Neil Craton M.D. - Wisdom From the Homeless: Lessons a Doctor Learned at a Homeless Shelter

This photograph was taken by me on a beautiful Friday morning heading into the Mission.

Preface

Sometimes the world seems like a very dark place. Partisan grievances have increased exponentially. Left and Right find new ways to vilify each other, hardening points of view into the points of a spear. To disagree with someone is to hate them. A news cycle is not complete without a tragic tale of someone killing their neighbor or themselves. Children are terrified that the planet is ecologically doomed, where every breath of wind is perceived as the first whisper of the apocalypse. We are increasingly fearful of one another, drowning in a toxic soup of racial tension, political gamesmanship, ethnic marginalization and the vicious habit of depersonalizing everyone into a rival. (1) The affluent seem increasingly obsessed with small minded and lop-sided pursuits. (1) Now more than ever, we are suffering from a deficiency of kindness and hope.

In this dark and angry world, I see a glimpse of light. I have seen kindness, care and hope at a homeless Mission. In the spiritual tradition of this Mission, the source for hope, light, care and kindness is Jesus of Nazareth. The Mission, Siloam, is named after an ancient pool referred to in the gospel of John, where Jesus healed a person. In this tradition, the Mission has a medical clinic, and I have had the privilege of working there.

Hope for healing may be the most important benefit doctors can give to their patients. People of all walks of life need hope and every problem is easier to handle if we have it. Hope is hard to serve without the garnish of kindness. The present cultural context seems to know little of kindness. I have witnessed far more hope and kindness at Siloam than I see in many celebrities, newscasters or politicians.

This book isnt about me. Im not an activist. I dont go to protests, and I seldom engage politically. I have only reluctantly become an advocate. I would be lying if I said I was a champion of the homeless. This book also isnt about medicine. While all the lessons were learned in a medical context, I believe they represent wisdom for all.

This book is about homeless people. It is inspired by the incredibly difficult lives lived by men and women who attend a homeless mission in Winnipeg, Manitoba. This book is about joy that can be seen in the midst of that difficulty. It is about the powerful role suffering can have in shaping our character and our lives. It is about the overcoming of that suffering and the inspiration that comes from persevering through adversity. This book is about the wisdom that people with nothing can teach all of us in affluent North American culture. Ultimately, this book is about relationshipthe type of relationships you can discover when you decide to serve your fellow man.

Telling a patients story needs to be done with discretion and care as it always involves an act of appropriation. The physician is opening a closed door, looking into a soul, discovering truths that are profoundly personal. The telling of that story demands meticulous safeguards to protect the identity of the patient. (2) Yet, there are few things more meaningful to doctors than the stories of their patients. Danielle Ofri, a physician-writer and scholar, notes that when she began writing her book, What Doctors Feel : How Emotions Affect the Practice of Medicine , she asked her medical colleagues to tell her what made them the doctor they are today. (3) She was flooded with responses, and not one physician mentioned Harrisons Textbook of Internal Medicine , The Lancet , or any disease process. Instead, they related meaningful stories inspired by their patients. Ofri observed that the stories were crafted with metaphor, character development, irony, connection, interpretation and perspective skills more reflective of the humanities than the biomedical sciences. This makes sense, since doctors are immersed in their patients stories, tales of tragedy and victory, suffering and perseverance, pain and joy. Ofri found that doctors often have profound emotional reactions to the work they do, and she concluded that exploration of these reactions may offer benefit to the patient, doctors and society at large. (4)

A respectful rendering of a patients story should honor them and what theyve endured. If a particular story can edify future physicians, or the public, there is value in sharing it. (4) These are my hopes in relating these stories: to honor the homeless patients I have seen at Siloam; to acknowledge all they have endured; to provide some of benefit to young doctors and to raise awareness of the overwhelming challenges faced by this group of people.

The stories in this book are true. Only one patients story was fictionalized into a hybrid of several people to ensure anonymity of the character. To protect the patients identities, I have changed all names and most of the genders, ages, races and physical characteristics of the individuals. Any medical condition that would allow the identification of a patient has been altered. I have not changed the ethnic background of the Indigenous patients, as the suffering faced by Indigenous people in Canada is very real and needs to be contemplated by a wide audience. I have learned that referring to an Indigenous person by their tribal origin is honorable. Unfortunately, at the time of my encounters with these Indigenous people, I was unaware of that fact, and so failed to ask my patients of their tribal origins.

This photograph is taken with permission from Leah Denboks work, Nowhere to Call Home. Photographs and Stories of the Homeless. Volume One or her website . It is not an image of any character referred to in this book. To see more of Leahs photography, visit ldenbokphotography.com.