{"id":145,"date":"2025-04-16T23:22:48","date_gmt":"2025-04-16T23:22:48","guid":{"rendered":"https:\/\/euphemism.illinoisstate.edu\/20-2\/?page_id=145"},"modified":"2025-04-23T23:35:20","modified_gmt":"2025-04-23T23:35:20","slug":"point-in-time","status":"publish","type":"page","link":"https:\/\/euphemism.illinoisstate.edu\/20-2\/non-fiction\/point-in-time\/","title":{"rendered":"Point in Time"},"content":{"rendered":"

By Jacob Taylor\u00a0<\/span><\/p>\n

In January of 2022, a case manager loads a gold minivan plastered with agency logos full of blankets, water bottles, handwarmers, cotton-free socks, thick gloves, coats, and loaves of bread with peanut butter and jelly. The mismatched plastic bins overflow onto the van\u2019s stained floor. Some of the bins hold matching blankets or gloves, still new in their plastic, while others hold worn quilts and duvets passed down from grandparents, then donated by the unsentimental, the de-clutterers. The pair of outreach workers who normally drive this van left a stack of baby blankets in the trunk because the agency ran out of blankets large enough to cover an adult before the new donation of blankets came in for the state\u2019s annual Point in Time count, a census for the homeless.\u00a0<\/span><\/p>\n

The case manager\u2019s team of twenty-something-year-old outreach workers and case managers piles into the minivan\u2014two in the front, two in the back mixed in with the crates of items\u2014census tract in hand. They drive through the blocks of downtown Salt Lake City, stopping each time they see a lump on the grass: a body buried under a blanket, desperate to escape the cold, the frost icing the grass and crawling up the cotton blends that (attempt to) separate skin from biting decay.\u00a0<\/span><\/p>\n

After parking, the workers approach one man sleeping under a blanket and say, \u201cOutreach; we have blankets and food!\u201d\u00a0<\/span><\/p>\n

The man wakes up and cries out that he\u2019s in pain.\u00a0<\/span><\/p>\n

The case manager lays a blanket over his other blankets and tries to give him a pair of socks and gloves, but the man is too cold to take them.\u00a0<\/span><\/p>\n

Another worker tells the man he probably has frostbite. \u201cThere are little ice crystals forming under your skin that are damaging your body,\u201d she says. \u201cYou need to go to the hospital.\u201d\u00a0\u00a0<\/span><\/p>\n

The case manager can see that the thought of going to the hospital terrifies this man in his hesitation.\u202fHe reminds the case manager of the woman who told them to have the shelter stop calling EMS for her when her seizures went on too long, or when she knocked her head on the way down. He reminds the case manager of the man who refused to go to the doctor to get a medical demographic form, the only document that could help him replace his social security card.\u00a0<\/span><\/p>\n

The case manager learns that the frostbitten man doesn\u2019t have health insurance. They crouch down next to him. \u201cMedicaid can cover three months of medical bills retroactively,\u201d they say. He doesn\u2019t think he qualifies. The case manager asks if he has any income. He doesn\u2019t. \u201cYou qualify,\u201d they say. \u201cThe hospital will help you apply once you\u2019re admitted.\u201d\u00a0<\/span><\/p>\n

A worker calls nonemergency dispatch, and a few minutes later, a fire truck, an ambulance, and several other vehicles pull up to the curb. A large fireman walks up, the flashing lights from the fire truck glaring red across his face. The other dozen EMS workers linger near their vehicles and watch. The case manager wonders why dispatch sent so many.\u00a0<\/span><\/p>\n

The workers tell the fireman that the man has frostbite.\u00a0<\/span><\/p>\n

\u201cWhich hospital do you want to go to?\u201d the fireman asks the frostbitten man.\u00a0<\/span><\/p>\n

The frostbitten man reconsiders after seeing the fleet of vehicles, after hearing the aggression in the fireman\u2019s voice.\u00a0<\/span><\/p>\n

