“I’ve been in Italy.” I fumbled in my wallet for the U.S. money that still looked weird to me. “My first true vacation in fifteen years. It’s hard to be back.”

“Foreign travel. I got all that out of my system at nineteen when Uncle Sam paid my airfare to Saigon.”

I pulled out a five, and Elton fell to the sidewalk. I dropped keys and papers and knelt next to him. He’d hit his head as he went down and was bleeding in an ugly way, but he was breathing, and I could feel his pulse in an irregular, feathery beat, like some fragile ballerina dancing against the music.

The next few hours were a blur of ambulance, emergency room, hospital admissions. They wanted a lot of details, but I didn’t know him except as the homeless guy who’d worked this stretch of West Town the last several years. About the only personal thing he’d told me was that he’d lost his wife as his drinking got heavier. He’d never mentioned children. Today was the first time I’d heard about Vietnam. He’d been a carpenter and sometimes still got daywork. As for health care, I couldn’t help the hospital with their paperwork. He was homeless. I hoped he had a green card for city health services, but I had no way of knowing.

I wanted to get back to my office—I’d been away ten weeks and had an entire Himalayan range of paper waiting for me—but I didn’t feel easy leaving Elton until there was some kind of prognosis or resolution in his care. In the end, it took two hours before an intern who was stretched to the breaking point came in, and that was only because I kept going to the triage nurse and pushing Elton’s case: his crisis, asking for oxygen, heart monitoring, something. He had regained consciousness while lying on the gurney, but his skin was cold and waxy, and his pulse was still very weak.

A white woman in her early thirties, who seemed to be caring for an elderly black man, gave me a wry smile the third time I went up to the counter. “It’s hard, isn’t it? The staffing cutbacks have been too steep. They just can’t keep up with the patient load.”

I nodded. “I just got back from a long stay in Europe yesterday. I haven’t adjusted—to the time zone or our health-care system.”

“Is he your brother?” She pointed toward Elton’s gurney.

“He’s a homeless guy who collapsed in front of my building.”

The woman pursed her soft rosebud mouth. “Would you like me to look in on him if they manage to stabilize him? I have friends at some of the homeless agencies here in town.”