Saturday, November 29, 2014
On Boston Streets: A Night on the Pine Street Inn Outreach Van
by Karen Shafer
I had the privilege last month to ride along on the overnight Outreach Van for Pine Street Inn, the largest homeless shelter in New England. On the van that night were a physician, Dr. James O’Connell, founder and President of Boston Health Care for the Homeless Program, and three Pine Street outreach workers.
The van goes out 365 days a year into the city of Boston to minister to those men and women who live on the street and who are either unable or unwilling to enter the shelter system on any particular night. It carries food — soup, oatmeal, sandwiches, hot chocolate and bottled water —as well as blankets, coats, hats, gloves, underwear and socks. The workers track each person’s progress and monitor their health conditions and concerns. In an emergency, an individual can be transported into a shelter. Perhaps the most important component of what the staff provides is personal contact and compassion. And they are friends to those who often don’t have many.
The dedicated Pine Street staff, along with medical personnel from BHCHP on some nights, know by name most of the people “sleeping rough”, as well as their personal stories. These service providers are so respectful of the privacy of each individual that if, on previous nights, the person has requested not to be awakened to receive the van’s services, they do not disturb them if they are sleeping. On this particular night, the temperature was in the forties — chilly, but not life-and-limb threatening. All of the “regulars” — generally referred to as the “chronically homeless” — know the van staff well, and Dr. O’Connell, whom they call Jim, has in fact been friends to many of them for as long as thirty years. It was a tremendous privilege to to follow Dr. O’Connell out onto the street as he approached each person, to have the opportunity to be introduced to them, and then to be trusted enough through the currency of his and Pine Street’s long-standing relationships with them to hear some of their stories.
There were people sleeping out who were struggling with serious head trauma, with mental illness, with chronic and acute health conditions, with addiction. One of the people I remember most clearly and felt particularly drawn to was “Sam,” lying on a cold sidewalk, his wheelchair nearby and his girlfriend on hand to look out for him. After many years on the street, last year he became afflicted by a permanent disability due to frostbite, but he still doesn’t want to go indoors.
On this night, he was dozing under the awning of a business with a security light shining overhead. Dr. O’Connell first greeted him, checked on his condition, then returned to the van to secure a blanket and food. I asked Sam if he could sleep with the brightness of the light overhead. “Not really,” he said, “I wish I could shoot it out.” “I’ll go back to the van and get my pea shooter and see if I can take it out for you,” I joked with him, and despite his evident discomfort, he smiled. The radiance of his personality shone through even the bleakness of his situation. He was so weak that, when Dr. O’Connell brought him hot soup and a sandwich, he couldn’t sit up to eat them, so the doctor leaned in close, unwrapped the sandwich, and put it in his hand.
I was surprised by the tolerant and even supportive attitude that some downtown Boston businesses have towards their homeless brothers and sisters. At one of the van’s stops, there were freshly built cardboard shelters in which people were sleeping under the overhang in front of a mattress store. Astonished that people were allowed by the city to sleep in this location, I was even more amazed when the Pine Street outreach workers informed me that the business owner or other nearby citizens bring fresh boxes each night which the people use to build their shelters in the business doorway. In the morning, a city recycling truck comes to pick them up. If criminalization of the homeless is a part of street life in the city, I didn’t observe it. This is The Boston Heart.
There are federal laws regulating the circumstances under which people can be involuntarily committed to care, and Massachusetts interprets those laws with an emphasis on personal liberty and respect for individual rights. I count this as a very good thing, but sometimes it makes it particularly challenging for medical personnel and service providers to deliver the kind of care people “sleeping rough” need most — when that care involves being inside an institution. Often, individuals will agree to be hospitalized long enough to deal with an acute health challenge, but will return to the street when the crisis has passed.
This is where Boston Health Care for the Homeless Program sets the standard nationally and internationally for the delivery of medical and support services to the homeless and those living in poverty. The staff of more than three hundred physicians, dentists, nurses, social workers, physician assistants, nurse practitioners, psychiatrists, mental health counselors, case managers, dental hygienists, administrative staff, building maintenance, and food service workers brings health care to those who would not otherwise be able to access it — to the street, to domestic violence and emergency shelters, to hospital walk-in clinics, to temporary and permanent supportive housing units, and in their own respite care facility, Barbara McInnis House. Their doctors are on the teaching faculty of Harvard University, Boston University and Tufts Medical Schools. It is an extraordinary system and one that is well-coordinated with other service providers throughout the City of Boston and surrounding areas.
Monthly, a group of service providers in Boston — BHCHP medical staff, shelter directors and case workers, police, and others who interface with those living on the street — meet to assess the specific needs of around a hundred homeless individuals needing particular attention, and coordinate their plans on how to help them. Equally impressive is the fact that at any point in time, Dr. O’Connell and his medical staff can access by email the number of their patients who are in the city’s emergency rooms or have been admitted to its hospitals.
As I rode along with the Pine Street van and observed first hand the functioning of a respectful, organized, efficient system of registering patients and delivering to them direct care on the street — seamlessly carried out in a milieu of kindness, love, generosity and respect — I was in awe. It is a model of compassion, service and cooperation to which every city should aspire.
Boston Health Care For the Homeless Program: http://www.bhchp.org To request a copy of BHCHP’s newsletter or be added to their mailing list, please contact Carrie Eldridge-Dickson at <firstname.lastname@example.org>
Pine Street Inn: http://www.pinestreetinn.org
Boston Globe: http://theintermittentvolunteer.wordpress.com/2014/10/29/why-some-bostonians-refuse-shelter-in-the-dead-of-winter-and-how-they-survive/