I took the picture that heads up this post on a walk this week in Albuquerque. I was there to visit my son and his wife. They moved to Albuquerque in 2007. For my daughter-in-law it was a return to her hometown. Both of her parents had been teachers in the Albuquerque school system. At the time of their move my daughter in law’s mother was chronically ill and failing, and she needed the support of a daughter who was close by. In the intervening dozen years both her mother and her father have succumbed to their chronic diseases. A second motivation for moving back to Albuquerque was the cost of living. Even with the combined salaries of a teacher and a social worker they were finding it hard to make ends meet and purchase a home in Massachusetts. The price of real estate and the cost of living in Albuquerque are substantially less than on either coast.

 

My son is a licensed independent clinical social worker (LICSW). His professional expertise is with the socialization of children, especially adolescent boys, who have special needs. He has worked in correctional facilities and in ambulatory programs with juvenile offenders, and has extensive experience, going back to graduate school, working with children and the families of children on the autism spectrum.  His work includes individual therapy and family counseling. Occasionally he has interactions with the judicial system in custody and abuse cases. For the last half dozen years he has split his time between the Albuquerque public school system and an ambulatory counseling practice where the typical client is on Medicaid and whose parents are battling the consequences of their substance abuse. I am very proud of the work he does. It is taxing physically and emotionally, but his clients are some of the most disadvantaged children and young adults in Albuquerque. He has become known as someone who can skillfully manage difficult cases, and receives referrals from all over greater Albuquerque. My daughter in law is bilingual and teaches and administers programs for special needs children who often only speak Spanish. At times they are both working with the same child or family.

 

New Mexico and Albuquerque face many challenges, not the least of which is “equity.” The W.K. Kellogg Foundation and The University of Southern California have produce a very informative document, “An Equity Profile of Albuquerque” that was published in June 2018. The summary of the 160 page document gives a great overview of Albuquerque’s unique character and challenges:

 

While the nation is projected to become a people-of-color majority by the year 2044, Albuquerque reached that milestone in the 2000s. Since 1990, Albuquerque has experienced dramatic demographic growth and transformation – driven mostly by an increase in the Latino and Asian or Pacific Islander population. Today, these demographic shifts – including a decrease in the percentage of White residents – persist. Albuquerque’s diversity is a major asset in the global economy, but inequities and disparities are holding the region back. Albuquerque is the 59th most unequal among the largest 100 metro regions. Since 2000, poverty and working-poverty rates in the region have been consistently higher than the national averages. Racial and gender wage gaps persist in the labor market. Closing racial gaps in economic opportunity and outcomes will be key to the region’s future. Equitable growth is the path to sustained economic prosperity in Albuquerque. The region’s economy could have been more than $10 billion stronger in 2014 if its racial gaps in income had been closed: a nearly 20 percent increase. By growing good jobs, connecting younger generations with older ones, integrating immigrants into the economy, building communities of opportunity, and ensuring educational and career pathways to good jobs for all, Albuquerque can put all residents on the path toward reaching their full potential, and secure a bright future for the city and region.

 

My own experience with Albuquerque has lead me to conceptualize it as what a “mini” New York City minus Manhattan and the subway system would be like if it were magically transported to the desert. There is also a bit of the feel of the sprawl of Southern California. Within the crosshairs of east/west and north/south Interstate highways there is a grid of eight and ten lane streets at perfect right angles where cars reach highway speeds as they accelerate in packs toward the next intersection. Most of the metropolitan area lies in the valley between both sides of the Rio Grande River and the Sandia Mountain range. At night you can look out from the road that runs along the base of the mountain and see a vast blanket of twinkling lights in every direction up and down and across the wide valley. For about 330 days of the year the sky is high, the sun is bright, and the air is dry. It is not a surprise that it is the home of a large airbase and many aerospace activities.

 

Everything seems out in the open in Albuquerque. It is easy to see progress, and it is easy to see the persistent social and economic problems if you just go for a walk. I stayed in a fabulously comfortable Marriott Hotel in the fashionable “Uptown” section of the city for a pre tax rate of $99! That tells you something about the economy in Albuquerque. I paid over $300 recently at a similar Marriott in Tampa, and my guess is that it would have been over $400 in New York.

