Thinking Citizen Blog — “Rough Sleepers: Dr. Jim O’Connell’s Urgent Mission To Bring Healing To Boston’s Homeless” (Tracy Kidder)
Thinking Citizen Blog: Thursday is Health, Health Care, and Global Health Policy Day
Today’s Topic: “Rough Sleepers: Dr. Jim O’Connell’s Urgent Mission to Bring Healing to Boston’s Homeless” (Tracy Kidder)
Three weeks ago, the changing demographics of cancer in the US. Two weeks ago, the US withdrawal from the World Health Organization. Last week, the confirmation hearings for Robert F. Kennedy, Jr. This week, the story of Dr. Jim O’Connell, founder of the Boston Health Care for the Homeless Program.
Do you have a doctor hero? What is his or her story? This week I happened upon a copy of Tracy Kidder’s “Rough Sleepers.”
Kidder had won the Pulitzer Prize back in 1981 for “The Soul of the New Machine” which told the story of the development of a new computer at Data General Corporation. In 2003 he published “Doctors Without Borders” the story of physician and anthropologist Paul Farmer and his work fighting tuberculosis in Haiti, Peru, and Russia. “Rough Sleepers” is an account of another heroic physician, Dr. Jim O’Connell who decided to devote his professional life to caring for the homeless of Boston. Today a few excerpts from a New York Times Review of “Rough Sleepers.”
Experts — please chime in. Correct, elaborate, elucidate.
“IN AN INCREASINGLY EXPENSIVE, GENTRIFYING BOSTON, THESE PEOPLE INHABIT A UNIQUELY HELLISH LANDSCAPE”
1. “Bedding down outside, they die at 10 times the rate as housed Bostonians. They die of overdoses, of being set on fire, of being beaten to death, of suicide, of falling asleep in the snow and never waking up.”
2. “The best feeling in my life, the best feeling was going to sleep,” says one, Tony Columbo (a pseudonym; Kidder has changed the names of many of Dr. Jim’s patients), after he overdoses on fentanyl.”
3. “The worst feeling was waking back up. To realize, first of all, that tomorrow there’s no such thing as religion or God….It’s just that I want to disappear.”
THE STORY OF TONY — 6 ft 4 in Italian American from the North End who got out of prison in 2013 “after serving nearly two decades for assault and attempted rape” (below Dr. Jim O’Connell)
1. “In the years, since his release, Tony has learned to train his anger on himself, even as he chivalrously protects those around him.”
2. “He self-medicates with booze, cocaine, and Suboxone. He breaks up fights and protects women on the streets from would-be assailants. He nurses BJ, another homeless man, who has lost a leg to frostbite and scoots around Boston in a red motorized wheelchair; the pair sleep side by side, Tony changing and cleaning up BJ’s shorts when he soils them.”
3. “When another rough sleeper, Rocky is dying from terminal cirrhosis, Tony is beside his hospital bed, sponging his lips with orange soda.”
NB: “Tony, it’s clear, years for a way out of a life of desperation and violence, but he has no clue how to find an exit.” “When I was a kid,” he tells Dr. Jim, “I seen people murdered. It didn’t bother me.” Now, he says, a “bird dies and I can’t stop crying.”
“FOR TONY, SUBSIDIZED HOUSING PROGRAMS ARE ESSENTIALLY NOT AN OPTION; HIS SEX OFFENDER STATUS MAKES HIM INELIGIBLE FOR MOST” (below Barbara McInness House for “medical respite care” for the homeless
1. “He routinely appears at McInnis House (a “medical respite facility” for patients “too sick for a homeless shelter or living on the street but not sick enough for a hospital bed”) only to disappear a few days later.”
2. “In the winter of 2018, he is discovered in a nearby street, lying in a pool of blood with a deep knife would in his thigh and three broken ribs, likely from being beaten with a baseball bat.”
