It’s kind of weird to be a small-town EMT visiting the city.  ‘Normal’ is relative between venues.

Starting out in wilderness EMS, I was taught that a person not acting in their own obvious best interest is an emergent situation.  Someone acting oddly in the woods is, if not right now, about to be a problem.  The problems that they may bring on themselves will then become problems for others in terms of the logistics and resources required to stage a rescue.

Moving into town, people are given more leeway for acting oddly.  In the city, even more so.


Walking to the grocery store, I came across an individual sprawled across the hood of a car with their pants unzipped. In the rain.

In the woods or, indeed, in the towns where I practice, this would be an issue; someone would stop to ensure that the person was okay.  People do not sleep on cars in the rain.

In the city on my way to work each day, I pass perhaps thirty people collapsed on sidewalks.  This is accepted; homeless people have the right to live as they wish.  If they chose, they would avail themselves of shelters.  It is egocentric to suggest that it is not okay to live in a homeless fashion.  Homelessness in and of itself is a choice, not a mental health issue.  Waking each collapsed person (“hello, sir! Are you okay?” with a sternal noogie) would not be appreciated any more than if I were to invade someone’s bedroom unbidden to provide the same unneeded and unwelcome check.

Still, this seemed an extreme example.  Did this person need help?

I eventually decided it was not my place to intervene.

When I left the grocery store, the person and the car were gone.