"[Dr. Jim] O’Connell recognized many of these homeless men.... [H]e’d seen them in the Mass General emergency room, sullen, angry, snarling, resisting all treatment. Here they seemed so docile that they might have been drugged, via foot soaking.... You filled a plastic tub halfway up with Betadine and put the patient’s feet in it.... [Y]ou always addressed the patient by his surname and an honorific — 'Mr. Jones.'... [O'Connell] spent three afternoons and evenings there each week, soaking feet and not doing much else for more than a month. Among the regulars was a very large elderly man usually dressed in three layers of coats, with wary eyes and a salt-and-pepper beard and a great wave of white-and-gray hair that seemed to be in flight.... He was classified as a paranoid schizophrenic, and his chart was thick... [and he] had always refused to take medications or to be admitted to the hospital.... [His feet] were so huge and swollen that O’Connell had to prepare a separate tub for each...."
Writes Tracy Kidder, in "'You Have to Learn to Listen': How a Doctor Cares for Boston’s Homeless/Lessons from Dr. Jim O’Connell’s long crusade to treat the city’s 'rough sleepers'" (NYT).
"[O]ne evening, as O’Connell knelt on the floor filling the tubs, he heard the old man say, 'Hey, I thought you were supposed to be a doctor.... So what the hell you doin’ soakin’ feet?'... About a week later, he put his feet in the buckets and said to O’Connell: 'Hey, Doc. Can you give me something to help me sleep?' He never slept for more than an hour, he said. Within about a month, O’Connell had him taking a variety of medicines for his many ailments. Foot-soaking in a homeless shelter — the biblical connotations were obvious. But for O’Connell, what counted most were the practical lessons...."
Are the "biblical connotations" not "practical"?
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37 comments:
It is the NYT. They have to put a "but" after Jesus' good works. It's in their stylebook.
I know this is supposed to be highlighting doctor empathy but I reject it. It’s these same assholes who have been perpetuating the same drug/homeless/mental illness crisis as 35 years ago when I worked in outreach in college. There is too much deference paid to the ‘rights’ of addicts- to sleep in the street, to hustle good people for drug money, to demand endless public services from enabling governments. Too much money is spent enabling drug habits while too little is spent on mental illness. Live-in mental care facilities are dismissed as barbaric because of mistakes made in the past. Open borders allow the free flow of product and slowly destroy cities…
Fuck these doctors…
There is something about a warm foot bath that does bring a sense of calm and relaxation.
Thank you, Ann.
While "listening" is therapeutic, that is not what is going on here. The doctor was actually serving the homeless guys, not just admitting them into his presence. This gives dignity to someone who is always directed by whatever ideologue he finds in the "medical" system, allowing them to choose to get better. It is why actual love works therapeutically.
Saints and angels, working in healthcare.
So they have soft and soothed feet while continuing to make city life impossible for everyone else, good on them
What an interesting piece to highlight.
I wonder if it's foot-washing in particular, or just the sense of judgment-free intimate care, that could get through to these poor people. Jesus was pointedly acting as a servant toward his disciples, doing something for them that no master would do for his students. Something that has happened in every church I've attended where the priest undertakes this ritual during Lent is that they have trouble finding volunteers to have their feet washed. Some are embarrassed about how their feet look, or afraid that they might smell bad if they're coming to Mass straight from work and can't pre-wash their feet at home. Some give such deference to priests that they can't bring themselves to have a priest wash their feet. Some are so invested in being servants themselves that they can't let anyone serve them in this way.
Foot issues, like bed sores, are just a misery, it seems to me. Even just a poorly-fitting pair of shoes can ruin your day - our daughter was preparing for a career/internship fair at school and wanted to buy some shoes at Goodwill that weren't her size because she'd spent her budget on her suit, and I told her we'd float her a loan for decent shoes because the comfort of her feet could materially affect her chances of getting a job. Anything that can relieve that pain and discomfort has to be so welcome to the recipient.
Final thought:
Live-in mental care facilities are dismissed as barbaric because of mistakes made in the past.
Terrible mistakes. But how often is this the story? We, the collective "we," did something terrible in the past. We learned our lesson and resolved never to make that mistake again. But the fact of the past mistake closes the door to whatever benefit could be realized from the past system. What sprang to mind for me was our discussion of the principles of the Left the other day, and how both Robert Cook and Daniel12 cited drastically cutting military spending, with Robert (I think it was) providing a bunch of examples of military adventurism that seriously harmed the economies and cultures of the countries where we went - all from like 1910 and earlier, as if our thinking hasn't changed at all since then.
