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Paul Rousseau


I think his name was James, but I can't remember for sure. What I do remember is the day's heat, the metal cart and a rust-colored dog. 

Like many homeless people, James carried his belongings in a grocery cart--a sort of mobile home for the homeless, but without the protection of a roof, the support of four walls or the security of a front door.

I'd just walked out of the local Safeway store into its parking lot. He ambled over from a park across the street. His eyes were narrow, his face tanned and his clothes dirty brown from weeks of sleeping in the streets.

Being a dog lover, I found my eyes drawn to the dog--a mixed breed with matted hair, worn eyes and gray hairs on his snout. He looked underweight; I guessed he weighed no more than thirty or forty pounds. He stood obediently by James' side, tethered by a rope leash. 

"What's his name?" I asked.

"He's Bob--best dog there is. In fact, best friend a man could have," said James in a deep smoker's voice. He smiled and rubbed Bob's back. 

Then he asked, "Can you give me some money so I can get some food?"

How many times had I been asked this question in this exact same Safeway parking lot? And how many times had I answered "No!" and kept walking? 

But this time felt different. James looked emaciated, and his plea seemed honest.

"Is the food for you, Bob, or both of you?" I asked.

"For both of us," he answered.

I thought for a moment, and then told James to tell me what he needed; I would go inside and get it for him. That way, I thought, he couldn't buy alcohol, cigarettes or drugs, and I would be sure that he and Bob would have a decent meal, at least for today.

James agreed and spouted off a small list.

After buying the groceries, I went back outside; James and Bob had seemingly disappeared. Looking around, I spotted them back in the park, walked over and sat down beside them. I handed James the groceries and filled two bowls for Bob--one with food, one with water. 

As they both ate, I somehow felt comfortable enough with James to ask how he'd ended up homeless and wandering the streets of Phoenix with Bob at his side. 

He told me he'd been a long-distance truck driver, with the truck being his only home for the past twenty or so years. For even longer, he'd also been a four-to-five-pack-a-day smoker, and an admitted lover of anything alcoholic.

"But I never drove when I was drunk," he said firmly. My brows raised in disbelief.

About six months back, while driving through Texas on a haul from Florida to California, he'd noticed he was shorter of breath than usual. When he coughed, bloody phlegm streaked his handkerchief of toilet paper. He'd continued driving through Amarillo and Albuquerque, then down I-17 to Phoenix. By the time he'd arrived in Phoenix, there were blood clots in the tissue, so he'd parked his rig at one of the local hospitals, checked into the emergency room and waited his turn.

Initially they'd been worried about a blood clot in his lung, given the long periods he spent sitting behind the wheel of his rig, so they ordered a CT scan.

"What did they find?" I asked.

"The doctor told me there were spots all over my lung. When I asked what that meant, he told me they looked like cancer."

Another CT scan done at the same time showed suspicious lesions in James' liver and "glands." The doctor referred James to an oncologist, but he had no insurance, wasn't from Phoenix and felt scared. It was then that he walked away from the rig, leaving it in the hospital parking lot, and began his homeless journey throughout the city of Phoenix and the surrounding suburbs.

"I wanted to live my final days free, not bothering anyone, not a burden to anyone."

I asked about his family. He'd been married once and had no children. Where his wife was now he had no idea. His parents were dead. He had two sisters, but didn't know their whereabouts.

I asked where he got Bob. 

"One day I was walking through Glendale and found this scraggy mutt wandering the streets," James said. That was six months ago, and they'd been inseparable since. 

He had only one concern about his illness: "I worry so much about what will happen to Bob."

Tears welled up in his eyes. He'd probably have to take him to a shelter, he said; he didn't trust anyone on the streets to care for Bob after he was gone.

I asked if I could help in any way--maybe try to get him in to see a physician--but he declined. I asked about hospice, wondering if any of the local hospices would take in a nomadic man with no address. Many times hospices will provide free care, I explained, and I would gladly see what I could do for him, because while he was able to get around now, his ability to care for himself would surely diminish in the future. 

Again James declined, but thanked me for my concern. Then he stood, thanked me for the groceries and said it was time for he and Bob to hit the road and find a place for the night.

"I appreciate your help, I surely do. God bless you."

He tugged at Bob and headed down an embankment toward the nearby highway bridge. 

They both turned, gave me one last look and disappeared underneath. 

I wondered if the story I'd just heard was true. But James had looked sick, and his story seemed legitimate; my heart begged me to believe it. What did he have to gain by telling such a story? Why would he lie?

I walked across the street and sat in my car for a few minutes, the cool, air-conditioned breeze blowing in my face. I vowed then to change things--to become an advocate for the homeless and terminally ill. I even envisioned finding some philanthropist to donate money so that I could provide hospice services at the homeless shelter.

But, like many dreams, this one dried up under the heat of the Phoenix sun and the demands of my own personal life. There were the long hours at work, the demands of caring for my daughters after the death of their mother, and the burden of my own grief.

I never saw James and Bob again, although I often looked for them. But to this day, their presence remains in my mind, a picture of loneliness, stubborn pride, bravery and the love between a man and a dog.

And maybe, just maybe, one day I'll develop that hospice for the homeless--and their dogs--with the things many of them so desperately need: the protection of a roof, the support of four walls and the security of a front door.


About the author:

A hospice and palliative medicine physician for the past thirty years, Paul Rousseau has had some 350 pieces published inAnnals of Internal MedicineJAMABlood and Thunder and elsewhere. "I've been writing my whole life, but I have used writing as therapy ever since the death of my wife. I enjoy writing about the patients and families who allow me the honor of entering their lives at such a frightening and vulnerable time."

Story editor:

Diane Guernsey