I want to ask a question you won't answer, in part because you don't know & in part because it subtracts from your thesis: Namely, what did the homeless man say to the firemen when they offered to transport him to the hospital?

Did he agree to go?

Or did he decline?

If the latter, what degree of long-term, community-based care are firefighters equipped to provide?

See, I've been in a similar situation. LA, East Hollywood, early 90s. Homeless man outside Natural Fudge. His right foot is rotting, literally rotting off. Security guard roughs him up—keep away from the door & paying patrons.

I say let's call an ambulance.

Guard says, you can't help people that won't help themselves...

I got my way. Called 911. Told homeless guy, let these people help you, for Chrissake!

Naw. Guard was right. Firefighters & paramedics responded. Homeless guy refused to be transported to hospital. What were they supposed to do at that point?

Sure. Maybe the correct strategy would be to appoint social worker, 2120 him—because he was, literally, being consumed by gangrene—& treat him that way. Maybe that eventually happened. I never saw him again after that night. Surely he didn't live much longer. He didn't want to.

I've seen people in big cities, (NY & LA) respond to others in distress. They do. I can't explain your homeless guy. Possibly his seizures were subtler than you imply. Homeless do tend to be invisible. I strongly suspect that in any society with a large, indigent population, illness, disease & injury are not rapidly detected among the beggars/street people.