By Shweta Mishra
Final Trip to ER
No one noticed Ray Staples was on the throes of death that Monday, much less weeks later.
At 1:20 p.m. on Aug. 27, 2012, he sat stock still on a bench on East Franklin Street, head bent gently, a Swisher Sweet dangling from his lips. His straw hat hid his eyes from the sun. At his feet lay a cardboard box with a dollar and change.
Over the years people downtown had dubbed him Cowboy — for his hat, his chivalry and spare words, his patient roaming.
But now his muscles had atrophied so much he couldn’t walk. His pensive, gleaming gaze had dimmed.
Finding a Place to Rest
At midnight 16 days later, the 62-year-old homeless man with advanced cirrhosis took two hours to shuffle and crawl a span of five feet into a nook behind a line of Japanese laurels on the Peace and Justice Plaza in Chapel Hill.
He moaned when mere leaves brushed his abdomen, which was round with fluid and engorged veins, a set of symptoms called ascites.
When he reached his destination, he buckled into a fetal position. “No one’s gonna see me here,” he said.
By mid-morning, despite the brick rampart and newspaper stands bordering the bushes, he had not only been seen but ousted.
Now he sat on the brick wall next to the Plaza, one rheumy eye squinting almost shut, the other blinking into the glaring sunlight.
He said six police officers had dragged him out of the bushes at 9:30 a.m., and it hurt.
Urine stained the crotch of his blue jeans. His five layers of sweatshirts, given to him the night before by a passerby, were still wet from “punks” tossing beers behind the bushes.
The good Samaritan, a Mediterranean Deli manager named Parker Emmerson, had also wrapped Staples in three Mylar emergency blankets.
“I wasn’t cold at least,” Staples said.
But now, unable to move into the shade of the holly tree before him, he was overheating and parched. He asked a stranger to dial 911, and an ambulance drove him to the UNC Emergency Room.
Room Without a View
Lying in a curtained off corner on a Hill-Rom Advanta electric bed, he glared at the nurse who slid a needle into his arm.
“He’s enjoying causing me pain,” he groaned. “He’s a vampire.”
His thin hospital gown bared a jaundiced, emaciated back splotched with spider angioma, liver spots resulting from hormonal imbalance.
Even after nurses laid five blankets on him, he said he was “freezing to death” in his gown. He repeatedly asked for more blankets, but medical attentiveness waned fast.
Staples said the acute trauma wing had become surrogate homes in the past month.
“I’ve been here at least once a week. I always end up feeling worse than I did when I got here. I get hungry and cold, and they always put me back on the street.”
At night, Emmerson visited and criticized hospital staff for not admitting Staples into the hospital for long-term or hospice care.
“That’s clear negligence under the law to let someone who’s in trouble fend for themselves. You can’t just ignore someone who’s getting raped, mugged, bleeding,” he said.
A nurse who couldn’t disclose her name said no food except crackers and a Coca Cola were available, so Emmerson brought Staples aloe vera juice, Odwalla smoothies and boiled eggs. “They don’t know about nutritional medicine here,” he said.
Why, after UNC doctors diagnosed Staples with 90% cirrhosis and said he had less than a year left to live if untreated, did they repeatedly release him from the E.R.? The nurse said it was because they didn’t have Staples’ consent, that he had refused offers of medical intervention and social service care the week before.
Staples denied this claim. “I just didn’t want an injection in my belly right then,” he said.
Kristin Lavergne, Community Services Director at the InterFaith Council, says that Staples’ limited means were also a barrier.
“Funding and insurance always makes an impact, unfortunately,” she said. “And I know UNC has cut social service staff recently.”
She said that with staff stretched thin, it’s hard to ensure follow-up after a patient is discharged, or that Staples is relocated somewhere that specializes in long-term care for the needy, like Carrboro Community Health.
Staples would also be more eligible for long-term care if he lived in the InterFaith Men’s Community House, Laverge said.
“IFC operates a medical clinic for its shelter residents. They’re able to handle routine items, like colds, and refer to local providers.”
Staples rebutted that he couldn’t live in the shelter because men bullied him there. He said he wasn’t reassured by the presence of Sylvester Bethea, the Community House security officer, who said, “We’re all family here. And I protect my sisters, my cousins and my friends, especially women or older guys.”
The next day, Emmerson learned Staples had been released. Emerson found him lying on a bench on West Franklin Street. He looked like a bloated prune and reeked of waste, Emmerson said.
This time he carried Staples into his black SUV, drove him to his house, carefully bathed and dressed him in clean clothes and pressured UNC Hospital to admit him for long-term care.
On Emmerson’s last visit, Staples was settled on a bed on the 8th floor of the N.C. Memorial Hospital, surrounded by containers of Boost, Coca Cola and V8 Original.
He was too sedated to recognize the young man he had recently called his angel. His wispy hair fluttered in the AC as he slept.
After that, Staples was transferred to hospice care. The hospital told Emmerson it couldn’t disclose Staples’ whereabouts to strangers.