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NEW YORK TIMES BESTSELLER • The powerful story of an inspiring doctor who made a difference, by helping to create a program to care for Boston’s homeless community—by the Pulitzer Prize–winning, New York Times bestselling author of Mountains Beyond Mountains “I couldn’t put Rough Sleepers down. I am left in awe of the human spirit and inspired to do better.”—Abraham Verghese, author of Cutting for Stone
A BEST BOOK OF THE YEAR: NPR, BookPage, Chicago Public Library Tracy Kidder has been described by The Baltimore Sun as “a master of the nonfiction narrative.” In Rough Sleepers, Kidder tells the story of Dr. Jim O’Connell, a gifted man who invented a community of care for a city’s unhoused population, including those who sleep on the streets—the “rough sleepers.” After Jim O’Connell graduated from Harvard Medical School and was nearing the end of his residency at Massachusetts General, the hospital’s chief of medicine made a proposal: Would he defer a prestigious fellowship and spend a year helping to create an organization to bring health care to homeless citizens? That year turned into O’Connell’s life’s calling. Tracy Kidder spent five years following Dr. O’Connell and his colleagues as they work with thousands of homeless patients, some of whom we meet in this illuminating book. We travel with O’Connell as he navigates the city streets at night, offering medical care, socks, soup, empathy, humor, and friendship to some of the city’s most endangered citizens. He emphasizes a style of medicine in which patients come first, joined with their providers in what he calls “a system of friends.” Much as he did with Paul Farmer in Mountains Beyond Mountains, Kidder explores how Jim O’Connell and a dedicated group of people have improved countless lives by facing and addressing one of American society’s most difficult problems, instead of looking away.
NEW YORK TIMES BESTSELLER • The powerful story of an inspiring doctor who made a difference, by helping to create a program to care for Boston’s homeless community—by the Pulitzer Prize–winning, New York Times bestselling author of Mountains Beyond Mountains “I couldn’t put Rough Sleepers down. I am left in awe of the human spirit and inspired to do better.”—Abraham Verghese, author of Cutting for Stone
A BEST BOOK OF THE YEAR: NPR, BookPage, Chicago Public Library Tracy Kidder has been described by The Baltimore Sun as “a master of the nonfiction narrative.” In Rough Sleepers, Kidder tells the story of Dr. Jim O’Connell, a gifted man who invented a community of care for a city’s unhoused population, including those who sleep on the streets—the “rough sleepers.” After Jim O’Connell graduated from Harvard Medical School and was nearing the end of his residency at Massachusetts General, the hospital’s chief of medicine made a proposal: Would he defer a prestigious fellowship and spend a year helping to create an organization to bring health care to homeless citizens? That year turned into O’Connell’s life’s calling. Tracy Kidder spent five years following Dr. O’Connell and his colleagues as they work with thousands of homeless patients, some of whom we meet in this illuminating book. We travel with O’Connell as he navigates the city streets at night, offering medical care, socks, soup, empathy, humor, and friendship to some of the city’s most endangered citizens. He emphasizes a style of medicine in which patients come first, joined with their providers in what he calls “a system of friends.” Much as he did with Paul Farmer in Mountains Beyond Mountains, Kidder explores how Jim O’Connell and a dedicated group of people have improved countless lives by facing and addressing one of American society’s most difficult problems, instead of looking away.
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Extraits-
From the coverI
The Van
Around ten on a warm September night, the outreach van stopped in the kind of South Boston neighborhood said to be “in transition.” On one side of the street was a new apartment building, its windows glowing, its sidewalk lit by artful imitations of old-fashioned streetlamps. On the other side, in murky light, stood an abandoned loading dock. A heap of blankets lay on the concrete platform. Someone passing by wouldn’t have known they were anything but discarded blankets. But when the driver of the van walked up the steps and spoke to them, saying he was doing a wellness check, a muffled voice came back from underneath: “F*** you. Get the f*** outa here.”
The driver turned away and shrugged to Dr. Jim O’Connell, who was standing at the bottom of the steps. “Let me try,” the doctor said, and he climbed up to the platform and knelt by the gray mound. “Hey, Johnny. It’s Jim O’Connell. I haven’t seen you in a long time. I just want to make sure you’re all right.”
An earthquake in the blankets, then an eruption: Tangled hair and a bright red face and a loud voice, saying in a Boston accent, “Doctah Jim! How the f*** are ya!”
