No Home to Go To

Ms. Brown, a 34-year-old Caucasian woman, comes into the emergency room to secure treatment for a head injury, plus minor bruises and abrasions that she reportedly received during an assault that happened about 20 hours ago. Ms. Brown is accompanied by her boyfriend, Roy. She indicates they were sleeping in a protected entrance to an elevator in the city parking garage when two young men began beating and kicking them. The two men took Ms. Brown’s purse, a sack of food she and Roy had accumulated, and Roy’s wallet, which contained $5.00. Ms. Brown indicates she has been homeless for over a year. She occasionally stays in city shelters but spends most of her time roaming the city and walking to secure meals at the various programs that feed the poor. She is tall and thin, with a variety of skin lesions. She came to the hospital due to dizziness that prevented her from walking to the church where she could eat. She and Roy occasionally work odd jobs, but use the bulk of their income to support Roy’s drug habit. She is trying to get Roy to quit using. The physician has the nurse clean Ms. Brown’s scalp and apply a dressing to the traumatic lesion. A contusion is expected, and the physician suggests that Ms. Brown rest for a few days and go to the neurological clinic if the dizziness worsens. The nurse points out that Ms. Brown has no place to rest and cannot get to the clinic without access to public transportation. The physician realizes this but indicates it is beyond her control.