Do They Have Homeless People Where You Come From?

Bright sunshine. Temperature in the seventies. It was a glorious Sunday afternoon, ideal for sightseeing in the city.

The tourists were out in full force. We parked outside of Quincy Market and watched the street performers as they juggled, and played drums, and did acrobatic stunts, and pretended to be statues.

Every so often, someone would stop and ask for directions. Which way to the Aquarium? Where's the nearest subway? And my favorite: Can you tell me how to get to Quincy Market? You're there, lady. Look around you. This is it.

Some of my coworkers get annoyed when a tourist asks for directions. "What do I look like, a road map?" they grumble. "Does it say 'Information' on the side of the ambulance?"

But I actually enjoy it. Maybe it's because I was on the night shift for so many years. Nobody ever asks for directions on the night shift, except for the occasional long-distance truck driver. The only people who ever talked to us after midnight were drunken college students who begged us for a ride home.

A couple came up to us. The man asked if he could take a photo of our ambulance. "We work for EMS, too," his girlfriend said. "We're volunteers on Long island."

I held up my keys. "Forget about the picture," I told them. "Just go ahead and take the ambulance. The city won't miss it." They thought this was funny.

After they left, a pair of women approached. They were in the process of moving to Boston from the United Arab Emirates. One was a nurse, and for some reason, she was fascinated by us and by the truck. She asked if I would pose with her for a photo to send back home. Even though I can't stand having my picture taken, I agreed.

Then another woman came up to us. After telling us she was an EMT in another, smaller city, she asked what we do in Boston when someone is homeless and drunk.

"Nothing," I told her.

"Nothing?" She seemed astonished.

"No, nothing. If they need help, we give it to them. But if they choose to sleep on the street instead of going to a shelter, that's they're business. It's not my place to bother them. And besides, there's something like six thousand people on the streets of Boston every night. If we took every one of them to an emergency department, there'd be no beds left for sick people."

What she said in response disappointed me. "Well, there's a guy around the corner who really needs help. I think you should go and look at him."

We hear this all the time from tourists. And that's understandable. Most of them have never seen a homeless person before, and it's natural to think that the filthy guy on the sidewalk has been beaten to within an inch of his life. This is rarely the case, of course. Inevitably, we shake the guy awake, and he responds by telling us to leave him alone. He's dirty because, well, he lives outdoors.

I would expect more of an EMT, though. If she really did work in a city, as she claimed to, then certainly she has responded to similar calls. One of the first skills you pick up on an ambulance in a city--whether it's a big city or a small one--is to distinguish between a sleeping drunk and someone who is truly unconscious.

Reluctantly I climbed down from the cab. "You sure he's not just sleeping?"

"Oh, no. There's a bottle on the sidewalk next to him, but his eyes are just slits. He's really unconscious."

In that case, we'd better get right over there. With a bottle next to him, he couldn't possibly be drunk. No, of course not.

We followed the woman around the corner and up the street. Before she pointed out the patient, I guessed who he was. He was about forty years old and filthy. He was standing unsteadily on the sidewalk, talking to a bunch of firefighters. "Is that the unconscious man?" I asked. "That guy over there, the one standing up?"

"Yeah, that's him. I guess he's not unconscious after all."

"No, I guess not."

The fire captain saw us coming. He shook his head apologetically. "We're not even here for this guy," he said. "We came down to do a sprinkler inspection, and we couldn't avoid him. He was blocking the sidewalk."

"Did you call anybody for him yet? An ambulance or a van to the shelter?"

"No, we haven't called anybody. We just came across him a few seconds ago. Right before you walked around the corner."

"No problem. We'll give Pine Street a call."

I looked at the drunk. "You want to go to a shelter?"

"Yeah, sure. Four forty-four Harrison Avenue." He'd memorized the address of the Pine Street Inn. He rattled it off as if giving instructions to a cabbie.

My partner took the man by one arm, and I took him by the other. Together we lowered him to the sidewalk, placing him in a seated position against a concrete wall. I gave the location to the EMS dispatcher over the radio. He confirmed the address and promised to relay the call to the shelter's outreach van.

"The van will come around and pick you up," I said to the man. "But it might take a while. You'll be okay here by yourself?"

The drunk waved his arm at me. "Yeah, sure," he grumbled. "I'm fine."

"Don't wander away. If you leave, they won't go looking for you."

"I'll be sittin' right here."

Suddenly the out-of-town EMT squeezed past me. She squatted in front of the homeless man. "Sir, are you in need of any other services?"

The drunk stared at her as if she'd spoken a foreign language. "In need of what?"

"Services. You know, like social work?"

"I don't know what you're talking about."

The fire captain looked down at the woman, confused. Apparently, he didn't understand what the woman was talking about either. He looked at me. "Um, I guess we'll be going now," he said. "Are you guys all set?"

"Yes, definitely," I told him. "Thanks."

