Inside Joseph's House

Theresa Vargas
Washington Post Staff
Tuesday, December 2, 2008

Michael Tyree will tell you that on the day Robert Wylie and another man died, the doves that had settled outside the window flew away.

For two weeks the birds had made a nest outside Joseph's House -- a gray-brick rowhouse in Northwest Washington where the homeless go to die -- but they had left by the time Wylie slipped away on a living room sofa in the arms of a volunteer. They were gone when his body was laid on the hardwood floor, bathed and dressed in his best, a pack of cigarettes tucked in his pocket. They hadn't returned a week later when his memorial service was held among that same faded furniture.

Tyree said he can't help but think at least "a little bit" that the birds knew what had happened. He too, avoided the memorial service, shuffling by the door several times but not stopping.

"I don't like funerals," he said, his words muffled by his own illness. "I want to remember him the way he was."

Here in Joseph's House, it is not unusual for death to play out in one room while life defiantly goes on in another. At the dining room table, the healthy pass biscuits to the unhealthy, and frail, slow hands clear place mats so that young, able ones won't have to. People die and then cookies are baked.

Twenty years ago on Dec. 1, the first World AIDS Day drew attention to the global epidemic. Within two years, family doctor David Hilfiker, who had been working and living with the homeless, opened the house after noticing that an increasing number of them had received HIV diagnoses. He, his wife and their three children moved into the third floor and filled the second with its first residents: a man who had spent most his life in prison for shooting a relative, another who had burglarized homes for almost two decades and a recovering drug addict with a suburban, middle-class upbringing.

"We saw ourselves as a community for rich and poor, black and white, sick and well," Hilfiker said. "At that point we took people in when they were well. . . . Our vision was really community, not a hospice."

Hilfiker's family moved out of the house in 1993, but he remained involved in managing the home's finances until March. About 50 percent of the funding comes from the federal and local government and the rest from grants and private donations.

Over the years, the house has evolved into one where a sense of community has remained but the frailty of its residents has increased. Even as medications have lengthened the life span of those with HIV, many residents have not consistently taken those drugs, facing barriers such as addictions, mental illnesses or a shelter life inconsistent with medicine that must be taken regularly and sometimes kept refrigerated.

Washington has among the largest AIDS and homeless populations in the nation, but officials say it is impossible to know how many people live at the intersection of those two statistics. What is known is that 3 to 10 percent of all homeless people are HIV-positive, which is 10 times the rate of the general population, said Nancy Bernstein, executive director of the National AIDS Housing Coalition. She added that the HIV death rate among the homeless is seven to nine times higher than that of the general population. In the District last December, there were at least 400 people known to be homeless and living with the illness, according to the D.C. Department of Health's HIV/AIDS Administration. And although officials say that number is incomplete, it draws a picture of who is most vulnerable. Most (75 percent) were men, and almost all (83 percent) were black.

Priscilla Norris, who has been a nurse at Joseph's House for eight years, said access to medication is not the problem, with most people at the house qualifying for Medicaid or other help. "But their lives are so totally out of control for one reason or another, or 14 reasons, that they can't take advantage of access" until coming to the hospice, Norris said.

She added that for every person who moves into the house, she doesn't doubt there are others who are dying in emergency rooms or on the street.

Sitting at the dining room table one recent Monday was a 52-year-old woman who started using drugs at 17 and thinks that is how she got the virus. She was living at a shelter for three years and had withered down to 87 pounds when she reached out to Joseph's House, which began taking in women four years ago.

"I wasn't taking my medicine at all, period. I mean, I had medicine six months in my locker," said the woman, who asked not to be identified by name. "For what? For what am I going to take it for? I'm already homeless. Here's the old song . . . you're afraid of living and too scared to die."

At mealtimes, she reaches for second and third helpings, sometimes reminding herself out loud to slow down. She has also started collecting postcards from whoever will send them in order to keep a positive attitude.

"I was rescued, I wasn't just saved," she said, adding that life is now comfortable but that she still struggles with her reality. "I'm crushed. I don't care how good I look, or how high I talk, or how educated I am, I'm tore up. Now, I am not contradicting myself. I can be anything I want to be as long as I keep my high spirits. But deep down, all the way inside, is a little something in me saying, 'Damn, I got AIDS,' that I will never be normal."

