Homeless beneath a BMW’s wheels

As I take a shortcut through a gentrified neighbourhood alleyway, which is strewn with needles and parked luxury vehicles, a hand reaches out to me, up to me. Requesting me. I reach for the hand and see a large man who must have stumbled beneath the axle of a parked BMW’s front wheels — unless he purposefully slept there. I go down on one knee, grasp his hand, and tell him, “I’ve got you. I’m going to help you. I’m here with you. I’m a doctor.” His hand is thickened by scabrous lesions, inflammation, angry skin. I place my other hand on his forehead. His swollen eyes are sand-wiched between the tortured-looking skin of his forehead and roughened cheeks with remnants of beard. His tattered plaid jacket, still wet from last night’s sleet, is missing buttons at the chest.

I will be late for the meeting I travelled to this city to attend.

“Have you been in an accident?” I ask the man. He shakes his head, “No.”

I gently pull him from between the car’s wheels so he can breathe more easily and I can better assess him. His watery eyes meet mine. I ask his name, and if he’s in pain, and reassure him again, “I’m a doctor.”

He struggles to breathe so can’t answer. I say that if he’s in pain, he should nod his head. He nods. I say that he needs a hospital, that I’ll call an ambulance. He nods “Yes” again.

Just then we hear a man grumbling as he walks down the alleyway. He stops by us. “These guys clutter our lane and should be arrested,” he says. He gets into his Porsche and, from its security, he lowers the tinted window and shouts angrily: “I’ll call the police, but I’ve done that before.” In more anger he continues, “The police can’t keep them off of our streets. They just tell me to ignore them, but that’s not easy, I park here.”

Image courtesy of iStock.com/Punnarong

I ask the Porsche man to call an ambulance. The man beneath the wheels squeezes my hand, nods his head. But we don’t trust the Porsche man, driving off, spraying slush. So, I let go of his hand. I find my phone and dial 911. When asked for the address for the ambulance, I describe an alley west of Parliament Street, south of apartment towers. I’m put on hold for several minutes, then told, “The police were dispatched.”

“He needs an ambulance,” I insist, “and I wouldn’t have called if he didn’t.” Then add, “I’m a doctor,” but at the same moment hear, “A car will soon be there.”

I cover the man with my winter coat and stroke his rough forehead. His blistered lips quiver, then whisper, “Thank you.” He shivers, as he waits and waits.

After many long minutes a police car ambles up the alley. Seeing me bent over the man, the policeman screams: “Get away from him. Are you crazy? Do you have any idea what that indigent might have?”

I answer, “Yes, I’m a doctor.”

“Then you should know better,” he replies. He throws gloves and a mask from his window and says I should at least wear these.

I don’t take them. The man seems to need to keep feeling touch, and touch is all I have. Touch and reassuring words.

I tell the officer, “This person is not a leper, and if he were, I could still touch him without harm to myself or others. So please help us and take us to the nearest hospital.”

The policeman shakes his head and stares at me in frustration. Then he says, “It’s your funeral not mine,” and finally calls for an ambulance.

The ambulance seemingly takes forever before it condescends to arrive. Its mission for this person seems to lessen its urgency. I hold the man’s hand as they pull him out from between the BMW’s wheels and lift him on a stretcher. As they load the stretcher into the ambulance, I ask permission to ride with him. I want to ensure he’s looked after in the emergency department, rather than endure the long internment that emergency visits can entail for invisible people like him. He can be seen as indigent, chronic, homeless; as a man who can be shunned, triaged to wait, to escape attention of the too-few staff who don’t have time to focus on “chronics.”

The ambulance attendants refuse to allow me to accompany him, and I’m not persistent. I don’t even ask them which hospital they are going to take him to, so I can meet the man there and ease his despair of potentially waiting in a curtained corner, ignored, enduring pain. I don’t ask which hospital, because I fear the mire of the system, and because it’s not my business. Besides, I have research that must be finished.

But I know in this minute I’ll always be diminished by my silence. I stand frozen in an alley behind the Parliament Street stores, watching the ambulance slush north on its course to some emergency department. Just an impotent physician letting down another patient, using the excuse of “Nothing I can do” to limit my advocacy, my responsibility.