Laura, how come you never asked me about Islam?”

I smiled at him. I said because your religion isn’t a factor for me, no one’s deserves to be homeless, especially homeless and blind.

He says to me, “I have been thinking to myself, why is this white Christian woman helping a Muslim black man” he laughs. He then lowers his head and says, “when I came to America, America was asleep. It was a beautiful country, then 9/11 happened and it became so hard for me. ” We sat in silence for less than a minute he turns to me, “Thank you, you are a great communicator and I don’t know how I would ever get here myself. God bless you. ”

Our journey together is not going to be an easy one, we are making small steps every week. Until you have become homeless or ever tried to assist the homeless you will never truly appreciate simple things such as making an appointment with a specialist, getting a pair of glasses, getting unemployment, applying for an apartment….for these people it takes months to obtain any of this. The average individual simply makes a phone call…applies online…gets the information mailed to their house…where does a homeless individual get their mail? What phone number will be called? Who has an email address?

As a nurse I don’t think I have ever felt like such a patient advocate as I do right now in my current career

Advertisements

How did I get here?

Yesterday, I spent 2 hours with a very special individual. He is currently homeless and when the winter shelter closes he has no plans. He doesn’t know where he is going to stay at night. He asks me, will the police let me sleep on a bench here? I sadly said no. He carries with him all his belongings in 2 plastic grocery bags. He smiles at me with his toothless grin and says, that’s OK, I’ll find a place to stay. We get escorted to his appointment room. He can’t help his legs from shaking in the chair, he tells me he has to use the bathroom all the time…not knowing this is partly because his diabetes is so out of control. I kindly asked the nurse to assist him to the bathroom, because in addition to his constant urge to urinate he has also lost his eye sight due to uncontrolled diabetes. He comes back, we discuss his current medical conditions with the doctor and they leave us. He looks at me kindly, says..you know, I have had several jobs, UPS truck driver, a cab driver, and a CNA. I have traveled the world been to Europe, road tripped across America…originally from Africa, I’ve seen a lot of things and places. But no place compares to America, you have so much available to you in America. It is the greatest country in the world, but it is competitive. If you are not competitive you will lose. I was not. Oh, Laura, how did I get here?

~ Laura LaCroix

 

Today I watched a woman and her boyfriend go “shopping” in our donations room….they have been wearing the same outfits for 2 weeks. They were so grateful for everything we had to offer. I was asked several times, “can we have this?” Every time I smiled and said of course..as they sorted through the items I heard them constantly say to one another, we don’t need that, leave some of those, this is amazing…

You see this couple had a rough past, burned the bridges with their loved ones, the only bridges not burned are through current drug users. They sought out help at a rehab. When they started dating they were kicked out of rehab…tossed to the streets. All of their belongings were kept at the rehab and they have nothing.  They didn’t want to speak badly about the rehab because they felt it had truly helped them. They are now staying in a winter shelter. How do we expect people to stay clean&sober? They fought the fight of withdrawal, found support and are put to the streets. I can’t imagine how hard it would be to stay clean facing the circumstances these people have to face. It’s very sad to me…we lack support in the areas that we need it most, for the people who need it and want it..

This couple, they told me not to worry, they found love and are going to support each other through this mess. I assisted them in getting clothes, hygiene products, nail polish…just so she could feel normal again…

And thank to the person who donated the Uggs…she was ecstatic, you would have thought she won the lottery as she screamed with joy. I wish you could have seen her face.

~Laura LaCroix, R.N.

The (EM)powering media

Posted: April 22, 2016 in Uncategorized

Every time an interview is requested, a reporter calls, a camera crew is invited-it is a difficult decision to make. Media has power. Or should I say the ability to EMpower when done right. Yesterday I received an email from an acquaintance who saw a homeless man in his usually spot who looked like he had lost weight and had a mass on his abdomen and didn’t know who else to tell. Brett got a call from someone who just learned that her coworker was homeless and living out of her car and didn’t know who else to tell. Media sheds a light in places where is was dark. Or rather helps you see what you have been looking at everyday on your drive to work. And that is why sometimes we say yes. This movement is really about you and asking you to act in some way to take better care of each other. Thank you for answering the call.

The vastness of need can seem endless.  When Brett and I started the DeSales Free Clinic, we had some experience under our collective belts to try to guide the creation of something that would be both meaningful and sustainable.  As it grew, so did our awareness about the larger problems facing the homeless population. Things like personal safety, humiliation, lack of affordable housing and lack of institutional loyalty.  It became easier to figure out reasonable treatment plans that actually had a chance of working because the context of their lives were so much clearer.

