With regularity we see middle-aged Polish men in the ER. Chicago has one of the largest groups of Poles outside of Poland. They come to America like all immigrants: to work. These guys are the backbone of the construction industry and their bones and backs end up broken. Many drink a lot, too. So because of the drinking and working an insane amount of hours for years on end, these men have lost wives, girlfriends, children. They end up with no support system, no one who cares about what happens to them. They speak survival English only: hello, good-bye, yes, no, thank-you, help. When they no longer have strong backs and hands to work and thus money under the table to keep a roof over their heads, they are cast out onto the dirty boulevards of homelessness.
The polish patient I’ll never forget was 57. He had diabetes, high blood pressure, CAD. He was sweating, weak and used a walker. He spoke no English. He hobbled into the ER with sugars off the charts. Homeless. My supervisor had assessed him and called the Department of Human Services (DHS) to pick him up. Then a polish interpreter explained to the man that a van would take him to a shelter. Hours later DHS arrived and the workers told me that no shelter would take him because he had too many medical issues and needed to be in a nursing home. I explained the patient didn’t meet the medical criteria to get into a nursing home. A patient has to have skilled nursing care needs, not “custodial” needs. Plus, he was undocumented and nursing homes by law do not have to accept and do not accept undocumented patients. You see, they won’t get paid for providing care and that is their number one priority: a payer source for the profits. Period. But who was the staff at DHS to be telling us in the ER the patient should be in a nursing home? We are the medical professionals, not them! They wouldn’t take him. I called and talked with the supervisor and he assured me the next time DHS came out they would take the patient to a shelter. I got the patient on the waiting list for Inter-Faith House, the only residential shelter in the entire city for the homeless with short-term medical problems. They simply don’t have enough beds to accommodate all the homeless that need a place to recuperate from illness, broken legs, minor wounds and minor surgeries. Even though my Polish guy didn’t fit Inter-Faith House criteria, I got him on the waiting list anyway, hoping they would make an exception. He was a patient falling through the criteria cracks, just an old man with a walker suffering from chronic medical conditions controlled by medication.
Next day the Polish guy was sitting in the ER, right where he was the night before. He was sweating and had a pasty pallor. I called an interpreter to find out what happened. DHS wouldn’t take him to a shelter, again. The patient said he was uncomfortable sitting in the chair all night, needed to wash and change his clothes. Even though I don’t understand a word of Polish, the desperation in the mans voice and eyes made me both sad and angry. I said I was sorry hoping he would understand at least the word sorry. I got on the phone and starting yelling at DHS. They were steadfast in their refusal to transport him to a shelter because of his medical issues. I was told again it was my problem and to find a “placement” for him, an impossible task given his undocumented and indigent status. So I started climbing the chain of command at DHS. I called my supervisor for back up. We were promised again by a different person at DHS that the he would be picked up. But the next day when I arrived to work and checked the ER waiting area, there he was, his third day in the ER. Now I started talking with the director of my department about calling the media. He said no, no yet and got on the phone to DHS. He knew some of the higher ups.
He was there the following day, sitting with his metal walker in front of him like a gate defining his space and blocking anyone who tried to get near him. His fourth day of living, if you can call it living, in the ER. This is not happening I thought to myself. I felt the full burden of finding this patient a place to go and I was failing miserably. No one was helping me. No one wants to house this man.
The patient looked and smelled awful, who wouldn’t living in an ER waiting room with no access to the basics of daily living, with the exception of food. I gave him something to eat everyday. Now my concern was this guy was going to stroke out, have a heart attack, or go into a diabetic come in the ER because of the enormous stress he was under. He said through the interpreter he couldn’t take it anymore, the ER was too loud, crowded, he couldn’t wash himself or sleep. The interpreter took me aside and expressed concern about his mental health.
I headed back to the social work office thinking that today the County ER was going to be on the 6 o’clock news. The lead story: Homeless Polish man living in ER for 4 days goes into diabetic coma, dies. Back in the office the phone rang. It was a woman from a Polish church that ran a shelter. They finally had a bed for my guy! I arranged for a medicar to take him to there. Poof, just like that he was gone.
I have asked these patients if they want to return to Poland given the fact that their lives in the United States are so hard. They can’t speak English, they are homeless, there is no family or money. There is no American dream anymore. Not one has ever said they wanted to go back.