Brutal. I've got a photo like this too, but with a second passerby kicking the foot of the downed guy.

It breaks my heart... I have another one that was even worse. It was snowing last winter and there was a guy huddled beneath a ratty blanket near the base of a store's large window - just inside of the window was a massive rainbow array of exotic flowers for sale. There was something about the juxtaposition of two that just left me feeling hollow.