At some point, we started to become aware of the needs of other vulnerable and disenfranchised populations that were all around us. Human trafficking victims.  Domestic violence. Veterans. We learned that recently released inmates are 12.7x more likely to die within two weeks of release from prison than someone else living in their same state (Binswanger, NEJM,2007).  I still sometimes feel like a young PA student at Midwestern University all over again learning about the people that we share our world with but know very little about.  It is like standing in a dark room with the door closed. Then, someone turns on the hallway light and you see a small bit of light spread over onto your side of the carpet. Who turned on the light and who is on the other side of the door? Do you crack the door open and peak quickly? Do you fling the door open and boldly shout “Who goes there?”. Or do you retreat from the door and figure whoever turned on the light, didn’t really mean for you to see it anyway.  I think of the door as status quo.  It is always there and it is always accepted both socially and professionally. These populations often give us opportunities to engage them. They flick on the light in the hallway to see what happens to the door.  But all to often, we choose to retreat from the door and maintain the status quo.  The door never opens. Soon enough, the light turns back off and all goes back to the way it was.  But sometimes, someone flings the door wide open and invites the light in. Sometimes the door is opened by a patient. And sometimes the door is opened by a provider.  As it turns out, the light, in fact, is hope. And hope is just about the most powerful thing two people can share. A patient of Brett’s commented that he let the light in for her for the first time. Perhaps it was hope for her but little did she know that her willingness to let the light in  provides an understand that allows the light to be shared with others and the status quo to be challenged.

 

 

Snowpocolypse. Snowmaggedon. Holy -Snow-Batman! Whatever you call it, the snowfall over the last weekend was historic. But something else was happening in Allentown while we were all watching from our windows and marveling at this weather phenomenon.

On Saturday morning, with 9 inches of snow already on the ground, the Warming Station in Allentown sent it’s overnight guests to the streets because they are only operational at night. If it had not been for a local pastor, these people would have been left to try to find a public building to shelter in, a business that was trying to remain open that would allow for loitering or an abandoned building that perhaps no one would be looking for trespassers in. And what about the people who were not at the Warming Station the night before who may not have known about the good Pastor and his open doors?  How could a Warming Station staff street their guests who would need a plan to endure another 10-20 inches of snow before the Station opened again?

It really made me think about whose ‘problem’ the homeless people really are.  Why are there only a few who will take responsibility or, dare I say, ownership over  ‘their’ problems? Are we societally too stoic, compartmentalized and self-determined so that we believe that those who face a blizzard alone and homeless should have thought about that before they ‘made all their bad choices’? Are we worried about becoming too involved, caring too much, knowing too much only to find that there are too many one-way, dead end streets in our society? Do we fear the futility that comes with knowing without being able to act?

It would be easy to blame the operators of the Warming Station for streeting these people in the face of an impending Blizzard. These stations are opened on the heels of a public health concern.  Who wants to have citizens of their town freezing to death on their streets? But it is also a public service based on the principles of justice and beneficence. So how could people be left to fend for themselves in these harsh conditions? Dr. Jim O’Connell, founder of Boston Health Care for the Homeless Program, and a Harvard trained physician issued guidelines on temperature associated health risks to the homeless. The bottom line is that while water freezes at 32 degrees, human flesh is at risk for freezing at just 40 degrees. Often the greatest risk occurs when the ambient temperature is warm during the day and then drops drastically at night. From a business standpoint, a warming station could say they don’t have funds to pay for staff to be there during the day. They don’t have a food source there. Maybe they don’t have permission to keep the building owned by the Park and Rec Department open during the day. There are a hundred other reasons that they could come up with and some might be true. But the truth of it is, it doesn’t matter. These are people and they needed shelter. Could there have been a solution? A work-around?

The gravity of this current snow situation for the homeless is likely not to be understood for some time. But with each challenge must come insight and solutions to minimize risk the next time around. First, is the issue of the Code Blue designation. The Code Blue designation is issued by Lehigh County Emergency Management when temperatures dip below 32 degrees. The Code Blue status is supposed to be posted on the Lehigh County Emergency Management website but currently does not indicate a Code Blue listing. Today is a high of 26 and a low of 9, certainly we meet criteria. ‘Code Blue’  isn’t a searchable term on their website and it is difficult to find any information about what this designation really means. Anecdotally, I can tell you that local shelters loosen their admission criteria and put people any where they can as a temporary measure. The most current listing of Code Blue places available on the internet is from 2014 and basically contains a list of local shelters. Shouldn’t this designation allow for other buildings owned by the City to remain open as a public health measure? And why is the temperature cut off 32 degrees when data supports danger starting at a temperature of 40 degrees?

