Swimming to the Horizon: Crack, Psychosis, and Street-Corner Social Work

Zak Mucha

Publisher: Koehler Books Pages: 299 Price: (paperback) $19.95 ISBN: 9798888242254 Reviewed: March, 2024 Author Website: Visit »

A therapist shares vivid portraits of the clients and challenges he encounters through a Chicago community treatment program.

After leaving manual labor for social work, author Zak Mucha first joins, then takes over running an assertive community treatment (ACT) program in Chicago. The job introduces him to clients suffering from severe and chronic psychotic disorders, drug addictions, homelessness, incarceration, poverty, and medical issues, opening his eyes to life “at the very bottom of the socioeconomic ladder, and sometimes just lousy human behavior.”

Scenes of Mucha’s interactions with clients comprise most of the book; the gallery of characters is unforgettable, ranging from Standish, a Vietnam Vet hiding a crack addiction, to Bobby, whose delusions include several celebrity wives. Mucha’s dead-on eye for detail and dry humor comes through in his description of Dean, who has “three teeth, a wandering eye, and a Cubs cap that never left his head.”

Much of the daily grind entails trying to persuade clients to take their meds and keep them out of jail or nursing homes; most are familiar with police calls, hospitalizations, and jail time. Between scenes of lively interactions that induce “a frustrating mix of sympathy and annoyance,” Mucha reflects on lessons of resilience and tenacity he learns by managing a therapeutic team when chaos is constant, gains small, and progress hard to detect.

There’s a loose sense of chronology here, anchored mostly in 2006-7, but minimal philosophizing and little sense of narrative development. Instead, Mucha makes his point through the distinct personalities he brings alive with punchy narration and pitch-perfect dialogue. His portraits are sketched with keen empathy and a complete lack of pity, blame, or stigma, with the crisp writing walking a fine line between humor and heartbreak. He doesn’t attempt grand insights into behavior, only small glimpses of what motivates us as humans: the wish to escape from suffering and hope for something better.

While not intrinsically uplifting, Swimming to the Horizon is highly illuminating.

Also available in hardcover and ebook.

Author's Current Residence
Chicago, Illinois
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