‘Million Dollar Baby’: Homeless Woman’s Horrific Plight Reveals SF’s Broken System

by Gil Duran

Mary Gilbert says she once worked for the San Francisco Municipal Transportation Agency, doing part-time office work at a bus station near Fisherman’s Wharf. Today, she lives on a bench at an abandoned MUNI bus stop in the Financial District.

Unable to walk due to a severe infection in her legs and feet, the 56-year-old befriends office workers who bring her food and water. When the infection becomes critical, ambulances transport her to local hospitals. She is a frequent visitor who needs ongoing care but, after a few days or weeks as a patient, she is sent back to the bus stop. Last year, she said, Saint Francis Memorial Hospital released her on Thanksgiving Day.

Homeless without access to wound care, Gilbert’s legs swell and his infected wounds seep through dirty bandages. She stays at the bus stop until the cycle repeats itself: ambulance, hospital, and back on the street until her rotting wounds necessitate another call to 911. The Medi-Cal program of the state pays the bill.

Gilbert’s story illustrates the challenge of providing care to the most vulnerable among California’s estimated 161,000 homeless people. Despite unprecedented efforts and billions of dollars in new spending, including more than $1 billion allocated to San Francisco, people like her fall through the cracks of a system that often seems designed to fail.

Without housing or sustained medical care, Gilbert has few options other than death on the streets. She’s suspicious, stubborn, and fiercely independent after a decade of homelessness, but her strong personality doesn’t absolve the city’s public health system of allowing this horrible situation.

“I’m a million dollar baby,” Gilbert said, estimating how much his serial hospitalizations were costing taxpayers. “We’re not just talking about a room and food. They detail painkillers and bandages. It takes an hour to heal my wounds, and we’re not even talking about CT scans…MRIs…X-rays.”

I met Gilbert in September. As I was walking to catch a bus, I heard a voice say, “Excuse me. I continued, but she became more insistent. When I stopped, Gilbert handed me $40 and asked me to bring him the fried chicken from Wayfare Tavern.

Fried chicken at Wayfare Tavern — number 8 on Food & Wine magazine’s “Best Fried Chickens in America” list — costs $40 with tip. So I went back to make sure Gilbert didn’t mean Irish Times chicken strips, which were closer to $15.

“No!” she said, annoyed. “I want chicken Wayfare Tavern!”

I went to look for the bird and learned its story.

Mahalia “Mary” Gilbert grew up in the East Bay. She once worked selling antique jewelry on the peninsula, and she moved to San Francisco in 2002. For years, she lived in a single-room hotel on Nob Hill and held various jobs. During the Great Recession of 2009, she said, MUNI laid her off and she lost her home.

“I held on for a little over a year,” she said. “There is no manual for this. I didn’t know where to go.

After bouncing around in shelters, she ended up on the streets, where she survives on help from strangers and a monthly Supplemental Security Income check.

In 2013, Gilbert suffered a pulmonary embolism and developed cellulitis in his legs and feet. The bacterial infection has progressed to the point where she can no longer walk. She stays in the Financial District because the office crowds during the day mean there are more people around asking for help.

From his perch at the disused MUNI stop, against a majestic backdrop of Corinthian pillars, Gilbert has built a network of supporters. Regular visitors include a barber, a policeman, a lawyer, a marketing consultant and a tech support specialist – as well as a pair of pigeons she calls “Lady Bird” and “LBJ”. Sadly, Gilbert’s fate remains unchanged despite the best efforts of these people, who know her as a compelling and knowledgeable conversationalist.

After St. Francis sent her away on Thanksgiving, Gilbert’s outraged supporters launched a determined effort to help her. On December 3, a group of them gathered at the bus stop, joined by members of the San Francisco Homeless Outreach Team and a fire crew. Hoping things might change, Gilbert’s friends watched as paramedics loaded her into an ambulance bound for hospital.

