For some St. Louisans living on the street, frostbite can cause lasting harm64%
By Sarah Fentem61%
2/9/2026, 11:00:00 AM
BS Summary: This article contains 17 faulty reasoning types, including Framing Effect, Fundamental Attribution Error, and Self-Serving Bias, with Negativity Bias as the most egregious example at 33.1% saturation with 609 hits. Analysis detected 1,732 faulty-reasoning hits from 1,839 analyzed words, generating a BS Score of 58.4% and a BS Rank of 64% (6,201 of 16,813 articles). This article is worse (more manipulative) than 63.10% of the article peer group.
It’s been months since Tonya Henderson has felt her hands.
Originally from California, Henderson has been in St. Louis for about a year, sometimes sleeping on church porches and sometimes in a tent near the Wells-Goodfellow neighborhood.
“These freeze bites are no joke, these burns are no joke,” Henderson said.
“It hurts, it hurts! My toes hurt.
Nothing else is cold but my toes and my fingers.”
Her hands look as if they’ve been dipped in wax.
A doctor told her it was frostbite.
“Sitting at these bus stops, waiting, I'm wearing two packs of warmers, three pairs of gloves, just trying to save my fingers,” she said.
“I think they’re unsavable now because I've lost the feeling.”
Many often associate frostbite with outdoor sports and famous pictures of mountain climbers with blackened fingers and faces.
But advocates say the issue is also commonly seen in people closer to ground level — people experiencing homelessness or who otherwise lack a stable place to stay in freezing temperatures.
It’s hard to tell how many unsheltered people are affected by frostbite, said Dr. Nathanial Nolan, founder of Street Med STL, a collective that provides medical care and outreach services to people living on the streets.
For years, Nolan said, medical literature about frostbite focused largely on soldiers.
“[The research] came from extreme situations, and most of those situations were war, right?” he said.
People that really had no choice and were in extremely austere environments … and by and large, that’s what we’re dealing with.
You have a population of people who are in a stuck environment, and despite these severe circumstances, they have no other options.”
'Dying on the vine'
This winter’s cold snap sent temperatures in St. Louis into the single digits on several nights in January — a perfect recipe for frostbite.
Street Med STL nurse Margoe Chesler said the team tries to do what it can.
On a recent Saturday, the high temperature in St. Louis was below 10 degrees.
“There were so many people who didn't have gloves, people who didn't have shoes, people who were just wearing a bunch of different layers of socks,” Chesler said.
“There were people with soot all over their hands and faces because they're trying to keep fires to keep warm.”
Like burns, frostbite ranges in severity.
People can recover from less serious “frostnip,” but more serious cases result in tissue damage that can lead to amputation.
It doesn’t always need to be below freezing for frostbite to occur, Nolan said, depending on wind chill and whether a person gets wet or has other health problems that affect their circulation.
Frostbite most often affects noses, fingers, toes and other extremities as the body conserves warmth in the torso and blood vessels constrict during cold weather.
That decrease in blood flow means tissue gets colder and ice crystals can form inside cells, which leads to tissue damage, gangrene and necrosis.
“[It] kind of just causes this cascade of tissue damage that's ongoing and doesn't have enough blood flow to recover,” Nolan said.
“It’s almost like it's a grape dying on the vine.
People can survive with frostbite injuries, but the problem is they're going to be more susceptible to repeat injury.”
Repeated freezing and warming — such as when a person goes to a shelter to get warm and then goes back into the cold — can make tissue damage worse and cause medical complications, Nolan said.
Resulting nerve damage and numbness mean people are more susceptible to infection and to injuries and burns, because they can’t feel pain.
Amputations can also be devastating for someone without stable housing, affecting not just their ability to button a shirt, dial a phone or fill out a job application but also their ability to stay safe.
Nolan takes care of a patient who had one of his legs amputated below the knee and got frostbite on his other foot.
He now uses a wheelchair.
“The place that he generally stays, the place where he gets a lot of support and services, is up a flight of stairs,” Nolan said.
“I watch him get out of his wheelchair and have to crawl his way upstairs as someone carries his wheelchair behind him.”
Ill at a shelter
When temperatures in St. Louis drop below freezing, the city triggers its “Code Blue” protocols, which were put in place by an executive order earlier this winter.
As the temperature drops, the city activates different levels of its plan.
When it’s colder than 25 degrees, the city operates warming buses and opens emergency beds at shelters and select sites around the city, where residents can receive help.
Earlier this year, Toriano Rice used one of the buses to get to the Peter & Paul shelter on North Florissant Avenue, one of the five sites city officials designated as emergency overnight shelters this winter.
When Rice arrived at the shelter, he was sick.
