The Call of the Streets
On a Thursday morning, I squeeze into a tiny examination room at Massachusetts General Hospital in downtown Boston alongside Dr. James O’Connell ’70, a specialist in treating the chronically homeless. O’Connell is 68 years old, with silver-white hair, blue eyes and a disarmingly amiable manner. Already in the room are two psychiatrists, two nurses, a nurse practitioner and a case worker, all full-time staff of the Boston Health Care for the Homeless Program’s street team. The BHCHP is the nation’s largest freestanding health care nonprofit for the homeless, and O’Connell is the agency’s president, as well its street team director. He has a longstanding relationship with the hospital, where he maintains admitting privileges, and every week he and his team run an all-day “street clinic” out of two exam rooms on the second floor of its ambulatory care center.
The arrangement is unique. None of the many other clinics for the homeless across the country operates from within a renowned academic medical center like Mass General, as the hospital is known locally. This inside perch gives O’Connell and his team seamless access to a full range of testing, surgery and specialty care, services that are challenging and time-consuming to arrange from off-site. The weekly clinic is popular among Boston’s street population, and, by a quarter past nine, several dozen homeless men and women are gathered on the ground floor in a special waiting area that is almost always a bit unruly and occasionally drifts into minor-league anarchy.