A man slumped over his lunch tray and fell to the floor. Within minutes, a medical crew had arrived on the scene, set up a powder-blue privacy screen, and cleared away a table and chairs to administer emergency care.
Throughout the dining hall, most continued lifting forkfuls of mashed potatoes, broccoli, and shredded meat to their mouths, unfazed. Volunteers clad in aprons continued to set down heaping lunch trays in front of diners who held up laminated food tickets. At St. Anthony's, where between 2,500 and 3,000 hot meals are served daily to needy San Franciscans, this sort of thing happens all the time.
"A lot of our guests are subject to seizures, for one reason or another," Robillard told me by way of explanation. Behind him, a pair of medics hovered over the man's outstretched body, his face invisible behind the screen. "In almost all cases, they're fine."
Seizures are just one common ailment plaguing the St. Anthony's clientele, a mix of homeless people, folks living on the economic margins, and tenants housed in nearby single room occupancy hotels.
Jack, an elderly gentleman with a gray beard and stubs on one hand where fingers used to be, told me he'd spent years in prison, battled a heroin addiction, and sustained his hand injury while serving in the military. He previously held jobs as a rigger and a train operator, and said he became homeless after his mother passed away.
St. Anthony's staff members mentioned that Jack had recently awoken to being beaten in the head by a random attacker after he'd fallen asleep on the sidewalk near a transit station.
A petite woman with a warm demeanor, who introduced herself as Kookie, said she'd been homeless last August when she faced her own medical emergency. "I was in the street," she said. "I didn't know I was having a stroke."
She'd been spending nights on the sidewalk on Turk Street, curled up in a sleeping bag. When she had the stroke, someone called an ambulance. Her emergency had brought her unwittingly into the system. At first, "They couldn't find out who I was."
She said she'd stayed in the hospital for six months. Once she'd regained some strength, care providers connected her with homeless services. Now Kookie stays at a shelter on a night-by-night basis, crossing her fingers she'll get a 90-day bed. She's on a wait-list to be placed in supportive housing.
Kookie unzipped a tiny pouch and withdrew her late husband's driver's license as she talked about him. Originally from Buffalo, NY, she lived in Richmond while in her early 20s and took the train to San Francisco, where she worked as a bartender. She's now 60.
"When I was not homeless, I used to see people on the ground, and I never knew I would live like that," she said. "Now I know how it is."
Kookie: "I used to see people on the ground, and I never know I would live like that."
Guardian photo by Rebecca Bowe
HOUSING, HOUSING, HOUSING
Way back in 2003, DPH issued an in-depth report, firing off a list of policy recommendations to end homelessness in San Francisco once and for all. The product of extensive research, the agency identified the most important policy fix: "Expand housing options."
"Ultimately, people will continue to be threatened with instability until the supply of affordable housing is adequate, incomes of the poor are sufficient to pay for basic necessities, and disadvantaged people can receive the services they need," DPH wrote. "Attempts to change the homeless assistance system must take place within the context of larger efforts to help the very poor."