The Rain is Making the Ants Scurry Up The Hill

I’m hugging the wall in the hall of the ER with a patient on the gurney with several other crews.  It’s pouring rain outside.  We haven’t seen much rain in years.  All our patients are BLS, meaning not critical.  All are also homeless.  Most of the homeless encampments in our area are in river bottoms.  Many of these areas are flooded right now. Many of these people have lost their homes and all their personal belongings. 

The charge nurse in the ER is pissed. 

“We get a little rain and all the little ants in the river bottom come scurrying up the hill to seek the medical attention they’ve been neglecting for years.” He says, “So, now it’s the ER’s problem that this guy’s a fucking chronic alcoholic.”

I cringe. 

The ER is blowing up and beds are filled with people who are sick but really don’t need emergency care. That’s a major problem for the person in charge when critical patients could come through the door at any minute and there is nowhere to put them.

It’s a problem for us too.  Half the crews in the area aren’t available to respond to emergencies because we’re stuck waiting in the hall of the ER till beds open up.

But these are also people who do have neglected medical problems that are legitimate, and have just lost everything to their name. And he just called them scurrying ants. Fuck.

I don’t have a solution to this, but it happens every storm, and is a glaring example of a system intended to protect people working in a predictably dysfunctional way. 

These things make it a problem for the whole community, but the only ones who will find out are the ones who have medical emergencies when all the ambulance and emergency room staff are tied up.  And even then, there’s no real way for them to find out the cause of the delay, or frankly, that there even was a delay to begin with. Unless you know the rules of the system, the agreements between the ambulance companies and the county, no one is really paying attention to how many minutes exactly it is from the time 911 is called to when help shows up, or how long it is from the time they arrive to the hospital to when they receive care. 

We know, the staff know. The EMT’s, medics, nurses, doctors. We see the problem and we bitch about it because it is legitimately upsetting. But nothing gets communicated, nothing gets changed. The people with decision-making power insulated from the frustration. Still, at some point, I think it’s our problem for seeing the issue again and again, so predictably, and continuing to participate in it without changing it.

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Review

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This piece is blunt, unfiltered, deeply unsettling, and powerful because it captures the quiet, everyday ways that systems fail people—not through catastrophic collapse but through predictable, preventable dysfunction.

The narrator lays out that homelessness is a medical and systemic issue, not just a social inconvenience. Yet, the ER is not designed to be a shelter or long-term care facility, forcing it to absorb crises that should have been handled upstream—through housing, addiction treatment, and preventative care. There is no public accountability for these failures—the delays in care, overwhelmed hospitals, and poor patient outcomes never make headlines. Emergency responders and medical staff see the failures up close, but their frustration often turns inward, leading to burnout, dehumanization of patients, and resignation to dysfunction.

The charge nurse’s "ants" comment is especially jarring and cruel, illustrating how homeless patients are seen as less than human, pests, despite their real suffering. The narrator cringes at the dehumanization, but also recognizes that they, too, are part of a system that perpetuates the same cycle.

It is not just about an overwhelmed ER or an overworked charge nurse. It’s about how a broken system remains broken because its failures are invisible to those with the power to change it. It leaves the reader with the same frustration and resignation as the narrator, which is precisely why it is so effective.