The emergency room at San Francisco General Hospital, pictured in 2018, receives many overdose patients who often arrive without a wallet, phone or driver’s license.

There is another John Doe in the intensive care unit. 

“He is critically ill, hoping someone might know this person. Found down with overdose at 1180 Howard Street around 5am.”

This email, and too many others like it, arrive in the all-staff listserv at the San Francisco homeless clinic where I work as a physician. Leftover pizza reminders and meeting agendas routinely roll into frightening, blandly described near-death experiences.

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“John Doe arrived to SFGH on 1/22  found down near MISSION ST / 6 TH ST, possible overdose ( fent & cocaine ), active seizing on route to SFGH. See photo attached.”

Usually, the messages are sent by hospital social workers asking our team to help identify their client. 

“He tested positive for amphetamines. He currently is more awake, but cannot speak at all. He suffered a stroke. Oh, and in addition to the tattoos seen in the photos he has a very distinctive scar over his LEFT leg.”

The photographs are garish. The men, always men, look close to death. Limp faces with ointment smeared across half-closed eyes. Mouths hang agape. Floppy necks cannot support heavy heads that loll to one side. Oily, long hair lies limply across white, rough pillowcases. Breathing tubes are taped to lips, fastened across cheeks, wrapped behind........

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