, Oakland 510 437-2363

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