Sacramento nurse: ‘When I say I work with homeless, the first word I hear is ‘why’?’

Edward is lying face down in the back of his pickup truck in a Sacramento parking lot while two street nurses change the bandages on his calves.

He lives in this truck, too, which is why the cellulitis that came on after he ripped the soft tissue off the back of his legs trying to help a friend move an old fridge more than a year ago still hasn’t resolved, says registered nurse Nora Romo Vazquez. Still, “the swelling went down a lot, Edward,” she tells him. “I know it stings, but I do see a lot of progress.”

Between his yips of pain as she applies antiseptic, the 67-year-old former California prison guard tells me how he got here. And as is often the case, it didn’t happen all at once: First, he was injured on the job and became — not unemployed, exactly, but less so, doing whatever contracting jobs came his way. Next, his longtime girlfriend “wigged out” and broke off their engagement.

For the 17 years that followed, he spent full-time caring for his mother in Sacramento. As the only one of the seven children of a career military man and his German-born wife who did not have a family of his own, he was more than OK with that: “I gave it everything I had. My mom’s my mom.”

But when she died two years ago, he was evicted. “She had one of those reverse mortgages, so I had six days to get out.” For eight months after that, he paid $600 a month to stay in a friend’s shed, which had no heat, no air and many rats.

Edward, whose last name I agreed not to use as a condition set by Nora’s employer, the non-profit WellSpace Health, on accompanying her on her rounds, has been looking for a place of his own ever since. But even the most modest apartment he’s found has required $3,000 upfront, he says, and that’s just about twice what he gets in disability and Social Security every month.

So after he was injured trying to help the friend whose shed he’d been living in, his home became his truck, with the occasional splurge on a motel room. He’s doing that tonight, as a matter of fact, and Nora is elated that he’ll be able to take better care of himself for a few hours: “I beg you, Edward, what do you need to do tonight?”

“Test my glucose?”

“Elevate your legs! Elevate your legs, and I’ll see you next week.”

‘He doesn’t identify as homeless’

She treats Sacramento’s homeless folks wherever they happen to be. So why does she meet Edward in her office parking lot instead of wherever he parked the night before, I ask her as we walk to her van. Because, she says, he doesn’t want her using any more resources than necessary on him that he feels should go to “real homeless people.”

“Edward doesn’t let me go to him. He feels like he hasn’t given up yet, so he doesn’t identify as homeless.”

It’s what we identify as homeless that I don’t get. As a baby reporter in 1986, I spent a few months following a mentally ill homeless man everywhere he went in Dallas, Texas, sleeping as he did under bridges, in shelters and on the banks of the Trinity River.

Then and with just one recent exception, every time since then that I’ve written about people who are living on the street, readers have let me know that those without a home are actually only suffering from some moral failing: No matter what their medical problems, why aren’t they working? No matter what life has handed them — domestic violence, an abusive parent, exorbitant hospital bills, or just plain old poverty — they should simply have walked away, or worked harder. And since they didn’t, then why should any of the rest of us have to pay for their poor decisions?

What I’ve seen, though, isn’t that people without a home have necessarily made any worse decisions than the rest of us, but that no one was there to prop them up when they got sick or hurt or did take a wrong turn. For the most part, they are just people with worse luck, whose worst decision was being born poor or ill or both, in a culture in which families don’t always take care of their own the way Edward took care of his mother.

All of this to say that when some of you write to tell me that Edward would not be living in his truck if he had done x or y or z, just like you would have done, I will not be very surprised.

It’s a normal human reaction to say, “That could not be me, or anyone I love,” because to admit that yes, it could, might be unnerving. Which is why, even when I was diagnosed with breast cancer 20 years ago, people not very subtly wanted to know what I had done to unleash that malignancy, so that they could tell themselves that they were safe from it.

But maybe we can at least agree that it’s a noble thing that Edward, with his bad legs and his obdurate pride, is adamant that Nora should not burn any gas coming to him, because he’s not really homeless just yet.

A privilege to care for homeless people

All day every day, Nora and a colleague care for those the rest of us walk past. On the day I spent with her, these included Dennis, who came to the United States from Ghana to study at Fordham University decades ago, but was not able to finish after he was diagnosed with schizophrenia.

Dennis came to California in 2008, after an acquaintance promised him a place to stay. When that didn’t work out after all — “He told me he couldn’t accommodate me. He was very honest.” — he had nowhere else to go. When Nora found him, 14 years later, he was living in his wheelchair outside City Hall, with few possessions beyond his blanket. “I had given up on a lot of things,” he tells me.

Now he’s able to walk a little, with a walker, and is living in a tent in the city’s safe ground at Miller Park, waiting for Ghana to provide the birth certificate that he needs to be eligible for real housing.

Later, Nora delivers the best possible news — “It’s OK to stop chemo!” — to a newly cancer-free man and his wife who are living in a motel. “Congratulations, your hard work paid off!” she tells George with a big hug.

Her hard work has paid off, too: Because 79-year-old George distrusts doctors, it took Nora four months to persuade him to get his skin cancer treated. “The doctor said another eight weeks, and it would have been a different story.” Because he didn’t want to leave his seriously ill spouse, Nora was able to administer his chemo right in the motel.

She brushes off congratulations on saving his life, and his 58-year-old wife Evelyn’s, too, since George is her caregiver: “Team effort,” she says. But watching Nora and her colleague Yarely Barajas care for the despised is a beautiful thing.

“When I say I work with homeless people,” Yarely tells me, “the first word I hear is ‘why’?”

On one of the last stops of the day, Nora carefully swabs and bandages the feet of a woman who is lying nearly unconscious on the sidewalk, while Yarely takes her blood pressure. The woman barely responds at all, yet Nora walks away encouraged.

“Did you see that smile we got at the end? Now we can come back” without scaring her, and maybe do more. After 18 months in this job, the only part of it that 28-year-old Nora doesn’t love, she says, is that “pets not on a leash can come running at you, and that makes me a little nervous.” But if more people knew more about the lives of those she considers it a privilege to care for, she says, “they would help as well. Anyone would do it.”

Anyone, no. But I do agree that knowing more might make a difference, which is why I want to tell their stories, no two of which are the same.

This story was originally published August 26, 2022 at 5:00 AM.