Schizophrenics waking up in parking lots bloody and disoriented, suicidal college women threatening to jump, junkies in bathroom stalls, half-dead, face-down. This is a side of Eugene witnessed by people who choose to look after the city in ways most don’t or won’t. Men and women working in the shadow of their better-known cohorts, Eugene’s fire and police departments, CAHOOTS fills a niche somewhere between counseling and emergency medical care: it helps people.
The need is there every day, and so is CAHOOTS.
CAHOOTS (Crisis Assistance Helping Out On The Streets) is a rare and life-saving service that functions as an arm of Eugene’s White Bird Clinic. A mobile crisis intervention team linked to the city of Eugene’s public safety system, CAHOOTS operates seven days a week from 11 am to 3 am, responding to non-criminal crises such as intoxication, substance abuse, mental illness, street disputes and the like. The service is free to its clients and paid for by the city.
CAHOOTS administrative representative David Zeiss of White Bird Clinic says funding for the team “breaks down to $520,000 for this upcoming fiscal year,” with money coming directly from the Eugene Police Department (EPD) budget; the vans and the gas are paid for by the city. Zeiss says the $520,000 is an adequate amount of money for CAHOOTS, and that it recently acquired a new van as well as a few more workers.
The approximately 15 working members of CAHOOTS are trained in crisis intervention and/or are EMT certified (a great many of the staff hold both accreditations, and more). They are paired together in one of two vans that roam everywhere within the city limits. CAHOOTS is sent out by non-emergency dispatchers, who work side-by-side with 911 dispatchers.
I was granted the privilege of riding along with two teams of these professionals who (in my opinion) deserve to be knighted or sainted or whatever it is we do to legit heroes. Nonchalant in their super-heroism, they sip coffee and crack jokes like they’re cruising to the grocery store — that is, until a call comes in.
Scanner-heads & the daily grind
The radio crackles to life with the voice of a dispatcher, and CAHOOTS worker Niles Stuart-Pope seizes the handset with an urgency that betrays her previous calm. A homeless man with a nasty knee injury requires assistance. The team is dispatched to medically assess and then, if need be, ferry him to Sacred Heart Medical Center.
CAHOOTS aid worker Jose Alvarez, an 18-year veteran of the White Bird Clinic social services, turns around in his seat and hands me a pair of purple latex gloves. “Put these on, man. Blood and poop and puke are a routine part of this job,” he says. I wait for a smile that never comes. He isn’t kidding. There is little chance that I myself will come in direct contact with such fluids, but the team has learned to be prepared for anything, and they want me to be safe. I feel safe — sort of.
The CAHOOTS duo homes in on the injured man’s location and we arrive on the scene within minutes of the call. His leg is grossly misshapen and he accepts the examination and the ride with gratitude. This is a very mild CAHOOTS run, nothing like some of the grisly calls the teams get, which can involve anything from suicide intervention to child abuse to dead bodies. One two-person CAHOOTS team can receive upwards of 17 calls per shift.
Most striking about the CAHOOTS workers is the candor with which they address their clients. They know those they help by first name. They can identify the shopping carts of the city’s homeless on sight — Oh, is that Susan’s cart? No, that’s Laurie’s; see the blue tarp and how organized it is?
Many of the people CAHOOTS assists are unable to advocate for themselves, due to mental illness and/or severe intoxication. Clients may forget that they’ve been helped by the same CAHOOTS workers before, but the aid workers haven’t forgotten — they know the stories and histories behind the faces they encounter.
If you took away the uniforms, the latex gloves and the big-ass white van full of medical equipment, you might mistake these initial interactions as those of concerned friends looking after their buddies, who may have forgotten the last time their friends came around to help out. Such memory lapses can lead to altercations.
“Sometimes, we go on a call and get out to help someone, but their friends may think we are there to take that person someplace unpleasant,” Alvarez says, recalling times he was surrounded by less than friendly friends of a client he’d come to help. “Luckily we have enough street cred to make up for that type of thing.”
Alvarez goes on to tell me that on many such occasions, former CAHOOTS clients have intervened on his behalf and neutralized almost-hostile situations. “We must be doing something right,” he adds.