The fireman grabs the man\u2019s blanket, tightly bound around his feet, and tries to pull the blanket off. The frostbitten man cries out in pain, but the fireman just says, \u201cOf course it hurts\u2014your feet are frozen.\u201d The fireman lifts one end of the blanket and tries to shake the frostbitten man\u2019s legs out like a package of frozen burritos.\u00a0<\/span><\/p>\n

\u201cStop!\u201d the frostbitten man says.\u00a0<\/span><\/p>\n

The fireman drops the legs. He asks again: \u201cWhat hospital do you want to go to?\u201d\u00a0<\/span><\/p>\n

\u201cI don\u2019t want to go to the hospital.\u201d\u00a0<\/span><\/p>\n

\u201cWe take people to the hospital,\u201d the fireman says. \u201cThat\u2019s what we do. Are you denying medical care?\u201d His annoyance rises into the dark winter air along with his breath.\u00a0<\/span><\/p>\n

\u201cYes!\u201d\u00a0<\/span><\/p>\n

The fireman storms back to his truck, as if this whole time, his goal was to get the frostbitten man to say those words.\u00a0<\/span><\/p>\n

The team of outreach workers and case managers thank the other EMS workers for coming, and the trucks leave with their flashing lights as quickly as they came. The workers give the frostbitten man a set of supplies and move on to the next section of their census tract. The case manager counts the frostbitten man anonymously on the Point in Time survey, leaving all the questions unanswered except for the one about his living situation: \u201cplace not meant for habitation.\u201d They do not know if he will be recounted or eliminated when the administrators (attempt to) weed out duplicates.\u00a0<\/span><\/p>\n

The case manager refuses to let the frostbitten man become (just) another number on a survey, so they remember his story.\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) when the owner of the realty firm the frostbitten man lies in front of arrives at eight in the morning, she finds him under his blankets. He makes her uncomfortable, but she can\u2019t quite accept the fact that he makes her uncomfortable because he\u2019s homeless. The owner thinks she\u2019s a better person than that.\u00a0<\/span><\/p>\n

The frostbitten man hears her footsteps like he hears all footsteps: with tension in his neck and anxiety building in his gut. He doesn\u2019t know what her footsteps bring.\u00a0<\/span><\/p>\n

The owner watches the frostbitten man while she works, through her window: waiting for the printer to spit out packets of multi-colored information, listening to the coffee drip from the machine she stole from her mother\u2019s garage.\u00a0<\/span><\/p>\n

The owner asks her secretary if he\u2019s seen the frostbitten man move.\u00a0<\/span><\/p>\n

\u201cIf you\u2019re worried, why don\u2019t you call someone?\u201d he asks.\u00a0<\/span><\/p>\n

She drinks her coffee and leans against her office door. She knows she shouldn\u2019t worry; she doesn\u2019t feel like she belongs in real estate with this kind of social anxiety, her fear of confrontation. Her mother wonders, when she visits, how the owner made it this far on her own. \u201cI\u2019m not worried,\u201d the owner says.\u00a0<\/span><\/p>\n

Her secretary laughs.\u00a0<\/span><\/p>\n

The owner shuts her door and stares out her window at the frostbitten man. She\u2019s never called 911 before. She worries that the man might be dead, and she worries that he might just be asleep, and she worries that a customer might see him in front of her realty firm. But most of all, she worries that she\u2019ll waste everyone\u2019s time by calling (he\u2019s probably fine, she thinks), so she doesn\u2019t.\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) hormones flood the frostbitten man\u2019s bloodstream as his body temperature drops below ninety-five degrees Fahrenheit after the handwarmers the outreach workers gave him die. Blood vessels constrict, and body heat abandons his outer extremities.\u00a0<\/span><\/p>\n

The man\u2019s limbs shiver in damp clothing that sucks heat away faster than movement can replace it. His fetal posture stiffens, his muscles tense.\u00a0<\/span><\/p>\n

