The New Social Worker Vol. 20, No. 1, Winter 2013 | Page 18

In The Ogre’s Lair: Seeing Light in Shadow
by J. Scott Janssen, LCSW

should have seen it coming when I
slipped on the bullet casings strewn
across the front steps. Or when I rang
the doorbell and heard an angry-sounding voice bellow, “Who are you and
what do you want?” I identified myself as
the hospice social worker and waited. After what seemed like hours, I rang again.
This time the door opened to the sound
of an electric motor, revealing a cluttered
hallway stacked with cardboard boxes
bursting with yellowed paper.

I called out to the angry voice for
permission to enter.

“Come in if you want, but keep it
short.”

I followed multi-colored wiring
leading from the door’s motorized arm,
alarm system, and security camera. It
snaked down the hallway and into a side
room from which the voice seemed to
have emanated. A mirror was tilted such
that I could be seen from the room but
could not see into it. The wires merged
with a large tangle spiraling in from all
directions swallowing a computer with
lights blinking and flashing. On the computer screen, alternating images flashed
from what appeared to be four of five
surveillance cameras. Jack sat next to this
command center, scowling. His burly
frame, wild eyes, and the serpentine scar
running from his right ear to chin reminded me of the ogres I’d read about as
a child who, if you were foolish enough
to approach their lair, suddenly appeared
and pummeled you with boulders.

“I don’t need a social worker,” he
growled.

I’d read his medical history—respiratory disease, diabetes, hypertension,
skin ulcerations that just wouldn’t heal, a
long history of uncontrolled pain. And a

single line entered under “Social History”—patient can be hostile and combative.

Our visit that day consisted mainly
of him telling me what a bunch of incompetents his medical team had been and
why it was their fault he was in such bad
shape. He alluded to talks he was having
with his lawyer and how he would “settle
with those cranks” before he died. He
came across as angry, self-righteous, and
abrasive. And, yes, hostile and combative. He was also very secretive, refusing
to tell me anything about his life except
that he’d been in law enforcement and
that he had a brother in New England
with whom he hadn’t spoken in years.

The visit tension hit its high note
when I asked if he was having any suicidal ideation. It was a reasonable question—an ex-cop with guns, over sixty-five,
male, socially isolated, terminal illness,
secretive, hyper-vigilant, apparent anger
issues, wanting to be in control but facing
increasing physical decline, protective
of his privacy but needing help, possible
impulsivity, possible depression, possible aggression, possible PTSD—but Jack
didn’t see it that way. He hit the roof.

Over the next many months, I called
him regularly and offered visits, bracing
each time for rebuff and/or complaint.
He either declined my offers with the
contempt of someone for whom it was
transparently inconceivable that my
presence might be of even the slightest
value, or he accepted, it seemed to me,
just to make my life miserable. Even on
days when the conversation was civil,
he remained secretive and suspicious,
dismissing invitations to process thoughts
and feelings or engage in deeper reflections, sticking instead to his intellectual
interests like criminal psychology and
comparative religion. No conversation,
however, remained civil for long. He
always found his way back to things
about which he was angry, always went
back on the attack. When I pointed this
pattern out, he accused me of peddling
boiler-plated psychobabble and, seeing
no irony, went right back on the offensive.

The nurses on the hospice team
fared even worse. He fired three of them
for various imagined affronts. Because
of his wounds and lack of a caregiver,

16

Winter 2013

I

The New Social Worker

they had to make three visits a week
to change his dressings. He refused to
take medications as directed, and then
yelled at them for not controlling his
pain. When one of them suggested he
shouldn’t shoot his 22-caliber rifle or his
10 mm handgun while taking narcotic
painkillers, he fired her. When I agreed
with the nurse and asked him to put the
guns away or face being discharged, he
almost fired me, too, before begrudgingly a w&VV??rF??VWF?V??WB?b&?( ?0?&V6?v?V?WfW"vRvW&R&?V?B???Bv6?( ?B???r&Vf?&R?Rv2F?&VFV???rF?WB?W"??7?6R??F?Rw&?v??p??7B?b?6W2?Rv2?????rF?7VR??6?????G2GV?&?VB?WB??R&?G2GV?&??rF?&?Vv??'&?r6????gFW"??&B&???vRvW&R???rF????vRvW&P?F???r&V???B??2&6??vRv?FVB???F?&R?????vRv?FVB???FVC?vP?vW&R??6??WFV?C?vRF?F?( ?B6&R&?W@?????"???b?W"F?V?G3?F?R???F???p?vR&V??6&VB&?WBv2&????r?VF?6&R??gV???F???rv2?FW7?FR??26&66??6???????r??B??6?F???F?????7BWfW'?F???r?W"?W'6W27VvvW7FVB???6?( ?2?VF?6?6??F?F???v27F&?????r??7FVG?6&Rg&???W"7Ffb?B?6?( ?0?&V?V7F?Bv????v?W72F??7FV?F?fWp?&V6???V?FF???2?W&R?BF?W&R???vVB??2v?V?G2F?&Vv???V??r???0?&???B7Vv"v26??G&???VB??B6?v0???2&???B&W77W&R??RWfV?&Vv?F???p???&R???VF?6F????BvWGF??r??&P?6?VWB??v?B?F?V?F?vWF?W"???2V?FW&???r&W7?&F?'?F?6V6R&Vv?V&??r??&R6?&???2??W72FW&?????v?V??6?v2f????F?66?&vV@?g&????7?6R6W'f?6R&V6W6R?bF??0?7F&???F?????v2&V?WfVB??v?V@?v?F????r???Wr????F????p??( ?B6VV??????Bv?BF?&RF??Rv?F??????2f"2?v26??6W&?VB??Rv0??Vv?F?7F?6?'V????Rv2??6V?6?F?fR??f?V??FV?W&VB?FWf??B?bV?F??0?vV??2F?R??7B&V?VF??6?v?2?b6?6????"V??F??????FV??vV?6R??F??Vv??F?&VBF?RFWFW&??F????BF?66???R?@?F???F??fR???Rv?F???F?R6???V?vW0??Rf6VB?F?W6RvW&R??W?7W6W2f?"&V??p??V??7?&?FVB??vW"?FF?7FVB????F?R??V6???F?R?7GW&Rv2f??VB?????C??F?R7F?'?6??F?f?VB??F??V?76??&?P?G'WF???fW"F?R?W?B?V"?"6???F??Vv?@???