I avoided Bethany for nearly six months, from Christmas 2021 to late May 2022. I had a lot of legitimate personal reasons to do so. My life was becoming unmanageable because of the need to monitor a deteriorating health situation within my family, as well as a newfound obligation to help care for someone who I had been photographing and who became temporarily completely incapacitated. Balancing all of this while remaining active photographically was a challenging situation and one that I met with great energy most days, at least enough to drag myself through the long and bleak New York City post Covid winter, struggling through, remaining reasonably productive artistically. There was no energy left for Bethany. Being around her can be very difficult and challenging, and I just didn’t have it to spare. Occasionally I would stop nearby, and observe her from a distance, to be sure she was still alive. But I did not allow her to see me.
I felt increasingly uncomfortable every time I thought of how long it had been. I knew that it was time to face the disastrously changing person that I had gotten to know very well, and who I had allowed to know things about me. Bethany was my friend in many ways, and I had let her down by disappearing. Her health was severely impacted by scabies and multiple drug resistant bacterial abscesses. This extreme situation, and her inability to address it and get treated, was stressful for me. The need for a constant flow of drugs was and is the primary reason why Bethany and many, many others on the street often refuse desperately necessary hospitalizations for life threatening health problems.
I had gotten her medication at one point, expensive for me but worth it to try to save her life. She had gone to the hospital but with no insurance had to pay out of pocket for her antibiotic prescription. She was was unwilling to put her limited funds toward medication, because every cent she procures goes towards purchasing heroin, fentanyl, crack or meth.
When I felt it was no longer an option to go any longer without contacting her, I headed over to her part of the West Village and started searching. Her old spot at the corner of 8th street and 6th Avenue was reimagined and now occupied by an expensive take out restaurant. No sign of Bethany. A long time later, and still no sign. She could be anywhere, from Tompkins Square in the East Village to Bowery…..impossible to know. Just as I was ready to give it up for the day, she magically popped into view outside the subway station at West 4th. I was shocked by her condition. Covered in scabs, swollen feet and hands, limping and dressed in raggedy, blood stained clothing. Not the cocky transgendered style she had so carefully cultivated when she was more fully in control. Except for her augmented breasts, there was no outward sign that she identifies as a woman. It was hard to fully take in the extent of her physical collapse and I was struck hard, and almost unable to speak naturally with her at the beginning. Many people stopped, gaped, grimaced, sneered….the expressions of passerby ran a full spectrum of revulsion and displeasure.
We agreed that a hospital stay was necessary. Bethany may or may not have scabies, as well as some deeply imbedded abscesses that were surely infected. Infection is very dangerous, as MRSA and other resistant bacterial overgrowths can present a public health problem. Bethany was no longer able to panhandle due to people being unwilling to get close enough to drop a dollar into her hand, or even get within a few feet voluntarily.
Bethany had become convinced that the scabies she was sure she was infected with was a menacing, omnipotent presence within her. The bugs had a mind, and were deceitfully strategic, planning their moves within her. The scabs were the result of her digging and tearing into her skin, in an attempt to extract them. She used a lit cigarette to razor her flesh, ostensibly to pull them out.
She showed me numerous bits and pieces, telling me that it was the bugs, their bodies….but every time it was a piece of herself, her skin, changed in her mind to a insect, to be pulled out or burned to death on her skin.
When I met Bethany I had no idea that what seemed like a one-off photograph of her holding a crucifix and a cigarette would become a long term endeavor, full of so many contradictions. That I would alternately need to abandon her to her demons when it became unsafe for me, returning when she was more stable and I was no longer tapped out.
I watched Bethany peel her scabs, pull her skin apart, using specific tools to puncture holes in order to extract the “bugs”.
The holes and flat, scarred over areas cover the surfaces of her arms, legs and face. I watched and couldn’t imagine the discomfort she must be causing herself. She showed me what she thought were bugs, but I could see that the chosen specimens were pieces of skin or scab or random flecks of dirt. I remembered a Bethany I photographed during the Black Lives Matter transformation of New York City when she had a place to live in upstate New York, and even had pet ducks. That Bethany had a phone and the use of a car and the help of a friend. But now, I know that there is no way forward down a path towards health and restitution. I know, and she knows, that her hatred of herself was causing her to literally skin herself alive. I have known for a long time that it was her way of slow suicide. I can be there, I can listen, but I will never be able to give Bethany a much needed hug again. I cannot allow her to hold my puppy, and I cannot handle her possessions. Multiple infections and eruptions of pus and blood and self loathing stand between Bethany and the rest of us.