Recently while visiting Melbourne, we dropped into a milk bar near our hotel to buy The Saturday Age. The other customer in the shop — an old-looking man with wild, grey hair and sun-coarsened features — was asking something of the woman behind the counter. I couldn't hear what the request was, but her answer to it was an emphatic 'No!'
The man thumped his hands on the sides of his Vinnie's suit pants and, screaming a string of expletives and racist slurs, he pushed past me and out of the shop. My 14-year-old daughter, shocked more by the intensity than the content of his outburst, had shuffled behind me as he was leaving. 'What was that about?' she asked, his ranting still audible through the front window.
My wife put her hand on my shoulder. 'Welcome home', she said to me with a smile. In the 1980s we had both trained at the inner-city hospital around the corner where this sort of interaction was a daily part of our life. Here was a survivor of a population that had been forced to move elsewhere by the invasion of middle class people like us.
My daughter, though, was having trouble disguising the fact that she could smell something awful. It was the pungent odour of the down-and-outer and its ability to linger after its source had moved on, that sent me back in time.
A large proportion of our patients were homeless men and women, mainly alcoholic. A few of them were 'characters' who were good fun to interact with. But most were very sad or very mad and essentially unreachable. They would turn up in the Casualty department throughout the day and night and I would sew up their lacerations, bandage sprained limbs, plaster broken ones and, on occasion, get them ready for neurosurgery to remove a clot from around the brain. I became proficient in the management of end-stage liver disease. It was not until I was rotated to another hospital that I learnt that alcohol-related problems were actually a little exotic in the mainstream medical world.
The homeless were usually brought to the hospital after they had been found in trouble by the police or by the ambulance. They rarely wanted the help we gave nor offered any thanks when it was provided. Their inability to look after themselves was often interpreted by the doctors and nurses