Code 3 & other urgencies
Not all CAHOOTS encounters go smoothly. Given the often marginal or unstable state of their clientele, situations can get pretty sketch. When violence becomes a legitimate threat to the safety of a CAHOOTS team, they call in for police coverage with “Code 3,” meaning the need is immediate.
CAHOOTS works closely with EPD, facilitating crisis-intervention training for the department and often taking on calls the police are not professionally qualified to handle. “Cops didn’t sign up to be counselors,” says Alvarez. A mutual respect exists between the two agencies. This bond appears to be honored most when CAHOOTS calls for police assistance with the added Code 3 request of expediency. Stuart-Pope recalls the last time she went out on a call that turned hostile. The team radioed in with a Code 3 call for assistance and Stuart-Pope says, “It wasn’t minutes — they (EPD) were there in seconds. They swooped in from everywhere, fast.”
The team tells other rugged stories as they cruise the street, scanning the pavement for those in need. These tales stiffen the hairs on your arm, like the time Alvarez and CAHOOTS worker Matt Eads were dispatched to an alley to remove a lone trash bag stuffed with bloody plucked bird feathers, surrounded by and full of dirty syringes. Or repetitive incidents involving a homeless man who feels the compulsory need to masturbate openly while waving to passing drivers at busy intersections.
There’s the call to help a mentally ill man who believes the squirrels of Eugene are telepathically manipulating him for the purposes of world domination, or the guy who masochistically hacks at his arm with a machete and then passes out in random parking lots, or the neo-Nazi who (after being rousted from an unconscious state by CAHOOTS team member Brenton Gicker) physically attacked the CAHOOTS van. Or the client Alvarez tackled in order to prevent him from taking a swan dive off a local overpass. There are many other stories too, some so disturbing that I cannot morally reconcile telling you. CAHOOTS employees have seen their share of hard work.
Requiem for a box
Back in the van, the team heads to White Bird. Alvarez says he wants to show me something. We hop out and step into the alley beside the clinic’s main building. Stuart-Pope stays in the van, carefully eyeing a group of men standing outside, one of whom recently offered to trade her shift partner (Alvarez) a tall-boy of Budweiser for her, um, affection. Stuart-Pope is an attractive young woman. She says that sort of stuff happens all the time.
Alvarez is standing in front of a large vertical box, wrought with chains, bars and iron locks. “This is the most defeated needle box in town,” he says. The Eugene-based HIV Alliance maintains several needle drop-boxes in the city. The purpose of these containers is to provide a place where intravenous drug users or volunteer clean-up teams can safely dispose of used syringes, thereby reducing the risk of HIV, hepatitis C or some other blood-borne disease. Recently CAHOOTS was called in to remove a dirty rig from a red Eugene Weekly distribution box near a frequented restaurant on River Road — perhaps someone thought we at the paper provide a needle clean-up service as well. According to HIV Alliance’s 2010 annual report, 50 percent of people who inject drugs tested positive for hepatitis C in Lane County.
Alvarez tells me that six years ago about 3,000 needles were found in the Whiteaker neighborhoods Scobert Park during a single clean-up. The problem has gotten worse, he says.
Though the drop boxes sound like a great idea, they do pose a particular problem. Alvarez recounts a time he came outside to find the very box he is now showing me smashed and broken into. A woman had extracted a used needle and was attempting to shoot up what little residue was left in the rig. Alvarez ran to stop her but was unable to do so. The drop box outside White Bird has been broken into three times for the same purpose. That box is emptied weekly by HIV Alliance, and despite this it is always full. “This (intravenous drug use) is one of the real problems I see on my beat, all the time.” Alvarez says. “Heroin use here is serious.”
Later in the day, Alvarez and Stuart-Pope encounter a man who overdosed on heroin in the bathroom stall of a church. The team describes the mans skin as blue-colored. They busted into the stall with uncompromising immediacy. Through the use of emergency medical procedures and a burly, Pulp Fiction-esque opioid antagonist “Narcan” needle, Stuart-Pope saved the man’s life.
After this seemingly routine event, Stuart-Pope has stayed on to complete what will be an entire 12-hour shift, which is not unusual for her. Alvarez has clocked out and political activist, former prizefighter and CAHOOTS team member Gicker clocks in. Gicker is driving.
