Maté describes an addicted woman named Eva. In the throes of drug withdrawals, she moves clumsily and makes odd, sudden movements with her arms and legs. Eva is on Hastings street, and for Maté, her movements are a familiar sight he calls the Hastings shuffle.

He sees a wheelchair-bound man named Randall, who talks in an erudite stream of consciousness, reciting facts, historical dates, and paranoid stories. Next to Randall is Arlene, an addict who works as a prostitute for drug money. Self-administered slashes cover her arms.

These addicts are all outside the Portland Hotel, where they live and Maté works. His clinic is on the first floor. Maté is the staff physician for the nonprofit Portland Hotel Society (PHS). When his son Daniel arrives to pick him up, Maté tells him that he can’t believe his life, as he thinks about all the stories he has encountered that day.

Liz Evans also works at PHS. She is a former community nurse who says that “People need a space where they can exist without being judged and hounded and harassed” (11).

The PHS began in 1991. Its operating principle is to shelter those who would be homeless otherwise. Over 90% of the residents have criminal records, and 36% are either HIV positive or have AIDS.