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HOTELS or SHELTERS
Part 4
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"Patient dumping" is a real and serious issue in healthcare.
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- Oftentimes, a hospital or facility discharges a patient who still needs care without ensuring a safe, appropriate place for them to go.
There will always be people who choose not to be housed or cared for. We cannot always prevent people from making a bad decision. But that doesn't mean a better option shouldn't be available.
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Under the Emergency Medical Treatment and Labor Act, hospitals must evaluate and stabilize patients in the Emergency Department. They cannot refuse care based on the patient's ability to pay.
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- However, EMTALA does NOT guarantee a safe discharge destination. Once “stable,” hospitals can legally discharge—even if the patient has nowhere appropriate to go.
Hospitals are not designed to solve homelessness at the end of life—
but without places like HOMH, patients fall through the gap.
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-Meet Butch-
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Anyone who knew Butch will understand that his story requires more than one part. And for those who did not know him, you'll understand the need for two parts after reading.
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Butch came to Heart of Mary House just before Thanksgiving in 2023. He was fifty-eight years old but appeared much older. As a teenager, Butch was in a car wreck that resulted in the amputation of his left leg below the knee.
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Pain medication overtook his life, which eventually led him to poor decisions and three decades in prison. He was released on Christmas Eve in 2021. He had been baptized in prison and began a relationship with Jesus. However, after reentering public life he was faced with the same struggles that had haunted him before prison.
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Directly after his release, Butch went to stay with his parents, and then with his son and his family, and with each stay, he ran away when adversity struck or if he felt restricted in any way. The winter of 2022 chased him down to Florida and he found the community life he was searching for living in tents. He was also lovingly welcomed by a catholic homeless shelter in Fort Walton.
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He stayed in Florida for nearly a year. Due to health complications, Butch began to make his way back to Tennessee, in hopes of being closer to family. Enroute, and close to town, he was rushed to the emergency room with chest pains and difficulty breathing. He was admitted to the hospital and was found to have 6% function of his heart. He was too proud and stubborn to go home with family. His sons had been completely estranged at this point and his parents were too frail themselves to provide the care he needed.
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Butch had been medically stableized and was now needing to be discharged. Facilities were denying him due to the drugs in his system on admission to the hospital. The case manager was hesitant to send the referral for Butch to HOMH with his social and drug history, but once she called me, there was no hesitation on my part.
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I have very vivid memories of Butch. One particular memory was the day he arrived. I was going through some practical information, getting him oriented to the space and answering any questions. I remember him being child-like. Not in an immature way, but in the way that he seemed a little frightened and intrigued by his new surroundings. I told him he was on the campus of a Catholic church and that the church was just a few yards from our house. This really excited him. He began to describe how whenever he had shortcoming in life, Catholics always seemed to be there to help him. I will never forget when he shared with me how much it meant for him to get to be a part of a parish community. He said he has always seen how parishes came together to serve others and do things for one another. It also surprised me because I knew he was not talking about being on the receiving end; he was excited about participating as a volunteer in the parish.
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As the admission process continued, I began helping him get cleaned up and changed out of the old clothes he arrived in. He had taken his shirt off and as I was entering the room from behind him, I noticed a horrific scene on his back; devils and demons tattooed from shoulder to shoulder, but as I came around in front of him, I was overwhelmed! Butch had a large tattoo on his chest of Our Lady holding Her Immaculate Heart with angels on either side. He had already shared with me earlier that he was not Catholic. I asked why he had chosen to get a tattoo of Our Lady. His response is forever imprinted on my soul:
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"All the bad stuff in my life, I've left all that behind me. And I figure she (Mary) was the first person who ever really knew God. So, I think she can lead me to Him. That's why she is always in front of me."
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It was one of the many moments at the house where I was left from head to toe with chill bumps (Holy Spirit bumps).
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I let him know that his analogy was beautiful and that in the Catholic tradition we called it a Marian Consecration. The Lord was really up to something here! Butch was wise, and he understood more about the Church than most Catholics. Although his mind was sharp, his soul was fragile. The way he spoke of the Church was as if he felt unworthy, but not that he felt unwelcome.
