NEW YORK -- This was one of those city stories where all involved -- the ambulance crew and the hospital and the $H Emergency Medical Service authorities -- said the same thing, that it was unfortunate but that they had done everything they were supposed to do.
But when it was over in the morning haze, the stark fact was that a man had died on the sidewalk in the shadow of a hospital.
To hear his friends' rendering, Baltimore native William H. Black spent his last day unwittingly trapped in a Kafkaesque narrative. When he took sick Monday evening, his friends said they sought help across the street at the emergency room of St. Luke's-Roosevelt Hospital Center, but were told that doctors could not leave the premises.
They called for an ambulance, they said, but when Mr. Black waved off help, the crew said that there was nothing they could do, and, anyway, it sounded like a prank to them. When the sun rose Tuesday morning, Mr. Black was crumpled dead on a sidewalk grate.
He was known as Billy or Pop, and he lived 55 hard years. His home of late was where his life ended -- the sidewalk. He and his friends were homeless, and they drank a lot.
All of them were "canners." Dozens of them spent their days rambling along the streets of Manhattan's Upper West Side rummaging in garbage and transporting their finds in shopping carts to supermarkets. The proceeds -- $10, $12 on a productive day -- kept them stocked in beer and wine.
Mr. Black was particularly close to Bobby Tunkins, 44, and Lala Wigfall, 26. The friends slept beneath scaffolding at 113th Street and Amsterdam Avenue, in front of offices of doctors affiliated with St. Luke's. Directly across the street was the hospital. Without actually living in the complex itself, one could hardly be nearer medical care.
Memorial in Baltimore
This afternoon, relatives of Mr. Black will gather for a memorial service at the Leroy O. Dyett & Son Funeral Home on Liberty Heights Avenue in Baltimore. But when the service is over, they will still be left with lingering questions over Mr. Black's death.
"We cannot understand how this could happen by the doorstep of a hospital," said Mr. Black's younger brother, Armstead Black of Catonsville. "If someone is on their last moments of breath, you have to help."
The son of a steelworker and the oldest of six children, Mr. Black grew up in north Baltimore and held numerous jobs, including one at the former A&P; supermarket and another at a mattress factory, his brother said.
In the mid-1970s, Mr. Black lost his job, started drinking, had some brushes with the law and was divorced. He has a daughter, Lisa, of Baltimore.
In 1977, he moved to New York to work with Armstead Black, who managed a men's wear factory. But the factory closed in 1980 and by the late 1980s, Mr. Black fell back to his drinking ways and into the streets.
Armstead Black said the family lost contact with Mr. Black about seven years ago. He said a friend ran into his brother on the New York streets earlier this year, but the family had no way of reaching him.
"He just went backwards," Armstead Black said. "I just assumed fell from grace again."
Last full day
For years, one day seemed much like another for Billy Black and his fellow canners. Monday started out no differently.
They awoke under the scaffolding at 7 and headed down the block toward 115th Street and the piles of garbage where they habitually began their compulsive pursuit of cans. Then they prowled the side streets.
Around noon, his friends said, Mr. Black felt ill and achy, and he vomited blood. But they plodded on.
About 4 in the afternoon, they returned with their carts to the scaffolding to sort the bottles from the cans before cashing them in. Mr. Black was too ill to do his load, Mr. Tunkins said.
Mr. Tunkins said he later walked to the St. Luke's emergency room on 113th Street. He spoke to a person he said he took to be a security guard, telling him that a friend was sick and needed help, and was told that emergency room staff could not leave.
Hospital officials confirmed the rule that to leave the emergency room would violate hospital policy.
"That would be counterproductive to the mission of the ER, confusing and a waste of time," said Barbara Quinn, the manager of media relations for St. Luke's. When someone comes to the emergency room seeking help outside, she said, the hospital tells them to call 911.
After leaving the emergency room, Mr. Tunkins said he asked an EMS technician outside if he could help, but the man replied that he was too busy.
Next, Mr. Tunkins called 911 from a pay phone. The Emergency Medical Service received the call at 7:36 p.m. Using defined criteria, EMS technicians rank calls from 1 to 8, with 1 being something like a heart attack that would merit top priority and an 8 being something in which speed is inconsequential, like the removal of a dead body.
This call was given a 7 and entered as a "minor sick." An ambulance roving in the area responded to the call at 7:43.
Accounts vary
Here, the accounts of the next few minutes vary sharply.
Mr. Tunkins said: "When the ambulance came, Billy was out of his head, because he was sick. He didn't even know me. He said he didn't want to go, but he didn't know. I told them, 'Man, check him.' They wouldn't check him."
Ms. Wigfall: "They said we were faking. They said we all were drinking. 'The man is really sick,' I told them. They said if we called again they'd have us arrested."
Mr. Tunkins: "They told us to move on. To move on like we were dogs. They were here like five minutes."
The crew members were Tom Eppinger and Alexander Loutsky, and they stayed six minutes. They declined to be interviewed, but EMS and union officials who spoke to them gave this as their account: When they arrived, Mr. Black seemed lucid and told them he did not want an ambulance. They did not see blood. They did not think he was sick.
EMS officials, who are investigating the incident, said the crew followed the rules. "We don't have a mechanism in place to force someone to go to the hospital," said David Bookstaver, an EMS spokesman. "He was an RMA -- refused medical attention."
When Mr. Tunkins and Ms. Wigfall awoke before 7 the next morning, they found Mr. Black unconscious. They called 911 at 7:21, and EMS gave the call a No. 1 priority. Before the ambulance got to the scene, however, EMS said police canceled it because they had checked and found nothing.
Mr. Tunkins called again at 7:37. This time the ambulance arrived in two minutes. The crew pronounced Mr. Black dead.