What If Joe Buck Took Ratso to the Emergency Room Instead of Going to Florida in ‘Midnight Cowboy’?

When examining the 1969 film Midnight Cowboy, one can't help but wonder about the fate of Ratso Rizzo if Joe Buck had chosen a different path. What would have happened if Buck had brought Ratso to the emergency room at a hospital instead of taking him on a bus to Florida?

Putting Ratso in a Public Hospital

In the movie, if Ratso had been taken to a public hospital, he would likely have received the necessary medical attention and treatment. It's important to note that even in 1969, some hospitals had programs to assist the homeless and uninsured, giving Joe Buck another option to consider.

However, given Ratso's terminal condition, it's likely that his condition would have worsened no matter the treatment. The severe lung disease he suffered from, stemming from exposure to shoe polish as a child, had progressed to fatal stages long before the events of the film.

Additionally, it would be crucial to consider the extremely weak physical condition that Ratso was already in. Details within the film might suggest that Ratso actually died on the bus before it even left the station. This was written as part of the film's narrative structure, aligning with his deteriorating state of health.

Emotional Impact of Ratso's Death

Joe Buck's initial disbelief and emotional crushing upon learning of Ratso's death is a poignant moment in the film. The realization of a life cut too short by a terminal illness adds depth to both characters' arcs and the audience's empathy.

The Disillusion of Florida

Ratso's desire to die in Florida adds another layer of meaning to the character's journey. The bus ride represents a symbolic and literal move toward his preferred end. If Ratso had been taken to a hospital and then taken to Florida, the significance of the Florida destination might have been less impactful.

The film's sad ending, where Ratso is seen on the bus, is both inevitable and poignant. It serves to highlight the inevitability of Ratso's fate and the depth of the emotional and moral journey both characters experience. In this way, the film's ending feels both final and proper, reflecting the harsh realities of Ratso's terminal condition.

The Realities of Terminal Conditions

It's worth considering the parallels between the fictional Ratso and real-life cases, like the author's own father. Both were suffering from a severe form of lung cancer, one caused by early exposure to carcinogens and the other by prolonged exposure to asbestos. Both had similar progressions to fatal stages and were given similarly limited life expectancy.

Ratso's condition was likely similar to those facing patients with advanced lung diseases. Modern emergency rooms can provide supportive care to keep a patient alive for a very limited period, but they cannot reverse or substantially improve a terminal condition. Ratso's medical team would likely have tried to provide comfort and maintain his dignity during his final moments, but the outcome would have been the same.

The film’s realist portrayal of fate and illness serves as a powerful reminder of the human condition and the importance of empathy and compassion in life's uncertain moments.

.Editor's Note: Thank you to Mathew Culbertson for sharing insights on the medical aspects and personal experiences related to the film's themes. Your contributions have significantly enriched this discussion.