Content Warning: Graphic description of a fentanyl overdose.
I get my lunch from the same deli every day. Today, I step up to the counter, look straight into the face of the nice guy who weighs my hot bar container Monday through Friday (unless I get a tuna salad sandwich that week) and, my voice shaking, I ask, “Do you have Narcan?”
He looks confused, probably because I’m way too intense. I know I’m too intense. I can feel it. I’m not masking. I’m not smiling. I’m not putting on the friendly Jenny affect. And I’m probably visibly trembling. “In the store. Do you have Narcan and do you know how to use it?”
He’s not sure. He doesn’t think they do.
Kalamazoo, Michigan, has a large homeless population. I say homeless, not houseless, because I interact with homeless people every day; they call themselves homeless. They erect their tents and string their tarps along the streets north of Kalamazoo Avenue, and along the Amtrak rails that run parallel to it. One such street on my daily commute has a high concentration of people living rough. People sleeping on the grass, urinating into bottles, defecating in the open. People fighting, screaming, talking to themselves or someone who isn’t there. Tired people. Worn down people. And in the middle of all of it, drugs.
I’m stopped at a red light when I see it happen. A man, white, probably in his forties but it’s difficult to tell, reels and staggers to the corner on the side of the cross street. He gets shorter mid-stride, slowly folding and listing sideways, hitting the ground as his companion tries futilely to stop him from falling. I can see from across the intersection that he’s seizing. I throw on my flashers and abandon my still-running car, door wide open. I thrust my arm out in the direction of the one-way traffic and shout “stop!” as I dart in front of the cars.
By the time I reach the man, there’s blood coming out of his eyes and nose. It trickles down his chin where it froths out of his mouth. His eyes are wide open, pupils a fixed pinpoint, and his body jerks with tonic/clonic spasms. He urinates on my shoes.
A couple of bystanders join us, and I ask, “Did anyone call 9-1-1?”
No one has. Despite the insistence of your MAGA cousin, homeless drug addicts do not, in fact, have free Obama phones. I left my phone in the car. I dash back to the other side of the intersection. A truck has pulled up behind me. The light is green. The driver revs the engine.
“There’s an emergency! Go around!” I yell at him, just as the call connects. The dispatcher thinks I’m screaming at him. I apologize and give him the details. He tells me that medics are on the way, and connects me to… someone else. It’s hard to hear because his companion, clearly under the influence as well, calls out to me, “He’s choking on his blood! He’s drowning in his blood!”
“Get him on his left side!” I shout over the noise of traffic and the truck driver leaning on his horn. The person on the call thinks I’m yelling at him. The truck driver revs the engine more aggressively and lets his foot off the brake, coming so close to my car’s bumper that a dime wouldn’t fit in the gap between.
A human being is convulsing on the sidewalk in clear view, in the middle of the afternoon, but the big truck doesn’t want to go around. The big truck shouldn’t be inconvenienced. The big truck doesn’t deserve to be inconvenienced. Big Truck damn sure shouldn’t be expected to help.
This is the moment that I realize: we’re in an emergency, and we are all alone. We’re surrounded by people and nobody is helping. And Big Truck is still revving his big engine.
“There is a man dying!” I scream at Big Truck. The person on the phone thinks I’m screaming at him. “Ma’am, you can’t yell like that!”
The person on the phone wants to know the man’s name. My fellow bystanders are a woman smoking a cigarette and a man in a memorial t-shirt. They’re both shaking their heads, talking about how sad it is. They know him. He was just at the gospel mission, they say. He had a nose bleed there. He wasn’t acting right.
“They kicked him out,” the woman says, flicking her cigarette.
“Is he breathing?” the person on the phone says. I see a police car approaching. They don’t have lights or siren on. I step into the street to wave them down. They drive past me and keep going. “He’s breathing.” How do I know he’s breathing? “I can hear him aspirating his vomit.” Every time he breathes out, blood and bile spray across my jeans. The person on the phone wants to know if the patient is diabetic. I hand the phone off to the woman with the cigarette; she knows his name, so she knows more than I do.
The man is still convulsing. It’s been at least four minutes. It’s felt much longer. Like we’re trapped in a painting of the moment, with hundreds of people passing by without really looking at us. A man with a plastic nametag on a lanyard gives us a wide berth as he passes, muttering a sheepish “excuse me,” on his way back to work. The scene of this man dying on the ground has made him embarrassed and uncomfortable.
We’re in front of a plasma donation center. I bolt to the door. “We need Narcan!” I tell the man who rushes out to intercept me.
“We don’t have that.” He shrugs apologetically and goes back inside. He’s done all he can do. Never mind that people frequently sell their plasma in order to make money for drugs that could very likely leave them choking on their own blood on the very same street corner. Never mind that to get to their door, I had to step over someone passed out, snoring, with a wad of dirty tinfoil clutched in their palm. Never mind that there’s a literal camping tent set up in their parking lot. Why would they have Narcan?
