Who are Clive's friends? Latent sociality in the emergency department

Abstract

In the absence of social services and robust social networks, staff working at social service institutions serve as a significant element of sociality in the lives of a segment of people experiencing homelessness. Relationships forged within these institutions prove to be avenues of emotional support and material resources that facilitate the survival of some homeless people. To illustrate this point, this article draws on data collected over the course of 18 months between July 2014 and December 2016. I present an ethnographic case study of an elderly homeless man, Clive, who was labeled a “super-utilizer” of an Emergency Department (ED) in Atlanta, Georgia. This article explores how Clive's relationships with ED staff transcended professional obligations and enabled his survival during his estrangement from friends and family. I demonstrate that the ED, and hospitals in general, are better understood as human infrastructures that perform functions in excess of providing biomedical services. This sociality, I argue, is key to understanding how the most vulnerable individuals survive in the context of increasing social abandonment.