Category: the business of health care

“healing the homeless”-a review of ROUGH SLEEPERS

Pulitzer Prize-winning author Tracy Kidder presents the challenges and triumphs of the Boston Health Care for the Homeless Program in his new book. It gives an insight into the lives of the homeless ‘rough sleepers’, their struggles, and their stories. Primarily focusing on Dr. Jim O’Connell’s dedication, the book uncovers his 30-year journey caring for Boston’s homeless population, battling societal and political neglect, and medical inconsistencies.

Pulitzer Prize-winning author Tracy Kidder takes us on a virtual ride through the streets of Boston to introduce us to the homeless “rough sleepers” and the people who care for their medical needs. If you care or are simply curious about the homeless people on the streets of your community, you should read this book.

Rough Sleepers:

Dr. Jim O’Connell’s urgent mission to bring healing to homeless people 

by Tracy Kidder

The Boston Health Care for the Homeless Program has served thousands of people for over 30 years. Tracy Kidder rode on the program’s outreach van with the director Dr. Jim O’Connell, whose one-year commitment turned into a 30-year mission. Caring for the “rough sleepers”-those who sleep on the sidewalks, doorsteps, and parks of Boston’s streets- wasn’t what he envisioned when he finished his medical residency in 1985.

For five years the author rode along the late-night rounds with the Harvard-educated physician. He learned what the program does and why it matters. Homeless people are often alcoholic, drug addicted, ex-cons, mentally ill, or suffering from serious chronic illnesses. Living on the streets makes it impossible to get the kind of consistent medical care they need.

The homeless tend to distrust outsiders, especially the medical and mental health community. But through patience and persistence, Dr. Jim and the other staff won their trust by treating them as human beings with complicated stories that brought them to the streets and keeps them there.

The narrative reads like a novel as Mr. Kidder tells the backstories of these people shunned and ignored by society, but whom the doctors, nurses, counselors, and therapists treat with dignity and respect. He describes their frustration when the rough sleepers shun the care they offer or relapse after seeking care, as well as the lack of financial support from the political powers.

One rough sleeper, Tony, forms a special bond with Dr. Jim and we learn the most about him. Mr. Kidder relates his story bit by bit to a shocking climax when we learn what drove him to the streets and kept him there long-term.

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Rough Sleepers is not an easy book to read but is equally hard not to read. I found myself cheering for the staff when they get someone off the streets and into a small apartment but grieving when they lose one to disease, violence, or a drug overdose. I am inspired by the perseverance and persistence of Dr. O’Connell and his co-workers in caring for a population of patients for which there is often little positive feedback.

Content warning-this is a true story about people with rough lives. There is candid discussion of drug and alcohol use, medical conditions and treatments, and various types of sexual behaviors.

Thank you, NetGalley and Random House for sending this book for review consideration. All opinions are my own.

Professional Reader 25 Book Reviews

Jim O’Connell, M.D.

Dr. O’Connell is the President of the Boston Health Care for the Homeless Program and teaches and writes about care for the homeless. He wrote about his experiences caring for the homeless in, Stories From the Shadows: Reflections of a Street Doctor

Tracy Kidder wrote about another physician, Dr. Paul Farmer.

Mountains Beyond Mountains:

The Quest of Dr. Paul Farmer, a Man Who Would Cure the World 

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In medical school, Paul Farmer found his life’s calling: to cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most.

Tracy Kidder’s account shows how one person can make a difference through a clear-eyed understanding of the interaction of politics, wealth, social systems, and disease.

Profound and powerful, Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes people’s minds through his dedication to the philosophy that “the only real nation is humanity.”

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Mr. Kidder won the Pulitzer Prize in 1981 for

The Soul of A New Machine 

Tracy Kidder’s “riveting” (Washington Post) story of one company’s efforts to bring a new microcomputer to market won both the Pulitzer Prize and the National Book Award and has become essential reading for understanding the history of the American tech industry.

exploring the HEART of health

You can use the links to learn more about these books, the authors, and the physicians. Watch a video at the Boston program link to learn more about the care they provide. Some are affiliate links that may pay a commission to this blog.

This post’s cover photo is courtesy of Pexels and was shot by photographer Timur Weber.

Please follow this blog by email so you can know when I publish other book reviews and information and inspiration to change your health challenges into health opportunities.

