I’ve been a fan of Tracy Kidder’s work since I first read The Soul of a New Machine in 1981. Kidder won a Pulitzer Prize and a National Book Award for that book about the process of building a new computer. My favorite Kidder book is House (1985) about a team of guys building a house. Kidder’s method is to embed himself in his subject, follow the principle characters around for a year or more, and then detail all that he has learned.
Rough Sleepers (2023) is a rough read. I taught at an inner city college for nearly 40 years so I saw and encountered plenty of homeless people on my way from the parking lot to the main College building. One time an agitated young man offered to sell me a gold wedding ring (it was obvious that he needed a fix badly). I told him I’d have to go to an ATM to get some cash to buy his ring and that I’d be back in a few minutes. Needless to say, I drove away and didn’t come back.
Tracy Kidder followed Dr. Jim O’Connell around for five years as O’Connell treated homeless people on the streets of Boston. O’Connell, who graduated from Harvard Medical School, was offered a position for a year to bring health care to homeless people. O’Connell did his year–and stayed for 30 more years. I have vast admiration for O’Connell and his team of nurses who try to care for wretched, homeless people society ignores.
“Jim was sometimes asked how he came to be a doctor to homeless people, and what kept him going. At one public lecture, he answer the question this way: ‘Most of the patients I’ve been close to over these thirty-two years are dead. So there’s a certain sadness and moral outrage that I can’t get rid of. But when you work with people who’ve had so little chance in life, there’s a lot you can do.'” (p. 19).
The key factor in most of O’Connell’s homeless patients is mental problems. That, and abysmal family (or lack thereof) conditions. Sex abuse at early ages for both men and women, physical abuse, poor nutrition, little or no education, and no respect from American Society leads them to live on the streets or under bridges.
Despite Dr. O’Connell and his team’s amazing efforts, the homeless continue to struggle to stay alive in one of the most expensive cities in our country. I applaud O’Connell’s valiant efforts to help these poor people, but until America changes its attitudes towards mental health and poverty, the ranks of homeless people will continue to grow. Diane and I have made yearly donations to the Buffalo City Mission (who provides food and shelter for homeless people) and Friends of the Night People (who provides clothing and food for homeless people). But, the problem continues to grow. Do you help the homeless? GRADE: A
TABLE OF CONTENTS:
Author’s Note — xiii
I. The van — 1
II. The art of healing — 17
Conscripted — 19
Foot soaking — 25
Disaster medicine — 33
III. The pantheon — 49
Numbers — 51
A new face — 58
The street team meeting — 64
Angels without wings — 73
The memorial service — 79
IV. Against medical advice — 83
No loud voices — 85
Upside-down medicine — 89
Death by housing — 97
Eulogies for Barbara — 105
Living life backwards — 112
V. Searching for meaning — 117
A history of Tony — 119
Inventing a purpose — 130
The social director — 135
Autumn street rounds — 143
Success — 155
VI. A system of friends –163
Winter comes — 165
Tony’s world — 174
The beauty of human connection — 181
Sisyphus — 190
Boundaries and limits — 201
The gala — 204
The prism — 211
VII. The night watchman — 219
The worry list — 221
Button-down-shirt moments — 225
The hug — 228
The law of pariahs — 232
In Boston Municipal Court — 236
Childhood — 243
A free man — 248
Confession — 252
The night watchman — 257
VIII. The portrait gallery — 267
A pandemic season — 269
The portrait gallery — 273
Acknowledgements — 283
Sources — 287