He had pneumonia and undertreated diabetes.
That meant he needed to run to the shelter’s restroom every few minutes.
“Every time I have to urinate, I have to jump up and run, you know, to make it to the restroom,” he said.
“And so the guard on staff at the time kept telling me to stop running, and it's like I became a target because of it.”
After Rice urinated in a water bottle, he argued with two shelter workers, who he said went through his belongings and tried to get him to throw away antibiotic pills.
After the argument, Rice said shelter workers told him he had to leave or threatened to call the police.
“I found out, after I packed and walked up to the front desk, that, no, we're not sending you to another shelter,” Rice said.
“[A shelter worker said] ‘you can walk out the front door, or we can call the police.'”
Peter & Paul CEO Anthony D’Agostino said that he can’t comment on what happened to Rice but that “no individual is kicked out or asked to leave unless they are directly a threat to the clients and the other staff.”
“Usually when a person is asked to leave the shelter, it's because they've done something illegal, threatened or hurt someone,” he said, adding that calling the authorities is a “last-case scenario.”
D’Agostino said when it’s very cold, the shelter may give a person the option of having the police pick someone up or seeing if there’s another facility that could take them.
After leaving Peter & Paul, Rice thought he could get on a bus, or find another shelter.
He walked to another shelter he knew about, but it was closed.
He then began walking through the cold toward a relative’s house in the Baden neighborhood, about six miles away.
Along the way, he stopped at a gas station and asked to sit on the floor so he could warm up.
The gas station workers refused, he said, and he was out in the cold again, with no gloves and wearing mesh Reebok shoes.
When he finally got to his destination, his cousin put him in his pickup truck to warm up.
Immediately Rice knew there was something wrong.
“My hands and feet was hurting so bad.
When I got in my cousin's truck, I knew it, I knew it, I knew it,” he said.
“Then I was just waiting on the dark, for the skin to start dying, the cells to start dying.
I knew immediately there was too much pain.”
Rice eventually was admitted to Barnes-Jewish Hospital, where he recently had surgery to remove a toe.
A surgery on his finger is scheduled for this week.
Access to shelters
Advocates, researchers and health providers and people experiencing homelessness said warm shelter is the best way to prevent frostbite.
But shelters are not always open, available or welcoming.
The city has activated hundreds of shelter beds during this winter’s cold weather, Rasmus Jorgensen, a spokesman for Mayor Cara Spencer, said in an email.
The shelters have not had to turn anyone away.
“However, providing transportation and as many beds and meals as we do during [high-level Code Blue] activations requires significant financial, staffing and volunteer resources,” Jorgensen said.
“Activation levels, which we shaped based on best practices from other cities and in collaboration with providers and experts with the Department of Health, help us ensure our funds and personnel can sustain this historic effort through the entire winter.”
He said that officials “recognize the need for even better access to shelter” across St. Louis and are in conversations to open a facility that would meet needs in the western part of the city, where advocates have called for an overnight shelter.
The five sites St. Louis officials designated as emergency overnight shelters are near downtown or on the city’s south side.
Still, some people “don't feel comfortable going to shelters for a number of very valid reasons that aren't easy to address,” said Chesler, the Street Med nurse.
They're kind of stuck in this limbo space of not having anywhere to go, aside from depending on the community that's immediately around them.”
People sometimes avoid shelters because they don’t feel safe, because they have behavioral issues or because of restrictions on drugs or alcohol, they said.
“That scares a lot of people away, or makes them feel like, you know, ‘am I going to a place that's supporting me, or am I going to a prison?’” Chesler said.
“And also, some people just have a lot of paranoia, and their mental health challenges put them in a space where it doesn't feel safe to be around other people.”
Sometimes going to a shelter means they would be separated from their partners or pets.
Some people can’t physically get to a shelter.
Street Med's Nolan said the real question is why one of the wealthiest countries in the world still allows people to freeze so much their limbs are permanently damaged.
“People want to erase the problem on the back end," he said.
Like, 'We have this problem, how do we wipe it away? How you get rid of the encampments so that I don't have to see it on my drive to work?'
But no one's saying 'How do we move upstream so that people never are in such dire circumstances to begin with?'
Rice is still recovering from his surgery.
A couple of days after doctors amputated his toe, he said he was able to walk a little while holding on to the back of a wheelchair.
He’s scheduled for another surgery next week.
Before that, he’s heading to a sober living facility in St. Louis.
Henderson said she’s in touch with family members in California, and she’s trying to get back to the West Coast to see her children.
Both said how frustrating it was to see empty buildings that could be used to house people but that they can’t access.
“We all are human,” Rice said.
I don't know where, where people lose their humanity.”
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