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Josephine Ensign - Skid Road: On the Frontier of Health and Homelessness in an American City

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Skid Road: On the Frontier of Health and Homelessness in an American City: summary, description and annotation

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A compelling look at the historical roots of poverty and homelessness, the worthy and unworthy poor, and the role of charity health care and public policy in the United States.

Home to over 730,000 people, with close to four million people living in the metropolitan area, Seattle has the third-highest homeless population in the United States. In 2018, an estimated 8,600 homeless people lived in the city, a figure that does not include the significant number of hidden homeless people doubled up with friends or living in and out of cheap hotels. In Skid Road, Josephine Ensign digs through layers of Seattle historypast its leaders and prominent citizens, respectable or notto reveal the stories of overlooked and long-silenced people who live on the margins of society.

The sometimes fragmentary tales of these people, their lives and deaths, are not included in official histories of a place. How, Ensign asks, has a large, socially progressive city like Seattle responded to the health needs of people marginalized by poverty, mental illness, addiction, racial/ethnic/sexual identities, and homelessness? Drawing on interviews and extensive research, Ensign shares a diversity of voices within contemporary health care and public policy debates.

Informed by her own lived experience of homelessness, as well as over three decades of work as a family nurse practitioner providing primary health care to homeless people, Ensign is uniquely situated to explore the tensions between caregiving and oppression, as well as charity and solidarity, that polarize perspectives on homelessness throughout the country. A timely story in light of the ongoing health care reform debate, the affordable housing crisis, and the COVID-19 pandemic, the stories from Skid Road illuminate issues surrounding poverty and homelessness throughout America.

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Skid Road On the Frontier of Health and Homelessness in an American City - image 1

SKID ROAD

SKID ROAD

Skid Road On the Frontier of Health and Homelessness in an American City - image 2

ON THE FRONTIER OF HEALTH AND HOMELESSNESS IN AN AMERICAN CITY

Josephine Ensign

Johns Hopkins University Press

BALTIMORE

2021 Johns Hopkins University Press All rights reserved Published 2021 Printed - photo 3

2021 Johns Hopkins University Press

All rights reserved. Published 2021

Printed in the United States of America on acid-free paper

246897531

Johns Hopkins University Press

2715 North Charles Street

Baltimore, Maryland 21218-4363

www.press.jhu.edu

Library of Congress Cataloging-in-Publication Data

Names: Ensign, Josephine, author.

Title: Skid Road : on the frontier of health and homelessness in an American city / Josephine Ensign.

Description: Baltimore : Johns Hopkins University Press, [2021] Includes bibliographical references and index.

Identifiers: LCCN 2020015931

ISBN 9781421440132 (hardcover)

ISBN 9781421440149 (ebook)

Subjects:

LCSH : HomelessnessWashington (State)SeattleHistory. | Homeless personsHealth and hygieneWashington (State)SeattleHistory. | Mentally ill homeless personsWashington (State)SeattleHistory. | Skid rowWashington (State)SeattleHistory.

Classification: LCC HV 4506. S 43 E 57 2021

DDC 362.1086/942dc23

LC record available at https://lccn.loc.gov/2020015931

A catalog record for this book is available from the British Library.

Special discounts are available for bulk purchases of this book. For more information, please contact Special Sales at specialsales@jh.edu.

Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible.

Typeset in Chaparral Pro by Amy Ruth Buchanan/3rd sister design.

For Peter

Every day we tread

over Chief Sealths legacy

his prophetic words,

At night, when the streets

... will be silent and you think

them deserted,

they will throng

with the returning hosts

that once filled them

and still love this beautiful land.

We are not alone

save for his people

we are all immigrants here

waiter, teacher

artist, worker, nurse

we belong

all of us belong

Seattle is a house

we all need to afford.

Claudia Castro Luna, Seattles Poem

SKID ROAD

PROLOGUE
ONE WOMANS SEATTLE

At the foot of the hills, between the office buildings
and the bay, lies a narrow strip of land:
here on the waterfront Seattles history and
Seattles future meet and merge.

Murray Morgan,
Skid Road: An Informal Portrait of Seattle

The hills are so steep in downtown Seattle that many of the sidewalks have horizontal raised ridges, like logs laid down crosswise, to keep people from tumbling down, especially when it rains. It is raining on this November day as I walk down Yesler Way from Harborview Medical Center toward the oldest part of Seattle: Pioneer Square.

