In the midst of the COVID-19 pandemic, a debate has been ignited over how best to manage the issue of encampments in Canadian cities.
I gave my patient a tent.
Last week, a patient that I’ve followed for two years walked into our appointment with a sleeping bag under his arm and left with a tent. According to Hamilton’s Ward 2 Councillor Jason Farr, that makes me part of the problem.
I’ve gotten to know this patient (details changed to protect confidentiality) fairly well over the past couple of years. He has had a variety of medical concerns including infections, high blood pressure, broken bones from assaults and substance use disorders.
In the time that I have known him, he has been through and survived a great deal of physical and mental trauma and I have often found myself surprised and inspired by his ability to keep going, day after day, one foot in front of the other.
I try my best to see him or speak to him weekly. At times during the past two years he has been housed and during those times we have made important strides toward improving his health. He struggles to keep a phone – several having been lost or stolen – so knowing where he is going to be and where I can find him has been crucial in maintaining this momentum.
Unfortunately, these times of stability have been the exception. The rising cost of housing in Hamilton has been well documented as has the long waiting list for city housing.
As a single man on Ontario Works, he receives a maximum of $390 per month of shelter allowance. Finding and keeping suitable lodging under these conditions is challenging, to say the least. More commonly, he has been sleeping outside, finding a place to stay wherever he is able.
During these times, his health suffers. It is difficult to continue taking his medications and hard to organize times to meet up and check in. When I am able to find him, I watch as his physical and mental health declines, feeling powerless to intervene.
A tent shelter in Hamilton (RTH file photo).
At some point during every appointment, I ask, “where are you staying now?”
“Aw, you know doc, here and there, wherever I can lay my head. But it’s hard. It’s so hot out, and it’s hard to always be outside. I can’t hang on to my things, I can’t get a good night’s sleep and I’m constantly on the move. I just want to settle down.”
“What about a shelter?”
“The shelter just isn’t for me. I don’t feel safe there. I’ve tried so many times and I just can’t stay there. I’d rather sleep outside.”
At this point, it is important to state that I have nothing but admiration and gratitude for the work done by shelter providers and workers. I have publicly stated previously that the work done by shelter providers around the COVID-19 pandemic specifically has been nothing short of heroic, and I stand by those sentiments.
I work closely with the agencies responsible for Hamilton’s shelters and I have seen them move mountains to get my patients off the streets and into a place where they can have a roof over their heads. At the same time, many of my patients choose not to or are not able to sleep in shelters and they always articulate very valid and thoughtful reasons for those decisions.
So here we were again. In these situations, I have to force myself to take a step back.
I’m worried about his blood pressure, about whether he’ll show up to get his blood work, and whether he is taking his antibiotics.
He is worried about where he is going to sleep tonight, what he is going to eat today, and whether he’ll be able to find a place to use a washroom when he needs it.
Most of the time, I don’t have much to offer that can address his concerns. I write my prescriptions and he graciously agrees to see me again in a week or two, going out of his way to thank me for the little I am able to do.
On this particular occasion, I added a tent to my prescriptions.
Do I think that in doing so I solved any of the monumental challenges he faces day to day? Of course not. But for now at least I know he has shelter, a place to keep his things, and that he is staying where others are around him, can look out for him.
And I know where he is. If he doesn’t come back for his appointment, I know where to look to find him. I still worry about him every day. I hope that this is a first step toward finding permanent stable housing but I am also realistic and I suspect that there will be further ups and downs on the road ahead.
I gave my patient a tent. Some say that makes me the bad guy. What would you have done?
*This opinion was originally published in Raise the Hammer.
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I would, and have done the same thing. I think that as caring people we just want to help in anyway we can and if reaching out to someone by providing a tent makes you the bad guy, then we are in a terrible state of affairs. Thanks for your kindness
Bless your good heart. Thank you
Thanks Tim for sharing this! And for providing this dear man with a roof over his head in the hope that a better home is just ahead. It’s the relationship that speaks volumes about you and he, the humanity, the deep desire to be present despite the obstacles of poor health, precarious living situations and uncertainty about where the future leads. Your story makes me want to do more, to not only support people who are homeless with my thoughts and prayers, but with real, tangible, meaningful help.
I love this, thank you for this story. We absolutely must address sociopolitical & economic determinants of health as the root cause of homelessness, mental illness, addiction, etc. But these long-term, hard-to-reach solutions at the legislative level must be also met by immediate, point-of-care delivery to those on the ground. That is where most people can directly & reasonably contribute. Simple albeit temporary solutions for complex problems. It is meaningful to have a place of privacy of our own & shelter from the storm. Hope for more ‘tents for the homeless’ projects globally while the root cause work continues.
I agree the Dr. O’Shea is a good doctor, and a good person, taking appropriate actions where and when he can. But his actions alone cannot make the changes required.
We need to frame the situation in the terms that politicians understand. After all, they are the ones with the ability to compel the required changes.
Someone living on the streets undoubtedly has a reason for doing so. They will interact with into the police, medical and mental health care systems, social workers and shelter workers, among numerous others, and all of these interactions incur public costs. Medical, social or mental health problem are not usually improved by living on the streets, although the street is obviously preferable to many even more problematic situations.
We know that a safe and stable living environment is the base requirement for pulling a troubled life together. Providing supportive housing is not without considerable cost, but such housing is, at the least, no more costly that the inefficient systems currently working to such futile effect.
Brian Mulroney’s government eliminated the federal funding that had been used to build affordable housing, and that funding has never been reinstated. As an initial baby step, the various levels of government need to recognize the problem and make the decisions to provide more than a coverup bandaid.
Doing this right will not only improve the lives of many, it will even save tax dollars. Surely one or another of those is an idea most can rally around!
This definitely puts you on the “Good Guy” list. You did something so kind. Our homeless population struggles so much just to live on a daily basis. Bless you for caring so much about your patients. You did a good thing, Doc. Don’t let anyone tell you otherwise!
When I worked at St. Mikes years ago we had a doctor that would ride his bicycle around the area and check up on some of the patients that he had had over the years. Truly a great physician and kind and gentle man that would fight for the poor souls that were often discarded by society. Dr. K you and the people who worked with you made the lives of the poor and homeless a better place. May God continue to bless you and yours
R.M.
In my book, you are a hero++++ , we need more docs like you in this world! Your compassion and dedication is inspirational. May your colleagues learn from this amazing act of kindness.
I certainly would’ve done the same thing,we have a manufacturing plant opening up in welland,they are building house out of storage containers.I think this would be an amazing solution to homeless situations, just sayin