Take it to the Streets

On Wednesday morning, I had the opportunity to shadow a Boston Health Care for the Homeless provider as she did her street rounds. Back in June, I attended a session of the National Health Care for the Homeless Council conference where my host had presented some of the nifty gadgets that she used on her rounds. The opportunity to see those gadgets in action was a memorable experience! At 9am I met Jill, and a student who was shadowing her for the week, across the street from a busy downtown Boston t-stop. She briefly told me what to expect and we were off!

Not even two blocks down the street we encountered three of her regular patients and by the end of the day we had seen over a half dozen people. Most were on the street but three had secured housing and we visited them in their apartments, two of the three had studio apartments on Beacon Hill (one of the richest parts of Boston) thanks to a housing first voucher program. I hate to admit that I was surprised by how clean the apartments, and their tenants, were but I was impressed. One's apartment was cleaner than my own!

The people on the streets were a different story. They were in rough shape. One had the opportunity to go to a shelter but was nervous that they wouldn't take him because he smelled bad and I'll admit, he did smell really bad. But who can blame him? I smell bad after a day in the park. I can't imagine not having the option to shower after spending an 85 degree day outside, never-mind weeks on end of those kinds of days.

Health Care For The Homeless is a particularly unique type of program, when these programs conduct outreach they often are actually practicing medicine on the streets. It is mainly basic medicine, but they use the relationship that they build to help the individual access specialized services when they are ready. I was impressed with the way that she asked what they wanted and gave them options. No one was forced to do anything that they didn't want to but we got two people off the streets that afternoon (though one was to the ER).

The experience also heightened my awareness of how severe many individuals' alcohol addictions are. As both men who agreed to be transported to services (BHCH has cab vouchers for this purpose) they discarded their bottles of mouthwash first, one handed his off to a friend, the other dropped to the ground with a hollow thud. Mouthwash is the easiest way for alcoholics to get their fix and is an indicator of exactly how bad the disease is.

It was a great experience, I hope to do something like it again!