After Insurance Issues Are Settled

There's a new man here to see you,” said Joyce, the nurse at the Toronto homeless shelter where I see patients once a week. “He just had his leg cut off. Says it hurts a lot.”

I stepped out of my small examining room and into the hallway of the shelter. Micah was sitting quietly in a wheelchair, his pants already rolled up to reveal his right leg, which had been amputated below the knee. He was a brown-skinned man in his late 50s. He looked tired, and his black hair and mustache were streaked with advancing lines of gray. I introduced myself and asked him what the problem was.

“My leg's paining me again where they did the operation,” he said. “And it's leaking.” I rolled Micah into the examination room and removed the dressing covering his stump. The tattered gauze had not been changed since his discharge from the hospital 6 days ago, and it was soaked with a thin, yellowish fluid. The dressing emitted the unmistakable, nauseating odor of infection. A line of surgical staples surmounted the reddened and tender ridge of his wound, the edges of which were beginning to pull apart at one end.

Micah told me his story. Almost 2 decades ago, he had left his home in the Caribbean and had come to Canada on a temporary visitor's visa. He had stayed on since then, working full-time as a cook at a small restaurant and living …