Evening approaches. The van pulls up to the “Bar-muda Triangle” (aka West Broadway and Olive Street) and groups of haggard men and women descend upon the vehicle. It is as if they’d suddenly materialized the moment we hit the intersection, like video game characters cued to spawn and interact once the player has crossed a certain game threshold. The street was full in an instant. They swarmed, almost blocking the vans passage.
Gicker motions for the congregation to meet him up ahead past the stop signs. He pulls forward. “Reach back and open that box right there,” Gicker preps me as the throng of (perhaps) homeless people comes to the front windows of the van. I open the large plastic tub of neatly packed supplies.
Condoms, socks, toothbrushes — these are what the people ask for and this is what they are handed by the CAHOOTS team. “Do you have any shoes?” one of them asks. A team member scrambles about in the back of the van, but comes up empty. No extra shoes. Somewhere from the distance a hoarse voice calls out, “You’re doing a great job CAHOOTS! Keep it up!”
The group vanishes as quickly as it descended upon the van. The team receives a call to pick up a man and ferry him to the Buckley House detox center, and they’re off again, driving in silence, the radio chirping. “We’re not trying to be anyone’s savior or something,” Gicker says, breaking the silence while Stuart-Pope nods in agreement. I think to myself that this woman has already saved a life today. “But this is the most fulfilling job Ive ever had, and I’ve had a lot of jobs,” her partner adds.
The man we pick up is quite happy to be heading to detox. He is poppin’ and lockin’, showing off his slick Michael Jackson-style moves in the back of the van. He then insists on showing us and the Buckley House staff more dance steps as he stands in the lobby, waiting to be processed.
Faces & death
Conscious of the fact that I (luckily?) came along on two rather tame CAHOOTS shifts, I asked both teams if there were ever moments or things they encountered that were too much — or rather, calls they went on that haunted them. All of them mentioned that the death notifications were the hardest to put out of their minds.
Let’s say someone hasn’t shown up to work in days, no one has heard from her, mail is stacking up at the house. It starts to smell funny. CAHOOTS is dispatched to check on things and find the body. CAHOOTS declares the death in the field and calls dispatch back with the somber 12-49 code. Police are sent. CAHOOTS controls the scene until police come to rule cause of death. Immediately after, the CAHOOTS team goes to notify the family of the deceased and provide on-the-scene grief counseling.
“Finding a dead body is bad, but having to tell someone their son or daughter is dead is far worse, but I feel honored to do it,” Alvarez says, then pauses. “The people Ive informed, I remember their faces. I don’t remember their names but I remember each one of their faces clearly.”
Back in the van with Gicker and Stuart-Pope: The sun is setting and out the windshield the clouds are purple. The postures of both team members go from relaxed to very alert at the same moment. A balding man in faded clothes stands on the street corner adjacent the van. In the man’s hand is the hand of a woman, and in the woman’s hand is the hand of a little girl. The mans pupils lock on the vehicle. His entire demeanor changes the instant he spots CAHOOTS.
For a moment, because of how unwavering he appears, it looks as if the man means to act aggressively. Piercing blue eyes dart about as he readies to cross the street. He looks down at the little girl, and then to the woman. He keeps his family close as they quickly approach the van.
Stuart-Pope reaches back and retrieves bottles of water and packets of new socks. No words are spoken by anyone and the man extends his huge hand to take the supplies. His other hand still gripping the woman’s, whose hand is holding the little girl’s. The silence is humid with a tension I cant describe. It was as if everyone involved understood the severity of the moment, the absolute need that the family have these things. “Thank you,” the man says, gravel in his voice. His quivering eyes look up and into the van where they meet mine. I muster a smile.
Supplies in tow, the man with the jagged eyes and the woman and the little girl get across the street safely. Gicker says that they are a recently homeless family, and suddenly the depth of what CAHOOTS does for the community stabs like a hunger cramp. How these people stomach such a job every day is beyond admirable.
I still remember that man’s face. The way he was categorically determined to keep his family close while he crossed the street, seeking a little bit of bottled water for them to drink. I still see his eyes and I won’t ever forget them. That family walked off into a muggy evening of swollen clouds. Who knows where they slept that night? At least they had some water. At least they’d found a bit of help before night fell.