MovieChat Forums > Midnight Cowboy (1969) Discussion > Why didnt Joe Buck just get Ratso a Doct...

Why didnt Joe Buck just get Ratso a Doctor or take him to the hospital?


Thats one part that always bothers me upon rewatching this great movie, Joe Buck goes from hating Ratso Rizzo early on because he was ripped off by him and taken to the cleaners when Ratso stole twenty dollars off of him and ditched him with Mr. O'Daniel but Ratso takes Joe to his apartment and makes it up to Joe by teaching him how to survive and getting him his first customer Shirley.

When Joe Buck returns from his first successful Hustler score with Shirley he is told by Ratso that Ratso does not think that he can walk anymore because hes been falling down a lot and is scared, he needs to lay down and feels hot and Joe goes to leave to get a doctor for Ratso but he refuses to see a doctor and Joe Buck settles for doing a Hustler job to get the money to bring Ratso to Florida as quick as he can which he does after he supposedly kills Townie and robs him of all his money.

But the main question is why doesnt Joe Buck just leave the apartment and call 911 and bring an ambulance and just have Ratso taken to a hospital where he could be treated in an emergency room and discharged after a few days?

Hospitals have to treat anyone that comes to them under the law, homeless people like Ratso Rizzo have no money and cannot pay for treatment but cannot be denied treatment under the law at all either, likely Ratso would have been given some shots and antibiotics and some food to help him recover and then get released after that, hospitals cannot hold people against their will and Ratso would have been fine, the downside is that the Ambulance crew would have contacted the police and landlord and informed them about Joe and Ratso squatting in that building and they would probably lose their home after that.

But it would have saved Ratso's life, Joe could easily rob Townie and score with Shirleys friends while Ratso was in the hospital, find out when he was supposed to be released and take him to the bus stop to go to Miami right after he got released, This way Ratso would have survived the bus ride and lived in Miami with Joe as his caretaker.

Joe wouldnt have lost his best friend if he had just called an ambulance and had Ratso removed and taken to the hospital, Ratso would get over his anger at being taken after he was treated and released anyway, never understood why Joe thought that bringing him to Florida would improve his condition.

Hospitals treat people for tuberculosis and pnuemonia all the time, Ratso would have probably recovered and not had to pay for his treatment, then left New York with Joe as planned.

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You're talking like Ratso had a cold. He had a terminal illness and had just days left to live. A hospital couldn't have saved him at that point. Joe brought him to die in Miami because it was Ratsos final wish.

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The reason Joe didn't take Ratso to the doctor is because Ratso told him not to. Even if Joe thought it was the best idea, he was definitely the type to defer to other people. Ratso tells him that they have to go to Florida, so Joe believes it because, even if it makes no sense to him, Joe knows he's dumb and Ratso isn't. He'll do whatever Ratso tells him to do.

The question is, why didn't Ratso want to go to the hospital? Seems to me like it was a combination of hopelessness, fear, and delirium. If he had TB, the situation was probably futile, and Ratso may have known it. As far as fear, well, it's not a huge stretch that a guy who suffered a crippling childhood illness might develop a fear of doctors and hospitals. Remember, he would have been hospitalized around the early to mid 1950s. This was not a time of cute pediatric wards with cots for mom and dad to sit by. Most likely, he'd have been dropped off in a cold institutional building, barely seeing his family for days, weeks, even months at a time, enduring painful procedures and claustrophobic oxygen tents and iron lungs. See the short educational film "A Two Year Old Goes to the Hospital" from 1952 to see how different pediatric medicine used to be.

In the book, Rico, youngest of 13 children, is in the hospital for pneumonia for several weeks, contracts polio there, is kept until the next year, and is released to find that his mother has died. I'd avoid hospitals too. Whether this applies to the film version of Ratso or not is up to you, but in the movie, I took it to be a fear of hospitals and authority in general that made him want to stay away.

