“He is clinically sober, let`s discharge him!” the doctor would conclude.
Then John, dragging his feet on the floor, trailed by a hospital policeman and the giant Herman`s gaze, would leave the ED.
Some hobos though, were intolerable. Once in the ED, they demanded to be given new clothing and shoes, special food, new wheelchairs or walkers (as they drank away or lost their own). They demanded to be given narcotics, to be covered in warm blankets, to be assisted to the bathroom, washed in the shower, all the while cursing and insulting everyone around them.
The ED staff knew well their histories, who they were and how they fell off the deep end. At times, one of the doctors or nurses would point to one and tell me, the newbie, the story of who this man once was. For me it was hard to believe that this fallen individual once had a family, worked, and even had his own business.
While observing some of them, I was convinced that every human resource, physical and spiritual, was not infinite. When a person has lived for some time with friends or relatives and not on the street, then ends up homeless, he still comes with a certain safety margin, some inner reserves. However, once on the street, he is bound to start drinking, eventually ending up in the ED for mild withdrawals, face laceration, or broken fingers. In the ED, he gets the basic necessary help and gets discharged. He typically leaves feeling strong, holding on, confident that he can last and manage. A few weeks later, he finds himself in the ED again, then in three days yet again. After several more months, as all the physical and mental resources are exhausted, he becomes completely wounded and crippled, shaking like a luckless rabbit. If he gets kicked out of the ED then, will he be able to make it until tomorrow, this time?
In those very serious cases, the homeless patient is sent to the medical floor or to a psych ward. There, in the span of a few weeks, he is patched as best as possible and offered a referral to sober houses, adult homes, or rehab centers. Very few agreed to consider these recommendations as the majority dismiss them and end back on the street.
It was hard for them to be among people for a long period of time. They had gotten unused to this.