On December 27, 2006, Kushel and Miaskowski1 introduced Mr K, a 66-year-old African American man who has lived on the streets for nearly 50 years and for most of those years has used heroin and other illicit drugs daily. Mr K was diagnosed with advanced renal adenocarcinoma in February 2002 at a large urban hospital. For unclear reasons, resection was made contingent upon cessation of drug use and was not done. Thereafter, Mr K was lost to follow up for almost a year, until he presented to the emergency department with abdominal pain and heroin withdrawal. He was then referred for palliative care to Dr E, in the hospital's palliative care clinic.
Markowitz AJ, McPhee SJ. End-of-Life Care for Homeless Patients: “She Says She Is There to Help Me in Any Situation”. JAMA. 2007;297(3):305. doi:10.1001/jama.297.3.305