Two Cheeseburgers and a Piece of Sidewalk

An emergency room, a homeless woman, and a long walk to downtown

I picked up the phone, and a familiar voice on the other end pleaded: “They just brought Ruth in—you have to get her out of here. She’s tearing things up, and we can’t have that. We need you ASAP.”

There was no need to ask questions. I agreed to help, I just needed a few minutes to make some phone calls. Sitting at my desk, I smirked. I’m not a doctor, not a nurse, not even a social worker, but the emergency room just called me asking for help.


Ruth is in her sixties and very petite—barely ninety pounds soaking wet, a colleague once remarked—but she’s fiery. Oh, she’s fiery. When she’s upset, Ruth screams in a terrifying, hoarse voice, ranting to no one in particular. Her wails come from somewhere deep inside, as if she’s trying to scare her troubles away. Sadly, she has troubles aplenty: she’s poor, homeless, traumatized, and addicted to alcohol.

I first met Ruth a few years ago when she was admitted at our medical facility, and she had settled in nicely. She was contemplative, and when she wasn’t reading you could find her in the arts and crafts room without fail. I had heard a bit about her history—she had been staying outside on the streets for the past few years and was wary of nearly everyone—but it was hard for me to picture. The phrase “quiet as a church mouse” seemed to describe her perfectly.


The nurse and social worker were already waiting for me at the entrance to the emergency room, and they ushered me inside. Truthfully, there was no need for the escort—I could have found Ruth by the sound of her screams. When I entered her glass-enclosed bay, Ruth was sitting up on her stretcher flailing her arms about. She was clothed in a pair of baggy hospital pants and a large navy sweatshirt, the combination of which virtually swallowed her tiny frame. The nurse hurriedly put her into a broken wheelchair, handed me Ruth’s shoes, and pushed us both out the door.

Boston at twilight

No medical clearance. No discharge paperwork. No follow-up plan. Just a desperate hand-off to a case manager.

It was about dinnertime and the gray of urban twilight was settling on the street corner where Ruth and I were perched. I crouched next to the wheelchair and looked Ruth in the face.

“Well, what now?” I asked.


To be fair, it’s not that the emergency room employees were uncaring nor were they particularly harsh. They rushed Ruth out because they were ill-equipped to deal with her problems. Ruth had been brought into the emergency room by ambulance mistakenly—a compassionate bystander had found her lying facedown on the concrete and called 911. Ruth had simply been sleeping when she was hoisted onto a gurney and whisked off to the hospital.

Ruth’s problems are chronic and not primarily medical. Lab tests and medications won’t solve anything. Even the best doctors can’t save her. She needs a home, she needs social supports, and she needs the stability they afford so she can face her long history of trauma and conquer her alcohol addiction.


After reviewing (and exhausting) her shelter options—Ruth can’t tolerate the confinement and chaos of the homeless shelters—I turned my focus to safety. We were in a part of town where she is largely unknown and which turns eerily vacant after sundown. It seemed best to get her to the area of downtown where she is known by the police and outreach workers.

“Why don’t we go to Faneuil Hall? I know you love to watch the street performers there,” I suggested.

In the midst of her incoherent shouting, she paused and responded softly, “That would be nice.” She immediately resumed ranting.

Given her current state, there was no way I was going to take her on the bus, and no taxi driver in their right mind would pick us up. The only way to get Ruth downtown was to push her in that rickety wheelchair. I shrugged to myself and started pushing.

In a longshot attempt to get Ruth out of her foul mood, I teased her about the oversized hospital pants she’d been given—and to my surprise she shot right back about my ugly shoes and followed with a burst of laughter!

And the laughing didn’t stop. We giggled our way up and down the bumpy brick sidewalks all the way to downtown. Ruth told me how much she loves Cher and jabbered on about Tina Turner’s amazing legs. She reminisced about riding horses as a child and about her love of root beer. She poked fun at my plaid shirt (and insisted I check out the sale at Macy’s pronto!).


The sad part is that there’s no home for Ruth yet. The building she lived in burned down years ago, and with no one to call on for help, she found herself alone outside. She’s been sleeping on the streets for years, and that kind of inertia coupled with trauma and addiction is tough to overcome.

The hopeful part is that there is a team of people diligently trying. Trying to continue earning her trust. Trying to line up an affordable apartment and to coordinate the supports she’ll need. Trying to empower her to take small steps in the right direction, so she can live safely and happily in her own apartment again.

But until everything falls into place, all we can do is help her stay safe and healthy. All we can do is be there for her when she’s in need. All we can do is walk alongside her in this journey and encourage her not to give up.


When we arrived in downtown, Ruth had sobered up significantly. She was feeling pretty tired, so she asked for a cup of coffee. Concerned that she still might start shouting, I parked her wheelchair outside of McDonald’s. I asked her to stay put and ran in to grab the coffee. When I returned a minute later, the broken wheelchair was sitting empty on the sidewalk.

Undeterred, I turned the corner and marched up the block looking for Ruth. Just as I had expected, I found her two blocks up lying in front of a trendy restaurant. She was sprawled out on the cement—likely the same position that had resulted in her trip to the emergency room earlier. I knelt down by her side and nudged her elbow, asking if she still wanted her coffee.

Sleepily, she looked up at me and graciously took the coffee from my outstretched hand. She propped herself up against the granite facade of the restaurant, and I followed suit. Then from the paper bag clutched in my other hand I pulled two double cheeseburgers (her favorite, I had learned on our journey).

“Cheeseburgers,” I proclaimed. “One for you and one for me. Would you like to have dinner with me?”

Ruth and I sat together on the sidewalk with our backs against the trendy restaurant. For the next fifteen minutes we bantered and joked, eating our cheeseburgers. While this was probably just another meal for Ruth, I hope that it was also something more. After years of living on the streets, after being shoed from doorsteps countless times, after many long nights of hunger and loneliness, I hope that in this moment she felt valued.

Two cheeseburgers, good conversation, a little piece of sidewalk, and someone looking her in the face person-to-person.


Double Cheeseburger by McDonald’s” by ekkun. Licensed under CC BY-NC 2.0

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Matt Mitchell is a program coordinator at Boston Health Care for the Homeless Program. He is passionate about caring for the overlooked and underserved.

Follow on Twitter: @matt5mitchell

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