A doctor wrote an open letter to Obama, complaining about a recent case. A woman arrives at the ER, arms covered in tattoos, a few gold teeth in her head, a pack-a-day track record of smoking… overweight, drinker…you get the picture. On the admission form, in the section squared off for payment type, she checks ‘Medicaid’. The doctor’s complaint is this: Why are taxpayers paying the healthcare costs of a woman who is so reckless with both her money and her health? Why couldn’t she have foregone a few of those mouth trophies, skipped the 12-dollar-a-day pack of cigarettes, and paid for her own damn healthcare?
I live in NYC and regularly encounter not only those that
are sliding their way down the socio-economic scale, but those that have crash
landed at the bottom. I talk to many of them.
Once, while I was working at the Heart of Chelsea Animal Hospital, we
had a homeless man decide he was going to use our outside bench for an
afternoon nap. As you can imagine, a
pungent-smelling and drunk homeless man sprawled out on an entrance bench wasn’t
the best way to say ‘welcome’, so my employer asked me to shoo him away. Mindlessly I complied, but found the man
difficult to rouse. Finally, I alighted
on an idea and pitched it.
“Hey, tell you what.
If you can get yourself off that bench in less than a minute, I’m going
to buy you dinner.”
“Huh?” The guy
muttered.
“You heard me. The
best dinner you ever ate. But you have
to get up in one minute.”
“What kind a dinner?”
“A delicious dinner. You just go down the street to the
loading dock and meet me there. I’ll
bring it to you.”
“Down the street?”
“That’s right.”
“You won’t forget?”
“I won’t forget.”
And I didn’t. On the
contrary I was excited. Here was a chance to not only clear the front entrance,
but also clear my conscience. I had a
chance to be both a responsible employee and, more importantly, a responsive human. I set off for a gourmet grocery just a few
blocks away and when I hit there, I pulled out all the stoppers.
“What’s that,” I
asked the guy behind the prepared food counter, “tuna steak?
Let me have it. And are those
scalloped potatoes?”
“With a sour-cream-chive topping!”
“Sounds delicious.
What about a vegetable?”
“We have roasted Brussels sprouts with Parmesan cheese.
“Oh my god…”
“We have soup too. Toasted butternut squash.”
“Oh! And I think a
piece of that German chocolate cake. He’ll like that.”
The 47-dollar bill and the beautiful handled bag in which
everything was packed were proof that these were some good eats. I couldn’t wait to heap them on my compliant
hobo.
When I arrived, he was exactly where I had ordered him to
be. In a shaky stupor he rifled his way
through the bag and went straight for the cake.
“No,” I protested, “that’s desert. Try the soup instead. Here.”
He clumsily handled the boiling-hot container and plastic
utensils. He was about to spoon this
lava into his mouth when I cautioned, “Wait!
It’s too hot! Blow on it. You’re
going to burn yourself.”
Blow on it, he did and the whole spoonful ended up on his
already filthy trousers. I tried to help
him. “Oh for heaven’s sakes. Here, let
me do it.” I take the spoon, get another
scoop, blow on it, and offer it to him.
“Are you going to eat it or am I?”
“ No, you’re going to eat it. I’m feeding it to you.”
“ How come?”
“Oh never mind. Here.
You do it, then.”
I watch this man
wrestle with the simple task of eating a cup of soup and think to myself, ‘Jesus’.
After a few minutes of watching my ‘stray’ enjoy his meal, I walk away with a mixed
sense of satisfaction and failure.
Later that night, I return to the practice to do evening
treatments on the hospitalized pets. As I make my way up to the door, I first
notice a smooshed piece of German chocolate cake that someone has mashed into
the sidewalk. This is followed by a few
chunks of uneaten tuna, then a demolished container of uneaten scalloped
potatoes with a sour-cream-chive topping, and an overturned container of bright,
orange, squash soup. The homeless guy is standing over the clinic’s trashcan
looking through it and urinating at the same time. I stand there watching him for a good minute
or two. He finishes urinating, puts himself away, and continues to randomly
look through the junk in our trashcan.
I say nothing to him.
I open the gate, enter the practice, lock the door behind me, and
commence the evening treatments. When I come
back out, he is sound asleep on the bench.
This is one of many attempts I’ve made to assist the
homeless and poor during my time living in New York City and elsewhere. I can tell you some of their names: Theresa,
Mary, Jose, David, and Juanita. Each of
them stands out as a vibrant character.
There’s almost nothing conformational about them because each is by-product
of a distinct history of what: marginalization, disease, substance abuse? They are sociological wrecks of adversity or
maybe of just plain bad luck that has carved them into unique, but broken individuals.
Helping the homeless and poor has not taught me how to help
them beyond offering up the most immediate of care: food, money, cigarettes,
liquor, a shower, etc. Whatever comfort
I offer lasts what…a few minutes…a few hours?
Is it even worth the effort?
Helping the homeless and poor has helped me to understand
that the problem is not straight forward and not easy to solve. It has taught me that the last thing to go in
a person, after their home, their health, their integrity, their clothes, their
possessions and their hope, is their pride. Dirt, body odor, and poverty do not
rob one of the need to be acknowledged.
Interacting with the poor has taught me that I have more
money, that I have opportunity, that I have ability, and that I have my health,
but it hasn’t taught me that I have specialness. It hasn’t taught me that there are classes
and subclasses of humans. On the
contrary, it has confirmed to me that there are not.
A woman walks into an ER and seeks medical assistance. She’s
got tattoos up and down her arms, gold teeth in her head, half a pack of
cigarettes in her purse, and no money.
Do you spend the money to treat her, or do you turn her out into the
streets? Betcha if you treat her, she’ll
step outside the hospital door, take out her cigarettes, and light up. Betcha if you don’t, she’ll probably do the
same. What’s the point?
I’m convinced that a debate on the costs of action versus no
action is weighted heavily in favor of the former, but I’d rather argue
this: providing care to those in need
provides immediate relief, however fleeting, and more importantly provides
insight into a problem that must be solved.
I don’t have the answer to the homeless, the poor, and the
derelict, but I know where to find it and I know on the way you have to step
over some smooshed chocolate cake and I know on the way you’re probably going
to have to lay out some money. I don’t
know if I like it any more than you do, but I don’t hate it.
