Courage

He is on his back on the ground, sneakers next to a backpack covered by two or three blankets, under a tree, behind a hedge, next to a million dollar building, next to a multibillion dollar university, near a well groomed public park.  And I think he has courage.

Many wouldn't agree.

Courage to go back to his "spot" every night and lie on the ground to sleep with his paltry assortment of wordly possessions and not take his own life.
Bravery for continuing on in this difficult life despite having nowhere to lie his head at night.
Fortitude in staking out a relatively safe campsite, likely waiting to return after cover of night and leaving before too many workers come in and ask him to leave.

Is there room at the shelter?  Probably not, or perhaps he has been robbed there, or it could be too overstimulating for him, or he has used up his time there.

How does one have the courage live day after day having no shelter, nowhere to wash, lacking the basic comforts of stability, to be able sit without needing to move time after time?  I cannot think of a more fearful situation and yet this person still continues on, likely in fear, likely self medicating to overcome the constant uncertainty.

Yet if he were to come to the ED and say he were suicidal we would be concerned.  We should prevent him from taking his own life, we should hospitalize him until he feels less suicidal, then discharge him back to the street again, the same situation, the same fear, and feel vindicated that we "intervened", we prevented him from suicide.  Yet nothing has changed.  His courage was sustained by four days in a hospital with food, and clean clothes and a shower, and warmth, and company.  Another week of bravery, another week of soldiering on, until it rains, until the snow falls, until the gnawing hunger and instability causes him to lose heart and go to the ED again, or not, and he is found on the ground, under the tree, behind the hedge, beside the million dollar building in the heart of a multibillion dollar university that studies such things..........