Coffee and Cigarettes

When my brother Patrick died, it caused a minor family crisis, because Patrick was the primary caregiver for another one of our brothers, who I will call “Dustin.” Dustin suffers from mild schizophrenia, complicated by a genetic disease that affects his blood chemistry.

Doctors have prescribed a daily cocktail of pharmaceuticals that control his symptoms, but if he’s not monitored every month or so, his blood chemistry can get out of balance, and his schizophrenia gets turned up to 11. He becomes disoriented, paranoid and incoherent, and the family worries that he’ll be arrested because his symptoms resemble those of serious drug users.

When his blood chemistry is properly maintained, he’s sweet-tempered, funny and personable. He’s intelligent, but has very little formal education. When he was a kid, he liked to take electronic things apart, but he wasn’t very motivated to put them back together once he found out how they worked.

Dustin has very few life skills. He won’t bathe unless told to do so. He doesn’t know how to cook. His caseworker takes him to the doctor, helps him do his taxes, and buys his cigarettes. My brother Patrick used to reimburse her for that, but now I do.

Once Patrick died, the family members agreed that it was time for Dustin to live in a group home. So Dustin’s caseworker found him a fairly nice one, and he moved in. I fretted about it for months. But when I visited him in St. Louis, I stopped worrying, because he’s thriving.

They serve him three good meals a day, his medications are doled out on a carefully monitored schedule, and he’s only allowed one cigarette an hour until bedtime. This last item is important, because like many people in his condition, he’d smoke a carton a day if he could. He’s not allowed to carry a lighter; the nurse hands him one to light his hourly cigarette, and then he must give it right back.

There are about 70 residents in Dustin’s group home. He told me that they give him one cup of coffee at every meal, but then he added, “I think it’s decaf.” No big surprise there, Dustin. You live in a house full of crazy people.

Dustin asked me to buy him a jar of instant coffee, and he smuggled it in to his friend Vern. When he pulled it out of his pocket, Vern looked around nervously and said, “Put that away! We need it for Saturday night!” Both Vern and Dustin missed breakfast on Sunday, because they were up all night buzzing on a caffeine high.

I bought Dustin a small netbook computer, and he loves it, but of course, he’s falling for every stupid internet scam imaginable. So his e-mail box is full of spam, and he’s rapidly acquiring every spyware virus known to man. The good news is, he doesn’t have any money to give the Nigerians.



Mostly, he uses it to download what he calls “rage metal” music that he listens to when he can score a jar of instant coffee.