Book Review: Rough Sleepers by Tracy Kidder

Rough Sleepers is a term used to refer to the portion of the homeless populace in Boston that sleeps outside on the streets instead of in shelters. This book tells of the Boston Healthcare for the Homeless program, and specifically of Doctor Jim O’Connell, the man who initiated it and gave most of his life to it. Originally, the chief of medicine at Massachusetts General Hospital asked O’Connell to participate in homeless outreach for a year when he finished his residency; that one year turned into two, and then into a lifetime of service. O’Connell developed real love and empathy for the patients he met on the streets and in the shelters, and devoted himself to their care. He was not always able to get them off the streets, and Kidder, who spent a considerable amount of time riding along in the program’s van and observing the level of care at its clinics, explains why. The problems of many of the program’s patients go back to their childhoods, to broken homes, dysfunctional parents, violence, sexual assault, and early drug and alcohol abuse. Still, despite these difficulties, O’Connell and his team always see them as precious people with their own sensitivities, vulnerabilities, talents, and stories.

There is no doubt that the United States is in the midst of a homeless epidemic. Often what we hear about in the news is precisely the wrong ways of addressing the problems: by ostracizing the homeless, arresting them, destroying their makeshift homes, outlawing sleeping on the streets – everything except providing the basic food, housing, and medical care that they need the most. The program in this book is a model for how to deal with homelessness in a positive way. Instead of criminalizing those who have become destitute, the program’s personnel treat their patients with respect and dignity. O’Connell likens his task to that of Sisyphus, the Greek king whose punishment in hell is to roll a heavy boulder up a hill only to have it roll back down so that he has to return to the bottom and roll it up again. Despite all the program’s efforts, the homeless problem seems endless and insurmountable. But that doesn’t mean they can just give up. Indeed, once the doctors and nurses in the program discern the depth and personalities of the patients they are nurturing, they often form long-term commitments to the program.

I have been homeless in the past, mainly when I spent time on the road traveling around the world in my youth. I was often broke and dependent on the hospitality of strangers. Once when I had run out of money and my passport was stolen in Iran, I begged on the streets of Tehran for two weeks before I could raise enough money for a new passport and move on. As a writer seeking experiences I could turn into stories, for me homelessness was a grand adventure. For most of the modern-day homeless the situation is different, though. They have no option but the streets – as well as shelters and clinics when they can find them. Try to imagine being thrown out of your house or apartment and being forced to abandon everything except the few belongings you can carry with you. Imagine further that when you try to pitch a makeshift tent to keep off the rain or snow the authorities come along, rip it down, and possibly cart you off to jail. Homelessness could happen to any of us under the wrong circumstances. If it does, we will be very fortunate if we can find sympathetic, compassionate people like Doctor O’Connell and his team to help us out.

This book needs to be read and appreciated by as many people as possible. Highly recommended.