For the next half hour, Johnny reminisced—about the alcohol-fueled adventures of his past, about mutual old friends, mostly dead. The doctor listened, laughing now and then. He reminded Johnny that the Street Clinic was still open on Thursdays at Mass General. Johnny should come. That is, if he wanted to come.
Dr. Jim—James Joseph O’Connell—had been riding on the outreach van for three decades. During those years he had built, with many friends and colleagues, a large medical organization, which he called “the Program,” short for the Boston Health Care for the Homeless Program. It now had four hundred employees and looked after about eleven thousand homeless people a year. Jim was its president, and also captain of the Street Team, a small piece of the Program, with eight members serving several hundred homeless people who shunned the city’s many shelters and lived mainly outside or in makeshift quarters. About half of Jim’s administrative work now lay in managing the Street Team, and all of his clinical work went to doctoring its patients, Boston’s “rough sleepers,” as Jim liked to call them, borrowing the British term from the nineteenth century.
The van was a crucial tool for reaching those patients. It was financed by the state and managed by the Pine Street Inn—Boston’s largest homeless shelter. Nowadays two vans went out from the Inn each night. They had become an institution, which Jim had helped to foster in the late 1980s. Back then he used to ride three nights a week, usually until dawn. Now he went out only on Monday nights and got off around midnight.
When Jim had begun these tours on the van through Boston’s nighttime streets, he had imagined the world of rough sleepers as a chaos. But it turned out that most of them had territories where they hung around and panhandled during the day—“stemming” was the street term, its etymology obscure. For sleeping, they had favorite doorways, park benches, alleys, understories of bridges, ATM parlors. Rough sleepers were like homebodies without homes. At the start of a ride, Jim and the driver and the driver’s assistant would trade the names of people they were worried about, and they could usually find each of them within an hour or two. Jim was like a 1950s doctor making house calls, though the van rarely dispensed more than minor...
Critiques-
November 7, 2022 Pulitzer winner Kidder (A Truck Full of Money) spotlights in this poignant account the Boston Health Care for the Homeless Program, “the country’s largest medical system wholly devoted to the care of homeless people.” At the center of the narrative is Jim O’Connell, the program’s founding physician and organizer of its Street Team, which ministers to people who shun shelters and live “mainly outside or in makeshift quarters.” According to Kidder, the Health Care for the Homeless Program works against the grain of corporate medicine by emphasizing continuity of care and the importance of listening attentively to and spending time with homeless people. Interwoven with O’Connell’s story are those of his patients, including Tony Columbo, who spent 18 years in prison for sexual assault and struggles with substance abuse and mental disorders. Drawing on five years’ worth of reporting, Kidder vividly portrays life on the streets and in the program’s health clinics, and sheds light on various legal and policy matters, though the focus is less on the institutional forces that contribute to chronic homelessness than on the individual lives it touches. Keenly observed and fluidly written, this is a compassionate report from the front lines of one of America’s most intractable social problems.
Pulitzer Prize winner Kidder (The Soul of a New Machine) takes listeners inside an organization providing health care for Boston's unhoused population. At the end of his medical residency, Jim O'Connell was asked to spend a year providing health care to citizens without homes. This was a job he felt he could not refuse, and his one year became his life's calling. Kidder reveals the complications and daily frustrations faced by unhoused people and the flawed systems that continue to fail them. O'Connell learned firsthand how challenging it is to provide health care to a population that cannot store medications, is often robbed, and who needs to find their next meal rather than consider long-term treatment. The stories contained here are gruesome and heartbreaking. Narrated by the author, this audiobook brings humanity to his subjects as only a firsthand observer can do. He differentiates voicing, which helps listeners get to know the people in the book. VERDICT This excellent audio shines a light on the unsung heroes providing frontline health care to unhoused people and demonstrates the power of a small group dedicated to a cause. A recommended purchase for all libraries.--Christa Van Herreweghe
Copyright 2024 Library Journal, LLC Used with permission.
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At this time, the difficult circumstances of approximately 150 million people who are unhoused in the United States fill the news. Author Tracy Kidder's light, somewhat raspy voice unfolds the story of Dr. Jim O'Connell and his clinic partners, who have devoted themselves to bringing comprehensive and compassionate healthcare to those living on the streets of Boston. Although Kidder follows Dr. Jim through years of street rounds and clinics, the focus is firmly placed on those who use their services, showing how poverty often leads to alcoholism and drug addiction, rather than being the cause of it. Kidder's approachable performance is in sync with his captivating writing style. He provides a riveting, intimate glimpse of the lives of rough sleepers that is both inspiring and heartbreaking. S.G. © AudioFile 2023, Portland, Maine
