I took the pooch for a walk yesterday afternoon, and we weren’t far from the house when I had an interesting encounter that left me wondering if I’d done the right thing.
As I walked the dog across a nearby commercial street there was a lady crossing just in front of us. The lady and I both saw him at the same time.
There lying on the corner was a man, unconscious, crutches laying beside him. He had what looked like a brand new temporary boot cast on his left foot. His age, clothing and worn backpack led me to believe he was a homeless guy. “Diabetic,” the lady in front of me said. She was turning to ask me if I had a phone just as I was pulling it from my pocket. “Call 9-1-1,” she said.
But by now, the guy, who seconds before looked as if he might be dead, was stirring. He was extremely groggy and disoriented, but one of the first things he said, to the lady, was, “How did you know I was diabetic?”
I was wondering the same thing when the lady turned to me and again said, “Call 9-1-1.”
But with the guy conscious and able to answer questions, I wasn’t sure I should. Someone who’s passed out and possibly in a serious health crisis? That’s one thing. But with someone who’s just been passed out but now seems to be coming out if it, it seemed important to determine whether he had the judgment to assert what he wanted.
So I said, “Dude, do you want me to call 9-1-1?” And he said, wearily, “No, man, no. Please don’t call 9-1-1.”
“Please call 9-1-1,” the lady beside me quietly urged again. Turning from her, I asked the guy, “Where are you coming from?”
“Brackenridge,” he said, referring to the local city hospital. Which is where he’d go if I called 9-1-1. “They just gave me some pills and cut me loose.”
“You just came from Brackenridge?” I asked. “What’s wrong with your foot?”
“Diabetic foot,” the lady next to me said. The guy nodded. That’s why the temporary boot looked new. The hospital just gave it to him to protect his inflamed foot.
But he said, “I don’t want to go to Brackenridge. It’s just a long line and then they don’t do anything for you.”
I continued talking to him, trying to assess whether he was OK or in a serious health crisis. The lady gave up and walked off. I sensed she was put off with me for not calling 9-1-1 right away.
As I asked him questions, I wondered, People don’t just rouse from a diabetic coma this easily, do they? I was starting to think from the way he was acting that he could’ve been drunk as much as anything. And sure enough, once he saw the lady was out of eyeshot, he opened his backpack, pulled out a bottle of vodka and took a pull.
“Dude,” I said. “That’s the last thing you’re needing right now.” “I know,” he said, “but that’s why I don’t want to go to the hospital. They’ll take it from me.” He’d obviously been through it before. I felt for the guy. He seemed decent, intelligent, without a trace of belligerence. If I were in his shoes (well, shoe and boot), I’m sure being left the hell alone by the system would be number one on my hit parade.
Now if you had taken a poll of me, the lady and this guy, and the question was, “Would this man be better off if he quit drinking and started paying more attention to his health?” I think the results would be unanimous. Yes, he would. The problem is, of the three of us, only one of us had a say in whether that happened, and that was the man himself. And regardless of what was best for him, that’s not where he was at.
And I thought if I called 9-1-1 the cops might show up too, and this guy might end up going to jail. The EMTs might tell the cops, “He was just treated and released from Brack,” leading the cops to think there’s nothing wrong with this guy, he’s just publicly intoxicated. So maybe he’d get arrested. And I’m sure he’s been through that probably as many times as he’s been to Brack. Homeless people, cops and emergency medical personnel engage in this cycle of futility every day.
Meanwhile, the guy was pulling his shit together more and more. After talking to him for a few minutes longer, I urged him to be careful, wished him luck, took the dog and walked on.
But the lady who’d left in a huff, she had me questioning whether I did the right thing.
Walking along, phone still in my hand, I called my sister. She’s an RN, a charge nurse on a floor at Brack where guys like that guy end up, if they get admitted. I told her the story. And I asked her, “People don’t just rouse out of a diabetic coma, do they?” No, she assured me, they do not. Low blood sugar combined with the booze probably made him black out.
She also validated my choice. After discussing it for some time she concluded, “Brack doesn’t want him,” she said. “I know everyone at the hospital will think you did the right thing.” It’s not that they don’t care. It’s just that there’s only so much you can do for someone who doesn’t want to get better. And they’d already done as much as they could do for one day.
So even though I was very concerned for what would ultimately happen to the guy, I felt like I did right by him in the moment. But the lady. I felt the urge to justify myself to the lady. She’s someone I see on the hike and bike trail fairly regularly, and I wondered if I should try to explain it to her the next time I saw her, whether that was a few days or a few weeks from now. But as it turned out, I didn’t have to wait that long.
Just as I was hanging up with my sister, I saw the lady walking towards me on the trail. “Excuse me,” I said, “I’m the guy who was just with you when we saw the homeless guy.” She nodded. I told her why I’d done what I’d done. Wondering how she’d guessed this guy was a diabetic and had a diabetic foot, I asked, “Are you a nurse?”
“I’m a physician,” she said. I said that I felt compelled to explain myself to her because she seemed frustrated that I wouldn’t call 9-1-1 when she asked me to.
“I was, a little,” she admitted. But then she said as she walked off, she engaged in much the same thought process I had. “I have to treat people all the time who don’t want to get well,” she said. “There’s only so much you can do.” We ended the conversation in kind of a mutual shrug. What’re you gonna do?
When the dog and I finished our loop along the hike and bike trail and returned to the corner, the guy was gone. From our conversation, it seemed like his goal would be to get to the nearby homeless hangout by the railroad tracks. I didn’t see any ambulances down there.
Dude’s set his course. He probably knows it’s not the right one. It’s a hard, hard course. But in this case, it seemed like respecting his sense of agency was the best way to do right by him.
What do you think?