Yesler Way, once called Mill Street as well as Skid Road, is one of Seattles first roads, made by white pioneers and Native Americans who worked for Seattles earliest entrepreneur, Henry Yesler. In the early 1850s, his workers cut the towering old-growth fir and cedar trees thickly lining the hills around the small village on the banks of Puget Sound. The rough road was lined with partially buried logsskidswhich were laid across the mud road at seven-foot intervals to allow the men to roll the freshly cut trees down the steep hill to Yeslers sawmill on the waterfront. The skids were kept lubricated by a low-paid and nimble loggera greaserwho ran ahead of the tumbling logs, splashing the skids with salmon oil from a bucket. Early visitors joked that they could smell Seattle before they could see it due to the pungent, rancid fish odor emanating from the settlement.

The odor of Seattle has changed considerably from those early days, as, of course, has the entire city. On this rainy November day, walking down Skid RoadYesler Waytoward the waterfront, I smell car, truck, and earth-moving equipment exhaust mixed with the tang of saltwater carried on the wind from Puget Sound, part of the Salish Sea. I am on my way to the Chief Seattle Club located in the heart of Pioneer Square. At the bottom of the hill, I stop at the paved, wedge-shaped Pioneer Square park with its Victorian era iron pergola, its elegant but now sealed-off underground public restrooms, and its Tlingit sixty-foot-tall cedar Chief-of-All-Women totem pole. This is the land where Yeslers sawmill stood. I notice an art installation that I had previously overlooked, thinking it was merely public signage. Next to a bronze bust of Chief Sealth, for whom Seattle is named, is Day/Night by Cheyenne Arapaho artist Hachivi Edgar Heap of Birds. It consists of two ceramic panels covered in green dollar signs and crosses, with bold black text in both Coast Salish and English that states, Chief Seattle now the streets are our home. The installation is dedicated to Seattles Native American homeless people, of which there are a disproportionate number.

Across Yesler Way from the park is the Chief Seattle Club, which provides food, day shelter, an arts program, and healthcare to Seattles Indigenous homeless adult population. I am scheduled to be there today as the faculty nurse preceptor for a group of university health science students providing basic foot care. As I walk toward the Chief Seattle Club, I pass through another small park, Fortson Square, which has a public art installation of concrete building ruinsincluding a fallen and fractured Corinthian columnand bits of poetry in the bricks paving the ground. Glancing down, I notice that one of the bricks, partially covered in cedar chips, is inscribed with Skid Road. Other bricks, spaced apart and running downhill, read, We are proud people and we survive. Even in the steady drizzle, this area is thronged with people dressed in stained, soggy clothing sitting on the concrete ruins. A woman is wrapped in a bright red blanket. They all appear to be patiently, or resignedly, waiting for something. An older man with a bandaged lower leg, shuffling slowly with a walker, stops to ask me where the Lazarus Center is. I tell him it is just up ahead, next door to the Chief Seattle Club.

In the foot clinic that day, we see a gray-haired man from a Coast Salish tribe, who tells us he was a logger in Alaska for six years back in the 1980s. He describes the repeated injuries he sustained from the work, especially to his lower legs. He had surgery at Harborview Medical Center on one leg to repair a nasty fracture and had two pins put in the ankle. Harborview is the Level I trauma center for Washington, Alaska, Montana, and Idahoa land mass close to 250,000 square kilometersand is the King County hospital with a mission of providing quality healthcare to indigent, homeless, mentally ill, incarcerated, and growing refugee and immigrant populations. This former logger now has diabetes, uses a walker, and lives in an emergency shelter across the street, with his healthcare coming from Harborview and the Indian Health Board. Later that day, I meet another older man with long salt-and-pepper hair tied back by a red bandanna. In the arts and crafts room, he proudly shows me the intricately carved pipes he makes out of deer antlers he finds scattered around his reservation on the nearby Olympic Peninsula. He sells the pipes to tourists along the Seattle waterfront and in Pioneer Square near its numerous restaurants and bars. These pipes are more popular now that weed is legal here, he tells me with a laugh.

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