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Joe would have no way of knowing that hospitals were dangerous places to go, he just knew that his best friend was sick and not right mentally, Ratso does display delusions and acts like he is out of touch with reality by his lifestyle alone, so if i was Joe Buck i would have ignored the no doctors request and called an ambulance anyway, let them give Ratso shots and treat him, give him some food and see if Ratso makes it or not.

That way Joe still gets to meet Shirley and remain in New York, if Ratso died then Joe would just get a job doing outdoors work in NYC itself and remain there, he would have been happy and better off, Ratso being afraid of hospitals is more akin to a delusional homeless man being afraid of being locked up by the police and losing their freedom to beg and live easily out on the streets, in reality the hospital would treat Ratso quickly and then kick him out quickly because hospitals hate homeless people that have no money to pay for treatment and Ratso was dirt poor.

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Joe isn't right mentally either. Whether or not he realizes that Ratso is (possibly) delusional, he's a deferential person, the very opposite of a leader, very dumb, and he knows it. Joe wanted to get Ratso to a doctor, but as soon as Ratso told him 'no hospitals,' Joe dropped that idea, because why wouldn't he? He's an idiot. He had no way of knowing that, for once, he was right.

...Ratso does display delusions and acts like he is out of touch with reality by his lifestyle alone...


So does Joe. I'm not saying that someone has to be delusional to be a sex worker, but Joe is a guy who responded to sexual abuse and rape by dressing as a cowboy and trying to prostitute himself in the street, all while running from, and repressing, his past. There's something very not right about him. It's obvious to us what Joe and Ratso should have done, but it makes sense for them to, tragically, not see it.

I sometimes see people state that things were just about to get good for Joe with Shirley and her friends. No. No they weren't. He desperately needed to get out of New York, and failing that, at least away from sex work. The realization that he's not cut out for hustling is the most self aware moment Joe has in the entire movie.

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Joe isn't right mentally either.
exactly, this answers OPs question

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That is what I wanted to say.
Thank you.

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in reality the hospital would treat Ratso quickly and then kick him out quickly because hospitals hate homeless people that have no money to pay for treatment and Ratso was dirt poor.


I had thought this also. I don't know if anyone saw this feature on Rock Center a few years ago called 'Limbo Patients." Some of the patients had been living in hospitals for several years because they had no where else to go and their families didn't have the means to take them in. It was said that by law they couldn't throw them out unless they had a place to stay.

My first thought was why didn't they put them in a nursing home instead. Well, apparently nursing homes aren't required to take someone in if they don't have insurance or getting Medicaid, so they don't. It took one man a year or two to finally get approved for Medicaid to get accepted at a nursing home. If I remember correctly he didn't have any family members.

"He had Four-on-the-Floor and I was ready to Clutch"🌈

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If Joe called an ambulance, I can't imagine how it would play out. He would need to explain the circumstances of Ratso's condition, which was not really an emergency. They likely would tell him to walk in to the emergency room, as they ask Ratso to fill out paperwork etc. Not realistic. A free clinic would have been better, since it would not be so intimidating, but Joe could not force Ratso to aboard an ambulance or enter a clinic-- and health care workers are not that personally invested , especially in crowded NYC.

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"why doesnt Joe Buck just leave the apartment and call 911"

The movie was released in 1969 and 911 was brand spanking new in 1968 and not all areas of the country had it even in 1969. For example, Chicago didn't have 911 service until 1976. NYC did have 911 in 1968 but would Joe Buck know?

Of course, Joe Buck could of dialed '0' and gotten emergency assistance but the 911 was an anachronism I couldn't resist pointing out.

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Calling an ambulance would have been a risky move, number one they were living in an abandoned building and the ambulance crew would report them trespassing or squatting to the police and then they would alert the landlord, they would lose their home and be locked out, possibly face charges for that and being there because it would be obvious that they were living there.