Second, those who are in the business of providing shelter as a public service should be held accountable for their actions. Many of these shelters and warming stations receive monetary support from citizens, government, grants etc. who expect that they are providing the service of warming and shelter.  You are accountable to your stakeholders. Is the city of Allentown responsible for sheltering these people or are they relieved of their responsibility because they funded another entity to provide this public service?  Take the example of our local hospitals. Healthcare workers slept in the hospital and shoveled on-ramps on 78 in order to get to work because the hospitals take their responsibility of being prepared for patients despite weather or any other natural disaster. The hospitals require it and the healthcare workers abide by it because of their moral responsibilities to their patients. Another example is the accountability of disaster preparedness where organizations accept risk for the greater good. Successful organizations balance between risk and preparedness with the ethical principles of justice and nonmalifecence. These preparedness documents should be well thought out and easily implemented. Just as in disaster preparedness, when running a winter shelter, one must be prepared for winter weather.
Finally, there is the humanistic aspect. In times of trial when human lives and dignity are on the line it is ALL of our responsibility to care for those in need.  If you’ve accepted the public commission to care for the most vulnerable, you can’t abandon that post in the worst of times. At the same time, if you haven’t accepted that post in an official matter you aren’t absolved of your moral responsibility. This weekend in Allentown that is exactly what happened. Although not bound by grants or funding, Zion Church opened their doors to those most in need of sheltering from danger, just as they did in 1777 when they “housed” the Liberty Bell, keeping it safe from the British during the Revolutionary War (www.libertybellchurch.org).  Let it be a lessoned learned; that true responsibility comes from within.

Gift giving.  Tis the season for the imagry of Christmas presents under a carefully decorated tree or eight stacked presents to represent the eight nights of Hanukkah. Having small children seems to make the season especially charming. But admittedly, sometimes this season can be challenging for people who work in the homeless community. The contrast between the haves and the have-nots is often stark and blinding.  All providers and advocates have to find that delicate balance in their lives between doing the work and going home to a life that is in such contrast to the life of our friends on the street.

We recently introduced a ‘vulnerable population curriculum’ to the PA students at DeSales. We talked about homelessness (of course!), global health, refugees, human trafficking and spent a lot of time challenging them to think about what it means to be ‘vulnerable’ and how that affects health.  During a series of reflection papers, a student exclaimed that he liked these activities but they were so depressing- who knew of all the things happening in the world. For a moment (or perhaps longer), he wished to live in the world where he eyes were still closed.

His comments though, really made me think.  How is it that there are people who chose jobs in which they take on the burdens of others. A friend who works in Oncology gets asked often – “how can you work in that office! It must be so depressing!”.  Many clinicians have occasional patients who have a story that will stop you in your tracks. Their story tends to haunt you for a few days before enough ‘regular stories from regular people’ wash away the traces of horror you felt a few days before.  But what about people who take on the horrors and traumatic experiences of many individuals at the same time. I think about people like Mother Theresa or Jack Prager ( who has been doing street medicine since the 70s in Calcutta, India) or Jim Withers (father of street medicine in the US).  The things they have seen and heard, the grief they have shared with their patients all while maintaining sanity, faith in humanity and a wicked sense of humor (especially Dr Prager!).  And somehow, seeming to find themselves in the midst of the chaos.

The word compassion derives from com- meaning ‘together’, and pati- meaning ‘to suffer’.  I often interview candidates for PA school admission who describe themselves as ‘compassionate’. When I ask what they mean by this, they usually answer that they are caring or empathetic. It isn’t a completely wrong answer but it isn’t completly right either.  There is a difference between feeling sad for someone and suffering with someone. And frankly, one is more exhausting than the other because it makes us vulnerable too. I think that much of the work we do in street medicine and with vitims of human traficking calls on providers to suffer with another person. And honestly, sometimes it isn’t easy. Often what is spoken about ones experiences have never been said to another soul.  It is a fragile truth that often can begin to free the speaker from the guilt and shame that comes with holding a secret for so long. I think some people, like Jack and Jim and many others, have been given the gift of suffering. An ability to see a world that has been so cruel to people but still resolve in the hope that exists for each them.  It is in these examples that we look to find the gift of suffering within ourselves. Each relationship is an opportunity to do more than just listen and leave, but to share, survive and hope with our friends.

