San Francisco Chronicle - (Sunday)
Em and I saved a life — but for how long?
It was a beautiful day in the neighborhood. After finishing breakfast at my neighborhood cafe in the Mission, I made my way up Valencia Street toward Hayes Valley to do a few odd jobs for my wife’s restaurant.
As I was crossing Duboce Avenue, I saw a man lying on the sidewalk, unconscious. A young woman — we’ll call her Em — was already tending to him. I ran over to help, asking if he was breathing.
“I think so,” she said with reservation in her voice. “He opened his eyes a few seconds ago.”
She had just administered a pocket-sized Narcan nasal spray, which she conveniently carried in the lanyard around her neck.
“I’m a social worker,” she said to the man while rubbing his chest. “Can you open your eyes for me one more time?” He could not.
I dialed 911. Fumbling to disconnect my headphones, I finally got the phone on speaker just as the operator asked, “What is your emergency?” I explained there was an unresponsive man passed out on the sidewalk and that I didn’t know if he was breathing.
“What is the location of the emergency?” I said Duboce and Valencia. He had me repeat the location for confirmation. Immediately, I heard sirens in the near distance, which provided a momentary sense of relief.
The operator asked me to check if the man was breathing. I asked Em, but she still couldn’t tell and felt no pulse. The operator then instructed me to put the man flat on his back, place one hand on his forehead and another under his neck to tilt back his head, then place my ear next to his mouth and count every time he took a breath. After about five seconds, I heard a breath, if you could even call it that — more like a faint snort. “One,” I said.
Maybe eight more seconds went by without a breath. Fear washed over me when the operator said this was insufficient breathing. He said I needed to perform mouth-to-mouth resuscitation. I looked at the middle-aged hypoxic man with his head in my hands; he had a yellowish puss-like substance on the edge of his lips, the pungent smell of alcohol coming from his mouth and pants soaked in urine. Guilt and shame do no justice to my feelings when I told Em and the operator that I couldn’t do it. I felt defeated.
The operator said that since nobody was willing to perform mouth-to-mouth, we needed to start chest compressions. Em got in position, ready to start, when we saw an ambulance coming. We flagged down the driver, and within seconds a team was checking the man’s vitals and trying to resuscitate him.
Em and I watched as the emergency medical technicians tried to revive him. The thought that he could be dead weighed on me. Would I always wonder whether I could have prevented it if I had just been willing to put my lips on his? A few moments later, the EMTs said the man lifted his arm, proclaiming that the Narcan had worked.
I stood there looking at him motionless on the ground, barely holding on to life. I tried to process what was happening. I felt grief remembering all the other times I had been around death. I knew he wasn’t dead, but he was close.
The paramedics thanked us. As they put the man on a stretcher, I chatted with Em about what would happen next. She said this wasn’t her first time doing this and that, unfortunately, the man would probably end up right back on the street. It was incredibly discouraging. Yes, we may have just saved a man’s life, but he is still plagued by a deadly addiction that is not being treated. It felt like we just bought him some more time, like resuscitating someone with a terminal illness.
I held on to the hope that he might get help.
About an hour later, I called the nearest emergency room to see if a man matching his description had been admitted. I said I wanted to leave him flowers and hoped it would bring him at least a glimmer of joy. The nurse confirmed he was admitted but, to my dismay, had already self-discharged. I asked why someone who nearly just killed himself was not put on a 5150 hold, and the nurse explained that he was not suicidal.
I was disappointed, to say the least, but my lousy phone reception distracted me from discussing the state Welfare and Institutions Code with her.
I brought flowers to Em to say thank you. People like her give me hope. I’m not sure how many people would have stopped to help the way she did. Mister Rogers once said that his mom told him to always look for the helpers: the people who spring into action during a catastrophe, just like Em.
We are now in the midst of an opioid overdose catastrophe; in San Francisco alone, around two people die every single day from fentanyl poisoning.
The system is not doing enough to stop this, but people like Em give me hope that we, the people, can help.