The sun has yet to break the horizon as we approach the two-family home in the heart of South Providence. This is my kind of moment: The normally hectic and loud streets succumb to the dead of night as the phosphorescent light envelops everything, blanketing all the noise and activity until daybreak. A house isn’t a home but for the people who live within its walls, and I suspect a lot of living has happened here. Places like this are everywhere in the city’s neighborhoods, well-kept multifamily homes, some dated, others freshly painted with ornate metal fences and gates offering some level of security and place to the people who make the best of their inner-city places of residence.
A trend has reappeared in this neighborhood, a wonderful resurgence bringing and keeping generations of family close together. Somebody buys a two- or three-family home, mom and pop live on the ground floor, the kids who own the place occupy the second and, if it’s available, the third apartment is rented, sometimes to another family member, to help foot the bills. The roots of my family were planted in much the same fashion generations ago, until time and prosperity divided the old from the young and single-family homes became the norm.
There is no gate here, no fence marking territory, just an old Ford parked next to the house. Paint has peeled from the siding, some windows need to be reglazed, and the old wooden steps give when bearing my weight. I notice the license plate as we walk past the car, a special issue from the state of Rhode Island that simply says Wounded Combat Veteran.
I walk into the home. An elderly couple lives on the first floor. It looks like they’ve lived here for decades. The space above them is empty—if anybody had lived up there, they were long gone, and nobody took their place. They are alone.
Slumped in a kitchen chair is our patient, an 89-year-old veteran named Joe. Engine 11 has arrived first, and an IV is already established, vital signs taken and high-flow oxygen is being delivered through a nonrebreather. Joe had tried to take a sip of his morning coffee, felt sudden weakness and spilled it all over his crisp white t-shirt. There is obvious facial droop and no strength on his left side when he squeezes my hands.
His wife of 50 years stands by, nervously wiping the spilled coffee from the green linoleum floor. “He goes to the VA,” she says.
As my partner, Adam, and the guys from the 11s help Joe into the stair chair, strapping him tight so he won’t tip to the left, I take his wife to the side. I hate doing it.
“When did you notice something different?” I ask.
“Right before I called you, about 10 minutes ago. He was fine, drinking his coffee like he does every day. But then he dropped it and couldn’t tell me what was wrong.”
“Joe is having a stroke,” I say as gently and quickly as I can. “If we get him to the proper facility, the damage can be stopped. We can help him, but the VA isn’t the best place for something like this.”
She starts to argue—insurance reasons maybe, familiarity more likely—but sees the urgency in my gaze and relents. Sometimes those closest to you refuse to allow the evidence of something terribly wrong into their minds until the last possible moment, holding out hope that everything will be OK. Subconsciously the truth cannot be so readily discarded. Joe is in very big trouble and likely will never come home.
“I’ll stay here and clean up,” she replies, nervously wiping the kitchen table where the coffee-stained paper sits, open to the sports section. There are no kids upstairs—where they went and if they ever existed, I’ll never know; my time with my patients is limited, and small talk is not an option with so much to do and no time to waste. I think of the new immigrant families who have taken so many of these houses over, teeming with kids, generations of people nearby, taking care of their elderly and starting their lives in their new country. I wonder if in a few generations they, too, will be alone, with empty floors above them.