Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Instagram
  • Listen to CMAJ podcasts
Humanities

Homeless beneath a BMW’s wheels

Jeff Nisker
CMAJ July 13, 2020 192 (28) E815-E816; DOI: https://doi.org/10.1503/cmaj.191702
Jeff Nisker
Department of Obstetrics and Gynaecology, Schulich School of Medicine & Dentistry, Western University; Children’s Health Research Institute, London Ont.
MD PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

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.”

Figure
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.

Footnotes

  • This article has been peer reviewed.

  • This is a true story.

PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 192 (28)
CMAJ
Vol. 192, Issue 28
13 Jul 2020
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Homeless beneath a BMW’s wheels
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Homeless beneath a BMW’s wheels
Jeff Nisker
CMAJ Jul 2020, 192 (28) E815-E816; DOI: 10.1503/cmaj.191702

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Homeless beneath a BMW’s wheels
Jeff Nisker
CMAJ Jul 2020, 192 (28) E815-E816; DOI: 10.1503/cmaj.191702
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Ten million and counting
  • My three-point turn toward personalizing good death in old age
  • Delirium: perspectives of a patient’s wife and daughter
Show more Humanities

Similar Articles

Collections

  • Article Types
    • Encounters
  • Topics
    • Homelessness
    • Vulnerable populations

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected]

CMA Civility, Accessibility, Privacy

 

Powered by HighWire