As it happens, the week before I gave this presentation, I was on my weekly "ride along" with the street outreach team, which was attached to our city's shelter. On these rides we would scour the streets and nearby woods to engage homeless persons in need of medical care. If someone was interested in treatment, we would make arrangements for the person to be seen in our shelter-based primary care or psychiatry clinic. On this particular day we came across an elderly gentleman who was lying in a garbage-strewn alley. His legs were crudely wrapped in gauze dressings, and he was smeared with feces. On his wrist was a hospital identification band revealing his age to be 77 years. He said that he had been admitted to our local hospital for several days to receive treatment for recurring, oozing cellulitis on his legs. Upon discharge he had been put into a taxi with instructions to go to the nearest homeless shelter. Unfortunately, by the time he arrived, he had missed the admission curfew. When we saw him, he had spent the previous 18 hours lying in the dirt, unable to stand. Next to him was a large plastic bag filled with sterile gauze wrappings and unopened medical tape. Before his hospital discharge he had been instructed to change his bandages once a day, fill his antibiotic prescription, and elevate his feet as much as possible.