The Great Equalizer

Posted: October 23, 2015 in Uncategorized

Statistics surrounding the number of physicians pursuing MBAs always seems to baffle me. From a distance, I think about how much schooling a physician endures (yes, I do mean endure) and debt incurred. After some time in practice, there is a shift in some to seek higher levels of administrative purpose. Department chair. Service line coordinator. CMO. VP of this, VP of that. Acronyms that I can’t even describe much less understand. Sometimes it is hard to wrap my head around this pursuit of upward mobility. Traditionally physician assistants share a common philosophy: we see patients. We do it in a variety of ways, in a variety of locations. But most PA’s don’t graduate and consider upward mobility as part of their job satisfaction or career plan. While there have been more administrative positions being offered to physician assistants as they gain decades of experience, it is certainly not the norm in most hospital systems. Physicians, however, have different choices to make in this regard.

Over the years, many people have passed through the shelter and soup kitchen based clinics. Often their feedback is similar. This is the way medicine should be. No red tape. No coding. No drama. Just good, simple medicine. We don’t pay any of our volunteers and we don’t beg them either. It is the simplicity of providing truly patient centered care, without time constraints, bundled payments, matrices and check lists, that keeps them coming back. Our philosophy in the clinics is that we are all equal parts of a team. Just like our patient philosophy, everyone matters. If staples need to be picked out of the carpet, the task will not immediately be assigned to the person with the least number of initials behind their name. Folks who aren’t interested in such credential ambiguity usually don’t last too long. For a time, I thought of these Clinics as a great equalizer. Egos in check while the patients get checked. But this isn’t entirely true. Even in the Clinics, titles are still prevalent- doctor, PA, student, nurse, volunteer. There is nothing wrong with identifying yourself (and we must so that patients are clear about who is treating them) but we have to be honest that titles place a degree of separation between us and our patients and often as soon as the words leave our lips, we are trying to find common ground to narrow the separation.

Enter street rounds.

As mentioned in previous posts, most of the rough sleepers of the Lehigh Valley retreat into the woods. Safer. Discreet. Remote. Invisible. While some of the street rounds are done by the LVHN street team on the streets of the Valley, most of them are done in the woods and under bridges (with an occasional storm drain thrown in for good measure). Participants in street rounds have included many interested parties over the last year; none of which are more fascinating than administrators. I don’t dislike administrators. In fact, they are critical to the health care system and to giving real legs (and the necessary teeth) to out-of-the-box programs like Street Medicine. The administrators who have come on rounds knew first hand that to really understand programs and patients like these, you have to see it. And as the saying goes, seeing is believing.

The woods are really the great equalizer. During street rounds, everyone is on a first name basis. No matter what the title or degree held, status is check at the edge of the wood. Maybe the uneven terrain makes us feel vulnerable. Maybe it is the starkness of the humble camps and being acutely aware of how incapable of survival in these conditions we would be. But most likely, it is our street friends who share their stories willingly. The humanistic experience that makes you realize in real-time that we are more similar than we are different. They see the faces and hear the stories of simple unmet needs and complex social histories that lead to what they see. It truly and respectfully on the backs of these survivors that Street Medicine is deemed necessary.

Sitting on a tarmac outside of the Newark NJ airport, I am trying to wait patiently for my plane to take off. I hear mostly white noise as people are shuffling to their seats and stuffing oversized bags into small overhead compartments. I look to my right and see a recent DeSales PA Program graduate sitting a few seats away. In the midst of our boarding process, I hear words being shared about street medicine and homelessness to the unsuspecting middle seat passenger. In 6 hours, Seth could have her convinced to attend the 11th Annual International Street Medicine Conference with us.

