Living and Dying on the Street

I didn’t think I cared. The frequency of the calls made it hard to care. Nuisance calls made up a large part of our routine. Spaced between medical emergencies, calls from the city’s underground emerged. Sivine Thatch made a lot of calls. He was a nuisance. One of many.


The tone from the station’s PA system was the new alternative to the traditional fire bell. Rather than being shocked into action by a loud bell like our predecessors, we were alerted to an emergency by a soothing tone. This sound woke you from a deep sleep as well as any bell. During a thirty-eight hour shift, the peaceful tone becomes your worst enemy. The station’s quiet is shattered by the relaxing noise as your body vibrates from its sound. It sounds hourly, twenty-four hours a day.

“Rescue One, respond to 1288 Broad Street for an intoxicated male,” boomed the voice from the loudspeaker. That voice alerted us to tragedies in other people’s lives far too often. Annoyed that I had to respond to another nuisance call, I was relieved that a real tragedy was not what waited at 1288 Broad Street.

 I knew from experience that Sivine would be waiting, full of cheap vodka, spewing venom from his filthy mouth. He was a small man, five feet tall, usually dressed in old doctor’s scrubs. Periodically the staff at the area hospitals cleaned and dressed him in whatever cast-off clothing they could find, usually donations or forgotten items from previous patients. Not long ago, I had transported him to RI Hospital’s detox unit. When his blood alcohol level became acceptable, he was released back into the city’s waiting arms. The hospital staff knew he wouldn’t be gone for long. They were aware of Sivine and others like him.

There are countless homeless alcoholics in the city. When they receive their disability checks from the government, they quickly change the cash into alcohol. After consuming as much as their tired bodies will allow, some find a pay phone and call 911 requesting medical assistance; others, they collapse where they stood, and a concerned citizen will make the call for them. Either way, one of the city’s five rescue units gets called to haul them off the street and out of the tax paying public’s eye. We would load them into our trucks, which we cleaned and sanitized diligently after each run, and take them in. Most of the time they left us with vomit, urine, and feces or a combination of the three on the floor and stretcher as a reminder of their visit with us. The smell lingered for hours. It saddened the rescue crews and stripped them of their morale seeing their hard work and professionalism being wasted time and time again on the same patients and their self-inflicted sickness.

After transferring care of the patients to the emergency room, they would be put into hospital beds, cleaned and fed, then put into the detox room until they were ready to leave. The taxpayer got the bill. Most of the alcoholics know how the system works, and the ones that don’t quickly learned how easily the system could be abused. They would make promises of sobriety with a grin on their faces as they left the hospital. Nobody believed them.

The path to Sivine from the station is a road that I traveled often. Triple-deckers loom on either side of the street. Litter fills the gutters which the rats call home. I turned down one of the streets that cut through the South Providence neighborhood between Broad and Allen’s Avenue. Like most of the inner city, this street is worn from years of neglect. Some homes showed the pride of the people inside. Sadly, most did not. When I allowed it, I recalled the horrors I had witnessed on these streets. Over the years I have seen a lifetime of bloodshed and heartache. Today, I have a job to do. Sivine waited.

I pulled the rescue next to the curb where he sat on the filthy sidewalk. This time his pants were around his knees. I approached him, he spit at me and screamed, “You go away!” I put on some latex gloves, and with the help of my partner carried him to the back of the rescue.

“I don’t care for you!” he shouted in broken English as we placed him on the floor of the truck. On the way to detox he rambled of his hatred of America. He wanted to go back to Vietnam. I did not think that he would be alive long enough to make the trip.

I met Sivine in 1996. Alcohol and despair were the only constant factors in his life. I didn’t know why he lived in Providence. I did know that he would never leave. His lifestyle had destroyed his ability to make rational decisions. He could no longer take care of himself. He spent his days roaming Broad Street, one notorious for violence. Nobody bothered him; they knew that he had nothing to offer. The few nights he didn’t spend in the hospital he slept in a burned-out garage located behind some trees, a few yards from the street. People had tried to help him, but he pushed them away. Eventually, nobody bothered; he had become a waste of time and effort.

At the hospital, I brought the rescue to the emergency room door, parked it, and wheeled a bed from inside to the rear of the truck. I opened the door, the smell of unwashed humanity filtered into the night. Feces and urine covered Sivine’s legs. As we wheeled our human cargo past the ER staff we were met with a mixture of laughter, sadness, and revulsion. Again I heard the chorus, “Welcome back, Sivine.” He spat onto the floor. “I don’t care for you!” he shouted at anybody who got near him. The routine of caring for him got under way.

While leaving the triage area where Sivine had been placed, I covered him with a blanket. Looking up at me with empty helpless eyes he simply said, in English, “Thank you.”

As night progressed toward dawn and the end of my shift, the look of empty despair in Sivine’s eyes came back to haunt me. I remembered joking with my partner about being better off when Sivine died. One January, we found him in a snow bank, unconscious and frostbitten. I don’t know how he survived. The temperature outside was in the low teens. He should have de was in the low teens. He should have died that day just as surely as the day he was found passed out in a field on an oppressively hot July day, his body temperature an astonishing 106 degrees. We started a pool to guess when we would be rid of him.

We brought our final patient of the night, a 64-year-old woman suffering from a seizure into the ER. I was shocked at what I saw. A clean, smiling Sivine sat on his hospital bed. A small crowd of workers and patients stood around as he entertained them, animatedly telling stories. Later, I discovered he spoke fluent French, Spanish, and Vietnamese as well as broken English. His audience thought he was quite charming. He looked me in the eye. I looked away.

I thought of Sivine during my days off. I wondered if the spark of life that he showed in the hospital could be a new beginning for him. I honestly hoped that it would.

It was business as usual when I returned to work. By mid-morning we had responded to four or five emergencies and another homeless alcoholic. Somehow, I managed to take a seat in the hospital’s break room. The conversation there ranged from the hockey game the previous night to a bad date over the weekend and everything in between. One subject got only a small mention. Sivine lay dying.

A call from a concerned citizen came in requesting help for an unconscious person lying in the street. The rescue crew working that day found Sivine. Whatever spark of life there once was now was extinguished. The crew did what they are paid to do, they brought him back to life with CPR and other advanced life-support techniques. They managed to get his heart beating, but his brain had died a long time ago. He lay in a coma for a few days before the plug was pulled. I thought of going to his room to see him but never did. Sivine died alone in his hospital room. At least he did not die on the street.

I searched the obituaries for a while to find some more about him, but no obituary was ever printed. Nobody cared. Sivine was gone. At times while dealing with nuisance calls, I think of Sivine and the spark of life that he showed on the last day that I saw him. His memory has helped me to find some compassion that I hope I’m not losing.

There are still plenty of homeless alcoholics rummaging around the city. Some manage to sober up; most die broken and alone. As annoying as they are, I know and genuinely like some of them. Their familiarity is welcome. It helps knowing what to expect in a job full of the unexpected.



  • Michael L Clark says:

    I remember while assigned to engine 10 one winter day we were dispatched for a man living in a burnt out house. While searching the house on the second floor Sivine was hiding behind an open door going into a bedroom, as I was walking back out of the room he shut the door scaring the shit out of me. I wasn’t expecting him to be there.. thanks for sharing your experiences Mike they are definitely heartfelt!

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