September 16

One of our clients at New Horizons is D. (confidentiality deprives you of his full name). He is 35, and smokes like a chimney- he is morbidly obese and by the time he answers the door when we come at 11 to watch him take his medication, he is already wheezing after his long walk from the couch. He often lets us in without bothering to get dressed in anything more than a bathrobe that falls apart as he shuffles slowly back into his recumbent position- if he is feeling particularly modest he will haul a blanket over himself with a great display of effort, before closing his eyes and reaching for his tobacco. Often there is a blue-striped glass on his table with a pool of congealed or congealing phlegm in the bottom: once, a puddle of vomit in the sink which he implied was the result of ingesting vegetables for the first time in living memory. He has pale pink nipples and ginger chest hair and a pair of strangely slanted blue eyes that he has inherited from his mother, a former junkie turned religious maniac and hypochondriac. Meeting her, it suddenly becomes much easier to understand why he is the way he is. One morning she proudly tells us that she has taken great steps in drawing boundaries with her son, by refusing when he shouted at her from his bedroom to bring him his tobacco from the living room. His case study. compiled by the hospital staff before his discharge, states: D. and his mother have a codependent relationship.

D. inspires in me the most bizarre mix of affection and revulsion. He is like a 12o-kilogram six-year-old, with a sweet smile that occasionally emerges from his red beard and a deep need for approval. Most of the time, however, he is grunting and dissatisfied and happy to blame everyone around him for the misery and squalour he lives in, and utterly unwilling to do anything at all with his time. He spends days lying on the couch, sleeping and smoking and thinking paranoid thoughts about his upstairs neighbour. ( "she knocked my shoes off the balcony, the bitch." " And what did you do?" "I called her a bitch".) When I start thinking that my life is not as it should be, I console myself with the thought that it could be like his.