 

While I don’t often spend much time reflecting back on progress over time, I find that preparing for conferences like these tends to send me back to a time when I knew less in both knowledge and people. Two years ago, Brett and I attended our first International Street Medicine Symposium in Boston. We had read so much about the world-renowned Boston Health Care for the Homeless Program (BHCHP) founded and flourished by Dr. Jim O’Connell. I had followed their website for years and had a visit to BHCHP on my bucket list for years. (Hey, some people sky dive, I visit homeless programs.) The opportunity presented itself for this visit with just a few weeks notice. Generous support from both of our sponsoring institutions (to let us go) and family (to keep our kids) allowed Brett and I to travel that Fall to Boston. It was the first time we were able to see a mature and robust healthcare for the homeless program and see first hand how something like that is grown and cultivated over time. Each member of BHCHP seemed to share the vision that had begun more than 20 years before. They were motivated, enthusiastic and committed. At a dinner reception after the first day, Brett and I met Dr. Jim O’Connell for the first time. He was genuinely interested in our small but eager programs. I mentioned that the DeSales Free Clinic has an operational budget of about $18,000. I’ll never forget his response. “You do all of that with $18,000? I have a multimillion dollar budget. It sounds like I have something to learn for you.” I was dumbfounded. You? Learn something from me? It sounded laughable ( and still does) but he was sincere. And a reflection of how all Street Medicine Programs are treated by their peers. This type of interaction has been repeated many times over as street medicine programs come from all over the world, once a year, to learn, share, eat, drink and be merry. Dr. Jim Withers of Operation Safety Net (Pittsburgh, PA) once told me that he thinks that people at this conference and his patients sometimes understand him better than his family. (True)

Now, we are heading to San Jose (CA) for this years conference. Our programs have grown exponentially since that first trip to Boston. So many ideas were illuminated, so many seeds planted. We are travelling with 8 other street medicine team members- 2 University of South Florida SELECT medical students, 2 DeSales University physician assistant students, 2 recent graduates of the DeSales PA Program, LVHN Street Medicine’s new case manager and new clinical coordinator. It is hard to imagine the life trajectories that can change when armed with the knowledge that comes from conferences like these. Brett and I sometimes joke that it feels like you are going away to camp. The time is short, the bond is strong.

Shared Luck

Posted: July 27, 2015 in Uncategorized

My path could have crossed B’s path long before they finally converged. Night after night, as the DeSales Free Clinic closed up for the evening, we were unaware that just across the street, B was settling in for a long, cold, nights sleep under an abandoned boxcar, in the parking lot of an abandoned nightclub. It was a harsh, cold winter and B had been ‘here and there’ as he would tell me in an attempt to find shelter. The boxcar, he said, wasn’t so bad. It kept out the elements and the ground under the boxcar was usually dry and not too cold. No one knew he was back there and the element of invisibility can be just as useful as a warm blanket when it comes to survival.

But I knew little of B’s hiding spot or of his story until one night, B awoke from a drunken sleep to discover his feet were tingling and extremely painful.  He was able to walk himself to the closest emergency room and was initially treated for frostbite. As luck would have it, it turned out that B needed much more that just frostbite rewarming. In fact, he needed urgent surgery to restore flow to his leg. The need for surgery wasn’t necessitated by the frostbite. The problems with his circulation were years in the making, but happened to make themselves evident to the hospital team during that stay.

B and I came to know each other as he started a road to physical recovery. He is a thin man who has aged well despite the things he has seen. He openly shared parts of his story over the 7 months that I came to know him. He was from New York City where he got ‘mixed up in lots of things’.  He spent over 10 years sleeping on the streets and surviving however he could. He battled addiction for many of those years and saw few ways out of his situation. His life changed when he met a man from Pennsylvania who ran a rehab and recovery farm in a rural area near the Lehigh Valley. He offered him a chance to start over and B took it. He was able to overcome his addiction and stayed on to work at the farm for many years as a peer mentor and advisor. Eventually, the farm closed and B was able to find employment at a locally owned grocery store. He worked there for nearly 20 years. He never missed a shift and seemingly took a lot of pride in becoming ‘part of the family’. I can see how it happened. B is an unassuming man with a narrow face, a pointy nose and gentle eyes. He is friendly and helpful. I can see how he became part of the fabric of many people’s lives over the years when folks did there weekly shopping, B was always there to bag, carry and check.

About a year ago, the small grocery store was sold to a large corporate chain. In B’s estimation, they one day realized that he was an awfully expensive grocery bagger. The original owners had allowed B to be paid more than your average bagger as a way of appreciating his loyalty and hard, honest work. But a corporate chain seemingly had no need for such expensive help.  He was fired and sent about his way. Over the next few months, he struggled to find more work. With the lack of income, he lost his car and then his house. He floated from couch to couch for as long as he could, but eventually, there were no more couches.