3. “Get me a life,” Tony tells Jim when Jim rushes to meet him at the hospital,” “Or a gun.”
NB: As a child, Tony was the victim of serial rapes by a priest. Tony eventually dies of an overdose.
FOOTNOTE A — Jim O’Connell’s bio from the Boston Health Care for the Homeless website
1. “Jim O’Connell, MD (he/him), serves as the President of Boston Health Care for the Homeless Program and is an Assistant Professor of Medicine at Harvard Medical School. Dr. O’Connell received his medical degree from Harvard University in 1982 and completed residency in Internal Medicine at Massachusetts General Hospital.”
2. “In 1985, he began full-time clinical work with homeless individuals as the founding physician of the program. He established the nation’s first medical respite program in 1985, with 25 beds nested within the Lemuel Shattuck Shelter. Working with the MGH Laboratory of Computer Science, Dr. O’Connell designed and implemented the nation’s first computerized medical record for a homeless program.”
3. “Dr. O’Connell served as the National Program Director of the Homeless Families Program of the Robert Wood Johnson Foundation and the U.S. Department of Housing and Urban Development.”
NB: “Dr. O’Connell is the editor of “The Health Care of Homeless Peersons: A Manual of Communicable Diseases and Common Problems in Shelters and on the Streets.” His articles have appeared in the
New England Journal of Medicine, the Journal of the American Medical Association, Circulation, the American Journal of Public Health, the Journal of Clinical Ethics, and several other medical journals.
His first book,”Stories from the Shadows: Reflections of a Street Doctor, was published in 2015 and featured on NPR’s Fresh AIr with Terry Gross.”
FOOTNOTE B — Quotes from Jim O’Connell’s “Stories from the Shadows: Reflections of a Street Doctor”
1. “Nothing changes in the life of a homeless person unless you slow down and take the time to earn trust and develop a lasting relationship. Consistency and presence are essential. Have a coffee, play cards, share bits of yourself.”
2. “Never judge. Remember that people have lived through hell and listen carefully to their stories.”
3. ‘The presence of death becomes a gentle and almost soothing reminder of our ultimate equality and destiny.”
Boston’s ‘Rough Sleepers’ and the Doctor Who Treats Them (Published 2023)
https://en.wikipedia.org/wiki/Tracy_Kidder
https://en.wikipedia.org/wiki/The_Soul_of_a_New_Machine
https://en.wikipedia.org/wiki/Mountains_Beyond_Mountains
https://en.wikipedia.org/wiki/Barbara_McInnis
Jim O’Connell — Boston Health Care for the Homeless Program
James J. O’Connell Quotes (Author of Stories from the Shadows)
QUOTE OF THE MONTH
“Make your own Bible. Select and collect all the words and sentences that in all your readings have been to you like the blast of a trumpet.”
- Ralph Waldo Emerson
My spin — then periodically review, re-rank, and exchange your list with those you love. I call this the “Orion Exchange” because seven is about as many as any human can digest at a time. Game?
LAST FOUR YEARS OF POSTS ORGANIZED THEMATICALLY
ATTACHMENTS BELOW:
#1 A graphic guide to justice (9 metaphors on one page).
#2 “39 Songs, Prayers, and Poems: the Keys to the Hearts of Seven Billion People” — Adams House Senior Common Room Presentation, (11/17/20)
NB: Palestine Orion (Decision) — let’s exchange Orions, let’s find Rumi’s field (“Beyond all ideas of right and wrong, there is a field. Meet me there” Rumi, 13 century Persian Sufi mystic)
YOUR TURN
Please share the most interesting thing you learned in the last week related to health, health care or health care policy — the ethics, economics, politics, history….
Or the coolest, most important thing you learned in your life related to health are or health care policy that the rest of us may have missed.
Or just some random health-related fact that blew you away.
This is your chance to make someone’s day. Or to cement in your mind something really important you might otherwise forget. Or to think more deeply than you otherwise would about something that matters.
