San Francisco Fire Department personnel respond to an emergency on a city street, with an ambulance and medical equipment visible.
Emergency responders load a man who was unconscious due to a suspected overdose into an ambulance on 15th Street and Mission Street, 1:35 p.m. 6/16. Photo by Jessica Blough

“Narcan! Narcan!” Geno G., a Public Works employee, shouted down Mission Street.

At the intersection of 15th and Mission streets in front of an apartment building, Geno had found an individual lying on their back, face up, unconscious and turning blue. Geno had been on his daily trash route, picking up litter from 15th Street to 18th Street. 

After failing to rouse the man, Geno suspected that he was overdosing and began shouting to anyone who’d listen that he needed Narcan. When no one said they had any, Geno began to panic.

He ran across the street and shouted up and down the busiest block of Mission Street, where over 100 people were congregating, using drugs, selling stolen goods, socializing in the plazas and waiting for the bus. He shouted for Narcan and for cold water. In a moment of horror, he shouted and no one responded, except to echo his yells. 

Then, within seconds, three people ran down the street, each holding a Narcan nasal spray. 

These people, Geno and a few other bystanders administered Narcan two times, called an ambulance and began chest compressions. Someone in the apartment building above brought down a bottle of water that Geno splashed on the man’s face.

Still, he did not regain consciousness. Justice Jones, who had run out of a nearby business with one of the doses of Narcan, did chest compressions after the first person became exhausted. 

A fire truck arrived within five minutes, and an SFFD ambulance arrived about a minute after that, along with the rescue captain in an SFFD SUV. About seven SFFD personnel treated the man, including administering a third round of Narcan.

They also administered oxygen and loaded him onto a stretcher. After being treated, the man seemed to lift his head off the stretcher and speak to the paramedics, responding to questions about his health history and thanking them. 

A city intersection with yellow crosswalk lines, apartment buildings, pedestrians, and two fire trucks parked on the street.
EMTs and bystanders attend to a man unconscious from a suspected overdose on 15th Street and Mission Street, 1:26 p.m. 6/16. Photo by Jessica Blough.

After ensuring that the SFFD personnel were in control of the situation, Geno walked diagonally across Mission Street, resuming his trash route and watching from a distance.

He’s been on this job for two months, he said, and this is the fifth time he’s administered Narcan after finding someone overdosing. 

“Five people I’ve watched turn blue, look dead and come back to life,” he said, a single tear sliding down his cheek. “There’s a lot of guardian angels out here.” 

A firefighter/EMT who arrived on the fire truck said that he could not comment on whether the man would recover. 

Jones, a local activist, was also visibly emotional after the man was loaded into the ambulance, and he said that he was angry with himself for initially hesitating when he heard Geno calling for Narcan on the street.

He said that one of the people who rushed to administer Narcan to the unconscious man was himself a drug user. Jones said he has been trying to organize local businesses around improving living conditions around 16th Street. 

“The community is owed an apology from the city,” he said as the ambulance and emergency vehicles packed up and drove away. “People are donating a million dollars in tech but people are still dying on the street.” 

Twenty minutes later, another set of emergency vehicles sped down Mission Street, flashing their lights half a block from where the man had overdosed. This time, though, it was just a rogue fire alarm that had been triggered in a nearby apartment building. Two firetrucks and a police car arrived, clearing a crowd of about 50 people who had gathered on the west sidewalk of Mission Street. Many of them were using drugs. 

Southwest 16th Street BART Plaza and the west side of Mission Street

  • A group of people with bags and suitcases stand and sit along a city sidewalk, some near a tree and a bicycle, with buildings and parked cars in the background.
    11:06 a.m. 6/16, West side of Mission Street. Photo by Lydia Chávez
  • A police car and a large mobile command vehicle are parked near a public plaza, with people sitting and walking nearby on a sunny day.
    1:17 p.m 6/16, southwest plaza, Photo by Jessica Blough
  • A city sidewalk lined with metal barricades, scattered litter, trees, a traffic signal, and a red and white bus in the street.
    1:17 p.m 6/16, west side of Mission Street, Photo by Jessica Blough
  • People are gathered on a city sidewalk next to a yellow building and parked cars; a red bus and palm trees are visible in the background under a clear sky.
    2:03 p.m 6/16, west side of Mission Street. Photo by Jessica Blough
  • People gather on a littered city sidewalk near a yellow building and parked cars; one person bends down near scattered belongings under a tree.
    2:05 p.m 6/16, west side of Mission Street. Photo by Jessica Blough
  • A city sidewalk scene with people near a building with a colorful mural, metal barricades, parked cars, and palm trees on a sunny day.
    2:08 p.m 6/16, west side of Mission Street. Photo by Jessica Blough

