Dr. James O’Connell has been a doctor on the streets of Boston for 30 years, providing healthcare to Boston’s unsheltered population. A founding physician of the Boston Health Care for the Homeless Program, he got his start in 1985 and now serves as the BHCHP’s president. Dr. O’Connell has recently released his book, Stories from the Shadows: Reflections of a Street Doctor, to document his work and pay tribute to the many clients he served over the years. He spoke with Spare Change News about healthcare, social justice and poverty.
What exactly is a “street doctor”?
When I think of “street doctor,” I think of teams of doctors going out into the streets trying to provide medical care. I remember [during my medical training years] that people were coming into the hospital when they were very sick but were getting no preventative or primary care outside. The theory was that if people are coming to the hospital it’s too late. These people were struggling to get taken care of, and preventative care was way down on their priority list. And not all of them wanted to go to the shelter to receive that care. In 1985, we realized we had to take to the streets.
Can you give a synopsis of the book? Is it a memoir, a book of essays?
I think it’s primarily a collection of stories that I try to keep myself out of. In between them there are essays that explain what was going on in the program and the outside world. Really I see it as a journey. It’s a journey against the injustice of poverty. The people hurt most tend to be excluded from the traditional American dream. The journey is to figure out how we bring social justice to these people, not just to the rich.
What was the most difficult part of writing the book?
[Laughs] To be very candid, it was finding the time to write. I live a busy life as a doctor. I need to give a huge thanks to people on our board for sitting me down like a little kid in trouble and telling me to write.
Were there any issues with confidential information or protecting identities?
Many of these stories are very personal histories about people—most of whom, quite frankly, are now dead. Never had a chance to ask if I could share it in public. But those people whom I was able to ask were happy to share their stories, and I got their permission. Of course, we changed names, backgrounds, any identifying factors. I work for a board made up of homeless people. [And] the board encouraged me to do this book as a way to celebrate those people.
This book seems pretty relevant. It’s one year after Long Island’s closing, and we’re in the midst of a so-called opioid epidemic—did those factors play a role in getting this book out?
I think these stories are timeless. It’s the cry of those excluded. Homelessness is to me a reflection of the weaknesses of so many different sectors of society. It’s the failure of our education system, of the criminal justice system, of welfare, of foster care. What we’re dealing with is a collision of all those failures. I’m really writing from a personal context more than anything.
How does the setting of Boston inform this book, and how has the city made your work possible?
We are extremely blessed to be not just in Boston but in Massachusetts. The doctors at Mass. General and Boston Medical Center forged a remarkable partnership that allowed us to really create a system of care, one that emphasizes continuity of care from street to shelter. It’s possible because of creative use of Medicaid in Mass., because of incredible hospitals and because of the cooperation of a supportive mayor and governor.
Don’t get me wrong, I know there’s still a long way to go in many ways. But we have a very creative system of care that’s been embraced by mainstream healthcare systems.
Where can we get copies?
You can go to our website to order the book!
To order Stories from the Shadows, head to bhchp.org/StoriesfromtheShadows.htm. Dr. O’Connell will also be reading at Trident Booksellers September 9, 2015.