I visited her at St. Mary’s before COVID rules halted tours. The sight of her safe and warm in a hospital bed, with the Sutro Tower looming in the distance outside her window, provided a stark contrast to her life at the bus stop. She kept everyone updated on her progress via text, sending photos of her injuries and signing “Mary from the Bus Stop.”

This hospital stay lasted two months.

“[Hospital] wants 2 to unload me, blisters and all,” Gilbert wrote on Feb. 7. “HOT TEAM came 2 days. Nothing 2 offers except one [room] they are not sure they can get.

On February 9, she was again at the bus stop. Hospital staff had accused her of resisting treatment, she said, and had also threatened to place her under guardianship if she stayed. The incident reinforced Gilbert’s view that the system is rigged to deny medical care to seriously ill homeless people – and she’s not entirely wrong.

“I think the system is reluctant to provide services,” said Kelley Cutler of the San Francisco Coalition on Homelessness.

Despite increased discussion about whether California should expand the use of guardianships to take control of the lives of homeless people, Cutler said we currently don’t have the resources and personnel to take adequately cater for homeless people with severe needs.

“There’s a huge need for different levels of care, but often there aren’t things in between, so there’s really not a good choice for people,” Cutler said.

“While many committed city workers are working to address this public health crisis, the homeless revolving door will continue without a clear and coordinated plan for long-term placements,” said Sunny Angulo, chief of staff. from supervisor Aaron Peskin, who tries to help Gilbert. “We have a lot of short-term solutions, but not a lot of options for homeless residents with multiple health conditions or specific behavioral health needs.”

Gilbert wants a room in an ORS hotel and access to regular wound care. It seems reasonable. Some homeless people got hotel rooms during the pandemic through the Roomkey project, but she spent the entire time shuttling between hospitals and the streets.

“I realized the system would let me die here before I even got an offer of decent housing,” she said.

A 2018 state law prohibits hospitals from dumping homeless patients with no place to go, but it clearly isn’t working. Saint Francis and St. Mary’s, both operated by Dignity Health, did not respond to requests for comment. The University of California, San Francisco Medical Center, which has also fired Gilbert on several occasions, said in a statement that it was following the law.

“Given privacy protections, we cannot comment on any specific patient, but we have a number of protocols in place to provide appropriate discharge planning and services to all patients, including resources and, when clinically indicated, placements in skilled nursing facilities or adult residential facilities. “, we read in the press release. “For example, for homeless patients, we provide resources upon discharge, including weather-appropriate clothing, food, medication, and transportation as needed, as well as follow-up care and community resources.

“Let’s move on,” Gilbert replied sarcastically when briefed on the hospital’s response.

The ruthless hospitals and inept government deserve much of the blame, but Gilbert’s choices also complicate matters. Like many homeless people, she packs her belongings into an assortment of bags and boxes that she insists on keeping close at hand. This prevents him from accessing facilities that do not allow people to bring their belongings.

Gilbert avoids shelters due to bad past experiences. She told me she also turned down the idea of ​​going to skilled nursing facilities in Los Angeles and Petaluma because she didn’t want to be stuck in a foreign city (and because she doubted that the offers were real). Additionally, she is still unvaccinated, although she said she would consider vaccination if it meant moving into housing.

Lisa Gruzas, who works downtown and has defended Gilbert, expressed frustration with a bureaucracy that offers no options beyond endless ambulance rides.

“I don’t know exactly how this is designed to work, but I can tell you that none of this makes sense to me,” Gruzas said. “The city has a lot of money and needs to understand that. I’m not interested in criticizing anyone when I don’t have the full story, but I’m disappointed in the lack of commitment to Mary.

For now, Gilbert remains at the bus stop, enduring the cold as his wounds fester under dirty bandages that haven’t been changed in over two weeks. But she is wary of hospitals now that St. Mary’s has raised the possibility of imposing a conservatorship.

“I’m not sure, with the way they threatened me with medical guardianship to take away my rights to make medical decisions for myself,” she said. “I’m not comfortable going back to the hospital because there’s this threat.”

Gil Duran is the editorial page editor of the San Francisco Examiner. [email protected]