Then Ratso has to agree to go with the paramedics and get taken to the hospital and he could always refuse to go with them at all, they cant make someone go to a hospital against their will in a democracy, at most Ratso would get looked at on the spot and be told that he was sick and advised to go to the hospital, if he did agree to go he couldnt afford to pay for the treatment and would have been kicked out within 24 hours after the basic level of treatment, they might be locked out of that building during this time too.

Ratso would get angry with Joe for violating his wishes and would be no better off than he was before, now at best Ratso would be taken to the hospital and go to the ER Emergency Room, giving all kinds of shots and tests and free food, get a bath and be told what was wrong with him, then kicked out after they couldnt do anything more for him, the city of New York would be given the bill to pay and they would probably lose their apartment after the landlord shut them out, Ratso might heal but might get sick again later.

Basically at best Ratso would be helped on a bare level and released, they cannot keep someone against their will in a hospital, if Ratso refused to go with the ambulance crew they would just leave and tell the police that two homeless guys were squatting in an abandoned building that was condemned, they might get arrested for that, Ratso could die in jail but might also go to the infirmary and recover there, Joe Buck would have to ply his trade in the general population and would get raped after his Hustler act was revealed during random jailhouse small talk.

Not a good ending anyway.

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Actually, arrest might have helped Ratso - there have been cases of people committing obvious crimes specifically to get help for a medical condition. I recall one case where a man went around slashing tires in broad daylight because he had a gastric condition that he couldn't afford to treat. But that would only work if what Ratso died of was septic pneumonia, and not TB. I personally think it was pneumonia, because there was no blood when he coughed, but I've heard that the filmmakers intended for it to be TB.

The idea of Joe and Ratso in jail together is kind of interesting. This is why I wish MC were big enough to have a real fandom. The two of them are such wonderful characters that it's great fun to shove them into different locations and situations and see what they do.

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Matthew7819.
You keep using the term "kicked out". Is that supposed to be macho (or trendy-extreme ) of you, or do you think everybody is that mean? Have you ever been to the ER to know? Maybe we can some these long essays on the board "kicked out"



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Hospitals kick out homeless bums and people that cant afford to pay for their treatments, taxpayers get the bill unless the person has a legal address and can be forced to pay.

Landlords and police kick out squatters that are found living on their property like inside of abandoned buildings, or they arrest them and block the property so they cant return and live there again.

So kicked out is correct and accurate, do you really think that hospitals would allow bums to remain inside after their treatment was finished? They are released quickly which is being kicked out in polite terms, landlords and police kick out squatters, homeless people living on property but not renting or legally being allowed to live there, its trespassing, why start arguing?

Im just being logical, care to offer a counterpoint? I welcome it, but thats reality and its cruel.

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Ratso told Joe Buck not to take him to see any doctors, he would have refused to speak with them at all probably, also Ratso didnt want to leave that building and Joe couldnt drag him out easily, imagine dragging him all the way to the hospital, now he could call the hospital and tell them that he had a sick boy on his hands here and that he needed them to pick him up, Ratso might meet with them and get basic treatment and told that he was very sick and needed to go to the hospital with them, he might refuse to go.

They were also squatting inside of that condemned building, the ambulance drivers would notice this because of the signs outside and the bad conditions, they might call the landlord and inform him that two homeless looking guys were living inside of his abandoned property, that would get them arrested for squatting and trespassing.

So it might backfire, Ratso would also become very angry with Joe and that might end their partnership, best case scenario is that Ratso goes on an ambulance with them and gets basic treatment at the hospital, is given all kinds of shots and free food and a bath, if he had tuberculosis he might be forced to stay longer, with pnuemonia he would just get medicine and released the same day or later, i know because they did that to me.

But none of it seems like it happen, him having a serious illness potentially like Tuberculosis might cause a lot of things to happen, they didnt have a cure for that yet back then wouldnt want to release an infected person back on the streets so soon, he might be kept for a long time, Ratso wouldnt like that at all, and Joe wouldnt be allowed to stay at the hospital.

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