Rough Sleepers: Dr. Jim O’Connell’s Urgent Mission to Bring Healing to Homeless People, by Tracy Kidder

Rough Sleepers by Tracy Kidder follows the life of Dr. Jim O’Connell from his time at Harvard Medical School and his residency at Boston’s Massachusetts General Hospital (MGH for short), to the twilight of his career, focusing on O’Connell’s tremendous work with the homeless population of Boston, its “rough sleepers.” When O’Connell is well into his residency, with an offer for a prestigious fellowship in Oncology at Memorial Sloan-Kettering Cancer Center in hand, leaders of the Department of Medicine at MGH draft him for a year of work with homeless individuals. One year becomes two, and two become three. The Oncology fellowship is postponed and ultimately declined, and O’Connell becomes the beloved Dr. Jim of the rough sleepers of Boston. He develops and directs the Boston Healthcare for the Homeless Program, starting from almost nothing and growing to quite a large enterprise. Dr. Jim selflessly, tirelessly dedicates his days to providing health care and his nights to patrolling the streets of Boston, dispensing blankets and advice to all of the unhoused he can find, over a period of decades, while he neglects himself and sometimes his family. He helps so many but saves only a few. Homelessness is hard to cure.

Kidder has a clean, direct writing style; he offers the reader many insights into a world most of us are only superficially familiar with. Poignant vignettes of the lives and eventual deaths of individual rough sleepers enrich the narrative. Rough Sleepers is of special interest to me, as I, like Jim O’Connell, am a long-time resident of Boston and a physician at MGH. Many of the places and some of the people in Rough Sleepers are familiar to me. Rough Sleepers is interesting and informative, but I am not sure I can say I enjoyed it. It left me feeling that the problem of homelessness would never be solved, given the problems that led these unlucky people to be unhoused: the backgrounds of physical or emotional abuse that many had suffered; the chronic alcohol abuse and drug addiction; the flawed legal system distributing citations for trespassing for sleeping outdoors in the wrong places; the byzantine lottery that rewards just a few with permanent housing. While compassion dictates an obligation to help these unfortunate human beings, many of them make poor neighbors, carrying their own psychosocial baggage with them wherever they go.

One wonders, how does Dr. Jim do it, day after day, week after week, year after year, fully embracing his mission to bring healing to homeless people? He draws a parallel to the myth of Sisyphos: if you don’t like rolling the rock up the hill, this is not the job for you.