‘Just give love’: One man’s tireless care for homeless people

Author Tracy Kidder shines a spotlight on Jim O’Connell, a Harvard-trained doctor who has spent 40 years caring for unhoused individuals in Boston, in “Rough Sleepers.”  

"Rough Sleepers: Dr. Jim O'Connell's Urgent Mission to Bring Healing to Homeless People," by Tracy Kidder, Random House, 320 pp.

Tracy Kidder, a master of narrative nonfiction, is drawn to self-effacing, unsung heroes who work tirelessly to make the world a better place. Kidder delves deeply into his subjects, deftly weaving the fruits of his research into a strong narrative line that keeps readers turning pages. He doesn’t hide his admiration for his subjects.

Kidder’s latest book, “Rough Sleepers: Dr. Jim O’Connell’s Urgent Mission to Bring Healing to Homeless People,” highlights the inspiring work of a Harvard-educated doctor who has spent 40 years working to improve the lives of inhoused individuals by providing compassionate continuity of care. O'Connell is a founding physician of the Boston Health Care for the Homeless Program and an organizer of its street team, which offers outreach to the hundreds of homeless people who avoid the city’s shelters and live mainly outdoors – often called “rough sleepers,” a term borrowed from England.

Kidder’s first book, “The Soul of a New Machine” (1981), won both a Pulitzer Prize and National Book Award for its riveting account of the development of an early cutting-edge computer. In the decades since, Kidder has turned his pen into a powerful tool for good. He has written deeply humanitarian books about public schools (“Among Schoolchildren”), nursing home residents (“Old Friends”), a Burundi refugee’s extraordinary will to survive (“Strength in What Remains”), and Dr. Paul Farmer’s determined global public health crusade to eradicate preventable diseases (“Mountains Beyond Mountains”).  

In writing about O’Connell, Kidder centers his story on a man who has persevered despite the often intractable nature of homelessness. O’Connell acknowledges that the work can feel impossible, but he refuses to be defeated. “We just have to enjoy the good days and accept the bad days. It’s sort of the theme of our work. Sisyphus,” Kidder quotes him as saying. “If you don’t enjoy rolling the rock up the hill, this is not the job for you.”

When O’Connell was a neophyte, fresh out of a medical residency at Massachusetts General Hospital, nurses at the Pine Street Inn homeless shelter in Boston instructed him in the art of foot soaking as a way to bring relief to patients and earn their trust. They advised a patient, gentle approach, instructing the young doctor that rather than try to heal, he should “just give love.” He took their lessons to heart.  

Kidder, who first met O’Connell in 2014, followed him with his notebook off and on for five years, including on his nightly rounds in the outreach van to alleys, underpasses, and Boston’s South Station. He comments: “Jim was like a 1950s doctor making house calls, though the van rarely dispensed more than minor medicine.” What it did dispense, besides compassion, was food, blankets, socks, underwear – and transportation to emergency rooms when required. Hypothermia in Boston’s harsh winters is a constant concern.

To go beneath the statistics and put a human face on homelessness, Kidder focuses on one of O’Connell’s patients, Anthony Columbo, a large, affable man who grew up in Boston’s tough North End. Tony came under O’Connell’s care after his release from prison in 2013, having served his full 18 year sentence for assault with attempt to commit rape. 

Like so many rough sleepers, Tony “had suffered the physical and psychological effects of severe childhood trauma,” including physical and sexual abuse. In prison, he became known as Big Tony, “an informal counselor to young convicts, especially young Black men.” Whether on the streets or in McInnis House, which offers respite care for homeless people, Tony became a sort of self-appointed social director and triage nurse, directing O’Connell to residents in need of special help. 

By following Tony’s story closely, Kidder captures “the chaos of rough sleepers’ lives” and the dismaying cycle of substance abuse and recidivism. As a Level 3 sex offender, Tony is ineligible for most housing or jobs, which means he is essentially condemned to homelessness. He is also required to register monthly with his local parole board – and faces re-incarceration when he fails to do so. “In the circuit of Tony’s current life,” Kidder writes, “things always fell apart, but between the breakdowns there were weeks-long periods of sanity and order, and moments of grace.” 

At fundraising events and lectures around the country, O’Connell calls homelessness “a prism held up to society” that refracts the weaknesses in our health care, public health, housing, welfare, educational, legal, and corrections systems. Solving homelessness, he reminds his listeners, is much more complicated than just providing housing, which in turn is much more complicated than just providing medical care. 

In chronicling such a challenging problem – and the stories of the tragically difficult and curtailed lives of Tony Columbo and other patients whom O’Connell and his team have worked so hard to help – “Rough Sleepers” is yet another enlightening reminder from Kidder that we should, and can, do better. 

Heller McAlpin reviews books regularly for the Monitor, The Wall Street Journal, and NPR.

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