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“Coffee George”
– As told by Dr. Sheryl Fleisch
An avid bicyclist, “Coffee George” rode across the United States before settling in Nashville and falling into homelessness.
Before his death from unknown causes in 2019, he made an indelible impact on the outreach workers who knew him—people like Dr. Sheryl E. Fleisch, a psychiatrist who directs the homeless psychiatric health services at Vanderbilt University Medical Center.
She tells his story. He is referred to by a pseudonym to protect his privacy.
An Invisible Man
Each year we have a Point-in-Time (PIT) count where cities across the U.S. count individuals experiencing homelessness—sheltered and unsheltered. In 2015 I was assisting Nashville’s PIT count, and my team was walking by a bridge at 2 a.m.
We ended up passing George.
He was in a blue sleeping bag, and in hindsight, I think he wanted to remain invisible. He blended into the scenery, and that’s why we passed him the first time. He had a terrible cough. He probably had pneumonia at the time. He had just moved to Nashville and was middle-aged, and had experienced homelessness for about 13 years. He told us he rode his bike everywhere.
I tried to assess him for psychiatric illness, but it was really hard because his cough was so strong. But he allowed me to check his oxygen and pulse, and I talked to him about different options—going to an ER or a clinic or taking antibiotics. He agreed to antibiotics, and when we returned, he took them.
I ended up following up with him on the street the following week, and he was doing much better. But every time I would see him subsequently, he would just give me a head nod—he was difficult to engage.
In their own words:
“He kind of grew on you.”
Building a Relationship
However, as the years went on, he would ask for very small things like bike parts and coffee, and he seemed to trust us a little bit more… Then, gradually, he engaged with more of our team and agreed to vaccinations we provided on the street. He would make us laugh, and he loved when our team would stand up to the police when they asked us to leave.
I think my best memory is of that. There was one time when the police were… not terribly happy that we were in one location. They came up to us, and I stood up to them. He thought this was fantastic, and he laughed hysterically. He was thrilled. It turns out that we were both born in the same place, and we had similar memories. It was one of the first times that he really opened up.
He told us he had experienced police harassment on the street and fights with other people. I think he saw those things as just part of life.
He told us that he hadn’t seen a doctor for 15 years. I think he distrusted the medical system in general. He was very proud and self-isolating. He only wanted to go to doctors if he really felt he needed it, and he did not feel sick enough.
If he could walk at all, in his mind, he didn’t need a doctor.
When we would see him on the streets, we could go to him, and we were in his environment where he was more comfortable. He was by his bike, his coffee, and his tent, and if he only wanted one of us there, then only a couple of us would be.
A Proud, Private Man
I don’t know where he was from originally. He was a very private man, a very proud man. He enjoyed travel, bicycling, the outdoors, wood-shopping—very manly things. He always kept his tent and his area very clean. He never asked for anything from anybody. He was always extremely reluctant to take anything. And he was always very reluctant to engage. But he was extremely likable, and he grew on you.
His two favorite things in the world were bicycling and coffee. Period. And we nicknamed him “Coffee George” because he drank so much coffee. If we went to his campsite, we would try to bring him bike parts and coffee—those were the only things he wanted. He would ask for coffee—hot coffee—even if it was 110 degrees outside. We’ve had patients before that love smoking as the thing most in their life.
This man loved coffee.
It would put a huge smile on his face. And he would show us all of his bike parts. He’d open up a tool bag, and he would have every possible size of screw or wrench, and he was so proud to teach us about it. We would all just sit there and listen, you know? Going there was like gaining a lesson.
Our understanding is that he rode his bike around the United States, ending up in Nashville. And so he gained a lot of that knowledge. But it may well have been part of a career. He was not somebody to share that past life with anybody, so we really don’t know. But we felt like it was a gift when he did share. It was like you had earned a right to learn it, and you gained that insight.
When he spoke, you listened. And when he did accept something, a.) you knew that he really did need it, but b.) you felt like you had just earned something because he had accepted it. It was a very reciprocal relationship. One of our fourth-year psychiatric residents, Danny Nygren, wrote about him:
Although he came off as rough and even curmudgeonly at times, there was something really lovable about him. I always looked forward to visiting that campsite to see how he was doing, what he was fixing on his next bike, and just to hang out with him. One of my favorite times with him was when we were walking back to our cars to get a spare tent we had, when he spotted a snake in the grass.
Not only did he have the eye to spot it, but he had the bravery to go and catch it with a stick. Much to the medical students’ displeasure, he was holding the snake in one hand and using another stick to… prove that there were no fangs and the snake was not poisonous. All the while the snake was squirming around. It definitely made me laugh that he was so cool and not afraid of the snake like I would have been. I’ll definitely miss him.
“I think when I first met George and provided him with an antibiotic and he accepted it, it felt like hard work, and it was a relief—I felt a sense of relief that he wasn’t going to die that night. But over the years, I learned that while there is some immediate gratification in providing the antibiotic, it was really about the value of the long-term relationship. There isn’t necessarily a curative process with homelessness, and homelessness itself can lead to death. But originally, I was just relieved, and that was a sort of self-righteous, perhaps selfish relief.
Over time I learned that there was greater value in long-term hard work put into developing a rapport over time—something that may come with a bag of coffee. We don’t consider the items that we give to people donations; we call them engagement items. We have those items—like coffee for George—for specific people, because we know they will allow us to build rapport with them.
And when we walk up to a campsite we can say, “Hey, we have some coffee. How are you doing today?” And it helps us engage them. It’s like if I know your favorite sandwich is a grilled cheese sandwich, and if I might have one ready for you when you meet me for coffee. It’s very similar to that. That’s what we had for him.
And I think for us success was not necessarily getting him housed, but simply building a rapport with him over time. It was learning about him and understanding his needs, which maybe one day would have led to being able to address his medical needs.” – Dr. Sheryl Fleisch
In their own words:
The origin of “Coffee George.”
A Lonely Death – And a Coffee
As the years went on, he began to look thinner and much worse. We always recommended that he see somebody, but he declined. I think his death was still surprising. A couple of weeks ago, we learned that he was found dead at his encampment, and I think the worst thing was that he was found totally decomposed. I later learned that his cause of death was likely related to another disease process and perhaps affiliated with his long-term homelessness. I can surmise [what his cause of death was], but I don’t think I would like to here.
Since then we’ve been working with medical examiners to try to figure out how we can formally identify him so that we can help bring closure to the community. Even though everybody knows it’s him, the examiners cannot identify him. It’s hard for us to provide identifying information, because we don’t know a lot about him—even though we probably knew him most.
I still have the coffee we were planning to give him at his next visit before we found out he died. It’s sitting here in my office right now, and it has his name at the top. I see it every day. It’s very sad that I have the coffee sitting here, and it shows how much we knew him—and how close we were.
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