A forty-five year old man lays slumped against the storefront of the Erotic Palace. He is out cold, drooling. He clearly has done some drinking from the smell of his breath. Doesn't respond to a sternal rub. We take his jacket off so we can get access to his arms. No track marks. He is clutching a small box in one hand. We get him up on the stretcher and then into the back of the ambulance, and get him stripped down on the top. His pupils look pinpoint, but he doesn't respond to narcan, which I give him in two doses, .8mg, then 1.2mg IV. His blood sugar is 244. He is tachycardic at 120. His blood pressure is fine. His respirations are snoring so I put in a nasal trumpet that slides in easily and helps with his breathing. In his wallet there is a non- driver's ID card, and a mental health clinic appointment notice.
I look at the box, which sits by my clipboard now. There is a gift bow around it.
In the ER, I give my report, running down what I have done. The doctor and nurses ask many questions.
"The answer," I say, "is in here." I open the box and show it around.
A small diamond ring.
"It's his heart."
