The young woman came to our walk-in clinic at Church Health because she was having a cough that wouldn’t go away.
She was 27 years old. She has long black hair with a round face and a ready smile. She is friendly, eager to please, and morbidly obese. She weighs well over 250 pounds. I’ll call her Mary Anna.
As I worked to get to know Mary Anna, she was very open with me and readily answered every question I had. Her answers were more troubling than her cough. As is often the case, Mary Anna’s eating disorder was triggered by her abuse.
When Mary Anna was 11, she began being sexually abused by her father while living in Mississippi. She is the oldest of 4 children. Her father eventually went to jail for abusing two of her younger sisters, but no one ever thought to ask Mary Anna if he had begun with her. Of course, he had.
Her father went to jail for three years. Her mother divorced him, got remarried, and left Mary Anna, a young adult by then, and her three siblings on their own. They moved into her father’s home while he served his time. It was tiny, but it was a roof over their heads.
When her father was about to get out of jail, he told Mary Anna: “I don’t want to have anything to do with you. When I get out you better be out of the house.” All of a sudden, Mary Anna was homeless.
A visit that started out as one for a cough had become much more. Thankfully, we have counselors embedded in our clinic. One of them was able to make a connection with Mary Anna. She will continue to see Mary Anna to help deal with the abuse she had never had anyone to listen to. Not even her mother.One of our social workers helped her find a place to sleep.
The basics of living were easy compared to the scars on her heart that would last a lifetime.
I have been at a loss as to why Mary Anna talked to me. I do suspect it reflects how few people have ever truly offered to show her that they cared. It doesn’t take much for people who are so broken to open up to someone who offers comfort.
I started Church Health in 1987 to provide health care for people who work in low-wage jobs and don’t have health insurance. Today, more than 80,000 people depend on us for health care.
We are a true charity. We aren’t federally funded. Along with our 20 staff providers, we have 1,000 physicians who volunteer to care for our patients. We operate out of a building larger than the Empire State Building, and we are able to provide the same quality of care you would expect for your mother.
Providing health care for the homeless has been a challenge, but more often than not it has been rewarding. After 36 years of providing medical care in a broad-based system of care, there are a number of conclusions I have come to about the nature of homelessness and the way to offer care for those who are experiencing it.
1) Except in rare situations like Mary Anna’s, it isn’t easy to be truly homeless. For most of us, if our house burns down tonight, we won’t actually be homeless. We will quickly have a number of family or friends who will take us in almost immediately.
2) When trying to care for someone who is homeless, do not be judgmental. It is highly unlikely that you can put yourself in that person’s place and imagine the decisions they have had to make over time.
3) Begin with the basics. Food, shelter, warmth. These things need to be addressed first before getting a job and turning one’s life around.
4) People may not be ready to make changes today.
5) When someone has not received love for many years, s/he may not be able to accept it right away.
6) The first thing that people who are homeless need is a home.
7) People act in a manner that they believe is in their self-interest even if that action might be harmful to them.
8) It is hard to trust when your trust has so often been broken.
9) Just giving someone a home doesn’t solve the reason s/he is homeless.
10) The number of people who truly care about the homeless isn’t very large.
When people become homeless, and this is especially true of those who are chronically homeless, much of the fabric of living gets thrown into disarray. But it doesn’t mean it can’t be repositioned and be made right. In most cases it can.
And for those who work day by day with the challenges that homelessness brings, it is hard work. It is not easy and can often bring about a desire to throw one’s hands up in despair. But it also can draw you closer to God and what feels to be the true meaning of life.
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