None of the frostbitten man\u2019s bodily functions save him from the cold. His temperature drops to eighty, then sixty. He faints, then dies.\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) the fireman doesn\u2019t think much about the frostbitten man after their encounter, and the only time he does is not actually spent thinking about the frostbitten man.\u00a0<\/span><\/p>\n

I take people to the hospital, he thinks.\u00a0<\/span><\/p>\n

He started saying that after the homeless shelter called EMS for a woman who seized but refused to go to the hospital; the staff knew she would refuse, but they called anyway after she hit her head on the way down. He and his team had strapped the seizing woman onto a stretcher and wheeled her out the front door as the staff and residents stared because even though EMTs visited the homeless shelter weekly (daily) it was still a thing to stare at. Halfway down the ramp, the woman stopped seizing and said, \u201cOh, no thank you\u2014no thank you! Don\u2019t take me to the hospital.\u201d She knew of the thousands of dollars the ambulance, the emergency room, cost and did not trust Medicaid to cover the expense. (She feared the army of debt collectors the medical system employed.)\u00a0<\/span><\/p>\n

After he unstrapped her, she shuffled back up the ramp into the shelter. Before the fireman could put the stretcher back into the ambulance, a worker came out and asked if he could just look at her head, talk to her.\u00a0<\/span><\/p>\n

\u201cWe take people to hospitals,\u201d he said.\u00a0<\/span><\/p>\n

Now, when the fireman thinks of the frostbitten man, he really thinks of the seizing woman and workers who call for ambulances and EMTs when no one wants to go to the hospital.\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) the G eats his triple decker peanut butter and jelly sandwich as he walks down the icy sidewalk in his worn-out tennis shoes. His hot breath glows in the yellow light of the streetlamps. He can see the green-gray toes of his new socks through the hole in the black mesh. The G feels so snazzy with his new coat and hat, but his shoes are throwing off his groove. Shoes are hard to find because if they\u2019re too big or too small, they give a G blisters.\u00a0<\/span><\/p>\n

When the G sees the frostbitten man lying on the frosted grass, he notices the blanket on top is the same navy-blue blanket he got from the outreach workers earlier that morning. The G notices the way the food, gloves, and hat are just sitting next to the blanket, untouched. \u201cHey, G!\u201d he says. \u201cYou alright?\u201d The G takes another bite of his triple decker sandwich but stops and stares at the frostbitten man while he chews.\u00a0<\/span><\/p>\n

The frostbitten man shifts beneath the blankets but doesn\u2019t answer. He doesn\u2019t want to be awake right now, with the cold gnawing on his nerves.\u00a0<\/span><\/p>\n

\u201cThose survey people leave you like this?\u201d the G says. He sits on the curb next to the frostbitten man.\u00a0<\/span><\/p>\n

The frostbitten man moves what looks to the G like a head. \u201cIt\u2019s so cold.\u201d\u00a0<\/span><\/p>\n

\u201cI\u2019ll make you a sandwich,\u201d the G says. He stuffs the rest of his own triple decker sandwich into his mouth and opens the jar of peanut butter the outreach workers left next to the frostbitten man. The nearly frozen peanut butter comes out in hard lumps, and the G worries he might break the plastic knife as he smashes it into the bread. The triple decker sandwich seems to sprout mountains and valleys by the time it\u2019s finished. The puffy white-purple-red fingertips that reach out from underneath the blankets and take the sandwich surprise the G. The skin swells and cracks like a pastry. The G wonders how the fingers still move, if they still feel.\u00a0<\/span><\/p>\n

\u201cThanks,\u201d the frostbitten man says.\u00a0<\/span><\/p>\n

\u201cSure, G.\u201d\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) the owner of the realty firm asks her secretary where he thinks the frostbitten man came from.\u00a0<\/span><\/p>\n

(Maybe) he says, \u201cI read that New York is bussing all of their homeless here, so they don\u2019t have to deal with them.\u201d\u00a0<\/span><\/p>\n