C.S. Lewis wrote a book called The Screwtape Letters. It is written from the perspective of a senior demon to his nephew who is new to the art of temptation. It highlights that the Tempter is often waiting until our most vulnerable moment to tempt us with the thing that we are most vulnerable about. It is a slam-dunk nearly every time. Addiction is much like this- often the weakest link in the strongest chain. The temptation of drinking his sorrows, or time, away was too much for B and he fell into an old (more than 20 years of sobriety) but familiar pattern of drinking his income away.

Once sober, B expressed no desire to return to any type of drug or alcohol use. In fact, he spent most of his time reading. I have never, ever, had a patient that read more than B did. He read every book in the entire facility. Nurses and staff were bringing in their favorites for him to devour. B was becoming the same type of staple that he was to his grocery family. Endearing, steady, calm. B was happy to have recovered from his medical issues, but he was now stuck in the facility. His insurance company had issued him a ‘cut letter’. ‘Cut letters’ are sent to the rehab facility when a patient’s insurance deems that the patient no longer meets criteria for rehab. It gives 48 hours notice to the patient and the facility- either discharge the patient or the patient pays out of pocket to stay. The ‘cut letters’ almost always come on a Friday and if you have a family or a home that you can go to, then a weekend discharge is not really a problem. But what if you are homeless?

The facility (as many do) was willing to allow B to stay if he signed over his social security check each month. Remember, he worked for 20 years, paid his taxes, paid into social security. They would give him $45 per month for other expenses. On one hand, it does keep the patient from being discharged to the street or a shelter. On the other hand, it prevents one from saving enough money to put down a security deposit, pay for a taxi to look for an apartment etc. B was grateful to have shelter, but he didn’t want to spend the rest of his days living in a nursing home.

I called a friend who is a housing specialist to assess B for any housing opportunities he might know of. I was thankful that he was able to see him and proudly declared that there just happened to be a single occupancy unit available in a quiet neighborhood that he could afford. I shared in B’s excitement at the good fortune and eagerly anticipated his departure date.

That was 4 months ago.

Getting subsidized housing is not straight forward. And who knew how many moving hoops there were to jump through, mostly feeling that you and the hoop were also on fire. The housing specialist got the ball rolling after the initial visit. But B needed documents- proof of this, proof of that, a copy of this statement etc. B had never had an email account, didn’t know how to do online banking or how to navigate the social security website to print out the precise document at exactly the right time so that it would be current enough but not too current. I, myself, had a difficult time navigating the site because I had no idea what I was even looking for. Once all the paperwork was finally in to the right person and approved, I did a little victory dance. Turns out , it was a very, very, premature victory dance.

The housing unit didn’t pass it’s annual inspection. While waiting for the landlord to make the improvements, the housing specialist quit and moved onto another position. No one exactly replaced him and so I was given the landlords phone number on B’s behalf. 4 phone calls and finally a returned call 3 weeks later. The building now passed inspection and B can move in- if he can physically get to the County Housing Authority in 4 days to sign paperwork. And then, of course, find a way to get to his new home by 2pm on day 5. I tried to find him a bus route but, as luck would have it, the LANTA bus website was down for multiple days. When it was up, I was convinced that my bachelor’s and master’s degrees were completely worthless because I couldn’t figure out how to get from point A to point B without seemingly visiting Toronto by way of Atlanta. Fortunately, a friend and homeless advocate, kindly rescheduled her own doctors appointment to take B to his Housing appointment (and ironically, also to the social security office because that damn paper STILL wasn’t adequate).  The night before he was to move into his new apartment, I was frantically trying to figure out how he was going to get there. He didn’t have enough money for a taxi AND  for the security deposit they wanted when he arrived. I had a free bus pass for him but, alas, the LANTA bus site was down. Again. As I began to blow a gasket on my couch at home, my husband leaned over and said, “Haven’t you learned by now? Some of our patients have the worst luck of anyone around. By helping them, you share their luck too.”

On July 1, I visited B for the last time at the rehab facility. I stopped in on my way to my other job in order to drop off a backpack for his belongings, bus tickets and a collection taken up to get him a cab. Later that afternoon, I learned that his taxi, had been 2 1/2 hours late picking him up though he had called them at 9 in the morning. I had presumed that he had eventually made it since he had not called me nor had anyone else who I had left my name/number with over the months of trying to help him. I had no way to reach him.

Last week, I received a text message from the original housing specialist. He had been out and about running errands and had seen B near the rental unit.  At the grocery store, of course.