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Butch understood my role at the house and respected it. Authenticity was a critical attribute when caring for him. We shared many unspoken connections, despite living completely different lives. I have never experienced homelessness or prison, yet Butch and I seemed to bond instantly over common interests.
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For the first few days, Butch loved every minute at HOMH. He was on top of the world with his newfound community. He loved getting to know all of the people coming in and out and everyone loved getting to know him too! He was a fantastic storyteller and always had a captive audience.
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But the enemy was lurking and telling Butch many lies, such as, "He did not deserve to be at HOMH" and "If we really knew him, we wouldn't like him so much." Like clockwork, as so often happened in Butch's life, boundaries, constraints, and loss of control were overcoming his peace and he wanted to leave.
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It was the Friday after Thanksgiving and I had been driving my college son back to school. Butch was having a very rough day. He had packed his bag, and was waiting for the hospice nurse to arrive and discharge him from their services so he could leave. I felt responsible even though I was not there. This was the first time since the house opened that I felt truly helpless and I had to surrender Butch's future and his decisions to the Lord. I prayed that Our Lady was barring the door so that he would stay until I could arrive.
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All throughout my drive, I was praying non-stop and communicating with the house. Once I arrived back at my own house, I ran in and made a plate of our delicious family Thanksgiving leftovers. Many of my conversations with Butch had centered on good southern food, and I heard from the house that Butch was triggered because one of our male caregivers (whom he felt intimidated by) had eaten all the Thanksgiving turkey. Butch took great offense to this. Simple enough, I loaded him up a plate of Turkey from my house, grabbed three of my younger kids (ages 6, 8, and 10), and we set off for Heart of Mary House.
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I honestly had no idea what we would be walking into, or to what degree things had escalated, but I was never concerned for my children's safety. I knew in my heart I was supposed to bring them. I felt very deeply that they would serve as a balm for Butch's wounds. We walked in and Butch was at the table with the nurse from hospice. His bags were packed next to his wheelchair. I did not acknowledge the day's events or that he wanted to leave. I just told him I had brought him all kinds of food and that I hoped my turkey was as good as his Mama's!
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Just like they always did, the kids got coloring books from the drawer and sat down at the table to color. This was their first time meeting Butch but they had spent countless hours at HOMH and were very comfortable there. Butch seemed a little taken aback by their presence. I had thrown him a curve ball. He asked them their names and even said something about how much he appreciated their mother. With that, I knew he was turning a corner.
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He had an expression of authentic gratitude that made me certain he would stay with us until the end. This gratitude is always the beginning of the veil being lifted and the residents finding true peace. The same is true for each and every one of us. We do not have peace in our hearts when we can't find gratitude in our lives. Once we find this peace, there is no turning back. Everything in front of us looks totally different. This is exactly what Butch experienced.
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The authentic love and looking at him as Jesus in disguise, was likely the sword that pierced his heart. Shortly after the kids and I had arrived at the house, he reached down into his packed bag and pulled out some small handheld games and paper crafts and handed them to the kids. He told them he had been holding onto them in hopes of giving them to his grandchildren in case he was ever able to see them again, but with tears in his eyes, he said "that would likely never happen."
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The authentic love was either something he had never known before, or something he recalled from his days of youth but could not pinpoint. By offering Butch mercy, the lies of Satan were uprooted from his heart. He began to understand that the Father does not expose us and bring shame upon us; rather, He reveals the truth and redeems us, so that we can be cleansed by His love.
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Butch had believed the lie that showing his 'true' colors would certainly mean he was no longer welcome at the house. His life-long pattern of feeling restricted, becoming enraged, and fleeing without anyone to chase after him was broken by the love and mercy of Heart of Mary House. By offering authentic love to Butch, he was reminded of his inherent dignity and value, regardless of his past.
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Shortly after the kids and I arrived at the house, Butch reached down into his packed bag and pulled out some small handheld games and paper crafts and handed them to the kids. He told them he had been holding onto them in hopes of giving them to his grandchildren. With tears in his eyes, he said, "That would likely never happen."
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He then wheeled back into his room and unpacked his bag.
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