Moving From “Not Me” To The Courage And Love Of Solidarity

In 2012 the city closed six mental health clinics and two non-profit providers shut down as well.  Three years later, I worked with therapists and social workers to save another clinic network from shuttering on Chicago’s north side.  Unlike the south side clinics, we were successful this time. The clinic employed 300 therapists and served 10,000 clients.

When I got to LA, I noticed homeless camped under every freeway.  There was a Hepatitis outbreak because between 50 and 100,000 homeless in the city had no access to basic sanitation, no running water, no showers, no where to piss or shit.  No one lets you use their restroom around here.

They camp out on the same streets that movie stars and media moguls would drive down in their luxury vehicles, porches, teslas, jaguars, lexuses and convertables.  There are three or four souls I see struggling to survive on the sidewalk everyday walking to my car before and after work.

After the DSA healthcare meeting on September 9th I went to the Ralphs grocery store on 3rd and Vermont.  I noticed a middle aged white man in a wheelchair near the entrance to the parking lot, his shorts around his knees, exposing himself to the general public, with only one left shoe, his right foot swollen with yellow toe nails that seemed as if they were about to fall off.  His hands and arms were also severely swollen, and what appeared to be two hospital wristbands on his left arm seemed to be almost cutting off his circulation.

After getting groceries, I approached him to give him a banana and a bottle of water—it was a hot day.  The man was semi-lucent, he said he had been discharged from a nursing home on our about the 24th of August, supposedly for fighting other residents, and had been staying on the street ever since.  He had repeatedly sought care at a hospital, but they refused to give him a social worker or care coordinator, and he was sleeping on the street.  He had social security disability, he told me, he was insured, but no one would care for him.  People had robbed him, taken his medicine, and beaten him while he sat helpless in the wheelchair all night, defenseless.  I said I had to go, but I’d be back and asked him his name, which he told me. He told me I had to come back, or he would die.

I returned 15 minutes later.  The banana was on the ground and he hadn’t touched the water.  First, I googled the nursing home.  I called them.  A woman answered timidly, and said he had been discharged to the hospital some 15 days before.  There was nothing she could do.  Call 911.  I called 911.  The operator asked me to ask the patient any health problems he had.  He said he had gout in his left hand, and suffered from seizures at night.  The LA fire department soon arrived, and I waved them down.  They thanked me for my help.  One fireman mentioned that it was the 3rd time that week that they had taken him to the Emergency Room.  He had a pained look on his face.  We’ve got it from here, he said.  Thank you for your help.

I ended up googling patient dumping that night.  I left a message on the city attorney’s patient dumping hotline.  No one called me back.  A few days later I called again in the daytime.  I ended up speaking with a lawyer who had prosecuted several hospitals.  They’ve been doing it for years.  Reimbursement rates are so low, they would rather risk killing a few mentally ill patients by abandoning them on the street than pay the cost of uncompensated care.  I went on a date with a nurse in Santa Monica.  She told me medical center in posh Beverly Hills was notorious for patient dumping.  ER Nurses are told to falsify the medical records and if someone comes, refer them to the hospital’s management.

And it turns out the hospitals do get away with it.  The lawyer referred me around, and nothing happened.  I called back several times, and wrote emails to follow up over the next two months.  The LAPD had to open an investigation, they said, but they couldn’t find the victim.  So no investigation, no prosecution, no trial, no discovery.  Nothing.  The attorney was helpful, he gave me a list of regulatory agencies, other places to report the medical center.  Shortly before New Years Eve someone from the California Department of Public Health called me.  She was going to the hospital to ask them questions and to see if they violated the law.  She would call me to let me know if she found anything.

She called me a week later.  She had gotten “their side of the story” and called to tell me no laws had been broken.  I asked if she talked to the LA fire emergency personnel who had transported the patient.  She said they were under no obligation to talk to her.  Obviously, I thought, the employees of the hospital are going to say what the hospital told them to say.

This is the brutality and cruelty of this broken system, a place where we dump mentally ill on the street to die, because our employers don’t want to bear the costs of uncompensated care.  Are we so indifferent to dehumanize and let die complicated difficult patients?  Just like Nuremberg, “just following orders” does not wash away our guilt.  We need to fix this broken system.  And we need Medicare for All.