A while ago I talked about "only in Haiti". In that entry I was able to uncover some equally strange "only in America" folk remedies I had seen recently. In keeping with that, in the last few months I have bore witness to something that is fairly commonplace in America. Four months ago, I switched hospitals. The company I work for staffs five local ER's. I was asked to help in a new place and I jumped at the change of scenery. It was in this place that I became acquainted with a patient I will call Phil. Phil lives in the lobby of the emergency room. Most folks probably would not give him a second look as he looks fairly ordinary. He sits day after day in the corner, not usually bothering anyone. He spends his time watching TV and will leave at times to pick up his social security check or go get some beer. He apparently drinks fairly regularly outside of the hospital. To be honest, it took me a couple of shifts to realize it was the same guy in that corner. I finally asked someone who it was. Was he a patient who just kept coming in to be seen every day? Was he a visitor? No, he was simply home. Phil is schizophrenic and homeless. He has lived in the lobby for 15 years. Yes, there are days he is a patient, which was where I spoke to him for the first time. Phil needed someone to cut his socks off and care for his feet. One of my coworkers who knew him better went with me to do this. We kindly explained to him that because he was always in shoes, his feet were constantly wet. This was why his skin was breaking down on his feet and his socks had to be cut off. She reminded him he needed fresh socks each day. He seemed to understand. In fact, he proudly explained his shoes, which were in good shape. He had bought them himself at Walmart. They were real leather.

During the conversation I found myself trying to take in the enormity of it all. To never have the ability to remove your shoes because you simply have nowhere to go. Things got rougher for Phil though. A few weeks ago he was being seen as a patient and had a big outburst and broke some computers. He was asked to leave for a while. This too, was a pattern in the past I came to learn. Well, it was cold out and in an attempt to keep warm, Phil went to an underpass and lit a fire. He lost his balance and fell into the fire and ended up in the burn unit across town. He was there a couple weeks. One day, I went in for my shift and there he was in his usual corner, in blue scrubs, as his clothes had burned in the fire. This would not last long though, as Phil disappeared last week. No one seemed to know where he was. Through the last few days I was amazed at the number of folks who knew him. There were police officers out looking, the bank had said he didn't pick up his check, the Rite Aid staff said he hadn't picked up his medicine, and a few of the nurses, who as it turned out had visited him in the burn unit, had not seen him either. Yesterday, we got our answer. Phil passed away. He was found a block from the hospital in an outbuilding.

Although Phil did not have a traditional home, or proper long term mental health placement (only in America), I can't help but to be amazed at how many people he affected. The funny thing is, I really don't think Phil had any idea that he affected anyone, but he did. I have worked in many hospitals in 20 years of medicine, but I have never seen a hospital ever allow a homeless person live in the lobby, or send the hospital shuttle to take a person to the pharmacy. So,achieving that is major in and of itself. He made people want to serve and help him, and his imprint will be in our emergency room for a long time to come.