He looked at the woman one last time, shook his head, and walked back to his truck.

We turned and walked back to the ambulance. The female EMT jumped up and followed us. "I'm sorry," she said. "But he really did look unconscious."

I was furious. Not because we'd been talked into looking at the guy, because we interact with homeless people all the time. And it wasn't because I'd been interrupted, because I was being paid, and I hadn't been doing anything anyway. What bothered me was that the woman was an EMT. She claimed to work in a city. She was supposed to be one of us. And none of us would ever approach an ambulance crew to alert them about a man who wanted only to sleep. We'd expect that of a tourist, but not of an EMT. EMTs are expected to know better.

"He was sleeping," I told her. "Just like I told you."

Quickly she backtracked. "I never asked you to do anything. I only asked what you do when somebody is homeless. I was curious about your policies."

"That's not true," I said, continuing to walk. "You told us he was really, really unconscious. You said he wasn't just drunk, and that his eyes were like slits. You said he needed somebody to look at him."

The woman stopped walking. We climbed into the truck. "Let's get out of here," I said to my partner. "She's going to keep finding patients for us."

The more I thought about what had happened, the more I felt a little bit guilty. Not about refusing to take the guy to the hospital, but about being so blunt. I could have disagreed with her without being so rude. That's not like me. I imagined the EMT back at her company headquarters, telling her coworkers about the critically ill man she'd assisted, and about the heartless Boston paramedics who'd refused to help the poor guy.

I'm sure the EMT thought I was lazy, but my reaction wasn't based on laziness. It had to do with ambulances being dispatched forty or fifty times a day to check on "unconscious" people who aren't really unconscious. It had to do with people who force us to bother homeless men and women who only want to be left alone. Mostly, though, it had to do with the EMT's inability to determine whether a patient was unconscious or not, and about holding that EMT to a higher standard than an ordinary 911 caller.

Before we'd gone two blocks, we heard the dispatcher sending an ambulance to the same corner we'd just left. Someone had called 911 to report a man needing assistance. The patient was not described as unconscious. The caller said only that he needed help.

"We just left there," I said over the air. "That's the guy who needs a ride to Pine Street. We'll go around the block and check on him again."

"Okay, great," the dispatcher said. "We'll keep the EMTs going, just in case he changes his mind and wants to go to a hospital."

Turning the last corner, I looked at the wall where our friend had been sitting. He wasn't there. A pair of men stood in the street, waving for cars to drive around them. They were protecting the homeless man, who was curled in a fetal position in the center lane.

"We kept dragging him to the sidewalk, but he just crawled back out again," one of the men told us as we climbed down from the cab. "We'd pull him one way, and he'd crawl back the other way."

The tug-of-war had attracted a great deal of attention. Tourists stopped on the sidewalk, pointing and staring at the strange person sleeping in the middle of the street. One woman snapped a photograph.

I grabbed the man's arm and shook it. "C'mon," my partner said. "Time to get out of the street."
We lifted him to his feet. He opened his eyes. "Oh, hello," he said, grinning up at us. "Thanks for coming by."

We half-walked, half-dragged him to the sidewalk. Most of the tourists wandered away. A few stayed to see what would happen next.

"Do you still want to go to a shelter?" my partner asked.

"Yeah. Pine Street."

"Then why'd you keep crawling into the street?"

The homeless man just shrugged. But I could tell from the smirk on his face that he knew exactly why he'd crawled into the street. He thought it was funny.

A siren wailed in the distance. The other ambulance turned the corner and pulled to a stop beside ours. The EMTs strolled up to us, hands in their pockets. One of them eyed the man suspiciously. "Do I know you?" he asked. "Yeah, I do. We took you to the hospital a couple of nights ago."

The homeless man chuckled. "Yeah."

"We might as well take him back to the hospital," the EMT said to me. "Otherwise, we'll keep getting calls for him. He's a pain in the ass."

The other EMT opened the door to the ambulance. We steered the man into the patient compartment and onto the bench seat. I told the EMTs about the woman who'd insisted he was unconscious; about our first encounter with him; about the tourists who'd dragged him out of the street. Suddenly I realized that the man was staring at me, listening intently to every word.

"It's quite a story, isn't it?" I asked the homeless man.

The guy smiled and shook his head. "Yeah. I'm enjoyin' it."

"Let me ask you something," my partner said. "Where are you from?"

"Providence. Providence, Rhode Island."

"What are you doing here in Boston?"

"Providence don't work."

"What do you mean, 'Providence don't work'? You mean, because there are no tourists in Providence to give you money?"

The homeless man pointed a grimy index finger at him. "Exactly."

"So, let me guess. They put you on a train and sent you up here."

"Yup."

"Hey, I know," one of the EMTs said. "Let's find out where that woman works as an EMT, and send him there."

Not a bad idea, I thought to myself. She could use some practice distinguishing drunks from sick people.