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The forgotten patients: When missing people are just lost

Veronica Bonales, MD
Physician
April 7, 2025
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I am a true crime buff, and I work in the emergency department. Sometimes the two seem to blur together.

In my career, I have followed my patients to the coroner’s office, going to see the autopsies on traumas, sudden deaths, or sometimes murders. We can do CT scans or MRIs. I can look at images and labs galore, but there’s nothing like looking at a fresh dissection to really appreciate the traumatic or natural process that led to someone’s death.

In the ED, we see a lot of human drama. We see people at their worst. We see dysfunctional families. We see the problems of substance abuse and mental disorders. We see those who get “lost in the system” or who are simply “lost.”

It’s amazing how many family members didn’t know anything about their loved ones until they got a call from the ED. So many times, I have called someone only to hear that it has been months, years, or even decades since they last had any contact with their family member.

One recent patient hadn’t been in touch with their family for over 15 years. Their mother didn’t even know if they were still alive until we called to ask her to make a decision about continuing or stopping care for her fifty-something child—a child lost to them because of alcohol abuse. They had been found on the streets and taken into a care facility because they were no longer able to care for themselves. Drugs and alcohol had destroyed their brain and liver, and now their body was shutting down. Somehow, someone found their mother’s phone number and made the call.

I’d like to say this was an isolated case, but so many others come through the ED, lost to their loved ones, their family members, and everyone else. You sometimes say a silent prayer and think, “There but for the grace of God.” This leads me to wonder about all the missing people featured in true crime shows. I question how many of them aren’t actually dead but are simply lost in a city somewhere, living on the streets, trying to survive, and caught in the endless cycle of the system’s “catch and release” protocols. Maybe one day, they will finally find their way home.

Veronica Bonales is an emergency physician.

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