The call comes in and, for the 10th, 12th, or 20th time, paramedics take a middle-aged man from the streets to the ER. Such frequent users cost the emergency medical system millions, yet don't get the help they need. This five-part series examines the problem of frequent users of emergency services. The frequent 911 users in this series are the most chronic users of the emergency room and can defy institutional, government-based, solutions. They will remain a challenge no matter what becomes of the health reform law currently under U.S. Supreme Court review.