Remembering Sarah Anderson

Sarah Anderson
Dr. Jim O'Connell

August 19, 2017

Sarah Anderson first graced our lives in 1986, joining a pantheon of breathtakingly strong women who forged not only our program but also my own career. After untold hours toiling in blissful obscurity in shelter clinics and on the streets, we had come to understand a constant rejoinder of Kip Tiernan and Barbara McInnis. Homelessness is all about poverty and inequity, and the medical care of individuals and families struggling without homes should be predicated upon social justice rather than charity. As clinicians working beneath the safety net, we desperately needed the wisdom and skills of a savvy and seasoned lawyer. As a doctor, I bristled of course at the thought of inviting a lawyer into our midst. Coming to us from Greater Boston Legal Services, Sarah immediately neutralized any skepticism by quoting the famous nineteenth century German pathologist Virchow, the founder of social medicine, who believed that “physicians are the natural lawyers for the poor.” She smiled and said that we were both in the same business, making the same subsistence-level wages, and we had a lot of work to do together.

Sarah Anderson quietly won our hearts, helped steady our fledgling program, and tirelessly devoted these past thirty-one years to nurturing, nudging, and nagging us to always find better ways to improve the health of those we served. She relished that our Boston Health Care for the Homeless Program (BHCHP) had emerged as the largest and most comprehensive program in the nation, serving almost 12,000 homeless individuals and families in Boston each year through a network of over 45 shelter and street clinics that are anchored by our daily clinics at Boston Medical Center (BMC) and Massachusetts General Hospital (MGH) as well as 124 medical respite beds at our Barbara McInnis and Stacy Kirkpatrick Houses serving ill and injured persons who have no homes in which to heal and recover. Sarah has been our rudder through sea changes in the health care system, a quiet and brilliant tactician who has never let us veer from our mission to serve our poorest neighbors, and a humble and gentle soul who shunned any encomium while deflecting all praise to others.

Governor Dukakis ran for President in 1988. At that time, other than the Robert Wood Johnson Foundation and the Commonwealth of Massachusetts, our only funding came from Comic Relief. Robin Williams and Billy Crystal came to spend a day with us in late summer several weeks before the election. After a rollicking session at the State House with the Governor, Sarah joined Mayor Ray Flynn and ourselves for a visit to Long Island Shelter in the middle of Boston Harbor. The island was electric that afternoon, with Robin and Billy mingling effortlessly with often-forgotten souls. Laughter was everywhere and a much-needed sense of solidarity and community emerged. Sarah tried to remain dignified, but was soon swept away by those precious moments as she sat doubled over in laughter in the crowd surrounding Billy and Robin on the steps of the Tobin Building.

Sarah matched brilliance with understatement. She taught me just about everything I know about SSI and disability, simultaneously the most boring yet most important thing a doctor can do for poor and homeless persons. Income and health insurance render an escape from homelessness possible. Sarah led a national committee that examined the obstacles to obtaining disability and other entitlements faced by those living in shelters and on the streets, and helped me write a manual to encourage doctors to get involved. Sarah generously mentored several homeless persons who joined our board of directors. Our board has long had members with lived experience of homelessness, and Sarah always reminded us that the people we serve are literally our bosses. Sarah never let us rest on our laurels, and taught us to toss caution to the wind, whether creating our first respite program in 1985 in the midst of the AIDS epidemic and a notorious outbreak of multi-drug resistant tuberculosis, addressing communicable diseases in the family shelters, setting up a clinic on the backstretch of Suffolk Downs to care for the hundreds of hardworking migrant workers living in stables while taking care of thoroughbred race horses, or establishing a transgender clinic to address an excluded sub-group of the homeless population.

Sarah was a fixture at the national health care for the homeless annual meetings, teaching about disability, helping involve consumers in all forms of governance, and keeping a watchful eye on Medicaid policy. She led workshops, lectured, and made herself fully available to the hundreds of persons from across the country who sought her counsel.

Sarah was bedrock through the inevitable vicissitudes of my personal and professional journey. She was with me through thick and thin. Each year I would meet her for my annual review, and no holds were barred. After the usual platitudes and niceties, she would then issue the inevitable challenge to do better or pursue yet another emerging challenge. Complacency was simply anathema. Each year she would ask me how my book was doing, and then lower her eyes in disappointment when I reviewed the litany of distractions that had kept me too busy to reflect. As we approached our 30th year at BHCHP, she put her foot down and demanded the stories be put to paper before our Gala. Sarah and Margaret Boles Fitzgerald became my Hounds of Heaven until the book was finally finished. Needless to say, I am forever grateful and can never thank Sarah enough.

Sarah Anderson’s humility was breathtaking. She was a woman of warm humor, remarkable breadth, transparent honesty, and sincere compassion who perfected the art of living in the reflected glory of all of us here today, while shunning all recognition of her profound and lasting accomplishments. Sarah lived quietly but heroically in service to others and had a truly unique ability to transcend the world before us, so riddled by poverty and inequity, and envision something better. Sarah will forever call us to serve the least among us with equal measures of excellence and joy because, as she said so often, it is simply the right thing to do. And that vision is what will live with me and all of us forever.

Finally, I stand in awe of Sarah’s inner strength and stunning courage in the face of the raging cancer that ravaged her body but never touched her soul. I have marveled through these past months at the love and care and devotion of her beloved Myriam, her family, Sally Kelly and her cherished and vast community of lifelong friends. Sarah is now at peace and I pray she can hear these long overdue thanks today. The memory I hold most dearly is Sarah’s gourmet Christmas dinner a week before that first surgery in December 2016, when Jill and I were invited along with our two-year-old Gabriella to sit at that long table of plenty that stretched across her living room and dining room in Charlestown.

Let me end with some words from a favorite Yeats’ poem:

Think where one's glory
Most begins and ends,
And say my glory was
I had such friends.

(The Municipal Gallery Revisited, W.B. Yeats)

Rest in peace, Sarah. Our world is diminished without you.

Sarah Anderson and Jim O'Connell Parade Grounds, Charlestown, July 2017
Parade Grounds, Charlestown, July 2017