When the homeless disappear

Two weeks had passed before I learned what happened.

I hadn’t seen him in several months. At our last meeting, the trees were full of red and orange leaves. He, as usual, was not interested in talking to me. He was sitting in front of a closed shop.

“Hi. How are you?”

“Fine.”

People in the neighborhood took care of him. Surrounding him were several plastic bags holding neatly stacked styrofoam containers filled with soup. Another bag held several pastries, most of them still wrapped in clear cellophane. Another bag contained many empty, crushed water bottles.

“Anything new happening?”

“No.”

He was old enough to be my father, though he looked like he could be a grandfather. Time had taken away some of his teeth. The joints of his fingers were knobby. Crescents of dirt were caked underneath his nails. He was wearing a different coat.

“You got a new coat.”

“Yes.”

He previously wore a blue windbreaker; now he was wearing a puffy black jacket that was three sizes too big for him. His thin neck poked out above the collar. The jacket was unzipped and showed the soiled white tee shirt he wore underneath.

“Any more thoughts about going inside for the winter?”

“Not now.”

People were starting to gather around us. In that particular neighborhood, passersby routinely stopped and gawked whenever I spoke with people who appeared obviously homeless. They were staring at us, their mouths hanging open, their faces perplexed.

“Can I help you?” I barked at them, doing nothing to mask the irritation in my voice.

In response, they closed their mouths, turned away, and walked on. (Related: One of the fastest ways to get people in New York to stop looking at you is to say, “Hello!”)

“Where are you sleeping now?”

“In the park.”

Sometimes he slept in a box. He usually slept on a flattened box, and it often wasn’t in the park. People had seen him underneath nearby construction scaffolding. Others saw him in the subway station, though he didn’t seem to use the subways at all.

He said that he had been outside for “a while”. Records from the shelter and from concerned citizens in the neighborhood suggested that he had been outside for at least 20 years.

“I know you’ve heard this before, but just humor me: You don’t have to stay outside. You can stay in a small studio apartment where they serve two meals a day, you can store your belongings there—”

“I’m okay.”

I felt for him. I wouldn’t want to talk to me if I were him.

When homeless people disappear from their usual locations, I wonder: Have they moved to a different neighborhood? Were they arrested and now in jail? Did they find a place to live? Are they in a hospital?

I often never find out.

This man had died. He contracted pneumonia and was in an intensive care unit for about a week. Was there a code? Did the physicians withdraw care? If so, who made that decision? Was anyone with him when he died?

There was no funeral. There was no memorial. Did anyone from the neighborhood notice that he was gone? Did any of those people who gawked at us notice his absence? Did people assume that he ultimately agreed to go into housing, that he finally changed his mind?

Did anyone think that he had died? Did anyone miss him?

Maria Yang is a psychiatrist who blogs at In White Ink.

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  • karen3

    Sorry about your friend. The reality is that its hard enough to keep someone alive in ICU and away from the body snatching doctors that someone who is homeless certainly doesn’t have a chance. Really, one is safer on the streets than in a hospital with the “can’t die fast enough” medical crowd.

    • OslerDisciple

      What a disgusting statement.  You should be embarrassed to say such things about people who sacrifice a great deal of their lives to care for those who are critically ill…often without appreciation (obviously by your statements) or financial reimbursement for their time.  But I dare try to debate you regarding your delusions.

      • karen3

        So let me guess. You would think that the ICU doc who deliberately starved my mother because she was a paraplegic (it;s in writing, and no she wasn’t dying and no, there was no advance directive) is a great guy and a saint.  Along with the umpteen doctors and nurses who never questioned the order, even when she had a heart attack due to potassium deficiency.  Personally, I don’t think people should get paid for attempting murder. And I don’t appreciate people trying to off my mom. Silly me. As I said, the “ethics” of the medical profession are much different than the rest of us. I was just saying glad to see that there are a few decent folks out there. 

        Get over the denial, dude.

  • http://www.facebook.com/amy.hoeghmaeder Amy Hoegh-Maeder

    Bless you for loving the unlovely.  This day and age there are few who will remember the baby some mother held, the little boy in wonder of his world, the young man with hopes and dreams.  These people are in the fight for their life with the brains that don’t work like “normal people”.  Many people like you described have addiction, mental illness, and loss of hope.  Again.  Bless you for loving the unlovely.

  • http://profile.yahoo.com/X3XQDCVBKI64EGUSWERNIIKZ4Y Helen H

    When I see the homeless, I always give a couple of dollars and think “There for the grace of God goes I” My biggest fear in life is to be homeless. You have a heart and when you have a heart you feel for these people. I know I do. Only death could keep you from trying to help him. What you gave out is what you will get back. Keep giving, he was blessed to know you, no matter how hard he tried to act like he didn’t care, he cared. He was probably like a lot of homeless people, they have nothing left but their pride.

  • Sapphire Storm

    This is sad of course. Perhaps one thing would be to somehow engage others rather than spurn of their interest as they walked by (by saying: Can I help you?) . Also I think some people who are homeless are fearful of a loss of control, and of course mental issues which contribute to this issue. Your curiosity about how it ended for him is, while interesting, not really that important, in my vision. His life is more important. I mean my own family member was not homeless and died in such a way that no one gave a memorial service and had she been homeless no one would have done anything on the hospital ward.
    Many many people do not have funerals or memorial services. I think these things serve the living more than the dead. And while I do not disrespect nor do I not understand your concern, the true need is in how to attend the individual while he/she is alive.  The memoriial or funeral is not reflective on the care the person received.

    It’s very sad; and as a society we must really address that we care for ALL of those in our society; not just those who have jobs and can pay for health insurance, or those who are deamed worthy. We need to see all people as worthy. The homeless, the mentally ill, those with HIV, transgender people, gay, poor, non-white. We really need to begin to see our society differently rather than separating people into groups who have greater or lesser degrees that are deserving of help or who are easily lost. I can see in your story that you value this group (homeless) and wonder about them. But it is within your own profession that changes will begin to happen. As well as other professions. However I think that Doctors have a larger influence due to cultural bias (and is misguided and totally undeserved, as Phyiscians don’t work with the lower classes as much as social workers and those like that).

  • http://www.facebook.com/people/Suki-Hoover/100003699872064 Suki Hoover

    Anyone of the homeless can be ourselves.  People do not want to see their own face therefore they look away.  Thank you for speaking to this man like he mattered.  So many people just walk by or say something ignorant.  None of us have walked in his shoes or known his life.  Did he have mental illness?  Did he have an addiction?  Was he a Vet?  Most people don’t even care.  Everyone matters in this world.  Unfortunately too many people are so wrapped up in their own self, they don’t really see other people around them.

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