Northeast Plaza and the east side of Mission Street

  • A group of people sit and stand near bikes and belongings in an urban plaza with pigeons and graffiti in the background.
    8:27 a.m. 6/16, northeast plaza, two outreach workers Photo by Lydia Chávez
  • People gather on a city sidewalk in front of a mural reading "American Indian Cultural District" with colorful graffiti and text on the wall behind them.
    11:06 p.m 6/16, east side of Mission Street, Photo by Lydia Chávez
  • Several people stand and gather on a city sidewalk where clothes and shoes are laid out on the ground, next to bags and backpacks.
    1:18 p.m 6/16, east side of Mission Street, Photo by Jessica Blough
  • People with belongings gather and sit on a city sidewalk in front of a building with colorful graffiti. Some are standing, some seated, with bags and carts around them.
    1:18 p.m 6/16, east side of Mission Street, Photo by Jessica Blough
  • People with belongings gather on a city sidewalk next to a graffiti-covered wall, near a bus stop with buses and palm trees in the background on a sunny day.
    1:19 p.m 6/16, east side of Mission Street, Photo by Jessica Blough
  • People are sitting and standing in an urban plaza with graffiti-covered walls, trees, and blue lamp posts under a clear sky.
    1:45 p.m. 6/16, northeast plaza, Photo by Jessica Blough
  • A street scene with people lined up along a sidewalk in front of a building covered in graffiti art, with palm trees and a car passing by in the foreground.
    1:46 p.m 6/16, east side of Mission Street, Photo by Jessica Blough

Caledonia Street

  • Narrow urban alley lined with a beige building on the left and a chain-link fence with colorful graffiti on the right, under a clear blue sky.
    1:49 p.m. 6/16, Caledonia Street. Photo by Jessica Blough

Julian Avenue

  • A city sidewalk with parked cars on the left and buildings with shops on the right, under a clear blue sky. A few people walk in the distance.
    1:48 p.m. 6/16, Julian Avenue, Photo by Jessica Blough
  • A city sidewalk runs alongside a white building, with parked cars and apartments across the street under a clear blue sky.
    1:49 p.m. 6/16, Julian Avenue, Photo by Jessica Blough

Wiese Street

  • Two people are on a narrow alleyway next to a yellow building, with metal barriers lining the sidewalk and no cars present.
    1:47 p.m. 6/16, Wiese Street, Photo by Jessica Blough
  • A worker in a safety vest stands in a narrow alley, surrounded by barricades and tall buildings, holding a long pole under a sunny sky.
    1:47 p.m. 6/16, Wiese Street, Photo by Jessica Blough
  • A worker in a safety vest uses an extension pole to paint or clean a high window on a building exterior, with metal ducts and safety barriers visible.
    1:48 p.m. 6/16, Wiese Street, Photo by Jessica Blough

Capp Street

  • City sidewalk with parked cars on the left, graffiti on the right wall, and a few people sitting and standing near a building under a clear sky.
    1:44 p.m.. 6/16, Capp Street, Photo by Jessica Blough

Follow Us

Reporting from the Tenderloin. I'm a multimedia journalist based in San Francisco and getting my Master's degree in journalism at UC Berkeley. Earlier, I worked as an editor at Alta Journal and The Tufts Daily. I enjoy reading, reviewing books, teaching writing, hiking and rock climbing.

Join the Conversation

6 Comments

  1. Reply

  2. Anyone have any idea, or want to guess, how many times the overdose victim has relived that scenario? So, three vehicles and seven personnel were involved in the rescue, you have to wonder how much that costs taxpayers each time this type of incident occurs. And, yet, some complain that no money is being spent to save lives on the street? Some individuals are costing the City in excess of $100,000, annually, in emergency care. Provide them with permanent supportive housing and they will have no access to narcan and the next time the OD, they may be DOA.

    0
    0
    votes. Sign in to vote
    Reply

  3. I carry Narcan in my vest usually with extras in bottom of my cart next to the litter jar and wire brush and plaster scrapers.

    Haven’t gotten to use it but 50 years ago I was an EMT.

    lol

    The City has done a great job of spreading the Narcan around.

    I recall a couple of years back there were complaints about how much it cost (thirty or forty bucks a shot ?) but when we started setting records for OD deaths the strings got loosened and now I regularly find unused packets on me and Skippy’s daily two or three hours on our City registered route.

    How we gonna get the Mayor to cancel the 15 million in useless designer trash containers London chose ?

    For a third of that we can have a City Million Dollar Trash Lottery every year with a hundred second place winners of ten grand each.

    go Niners !!

    h.

    0
    0
    votes. Sign in to vote
    Reply

  4. Why are the Urban Alchemy workers who attend the bathrooms always smoking cigarettes when they’re sitting five feet away from a sign on the bathroom that says “no smoking”

    0
    0
    votes. Sign in to vote
    Reply

  5. Thanks for reporting

    Take a look at the quartely sf coroners report .

    Tragic

    Again, on Lower Polk , zip code 94109, which is not that big, Twenty percent of all drug deaths happen there .
    Over 200 just for that small area .

    Why is that ?
    Maybe there are drug s available there?

    Overdoses are as common there as dogs/ humans defacating on the sidewalks .

    Who looks at the metrics .

    Sf is sinking . And for all that is being spent we should be able to walk on a sidewalk and not encounter a person high or unconscious everytime we go out

    Very weird that this is the “ norm” here
    I think it is sick and cruel for anyone to just walk by a person doing drugs and not call for help.

    0
    0
    votes. Sign in to vote
    Reply
  6. Reply
Leave a comment
Please keep your comments short and civil. Do not leave multiple comments under multiple names on one article. We will zap comments that fail to adhere to these short and easy-to-follow rules.

Your email address will not be published. Required fields are marked *