We had a few days of light rain early this week. Perfect for the garden which is just starting to take off. Then after that we had three days of cooler Santa Ana’s blowing through. The Santa Ana winds blow of the deserts north of us, and are terribly drying. They also profoundly effect the mood of the people around here. On the bus, people are less courteous, and more hunkered down, drawn inward. At night this is doubly so. I don’t know why, it is something about the really dry conditions, mixed with the huge gusts of wind. Wherever the cause, it makes public transportation less fun a people are less likely to talk with strangers (one of my favorite reason to ride the bus), and more likely to be sullen or angry.

For the mentally ill, however, the Santa Ana’s are almost like a punishment from God.  They not only have to deal with everyone else being far less understanding, they also have to deal with their own issues, which are exacerbated by the mood of others. Think of them as the canary in the coal mine when it comes to the mood of a group; they cannot help by be drastically effected by it, like a radio stuck with the volume on high, and can only be tuned to one station. For them it is literally maddening.

So on Thursday night, rolling home somewhat later (8:00-9:00), I met a charming lady from Miami who was here to take a single class on psychiatry to fulfill all her requirements for her MD. She was talking about being a Pediatric Doc, a job see seemed suited for.

Alas for her, she was staying in a hotel in downtown Hollywood, a part of town full of the mentally ill, drawn as they can be to the tourist areas. She had already had one experience when a gentleman had made untoward advances, and didn’t understand polite rebuffs, which had scared her some. Rightfully so as it is very difficult to deal with someone who projects their sexuality onto you, and does not understand they are actually acting like an ass. The mentally ill usually have just as much hormones as you or I, so when they see a person they think is sexy, they will react, only their reactions will often be totally inappropriate, because they view sex through the smashed up lens of mental illness. So a man night think he os being appropriately “sexy” towards a woman be offering to take off his shirt to show off his muscles, and ignore the fact that he is an absolute stranger, and the woman he is afflicted with has a look of horror on her face. And believe me when I say this, his was a mild reaction.

So as we were traveling on the bus, and she was telling me this story, I related to her how I used to teach special ed, and had spent several years surrounded by the mentally ill with what I like to call a hair trigger temper. I had run into mentally ill people on the bus, in fact quite often, but they never really bothered me.

I need to take a side track here, for just a moment, to describe for most of you some of the realities of this town. LA is a wonderful place. The weather is so nice that I often call it paradise; a term not without some tongue-in- cheek, mind you, but it’s not a bad term all in all. This means, among other things, that a lot of people drift here. They come because the weather is nice, or they come because they have a dream (usually to be an actor or musician) or maybe they come just to get away from the small town where they grew up and everyone knows them. Regardless of why they come, lots of people come here. Lots. Now if you couple this with the fact that a certain percentage of the population will always have mental illness, you understand that LA gets its share of the mentally ill, and then some. For instance, if you are mentally ill, and the people in your home town know (often is it all but impossible to hide mental illness), then you will have twice as many reasons to leave where you are, and try to make a “fresh start” somewhere else. That somewhere else is very often LA, the town that practically built itself as a fresh start.

One other thing. At night, living on the streets, a place many people who run out of money end up, is not all that safe. There are some who prey upon the street people, and take pleasure in hurting them. In fact we just had a case where a man was sentenced to death for pouring gasoline on a bumm, and lighting him on fire, killing him. So if you are mentally ill, and cannot hold down a job, guess where you end up at night? Well very often, the bus. You see some of the Metro lines (Metro is the name of our city wide transportation service) are 24 hour lines, meaning they run a constant 24 hours. If you can afford a bus pass, or have one as a part of a county mental health program, then the bus is a great place to be. It is warm, dry, reasonably safe, and if you can deal with the bumping, rolling, and sterile lighting, a place to rest, maybe even sleep. Most bus riders don’t know this because the crazies are smart enough to not get on until after the normal riders, commuters, students and such, have gone home, say 8:00 o’clock or so. I discovered this little trick by accident. I have a client which I get to by bus, and I often work late at that office. If just so happens, one of the two lines (the 217) that make up a significant portion of my route, is a 24 hours bus. This is how I discovered where the mentally ill often spend their evenings, because they would ride alnog with me on my way home from work.

So back to my story. This nice MD student and I were talking, and I was telling her how to deal with the mentally ill, while rolling on a late night bus, during a Santa Ana. In the midst of this, and elderly gentleman sits down next to me. By this time the topic had switched to something else, and the lady and I were conversing in opposite seats in the back of the bus. The bus was quite crowded, so having someone sit next to me was a given. Suddenly this man seated next to me stared yelling at another rider, also, we discovered, someone with mental illness. The two exchanged rants, and the man next to me got more and more agitated. I realized what was going on, having spent some time around the mentally ill, and having a slight mental illness myself. Since the bus is considered a “safe” place for someone thus afflicted, they will often “act out” or get more upset on it then they will out in the open Very much like the may most mentally ill will not act out until they are home, or around people they trust. (which is not so fun if you are in the later category, let me tell you). So these two guys were in a bizarre way, protecting their territory.

So this guy seated next to me, turns to me, and starts in on a rant, and it was pure stream of consciousness stuff; raw, unfiltered junk poured through his mouth, straight from his Id, literally without a thought at all. I don’t remember all of what he said, but this will give you an idea, “Those guys want to turn our shoes into jello, and all for a cup of donuts. That’s why the doctors are trying to close the hospital.” He went on like that for 2-3 paragraphs, each equally senseless. A classic example of a psychotic. As he talked he grew more and more agitated, until he was standing and yelling loudly to the entire bus. Chaotic ramblings and violent mood swings do not make for good company, let me tell you.

Fortunately, the man got off at the next stop, yelling at the driver to open the back door as he belatedly realized he was too agitated for the bus, and needed to get off.The sad thing is, I know he was trying to tell me, or us, something. Something terribly important to him. Alas, the lens of mental illness was so distorted for him that his very thoughts were a mangled heap of chaotic jumps and starts. He was clinically incoherent.

Imagine, of you will, that you had no one to look after you, lived with no money on the streets, AND could not communicate a coherent sentence to save your soul. What most people don’t realize is that crazy people usually know they are crazy, and desperately try to not act so. They get embarrassed when they act up in public, and try very hard not to. Alas, time and tides conspire against them. And when they do, man it must really suck to be them. Suck hard.

So after this man left, I did my best to cheer up this poor Med. student. But I have to admit, I was pretty rattled by the experience. So much so that I spent the past few nights, after Trevor had gone to bed, curled up in a book, waiting for the Santa Ana’s to pass so my ego can come out of it’s shell, and I can feel normal again.