At the very height of the financial crisis as the sub-prime mortgage bubble burst,the federal government was spending some tens of thousands of dollars to send to jail a patient, let us call him Hugo, who had been involved in a piece of financial chicanery to finance his education.   Hugo was guilty as charged,  although he argued that he had been subtly entrapped. Did Hugo lie about a number of things? Of course he did.


Once the indictment came down, Hugo was deserted by almost all those he thought were his friends and allies. There were a few exceptions, for which Hugo was deeply grateful. But he was terribly hurt by  a shunning that deprived him of his social and work milieux.   A man of frail self-esteem to start with, this shunning was devastating and dangerous. It made him think ill of himself against his own will.


The prosecution and the subsequent incarceration were costly. They were justified on the grounds of the importance of protecting against “moral hazard.”   Less than thirty thousand was involved in the patient’s financial chicanery, not billions.  The little man takes the fall. The big guys smile, apologize, asking for permission to do it again, and move on to do it again. Hugo was fully aware of this.   With a rueful smile of his own, Hugo remarked that he had always been a little guy.


Upon conviction, Hugo was suicidal, overwhelmed by sorrow, shame and dread.   He had grown up in the midst of South America’s most bitter civil war . The dead were a part of everyday experience. He was in terror for his life, but also subject to bullying and sexual abuse. His brave and resourceful mother managed to bring him to the United States. Adapting to a new culture and language had not been easy for him.   Nor was coming out to his family that he was a gay man anything but harrowing.


Hugo was the first one in his family to earn a college degree.   His love for learning was genuine and obvious.   To his great satisfaction and joy, members of the next generation were following in his footsteps.   His worry was that jail would be a rerun, more of what he had known from his wartime childhood.   A trilingual slight gay man who had had an overseas modeling career when he was younger, he worried that he would simply be snuffed out in prison.


Hugo was taken directly from sentencing to jail. The judge thought this would protect him against his suicidal impulses. I never expected to see Hugo again. I was not even sure that he would survive. I underestimated his toughness. He called me as soon as he had served his jail term of almost a year.   He wanted to come to see me. He was living in a halfway house that was in some ways more harsh than prison itself.   The staff’s homophobia was blatant and their indifference to anything that could be done to help the residents was equally open. The residents had to pay a fee for the services of the halfway house.

Hugo said he, too, was surprised he had survived prison as well as he had. It was grim and bleak. His strategy was simply to keep to himself and to try not to give anyone occasion to take offense.   He had had times when he wished that he were dead but thought then of his beloved dog, his partner and his mother who was by no means a young woman. Life after prison was hard, too, in some ways harder because he had dreamed of freedom.


Freedom came with a boatload of disillusionment. In the recession following the bursting of the credit bubble unemployment was at the highest levels in decades. It was hard for anyone to find a job and much harder even than that for a person carrying the label of “felon”. Hugo was hired and then summarily dismissed after the very first day from a job that would have been a good fit for him.   This was not the only time that employment practices were flouted. Hugo felt he was in no position to protest.


He talked in therapy about his worries, about his sense of shame, his feeling that he was a deep disappointment to his mother.   He felt she would never forgive him.   I thought that it was possible that the one who he feared would never forgive him was himself.   He talked about how lonely he felt without a job. He felt like an outcast.   His major consolation was his dog’s unqualified love for him.   When his time in the halfway house was done, he was overjoyed to be able to take his dog on long walks and to feed him and groom him.


Hugo survived. Hugo endured.   The trial and punishment were very expensive for him and for the taxpayer.   I admired the fact that he survived, that he endured what he had to endure.   What I did that was most helpful to him, I think, was just to be there, to listen and to listen respectfully.   We tried medications in various combinations, some of which were a bit helpful, but, useful as they are, I don’t know of a single medication that can listen respectfully.




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