Welcome to our first edition of News From The Fourth World. So what do we here at Doc Gurley mean by “the Fourth World”? It’s a world you see and deal with every day – maybe when you go downtown, maybe when you’re on vacation, or maybe right on the sidewalk in front of your store. Third World conditions, located in a First World country, adds up to what Doc Gurley calls the Fourth World. “News from the Fourth World” aims to share a bit about what’s going on with the people many of us are forced to step over on our way to work – news without digressing into rants, politics, or the blame game. Check this category on Doc Gurley for uplifting stories, insider info, ways you can make a small difference, and issues unique to the most destitute among us.
Imagine you’re in clinic with me. We’re speed-walking to the next exam room, where we find a young man, age 22. He went into his suburban rebellious stage of juvenile diabetes at age 16, took a wrong turn at marijuana, hung a sharp left at sleazy-friends-who-discover-you-can-get-all-the-needles-you-want, and crash landed at heroin. He’s now alone on the street in the big city, living with his insulin in a baggie in a backpack whose straps are stretched from the weight of cans of Ensure (which he hoards to see him through emergency low-sugar spells). He went through detox twice and the second time seems to have stuck (pardon the pun). You wonder if he’s always had (or gotten!) a personality disorder too – he’s a loner, resistant to help, and more than a little paranoid. Thin, looking years younger than his age, he’s frequently beaten up and robbed of needles, but he’s been doing better the last six months – keeping appointments, getting refills on time, staying clean. No one knows why he’s here today and he’s sleepy, maybe because he relapsed and shot up. But when you check, his sugar is 35. Eek. How could this have happened? You know he’s careful – hypoglycemia scares the willies out of him – so much so that if his food source is unpredictable, he intentionally runs high all the time. When he comes around in response to some glucose, he tells you his monthly food-stamps ran out two weeks early because things cost more, he drank his last Ensure a week ago, and he hasn’t eaten since yesterday at noon. He got in the massive line at St. Anthony’s for breakfast, but then got confused…and (scratching his head, still sweaty and clammy), well, he doesn’t know what happened next. Thankfully someone brought him to you.
Why should we care? It was (scarily) close, but he lived, didn’t he? Well, our patient is the proverbial canary in the homeless mine. As this economic tsunami has hit America, all of us are feeling the effects of the storm. You can’t start spending an extra $300 a month for gas without feeling soaked. That’s $3,600 dollars a year that used to be yours, and if you’re in the 33% tax bracket, a whopping $4,800 a year of your gross pay that is now gone. Prices of everything are rising like a tidal wave all around us. While everyone is feeling buffeted and chilled, many of us, frankly, are still up on relatively high, stable ground. Unfortunately, lots of folks are down at the tideline, seeing the ground erode around them, struggling to not get swept away. And the people who were already out to sea are starting to go under. The people who live on food stamps aren’t getting an emergency inflation-adjustment in their little life-jacket of funds. They have, in fact, sprung a leak.
It’s a commonly held belief that food isn’t a big deal to the homeless – that there’s lots of it all around, and they don’t really want it. This year, however, food banks nationwide are seeing increased prices and decreased donations. Places that serve food to the homeless, often on shoestring budgets, are struggling under rising costs. Food is becoming a big issue on the street, which means it’s probably a growing issue in many fragilely-housed homes/families. What can you do? First, are you cleaning your cupboards? Did you find a few hundred extra cans of tomatoes from a sleep-deprived, over-caffeinated PMS grocery store run (or was that just me?)? Whatever you’ve got, if you have some extra, give to your local food bank. And then give some more. Consider giving to free soup-kitchens. Don’t wait for the holidays, or a food drive. Nowadays, if someone’s hitting you up for a buck on the street, you might be surprised at how happy they’ll be if you offer to buy them a sandwich instead.