Posts Tagged ‘Feldman’

I was an accountant, I am an RN, I was a doctor, I am a CNA, I was a car sales rep, I am a factory line worker, I was a security officer, I am a cook, I was a teacher, I am a cashier, I was an apartment complex manager, I am a waiter, I was a taxi driver, I was a LPN, I was a legal partner…

This is who “they” are. This is who makes us our homeless population. They are not so different from you and I. Most the them held “respectable” full time jobs. Many hold degrees.

Many of us are living our lives paycheck to paycheck. I am one of them. Many of us are forced to “rob Peter to pay Paul”. In the blink of an eye, any of us could end up in a car accident that leaves us disabled, out of work and stuck with medical debt. An unexpected divorce or death of the family breadwinner. Many of us are more susceptible than others to addiction causing us to falter in our game plans. Or on the other hand, our loves ones become addicted and we lose everything we have trying to “save” them.

These are our friends, family members, neighbors, and co-workers. They were the valedictorians of our classes, the star athletes and the leads of our school plays. In fact, a number of you on my Facebook have been, almost were are currently are homeless. I want those of you reading this to think about THAT…we share many mutual friends.

Remember this as you are driving and walking past them. They are humans too. They deserve respect, love and recognition. Hold your judgement. Share a handshake and smile. Be polite. Take a stand and lend a helping hand.

~ Laura LaCroix, RN, LVHN Street Medicine

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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.

 

 

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.