by Suzanne Minor, MD, FAAP

The subject of the email read “MDC Commissioners Meeting to Address the Homeless,” the body asking me to attend the Commissioners Meeting to describe my challenges in dealing with the “homeless situation in our area” in order to force the Homeless Trust to allocate dollars to target the Miami homeless populations.  Common scenes in the nearby downtown Miami waterfront public park included all manner of dogs and owners frolicking in their respective packs, designer-clad joggers and boot campers, tourists snapping photos, parents hovering near toddlers, and men and women rolling out blankets or spreading out cardboard for the night.  This email started me to seriously reflect on the homeless living in the park.

I’ve lived in this area for 10 years now.  There are more homeless now than when we moved in, displaced to the local park by museum construction.  At first, it was awkward as the pristine park felt overrun with this new population.  For a time, I even avoided the park in the evenings, not wanting to be reminded of the poor after working to provide healthcare for them in the face of great obstacles in my professional life throughout the day.  Looking at the homeless in the park was painful, bringing up feelings of helplessness, hopelessness, failure – providing health care for the poor of Miami was so difficult.  For any patients in the county safety net system, subspecialty appointments might take 6-12 months patients and if homeless, those patients might not get the appointment notification at the shelter address they gave until after the appointment was actually scheduled.  Just to see me as a walk-in patient required them to spend hours in the waiting room to be fit in to the day’s census.  Work was like constantly climbing a steep hill without the necessary gear or support.  And seeing those patients at night reminded me of this defeat and wore at my reserves.

I reframed having persons who are homeless in the park as a growth opportunity.  What would happen if I opened up to really looking at the individuals living in the park and my response to this activity?  How were those homeless people in the park different than those I cared for?  Really, I didn’t know them intimately as I knew the patients I served.

Most strikingly, I have come to believe that my primary response to the plight of these homeless persons is strong emotional pain.  I feel others’ pain deeply at times.  At work, my role as physician allows me to be present and witness and feel pain. But that pain passes through me;  I don’t take it in as I did earlier in my career.  I can feel the grief or horror or anguish and let it move through.  When I’m in the park, I’m not in my physician role and I feel more vulnerable to other’s pain.  It’s much more real to witness someone set up their bed for the night rather than hearing about it secondhand from the patient.  It touches on my own previous feelings of hopelessness around financial insecurities, a deep and old wound.

It seemed that the message of this email was that the homeless were not to be tolerated in the park just because they were homeless.  I am sure that at the Commissioners Meeting many will try to provide reasons why the homeless persons must leave the park attributing some kind of threat them or arguing that shelters would be better for them. But the foregone conclusion that they must leave is desperately in search of support. Shelters are a quick fix and like a bandage over an abscess. Shelters don’t address the heart of the matter: mental and health care, affordable housing, adequate salaries, affordable mass transportation, and support during personal and financial catastrophes

I think this is so difficult because this is a “me problem,” not an “other problem.”  If it is an other problem, it is in those societal issues culminating in homelessness.  .  Can I personally address these issues?  Yes, indirectly with my votes and discussions with elected officials.  Yet, the me problem cannot be fixed by someone else – the assessing of my personal values, the opening of my heart, the feeling of old pain, the striving for a life of integrity requiring me to live compassionately despite those obsolete, background prejudices telling me to do otherwise.  This is the heart of the matter – my heart and the individual hearts walking about the park.  Can we, as a society and as individuals, cultivate compassion and support resilience so that we can face such difficulties head on, with open hearts, and have a real dialogue, choosing inclusion, compassion, and love rather than exclusion, isolation, and hate?

Suzanne Minor, MD, FAAP, is the Assistant Dean for Faculty Development and an Associate Professor at the Florida International University Herbert Wertheim College of Medicine She is a member of the Editorial Board of Reflective MedEd. Follow her on Twitter @minor_se