lessons learned from the streets

Sophie roe

MD Class of 2025

I met him at a camp located on a grassy patch alongside the highway. His face was sunken and he was in a large red tent that seemed oversized for his emaciated body. He smiled a toothless smile when we approached, and he and his encampment-mate expressed that they were happy to see “street medicine.” They asked where we went to medical school and we told them, also explaining that we were only going into our second and third years and had a long way to go before we’d become doctors. He had come here all the way from Tennessee and his cat, who he’s had for 11 years, traveled with him. They were trying to get off the street. I kneeled down to get on his level and inquired “Do you have any health conditions?” I explained, “You don’t have to tell me if you do or what they are, it just might make you eligible for supportive housing.” “Oh, I’ve got all of ‘em,” and then went on, “I have” and then mouthed that highly stigmatized fourletter word the same way I’d seen a patient do it before. I will never forget his face – a face I’d only seen in our HIV/AIDS clinical lectures – or his textbook symptoms and the difficulty he’d had adhering to medication because of his homelessness. On top of this, he had a slipped disk that made it hard to move much and a rotator cuff injury that had made him unable to lift his left arm sideways for the past few years. He had a PCP he saw regularly at the health clinic around the corner, but when he tried to get a surgery referral, he had fallen

through the cracks. Nonetheless, he remained adherent to his medications, took care of his cat’s health needs, and radiated this positive mindset and warmhearted spirit that benefitted those in his camp and those who visited. Despite his best attempts to move sideways, his health was regressing just by virtue of his being on the streets in this condition. How can we as a society fail to offer this person an alternative to living on the streets that would enable him to move sideways, both mentally and physically, rather than backwards?

I met her outside of her home in a large and beautiful urban park. With her tent positioned next to a very busy road, people constantly honk at her, yell at her, even throw condoms at her tent. They post on Neighborly about her “aggressive” dog although she responsibly keeps him on a leash, and he was very docile when I pet him. Little did her neighbors know, the park ranger allows her to stay there because she cleans up trash in the park. She ended up here because she lost her housing and the only shelter options won’t allow pets. She has responded to this unexpected setback by taking action. She has since gotten herself on waiting lists and has even been posting TikTok videos because “people are getting houses on TikTok these days.” She isn’t letting the beratement from neighbors or periodic police check-ins phase her and hinder progress toward her goal; rather, she copes and remains hopeful. She moves sideways.

What bravery it must take to be exposed, with no security but a tent, in such a highly populated area, all for the sake of staying with, and caring for, one’s pets. Why does this person become a scapegoat for the community’s anger, the subject of hostile online posts and condoms being thrown at her? Here we have a member of our community who does no harm, and in fact adds value by cleaning up the park, who has demonstrated incredible strength and bravery through struggle. We as a society are better off if we help – not hinder – her as she tries to move

sideways.

I met them under a bridge. They had been gradually moving sideways across the country from Seattle since they were four years old. I can tell by their facial expressions and demeanor that something was not OK at home and hasn’t been OK since then. Now they are undergoing treatment to become another gender, thanks to a local clinic that prescribes them the medication to make this transition. This is clearly a step forward, which is rare for them because their life circumstances have made it hard to move forward. They share a tent with a friend who they appreciate and rely on “like a sister.” This is also moving forward. Yet people driving by or running on the trail look on and assume this person isn’t trying to move forward or even sideways – they assume they have let themself fall far behind. Really, they’ve just been moving sideways since they were 4 and continue, sometimes even moving forward. As I traveled around the city going on “street rounds” with two different organizations this summer, I met people experiencing homelessness who were transitioning – literally or theoretically – into another stage of their lives. Each had ended up on the streets, which society views as moving backwards, but they chose to view it as moving sideways. They now respond to homelessness and other challenges they face with resilience. I feel humbled and grateful that I was able to stand in solidarity with them and try to help address some of their medical and service needs, as I bore witness to their resilience through struggle. I will remember what they taught me as I confront the challenges of my second year of medical school. If we could adopt a mindset in which we conceptualize unprecedented hardship, bad fortune, or even mistakes as moving sideways rather than moving backwards, how much more resilient could we become? How much more compassionate – Toward ourselves and others – could we become?