I just recently finished reading Tracy Kidder’s Rough Sleepers a book about Dr. Jim O’Connell and his work with the homeless in Boston. Nearly three decades ago as he was nearing the end of his residency at Massachusetts General Hospital, the chief of medicine made a proposal: Would O’Connell defer a prestigious fellowship and spend a year helping to create and organization to bring health care to homeless citizens? Jim took the job because he felt he couldn’t refuse. But what was designed to be a one-year commitment turned into his life’s work.
On his first day with the program he headed to the South End of Boston where many of the homeless found parks, doorways, etc. to sleep and find rest. He went to the Pine Street Inn shelter for the homeless equipped with his stethoscope, his collared shirt and tie and neatly pressed slacks. He was confident – but not arrogant. He said that while there was a lot he didn’t know, he knew medicine.
As he approached the Pine Street he saw hundreds of men looking for beds, some carrying backpacks or garbage bags. The shelter’s lobby was full of odors and the clamor of voices.
The nurse director was Barbara Blakeney. She told stories of the poor treatment many of the homeless received by professional providers. Some were cynical enough to say “Yeah medicine shows up when they can get reimbursed of it. We’ve been doing this for years without being paid.” Many of the nurses were, in fact volunteers.
As Dr. O’Connell got ready to visit with the homeless men who were hanging around the shelter Barbara challenged him: “You have to let us retrain you. If you come in with your doctor questions, you won’t learn anything. You have to learn to listen to these patients.” And then he heard her say, “Come on in now, and you’re going to soak feet. I’ll show you how.” It was simple enough. You filled a plastic tub halfway up with Betadine and put the patient’s fee in it. And, in keeping with an old rule left by the founder of the Pine Street Inn, you always addressed the patient by his surname and an honorific – “Mr. Jones.”
The book, Rough Sleepers, chronicles the basic principle of the Boston Health Care for the Homeless Program. It is a basic approach of ultimate respect for these women and men who live on the street. Judgment was never part of the program; expectations were minimal; approaching each individual where he or she was was essential.
The people that Tracy Kidder talks about are in many ways very different from the folks we encounter at The Center – but in many ways they are similar. They are all looking for the same thing: to be treated with respect no matter how they are dressed, what their addiction is, how their own particular history determines how they act, or even how they smell.
I guess the foot soaking that the nurse manager insisted be an initial part of the care says it all. Bringing comfort, bringing solace to people whose lives are filled with anything but comfort, solace. And that is what we see each day as our volunteers feed, nurture, love the folks who come to The Center. And then these volunteers are fed, nurtured, love in turn.