At the first siren, the companion vanishes. He was just pouring bottled water over the poor, overdosing man, anyway. I can see the blue police lights. He’s not seizing anymore. He’s gone limp, not blinking, but still breathing. I call his name and give him a shake. “Do you have anything in your pockets we need to get rid of? I’m going to go through your pockets, okay?”
“Don’t do that,” the man in the funeral t-shirt says, and points to the inside of his own elbow, fingers miming a syringe.
The cigarette woman agrees. “They’re going to take him to jail, anyway.”
The police are first on the scene. It’s an officer I know; he checks in on our business frequently, since the pedestrian mall is always dealing with some type of theft or vandalism.
“Did you give him Narcan?” he asks as I back up. He’s already got one out.
“They didn’t have any.” Cigarette woman gestures at the mission.
He does a double take. “The mission didn’t have any?”
The first dose doesn’t work.
More police arrive. They question us. They use a second Narcan. Then a third. That one works too well. Still disoriented, the man tries to stand up. He brushes off the officers trying to keep him seated.
“Please don’t fight,” I beg him. “Just sit down.”
The ambulance arrives. I give a police officer my statement. Cigarette lady and t-shirt man stand with me, and we watch the paramedics load the man into the back of the ambulance.
I stick out my hand awkwardly and introduce myself to my fellow bystanders. “Nice to meet you. Wish it could have been under better circumstances.”
Cigarette woman agrees and says, “And thanks for stopping. Usually, people don’t.”
Usually. It is usual for people to lie on the street, bleeding from every hole in their head. It is usual for people to walk past and do nothing.
I don’t know what to do. My body is vibrating with adrenaline. I get in the car and automatically drive back to work. I wash my hands, get some water, cry while my boss comforts me.
Then I go home and throw away my shoes.
As in any population, the homeless in Kalamazoo aren’t all drug users. One man I talk to often actively avoids the street I drive down. He’s clean. He doesn’t want to start using again, so he’s chosen a mostly solitary life, away from other street people. But the drugs are everywhere. Since I started working at the chocolate shop, I’ve stumbled across people making meth in the parking garage stairwell, people doing meth in the alley in broad daylight, and a woman strung out of her mind humping a turtle statue. An elderly woman clutching a crack pipe called me the n-word from her wheelchair. A man “Fenty-folded” in our recessed doorway for seventeen full minutes. We keep Narcan in the communal medicine cabinet.
Why don’t all of the businesses?
There was a proposed housing project in the works for years. The city bought manufactured pods based on a model that has been successful in other places. Plans fell apart when no neighborhood would consent to the presence of such a facility in their backyards. Now, people camp in the woods, along the river, and on those rundown city blocks, until the cops roust them and they move to another location.
They’re often rushed out of their campsite, forced to leave behind trash and belongings, which is then used as an excuse for why they don’t deserve help. “They trash everywhere they live. If they don’t care about keeping the city nice, why should we care about them?”
There’s a woman who comes into my work often. She’s schizophrenic and unmedicated. She’s also an addict and lives on the street. Sometimes, she comes in to buy a can of pop. Other times, it’s to warn about the portal that’s opened by the napkins on the table beside the door. Or to explain to us that it wasn’t her, but the napkins, which opened the portal. Today is a lucid day. She asks for a spoonful of ice cream and promises that when she gets some money, she’ll come and buy a scoop. She seems pretty clear, so I take a chance and ask if she knows the man who collapsed. She does; she hasn’t seen him. I tell her that he needed to be Narcaned three times, and that they took him to the hospital. She says she hasn’t heard anything, adding, “It was that Fentanyl. I told him not to take it. I wouldn’t take it because the color was off. But I told him, don’t take that.”
Later that week, the officer stops in, as he frequently does. One of our employees has standing beef with him over a parking disagreement. “Hey,” I say, maybe more forcefully than strictly necessary. “I watched him save a man’s life on Friday.”
I ask the officer what happened to man. “He’s out of the hospital. I just saw him this morning. He was sleeping on the sidewalk. I told him to move to the grass before somebody calls the ambulance again.” The officer pauses. “I was wondering why you were down there, though.”
It’s clear that he’s worried I’d gone down there to score.
Later, my boss tells me that she’s working with a local advocate to get Narcan into all the downtown businesses. “She said the gospel mission does have Narcan. She said she personally trained the staff there how to use it.”
I drive home, past the corner where the man collapsed. All along the grass, people are folding, curled up, passed out. Cars pull over briefly. Money is exchanged. Cars leave, carrying the people who want the drugs, who contribute to the problem, but who don’t want the people they’re trading with to exist near them.
I wonder if the gospel mission would turn them away.