 

As I always do, I asked the concierge for a good walking route near the hotel and was directed to the Passo de las Montanas Trail which is advertised as running through the upscale area of Northeast Albuquerque, and that is true although “upscale” is a relative term to describe what would be a middle class neighborhood in most American cities. The first day I went east and was passed by many bikers and an occasional jogger, but I did notice the occasional empty syringe lying on the ground near the trail. There were a few homeless people ambling along the trail with their bronzed and weathered faces who were pushing old grocery carts that contained what I assumed were all of their worldly possessions. Halfway into my walk I saw a woman sitting on an old suitcase next to her shopping cart. Her head was thrown forward between her widely spread legs and most of her waist length hair covered her face like a veil of privacy. As I passed she turned her head slightly and looked up at me. What I saw what was the twisted face of a once attractive person who was now so weathered that she could have been any age from thirty to fifty. Her eyelids were heavy and her features were expressionless. About a half hour later I walked by again on my return route and she was still upright and motionless except for a slight turn of her head when I passed her. I wondered if she would someday join the 72,000 others who died of a drug overdose last year.

 

On my second day I decided to go the other direction on the trail. To my disappointment it ended after a mile or so in a neighborhood park that lay between the acoustical barriers beside Interstate 40 and a small quiet neighborhood. Signs directed bikers toward a city street, but I noticed that a footpath continued on along the wall beside the highway so I decided to see where it went. Here the path was littered with bottles and wrappers, and the sort of trash that can accumulate in places where city services don’t reach. In a few hundred yards I emerged into a wider area and saw that I was coming to a street that crossed over the Interstate not far from my hotel, office buildings, and the most upscale mall in town. That is where I saw the two tents nestled against the wall that was meant to reduce the noise coming from the Intersate. As I crossed the bridge over the highway I could look down on the tents, some shopping carts, some old mattresses, and a lot of litter. People were camped next to the Interstate in the middle of Albuquerque, just as if they were on a mountain stream up near Taos.

 

I have seen the homeless before. We all have. I doubt that there is a city in America that does not have people living on the street and under bridges. When I was in Santa Cruz, California in early April visiting another son and his family, I saw that the police had pushed the homeless out of their camps in the redwoods and that there were hundreds of dirty yellow and blue tents pushed “cheek to jowl” in a narrow triangular area between the scenic highway 1 that runs along the California coast, the San Lorenzo River, and a busy street leading into downtown Santa Cruz. What  I saw looked worse than the living conditions I had observed in Langa Township outside Cape Town, South Africa. There I saw people living in shipping containers, using a public water supply, and waiting in lines in front of dozens of porta potties. My son told me that many of the people down by the river in Santa Cruz were not on drugs. They were working in local businesses. They just could not find an apartment that they could afford. A two bedroom, one bath, 1,000 square foot handyman’s dream fixer upper on a 5,000 square foot lot in a crowded Santa Cruz neighborhood a few blocks from the tents of the homeless will sell for over $800,000 these days in a bidding war.

 

It is easy to pontificate about the socioeconomic gradient of health and damages that accrue on a daily basis to future generations when the problem is on the other side of town or tucked into a place we do not see. When I saw the lady slumped over in her drug haze on the bike and walking trial, I was face to face with a reality that tested me. I walked by twice. I felt sorry for her, but I walked by without anything but a glance to verify that she appeared to be awake even if perhaps she could not stand. In retrospect perhaps I should have stopped and asked if there was anything I could do. Would that have been a violation of her privacy or an unwise thing for me to do? I do not know what percentage of the population would walk on by, but there were many others on the trail that day and no one stopped. I saw no evidence to suggest that anyone had violated her privacy or had enquired to see if there was anything she needed. Were we all prudent? Were we all afraid of what might happen if we gave any indication that we were concerned? Were we following conventional wisdom? Were we just confused with no idea what our response to her condition should be?

 

I am going to make a jump to what appears to be another subject and then come back to the tents by the Interstate and the lady on the trail.

 

This last week Jim Comey wrote a provocative piece on the op ed pages of the New York Times that got me thinking.  The article was entitled “How Trump Co-opts Leaders Like Bill Barr: Accomplished people lacking inner strength can’t resist the compromises necessary to survive this president.” Well, the title pretty much describes his thesis. Coming from a former prosecutor Comey’s title sounds like an indictment. He begins by referencing his own recent experience:

 

People have been asking me hard questions. What happened to the leaders in the Trump administration, especially the attorney general, Bill Barr, who I have said was due the benefit of the doubt?

 

How could Mr. Barr, a bright and accomplished lawyer, start channeling the president in using words like “no collusion” and F.B.I. “spying”? And downplaying acts of obstruction of justice as products of the president’s being “frustrated and angry,” something he would never say to justify the thousands of crimes prosecuted every day that are the product of frustration and anger?

 

Comey goes on with more “how could it happen questions” before he begins to speculate what the answer might be:

 

How could he write and say things about the report by Robert Mueller, the special counsel, that were apparently so misleading that they prompted written protest from the special counsel himself?

