For God's Sake!

As you know, Santa Monica is the "home of the homeless". Out of a population of 85,000, there are approximately 1,000 homeless people. The craziness of Santa Monica is that there are insanely wealthy people here and the dirt,dirt poor. Working in an ER setting, I can take care of a urine-stinking homeless person and then (after its cleaned) put the CEO of some gigantic corporation in the same gurney. The population in Santa Monica runs the whole gamut of every conceivable class of society. It's a little disturbing when I stop to think about it...

We see a large population of homeless people in the ER. Some are nice, some are horrible. Some reek to high heaven, some manage to keep themselves clean. Some abuse the system, some avoid us unless they are really ill. I could use these same examples for every social class. (i.e., the wealthy patients who come in; some are nice, some are horrible. Some reek (of perfume or BO), some are clean, etc.) We are all the same when it comes down to it. Everyone, no matter who you are, has to come to an ER sometime.

A homeless guy came in complaining of severe throat pain. He was with his (homeless) girlfriend. They were nice enough. But what I couldn't stop thinking about was that they were not mentally ill, nor did they come across as junkies. I couldn't quite figure out why they were homeless at their age. He was early 40's, she looked to be late 20's. It got me thinking that homelessness is a hard cycle. I think once you become homeless, you can't break it. How do you get a job, to pay rent, if you cant' shower on a regular basis? And even if you got a job (minimum wage), there is no way you would actually want to pay taxes, or an electric bill or all the other responsibilities that come with renting. I think it must be easier for these people to "live off the grid" and not have to deal with the day to day bill-paying, rent-owing, mail-getting, dog-feeding life that we all see as totally normal. Put yourself in a homeless persons position for a moment. Where do you take a shit? Where do you shower? Where do you put your "things"? What about your period? How do you get food? And even if you get food, it has to be ready to eat. You can't cook anywhere. Yeah, there are homeless shelters but the rules are strict and the scabies runs rampant. It's a shitty life.

Anyway, back to my homeless guy with the sore throat. He could barely swallow and had a fever. The PA seeing him diagnosed a peritonsillar abscess. Nasty shit. It means an infection has started in the tonsils but never could make it's way out so it just festers in the back of the throat. I started an IV (possible track marks but I wasn't sure), and gave him some antibiotics and morphine. He was obviously ill and we did our best to keep him comfortable while we waited for the ENT (ear,nose, throat) doctor to come in. The great thing about a catholic hospital is that if someone is truly in need, we will take care of them. So, the ENT doc came in and did what he had to do. Which means numbing up the back of the throat with shots of lidocaine, then using a scalpel to slice into the back of throat and let the pus drain out. Totally barbaric but the only way to do it. If that isn't gross enough, the doc made the patient spit the pus that was draining out of his mouth into a basin instead of using suction to whisk it away. So this guy had been struggling the whole time. How many of us would voluntarily open our mouths knowing that this horribleness was about to happen? The doc successfully drained the abscess and decided the patient could leave the hospital, aka "go home". When we know a patient cannot pay for a prescription we fill it for them through our "indigent fund". We told "throat abscess guy" that we were waiting for the pharmacy to fill the prescriptions for him. Our nurse, Holly, had taken the long trek to the hospital pharmacy to pick up the medications. When she got back, she opened the door to the exam room and found homeless guy and girlfriend in a "compromising" position. They were doing it on the gurney! She had her pants down and her leg up, he was pumping away like there was no tomorrow. Wow, draining that abscess obviously made him feel a lot better! Holly, the nurse, yelled, "For God's Sake! This is a hospital, not a brothel!" We kicked them out after they had pulled up their pants. Another question, where do you have sex if you are homeless? I had to excuse this couple for doing what they did. It's probably been a while since they had the opportunity to have sex on an actual bed...

Feel lucky you can have sex on a comfortable bed, or couch, or kitchen table...