She was not there when Wylie died. But her roommate Kim Corbin was.

Corbin, 44, spent her life avoiding trouble, going home straight from school as a child. She said she loved the man who gave her HIV.

"I thought we was gonna get married; that's why I wasn't worried about it," she said. "Shoot."

Her hair is gone where doctors operated on a tumor and she limps when she walks, but like some of the people who have come to the house, she has recovered enough to leave soon. Not everyone who is sent here to die by hospitals, case workers or shelters actually does. Some get better.

For those who don't, there are memorial services in the living room.

Corbin sat at Wylie's service in a gray sweat suit but did not participate as more than a dozen people (nurses, volunteers and former residents) took turns lighting candles and sharing memories of him. Each spoke of Wylie as if a relative had died and not as if they had attended dozens of these memorials.

"I was a latecomer to the Rob scene," volunteer Kevin Sullivan says after lighting a candle. " I remember the week before he died. . . . He and I went shoe shopping. He wanted two pairs of shoes from Payless. Me being me, 'Okay, let's try this pair on. Okay, that's good. Let's try this pair on.' I forget his exact words, but his message was, 'Stop. I'm in no rush. Take your time.' "

"It's funny because you see this guy who is so big and tells stories of prison, and I experienced a man who was full of love, who was playful. If his friends in prison could have seen this white boy from South Carolina leaning up against him, putting his head on his shoulder or wrestling with him. . . . I never would have guessed that two people from such different backgrounds could be close," says Brey Cribbs, a volunteer at a neighboring house who was holding Wylie when he died.

"We were sitting side by side, and I said to him, 'Rob, you are the tallest tree in the forest.' And he said, 'I feel that way,' " recalls Patricia Wudel. " I, too, took a lot of shelter in that tall tree."

Wudel first came to the house as a volunteer 17 years ago and has been the executive director for 11 years. Under her leadership, there is a visible effort to create an unguarded atmosphere among a staff that has every reason to put up shields. Volunteers are trained not just to change sheets, do laundry and cook meals, but to match their breathing to residents as they sit by their sides.

"I didn't want people to have to earn love. I wanted it to be given freely, unconditionally, no strings attached," Wudel said. "At Joseph's House, people are cared for in a way that we all very much hope that we'll be cared for as we die. I hope that I will not be abandoned emotionally or otherwise as I'm dying."

Here, it is okay for staff members to distinguish among the residents and admit that one death has affected them more than another. The cultural differences between the mostly white, middle-class staff and the mostly black, lower-class residents are also spoken about openly.

"I didn't want the folks who came here to die . . . to be standing in for somebody's father, or husband, or brother or lover," Wudel said. "I wanted them to be met for themselves. Not perfect, but beautiful. And not just beautiful, but complex, hurting, hurtful, whole."

Nurse Blossom Williams said she used to refer to many of the men who passed through the house as her husband, but she stopped that after Wylie died.

"Robert was my heart. After he passed, I decided I wasn't going to let anyone be my husband anymore. I will take care of them as if, but I won't call them my husband," she said, her words coated in a Jamaican accent. "You may not believe this: We take care of the clients, but they, in turn, take care of us."

Donald Harrell, 67, said when he first came to the house, he worried that it would be strange depending on young women to help change his adult diapers. He had served in the Navy for more than 15 years, visiting Spain, France and the Mediterranean. He later drove a bus for Metro, among other jobs.

Not to be able to care for himself is the worst part of the disease, he said.

"My son came home, and I was in my wife's house on the floor and I couldn't get myself off the floor. I didn't have the strength," he said. That was in February. After leaving the hospital, he lived with his youngest daughter but said it was a burden he didn't want for her. "I was urinating all over the couch, stuff like that. Who wants somebody in their house doing that?"

In March, Harrell came to Joseph's House. He has since started taking a computer class and carries a picture of a Porsche in his wallet that represents the first thing he ever printed from the Internet. He proudly shows it off while sitting in the same living room where the candles had burned for Wylie.

Like this, futures are planned where lives end.

"People are supposedly coming here to die. But I didn't come here to die, and I'm sure quite a few of them here think the same thing," Harrell said. "I got plenty of life in me."

Comments: vargast@washpost.com.