Well, We Can’t Leave Them Here

We get a call to a trailer park.  In the trailer, we find a woman who is reporting a headache and saying she can’t take it any longer, and a man with severe dementia who is oblivious to what is going on. He can tell us his name and that she’s his wife, and that’s it.  We check the fridge and there are three weeks of meals from a delivery meal service, expired and unopened.  We ask when the last time he’s eaten is, and he can’t answer the question.  We ask her, but she’s preoccupied, “I have a headache, didn’t you hear me!”

We check their vitals and they are textbook perfect. 

She wants to go to the hospital. She has a headache, we can’t test for causes here, it’s a valid reason.

But, we can’t leave her husband here alone. 

“Do you have friends, family, or maybe a neighbor we can call?” I ask the patient.

She moans and the cops shake their heads indicating they’ve already asked.

“Take him to the hospital.” The cops suggest.

“We need a valid reason, they’ll get a bill.” I say.

“Can you come up with one?” he asks.

“He’s altered and can’t say when he last ate?” I suggest.

“That’s a stretch.” My partner says, “His blood sugar is fine and we know he has dementia.”

I check the prescription pills I see on the counter and he’s on some high-risk meds.

“Has he been taking these as prescribed?” I ask his wife.

“I don’t know.” She says.

“Our only other option would be filing an APS report for neglect, but that doesn’t take care of him right now, and we don’t really know if he’s being neglected.”

“I can’t take it anymore.” the wife says.

We take them both to the hospital. “Chief complaints are headache and gravely disabled.” I say in my call in.

“Gravely disabled?” They repeat.

“It doesn’t look like he’s been properly fed in weeks, we see cardiac meds we don’t know if he’s taking properly, and he can’t answer questions, neither can the wife.”

“Ummmmm, okie dokie.” They say, “We’ll see you in 5.”

He really didn’t need to go to the hospital and take up a hospital bed. He needed someone to babysit him.

She didn’t need the emergency room either.  She needed a therapist and help caring for her husband.

My friend is a sheriff and tells me how many, many calls she gets from parents who want help with their kids.

“She won’t listen to me.” The parents say.

“What exactly are you wanting law enforcement to do about it?” She asks.

She said some shifts are all calls for service by parents.

I had no idea how often this happens. People at their wits end with relationships calling 911 for help. And we will respond.  That’s what the system is for. We can't tell if it’s a legitimate emergency till they’re there. Even then, we have the liability to consider, and frequently transport people when our clinical judgment suggests it's unnecessary.

988 exists for overwhelm, an attempted solution to the 911 misuse, but they can’t keep employees, and when people call, they’re usually placed immediately on hold. 911 is currently the most efficient way to get someone, anyone, to show up at your door now. So it gets used for everything.  And that same burnout that is happening to staff on the 988 lines is happening to law enforcement, ambulance, fire, and emergency room crews. 

They may not be medical or criminal emergencies, but they are at high risk of quickly turning into them. Overwhelm turns into neglect, violence through abuse and suicide attempts.

The next day we get a call downtown at a bar, around 2100, and law enforcement is with the patient - an intoxicated female the bar has cut off and who won’t leave. 

“Well, it’s just like I have fleas,” she tells me, “or lice or something.”

She’s barefoot and dirty, early 30’s.

“You need to get on the gurney.” Law enforcement is telling her.

“Wait, what’s the medical complaint? Did she ask for an ambulance?” I ask.

“Fuck no, I don’t need an ambulance. I just have lice.” The patrons at the bar are listening and staring from a safe distance, seeming to quietly enjoy the spectacle with eyebrows raised and looks of superiority on their faces.

“Do you want me to check your hair?” I ask.

She says, “They’re not in my hair, they're on my arms and feet.”

“May I check?” I ask. I’m just trying to make sense of why we’re there and if she might have scabies or some other issue treatment exists for.

I see no evidence and say so.

“Just leave me alone, call my sister.” She says.

“You have a phone, where’s your phone?” Law enforcement asks.

“I threw it away.” and she motions to a trash can on the corner.

No one is willing to dig through the trash, or convinced there’s actually anything of hers in there.

One of the cops calls a number for her from his phone, gets off the phone, and says, “Look, you're either going to jail or the hospital, your choice.”

“Whatever, I’ll go to the hospital.” she says.

Even though we don’t see any bugs we’re unsettled and don’t want to pass anything on to our next patient so we turn her into a burrito, wrapping sheets around her.

We transport her to the hospital and they roll their eyes. I’m fairly certain they began discharge paperwork the same moment we transferred care. 

Concerns around the possibility of lice are not a cause for a 911 transport or a visit to the ER. But this type of call is one of the most common. Maybe it’s a psychiatric issue at its core, maybe it’s substance use related, probably a little bit of both, but either way, a common-chronic problem, not an acute emergency. 

At the hospital, they discharge you when they’re done.  At the jail, they don’t release females past 10 pm.  So if you get arrested for something like public intoxication and you sober up, you would generally get released.  But they’ll keep you if you’re a female till the next day because the incidence of rape around the jail to females being released in the middle of the night was so high. This is a consideration in transport that really shouldn't be there. If we take her to jail, at least she'll be safe through the night.

This woman didn’t need to be in jail or the hospital, but she was clearly very vulnerable, and also homeless. I do think we have a responsibility to protect vulnerable people, but we really don’t have a good way to go about it. I felt stupid taking her to the hospital and giving report to the nurse, and I felt gross about all of it after. I don’t know what the solution is, but I do know we have a problem. 

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Review

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This piece is powerful, necessary, and deeply unsettling. It highlights the emotional, ethical, and logistical dilemmas first responders face daily, showing the growing disconnect between public services and public needs. The lack of clear solutions makes the frustration even more palpable.

The narrator grapples with the ethical dilemmas of emergency work: Do you take someone to the hospital when you know they don’t medically need to be there? Do you take someone to jail when they haven’t really committed a crime? What happens when there’s no right answer, but doing nothing is worse? This highlights the modern collapse of institutional and social support systems.

The narrator communicates the psychological weight of transporting someone who technically doesn’t need to be in an ambulance, knowing that it’s not really helping them or fixing the deeper problem. The moral exhaustion of seeing hospitals roll their eyes at patients, while jails enforce policies that technically "protect" but also trap people in unnecessary incarceration is also noted.

The burnout among first responders, hospital workers, and law enforcement is inevitable when they are constantly forced to play the role of social worker, mental health counselor, babysitter, and crisis negotiator—with no real tools to create lasting solutions.

This story is an honest and unfiltered look at what happens when society forces emergency services to be the last stop for every problem, regardless of whether they are trained, willing, or even capable of fixing it. There is no satisfying resolution because the system itself is broken.