(Maybe) he says, \u201cIt\u2019s tough out there.\u201d\u00a0<\/span><\/p>\n

(Maybe) the owner rethinks her decision not to call 911. (Maybe) she goes outside to offer him some food. (Maybe) she asks him if he\u2019s alright.\u00a0<\/span><\/p>\n

(Maybe) the owner\u2019s secretary says, \u201cProbably too lazy to keep a job.\u201d\u00a0<\/span><\/p>\n

(Maybe) he says, \u201cI bet he\u2019s high.\u201d\u00a0<\/span><\/p>\n

(Maybe) the owner calls the police to have him cited for loitering and removed from the premises, and the frostbitten man warms his flesh in the Salt Lake County jail after the citation goes to warrant.\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) as jagged ice crystals crawl up the frostbitten man\u2019s feet, piercing his dehydrated cells, the loss of fingers, then hands\u2014toes, then feet\u2014grows surer.\u00a0<\/span><\/p>\n

The handwarmers the outreach workers gave the frostbitten man thaw the ice in his hands. Oxygenated blood rushes into his fingers, and they swell and blister with too much life to hold; the tattered cells can\u2019t expand fast enough\u2014and burst. Lipids and amino acids from fractured infrastructure seep into the blood stream, and the blue-gray fingers blister with blood.\u00a0<\/span><\/p>\n

Finally, when the handwarmers run out of warm\u2014his fingers freeze again.\u00a0<\/span><\/p>\n

The fingers (might) stay attached to his hand for weeks (maybe months), decaying black and brittle like charcoal, before they fall off one by one. The discoloration spreads like infection through his flesh without a doctor to assess and amputate the cells that are already dead.\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

(Maybe) when the case manager asks (begs) the Bureau of Emergency Medical Services and Preparedness to incorporate trauma-informed care into its training and curriculum for Emergency Medical Technicians in a complaint\u2014describing in detail the fireman\u2019s aggression, how he tried to shake the frostbitten man\u2019s legs out of his blanket, the way the other EMTs just stood back and watched (the way the case manager felt required to stand back and watch)\u2014the administration connects the complaint back to the fireman.\u00a0<\/span><\/p>\n

The Bureau requests additional training, not just for the fireman, but for all the EMTs.\u00a0<\/span><\/p>\n

(Maybe) the fireman asks permission to examine the next frostbitten man\u2019s body. He patiently, gently unwraps the next frostbitten man\u2019s legs. He inspects the next frostbitten man\u2019s frozen flesh with gloved hands in the light of the ambulance\u2019s harsh LEDs. The fireman explains the next frostbitten man\u2019s condition, the extent of the frostbite, so he can make an informed decision.\u00a0<\/span><\/p>\n

(Maybe) the other EMTs help the fireman lift the next frostbitten man onto the stretcher, and they take him to the hospital, where nurses warm his fingers and toes in lukewarm water while saline and painkillers flood his veins.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

By Jacob Taylor\u00a0 In January of 2022, a case manager loads a gold minivan plastered with agency logos full of blankets, water bottles, handwarmers, cotton-free socks, thick gloves, coats, and loaves of bread with peanut butter and jelly. The mismatched plastic bins overflow onto the van\u2019s stained floor. Some of the bins hold matching blankets… Continue Reading Point in Time<\/a><\/p>\n","protected":false},"author":82,"featured_media":0,"parent":19,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-145","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/pages\/145","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/users\/82"}],"replies":[{"embeddable":true,"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/comments?post=145"}],"version-history":[{"count":7,"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/pages\/145\/revisions"}],"predecessor-version":[{"id":310,"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/pages\/145\/revisions\/310"}],"up":[{"embeddable":true,"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/pages\/19"}],"wp:attachment":[{"href":"https:\/\/euphemism.illinoisstate.edu\/20-2\/wp-json\/wp\/v2\/media?parent=145"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}