Where There's a Willi, There's a Way

Prader-Willi Syndrome - A condition marked by an inborn lack of muscle tone, a ravenous appetite, obesity, and mental retardation.

A guiding philosophy of social worker is for people to live in the least restrictive environment. Circumstances dictated moving Paget Leadermilken into a specialized institution for individuals with Prader-Willi Syndrome. The two dozen clients housed under this one roof looked so much alike that nobody would miss a mirror. Rotund and short statured, Paget christened his new home like he built the place brick by brick.

“I’m here. I have arrived.” announced Paget. “Now I would like to speak to the dietician about getting stuffed shells on the menu.”

Prader-Willi is a fascinating but debilitating condition. In Paget’s company, it is easy to feel like a spectator following the pagentry of a spectacle. Paget, not unlike any other Prader-Willi, is driven by food. He often argued over crumbs. He stole and hoarded food while defending that he received less rations than his peers. The absorption of food consumes him like the beast in obesity. Without playing the sympathy card with a sweet violin, Prader-Willi’s cannot help themselves. Paget couldn’t help himself.

I returned to the institution to visit Paget a month after his move. Eager to show off his twenty-one pound weight loss and acclimation to his new home, Paget strutted towards me like a proud peacock on Broadway.

“Joe, I walked to work today.” beamed Paget. “I may have lost another ounce of weight.”

His statement struck me funny but his glee convinced me that he adopted the regimented program. Any misgivings that I carried about the appropriateness of Paget’s placement were quickly erased. Following a meeting that included the presentation of his treatment plan and a chart review, the time came to say farewell forever.

Paget bid goodbye to me with a resounding bear hug. His outpouring of emotion made me forget about his passive aggressive nature. I felt his macrocephalic head corkscrew in the middle of my chest. Still confined by his embrace, I looked down to see his head tilt upwards to face mine. Our heads were now positioned one below the other. He smiled.

“Thanks for my new home, Joe. You are the best case manager I ever had.” Paget broke from the hug to pat my concave stomach. Paget dropped the plastic smile and toggled from passive to aggressive. “Now somebody has to send you to the fat farm!”

Paget just couldn’t help himself and Prader-Willi had nothing to do with it. His biting insult ate at me the whole ride home.