At our hospital we have a couple of neighbors who pass by our back door more than a few times a week looking for some spare change and a little conversation. They’re homeless and alcoholic and we generally try to hook them up with what they need at the time—though we know they’re likely to buy beer when we give them money instead of food.

It’s an increasingly common problem—even for suburban Miami. And it’s always tough to handle personal interactions with someone you know needs more than just a couple of bucks here and there to survive.

Today’s situation was worse than usual, though. One of our homeless friends had managed to slice open his foot a few days ago and the wound was now gorily infected. His skin was discolored over his swollen foot and the gash looked mighty angry.

He’d been walking around shoeless recently, which is how I guess this happened in the first place. I explained that he’d have to get on the bus and get himself to the hospital immediately. But he claimed he couldn’t handle five hours in the hospital waiting room without his beer. I didn’t doubt this for one second.

This might surprise you, but we vets find it difficult to pass up a chance to fix a wound—human or animal. It’s one of those practices that’s well within our skill set when it comes to most any species. And this guy needed help as much as any cat or dog with a barbarously mismanaged wound. But there was no way I could do anything for him beyond having him soak it in a pan of hot, disinfectant-laced water and handing him a tube of non-prescription triple-antibiotic gel.

So you know, there’s no Good Samaritan law that protects vets in these cases, even when appropriate professional help is effectively unattainable. In general, I don’t object to this, though I’ve heard some terrible stories that have made me think otherwise.

I even know one vet who was sued after he applied CPR to a dying man on an airplane (no human medical person volunteered on a plane full of more than 200 people). The man survived—due primarily to this vet’s intervention. But the vet was nonetheless sued for the broken ribs and miscellaneous bruises he inflicted in the process (to be expected with effective CPR on an elderly person). I guess that’s why no human doc volunteered. They know better. And that's a sad statement on the realities of medicine in a legally charged world.

The conundrum in today’s case is that my homeless friend will probably end up losing his foot because I don’t want to lose my license. He’ll never go to the hospital because he understands that waiting in an ER for more than a couple of hours (where they don’t allow alcohol) will eventually make him seizure. That’s just the reality of end-stage alcoholism.

So I told him to buy beer and stash it in the bushes nearby then sneak out every half hour or so to down some more. This was too complicated a plan for him, apparently. He stalked off, barefoot, to make his usual rounds. I seriously doubt I’ll be seeing him around much after today. At this late stage in his disease, losing a foot is tantamount to losing his life. But maybe that’s what needs to happen so he can finally rest in one place.