Out of ER and back onto the street – 25 years old, addicted, and alone.

What to do when you can’t ignore the suffering in front of you.

I read a post yesterday afternoon by Corey Preston , a brave trauma survivor and mental health coach, commenting on the crisis surrounding mentally ill and addicted individuals falling through the cracks after receiving medical treatment. In the comments, I found a hopeful response from Keir Macdonald of Coast Mental Health . The timing was synchronous with an encounter I had earlier in the day, which presents a case in point.

As I left the YMCA Saturday morning in downtown Vancouver and approached the Sutton Place hotel, I noticed a young man prostrate on the sidewalk, skinny, sunburned, and unconscious. Was he sleeping? Was he overdosing? Was he dead?

All I knew was he was young – could have been my own boy – and whatever state he was in, people just kept walking around him, walking by, some of them taking a moment’s notice, but then – carrying on.

While I regularly speak with and engage with many of the familiar street-involved people along my usual routes, I’m not proud to say that often, I can disassociate from seeing what my brain registers daily as street-death. It feels endless. It’s horrific, emotionally challenging, and just so sad. Fact is, I walk past homeless, mentally ill, and drug-addicted individuals suffering on the streets of my neighborhood every day. Maybe in that moment though, on that busy sidewalk, I maxed out. Yesterday, looking into that boyish face, I just couldn’t keep walking.

I also had no idea what to do. I was overwhelmed by the possibility that this lifeless looking person was either dead or dying. Yet, I told myself, “This happens all the time, right?”. ?“And besides”, I thought, “People are just walking by. Surely someone would call 9-1-1 if that was the thing to do”. Swirling in conflicted thoughts, I felt paralyzed.

Then, suddenly unthinking and somewhat blind with panic, I started marching up the block to St. Paul’s Hospital where I approached a paramedic in the loading zone out front of the ER. Overcome with emotion, I asked her what I should do in a situation like this. Calmly, without hesitation, and with palpable compassion in their delivery, she and her partner gave me some basic advice:

• If he’s flat on his back, starfish position, call 9-1-1.
• If he’s slumped over or curled up, nudge him gently on the foot, see if he stirs; if he does, he’s likely alive.
• If he is conscious and if you’re comfortable, you can say hello, tell him your name, and ask if he needs or wants help.

Extrapolating on that advice, I figure you’ll have learned at least two valuable things by then:

1. Whether stopping may have saved that person’s life; and
2. if it’s not an emergency, then maybe they could use a meal, a bottle of water, or help getting to a safer place and some support.

Turns out, I learned a lot more. When I got back to the spot where I’d first seen him, he was sitting up; slouched, but up and somewhat alert.

I learned his name (and he learned mine). I learned that he was hungry and thirsty. And I learned that he’s only 25 years old, living on the streets, won’t touch alcohol, but is using fentanyl. He’s in mental and physical pain when he’s sober. And he loves his mom.

I also learned that he had just been released from the hospital and was mere hours back on the street, confused and alone. He had no recollection of how he’d gotten there or what he’d been treated for in the hospital.?

“I’m pretty sure I overdosed, but I don’t really remember much. I guess I’m ok now,” he said.

Fact is, he’s not ok now. He is so far from ok it’s heartbreaking. And without being lucid, nourished, without support or a place to go, he’s got little hope of being ok any time soon.

I’m sure this young soul had compassionate paramedics, good doctors, and skilled nurses looking after him for the time he was under their care. Gosh, they probably saved his life. Thank God for every one of them. But there are countless other souls on the way to the ER as we speak. As the front doors open to admit an endless stream of new patients, the same doors are sending vulnerable individuals back to the people and places that make them unsafe, make them targets of crime, and get them back to using.

Which brings me to what happened next. I got him a meal. I sat with him in the sunshine while he ate and we talked about why he likes Vancouver, why he takes drugs, what he wants for his life, how frustrated he is that all his stuff keeps getting stolen, and why he believes (against all odds) that he’ll make it. There were smiles and thankyous and a few hugs. And then I asked him if he wanted me to help him find a place to stay and maybe even some help getting away from the fentanyl.

It seemed an empty thing to say – more hope against hope than something remotely feasible. Aware of what that could mean to someone in such a terrible place, I said, “I can’t promise you anything and I don’t want to get your hopes up, but we can try.” He replied, saying simply, “That would be really nice”.

I knew there was no way back from that last, impulsive step. So, thank you universe, challenge accepted.

Now, here’s some very basic yet practical advice for anyone like me, unable to walk past the suffering in front of you but not equipped to help. In addition to the simple act of checking in, connecting, and lending a hand, make a call to 2-1-1. Until that same paramedic who supported me in my moment of panic told me about 2-1-1BC, I had no idea what it was. I’m embarrassed to admit that, but not too embarrassed to share this with others if it can help.

Calling 2-1-1, a provincial information and resources hub, put me through to a services “navigator” who found a listing of open beds at local shelters and gave me advice as to which ones might be best suited to someone recently released back onto the streets from the hospital. I found one, with up to 30 days of shelter and at least some auxiliary support (counseling for mental health, addiction, shelter from violence, and connection to other services). With that information and a “yes” from my temporary charge, we walked towards what I hoped would be an immediate haven, a place to land for more than a night, and something that might even open the door to recovery.

?As we walked towards Homer and Pender, there was a lot of chatter, and I got a lot of questions from him along the way – “Where did you grow up? What was your childhood like? What do you do for a living? And do you have kids?” I was self-conscious of some of my answers given my glaring privilege, but his curiosity was endearing, and I was happy to share. There were laughs, one last hug and then we parted ways. Wow, was that hard.

It was hard to walk away knowing the complexity of problems represented in this one human being. I felt hopeless recognizing the tremendous hurdles to solving those problems, given the brokenness of our systems. It was hard to walk away knowing there were so many cracks for this young person to still fall through. And it was hard knowing he might not make it through the day.

No doubt the future holds ever more encounters like the one I had today – for me and for countless other housed, employed, and healthy people as we move about the streets of our city.

I know, realistically, there’s only so much we as individuals can do, even if we choose to stop and not walk on. There’s learning in doing though, isn’t there? And in the learning, there’s awareness and better understanding.

Maybe in the small steps we do take, and in that greater awareness and understanding, it will be harder to ignore the suffering in front of us and easier to engage through action and by adding our voices to much needed conversations.

In the meantime, without urgent reform in our healthcare and housing models, and absent any significant investment in follow-up protocols and wrap-around services for those who come into care, it’s difficult to see how this gets better.

I am no expert. Just another LinkedIn user. Just a passerby. But I trust those who know more and know better, not to stop, but to keep going and make real change happen, sooner than later.

One more amateur tip for sidewalk outreach – Keep a list of services on some index cards in your coat pocket, backpack, or purse. Where you can learn more:

• 2-1-1BC has a listing of services that can be sourced by calling 2-1-1 and through their website.
• The City of Vancouver has an online guide with information about access to free and low-cost programs that address food insecurity, homelessness, mental health and addiction.
• BC Housing has a listing of Homelessness Services & Programs here .
• Union Gospel Mission (Vancouver) has an Outreach Team, which sends Mobile Mission vehicles out to those seeking help, can be reached at 604-253-3323 and their “Get Help” webpage lists a holistic range of services here .

(Other advice and expert voices welcome!)