Medical stethoscope and heart on a textured background

Dr Aletha

ADMISSIONS-a brain surgeon’s memoir- a review

Besides his long career in England, he regularly traveled to Nepal and Ukraine to teach and assist in surgeries, both simple and complicated. Those national surgeons were grateful to receive this advanced education not available in their own countries. Mr. Marsh hints that he derives his greatest career satisfaction from working with the professionals and the patients in his adopted countries and ending that association is perhaps harder than leaving practice in his own country.

Admissions: Life as a Brain Surgeon

By Henry Marsh

Admissions is the memoir of Henry Thomas Marsh CBE FRCS, a retired British neurosurgeon (I understand surgeons in Great Britain are usually addressed as Mister instead of Doctor.)   Mr. Marsh shares his thoughts and feelings as he reminisces over his distinguished 40-year career of performing intricate lifesaving brain surgeries.

Don’t let the subtitle, Life as a Brain Surgeon, deter you from reading it. Although he narrates details of surgeries he has performed, he refrains from “gory” descriptions (although as a physician I may not be the best judge). He explains enough of the anatomy and technique to be interesting and informative, but not so complicated to bore the lay reader.

The true gems in his narrative are not the anatomical details of the patients’ conditions but how those conditions affect their lives. In his “Life as a Brain Surgeon”, Mr. Marsh routinely treated life-threatening conditions, like brain hemorrhages, as well as potentially disabling ones- tumors that destroy the optic nerve, causing permanent blindness.

All too frequently he faced a dilemma-is the patient better off with or without surgery? In either case, his decision will have permanent life-changing implications for the patient and family, a task he holds seriously.

Mr. March wrote about some of his many patients and surgeries in another book, Do No Harm: Stories of Life, Death, and Brain Surgery.

Besides his long career in England, he regularly traveled to Nepal and Ukraine to teach and assist in surgeries, both simple and complicated. Those national surgeons were grateful to receive this advanced education not available in their own countries. Mr. Marsh hints that he derives his greatest career satisfaction from working with the professionals and the patients in his adopted countries and ending that association is perhaps harder than leaving practice in his own country.

I don’t know for how much longer I will feel able to be of use here, or whether I will return, but it seems I am still wanted.

Anticipating his retirement, Mr. Marsh buys a run-down lakeside cottage where he hopes to “cope with retirement”, pursuing his hobby of woodworking. But before he can do that, he needs to spend considerable time and energy renovating it, a task proving more involved than he anticipated.

His narrative moves back and forth from his hospital in London, his cottage in Oxford, and trips to Nepal and Ukraine as he wraps up his work there and says goodbye to the surgeons who are now friends as well as colleagues.

Mr. Marsh also reminisces about his childhood and parents, his schooling, two marriages, and his children.  And after a lengthy career of helping others cheat death, he ponders how his own will happen.

As we lie dying, many of us will keep a little fragment of hope alive in a corner of our minds, and only near the very end do we finally turn our face to the wall and give up the ghost.

I think Mr. Marsh wrote his memoir more for himself than for others, but I am glad he shares it. Reading his candid reflection on a life far different from ours is entertaining yet deeply thought-provoking. Perhaps reading his book will spur us to look similarly at our “life as a…..” and be pleased with what we see.

Thank you, NetGalley and publisher, for sending this book for review consideration.

Professional Reader 25 Book Reviews

And Finally: Matters of Life and Death

Mr. Marsh continues his narrative with a look at his post-retirement life which unfortunately has been marred by the onset of a serious illness. As mentioned in my review of Admissions, he has pondered the end of life and wondered how he would face it; in And Finally, he answers that question.

I’ve just finished reading it so please follow Watercress Words so you will know when I publish my review of And Finally: Matters of Life and Death.

Hear from Dr. Marsh himself in this short interview.

exploring the HEART of health

I appreciate Dr. Marsh’s work and his willingness to share his experiences, wisdom, and insights. Although we practiced on opposite sides of the ocean in vastly different health systems, I can identify with his thoughts and feelings, and like him am learning to “cope with retirement” after a medical career.

Thanks for reading.

Dr. Aletha

Do you know that a neurosurgeon once ran for president of the United States? I wrote about him in this post.