 

How could Mr. Barr go before the Senate Judiciary Committee on Wednesday and downplay President Trump’s attempt to fire Mr. Mueller before he completed his work?

 

And how could Rod Rosenstein, the deputy attorney general, after the release of Mr. Mueller’s report that detailed Mr. Trump’s determined efforts to obstruct justice, give a speech quoting the president on the importance of the rule of law? Or on resigning, thank a president who relentlessly attacked both him and the Department of Justice he led for “the courtesy and humor you often display in our personal conversations”?

 

What happened to these people?

 

Comey goes on to suggest that people succumb in little bits and pieces to the effects of association with an amoral personality. They go along to get along while convincing themselves that they are strategically positioned to make a difference if things get worse. They gradually get numb to the daily deviations from normal behavior. They become complicit by saying and doing nothing to stop the daily erosion of accepted norms of behavior. Comey is judgmental:

 

Accomplished people lacking inner strength can’t resist the compromises necessary to survive Mr. Trump and that adds up to something they will never recover from. It takes character like Mr. Mattis’s to avoid the damage, because Mr. Trump eats your soul in small bites.

 

It starts with your sitting silent while he lies, both in public and private, making you complicit by your silence. In meetings with him, his assertions about what “everyone thinks” and what is “obviously true” wash over you, unchallenged, as they did at our private dinner on Jan. 27, 2017, because he’s the president and he rarely stops talking. As a result, Mr. Trump pulls all of those present into a silent circle of assent.

 

Comey presents Jim Mattis, the former Secretary of Defense as someone who separated himself with dignity and counts himself as one who went along to get along until he was fired, although he knew all along that “going along” was not right.

 

You feel this happening. It bothers you, at least to some extent. But his outrageous conduct convinces you that you simply must stay, to preserve and protect the people and institutions and values you hold dear. Along with Republican members of Congress, you tell yourself you are too important for this nation to lose, especially now.

 

You can’t say this out loud — maybe not even to your family — but in a time of emergency, with the nation led by a deeply unethical person, this will be your contribution, your personal sacrifice for America. You are smarter than Donald Trump, and you are playing a long game for your country, so you can pull it off where lesser leaders have failed and gotten fired by tweet.

 

Of course, to stay, you must be seen as on his team, so you make further compromises. You use his language, praise his leadership, tout his commitment to values.

And then you are lost. He has eaten your soul.

 

So what’s the connection between Comey’s op ed and my observations about the homeless who represent a population that certainly fits into the category of those suffering from the impact of the negative social determinants of health.  I think that many of us, myself included, demonstrate a behavior that is complicit acceptance of their plight. We may tell ourselves that we are working on bigger issues, and if we get those principles right then everything will be better, even for the homeless. It’s easy to say that our efforts are better spent working on the larger problem, and by the way, there are those urban saints who do try to minister to the homeless. But, maybe it means, that like those Washington enablers of Trump, our conditioned callousness to the homeless we see means that our souls have been eaten. Could it be that by avoiding the opportunity to help the people who are nearly comatose on the street, or living in a tent by the Interstate, we are complicit as individuals and as a society in the suffering of other human beings?

 

I am well aware of the fact that many of the street people suffer from mental illnesses like chronic schizophrenia. Perhaps being a “feral” human being is a choice that we have no right to prohibit, but I doubt that the current state of our collective response is the product of any considered path. Housing is a huge problem in America that is not being adequately addressed, and a major issue that must be addressed if we are ever going to improve the “health” of the nation, but I fear that it is far down the list of active concerns for most of us. Writers like Matthew Desmond, in his Pulitzer Prize winning book, Evicted: Poverty and Profit in the American City,  have tried to bring attention to the inequities that make many people homeless. Do you think that perhaps, like the cabinet members and leaders in Congress who enable our democracy to erode just a little bit each day, collectively we allow a few more people to live in a tent, live in a car, or descend into a life of pushing a grocery cart full of personal belongings because we are focused on protecting the nation from bigger issues? Could it be true that like them a few bites have been taken from our collective national soul? Are the homeless and drug dependent people that we avoid evidence that we are losing the battle for the soul of America that Jon Meacham described in his book THE SOUL OF AMERICA:The Battle for Our Better AngelsIf we don’t have courage or the energy to respond to an individual on the street, do we have the courage to collectively address the real issues that deny so many people decent housing and drive them to the street? The questions are uncomfortable, but not nearly as uncomfortable as the realities that are easily observed on our streets that we seem to be unable to address, and that lead many of us to want to live within the safety of a gated community.