“So they have soft and soothed feet while continuing to make city life impossible for everyone else, good on them.”
The feet aren’t being soaked in Betadine to soften and smooth them. More likely to stop or heal feet that have some degree of infection all the way up to gangrene.
I applaud the doctor's humanistic impulses toward comforting his patients - but it's plain to see that there is an aspect of re-arranging the deck chairs on the Titanic, here.
"Within about a month, O’Connell had him taking a variety of medicines for his many ailments."
Because in America, "good" doctors are those who serve the pharmaceutical industry first and foremost. The purpose of that sentence is to establish that yes, O'Connell's one of the "good ones", not just some quack who looks for non-pharma solutions to patients' problems.
Surveys have found for decades now that Americans think less of their doctors' skills if they leave an appointment without a prescription for some drug to take. If everything else weren't enough, this strongly suggests that we as a society are ready for the next comet impact.
Tracy Kidder is an interesting guy - his interests are amazingly varied, and when he takes on a new subject he immerses himself in it until he understands it. I played handball with him back in college; sometimes he would disappear for a while. He was riding the rails in California to research his first book "The Road to Yuba City" about migrant worker murders. Since then he's written about medicine, computers, education and other stuff.
Next up... Proctologists to the homeless?
From Wikipedia: "John Tracy Kidder (born November 12, 1945) is an American writer of nonfiction books. He received the Pulitzer Prize for his The Soul of a New Machine (1981), about the creation of a new computer at Data General Corporation. He has received praise and awards for other works, including his biography of Paul Farmer, a physician and anthropologist, titled Mountains Beyond Mountains (2003). Kidder is considered a literary journalist because of the strong story line and personal voice in his writing. He has cited as his writing influences John McPhee, A. J. Liebling, and George Orwell. In a 1984 interview he said, "McPhee has been my model. He's the most elegant of all the journalists writing today, I think." Kidder wrote in a 1994 essay, "In fiction, believability may have nothing to do with reality or even plausibility. It has everything to do with those things in nonfiction. I think that the nonfiction writer's fundamental job is to make what is true believable."
I have to assume that the "medication for many ailments" does not include the schizophrenia, or else they would have specified. That's too bad; without treating that problem, everything else likely seems doomed to fail.
So we're done following the science? Bias-confirming anecdote suffices?
"Ever Pick Your Feet in Poughkeepsie?!"
I don't think warm foot baths are the cure for paranoid schizophrenia, but they can't possibly hurt--unlike other some other forms of treatment.....I knew a guy who worked the midnight shift in the ER in a sketchy neighborhood. This was back in the seventies. Lots of drunks and drug addicts passed through. They had rolled their lives up into a huge ball of shit and they blamed their caretakers for the mess. He tried to treat the addicts and drunks all dignity and respect, but it took effort. By and large, people are not as committed to their kindness and decency as addicts are to their addictions.
[Y]ou always addressed the patient by his surname and an honorific — 'Mr. Jones.'...
I spent 40 years teaching office staff, medical students and residents to do this, then HIPPA changed the rules. It still annoys me. It is especially important in poor and charity patients.
I think the biblical reference is to foot washing, not soaking. Some churches such a s seventh day Adventist, still do this. My church does it every 13th sabbath. We all wash each other's feet. Men was men, women wash women.
Good on the doctors for foot soaking.
I used to be a big Kidder fan. I read everthing g from soul of a new machine to mountain behind mountains. Then I kind of lost track. I need to catch up. Great writer on any topic
John Henry
Foot-soaking in a homeless shelter — the biblical connotations were obvious
Christmas Eve is the big service in Christianity, of course. But the most powerful service, in my opinion, is Maundy Thursday. That's the foot-washing service. If you're afraid of intimacy like I am, boy that service is a little scary. The first time I tried it, I scrubbed my ugly damn feet for an hour or two and I did not go.
The second time I tried it, I really wanted to wash the feet of a beautiful woman. That was my #1 choice. I wanted to avoid men, children, and old people. That's because for most of my life I would associate intimacy with sex. Separating out the two is difficult.
No women? Sexist!
Kidder's Soul of a New Machine is very good depiction of what work on a leading-edge technical project feels like, - a sort of compound of exhaustion, exhilaration, and something like terror (since the leading edge may be over thin ice). And as someone in the book says, you're not really playing for money. You're playing for the right to play again. One of the players is the guy working on microcode, which is the firmware of the computer inside the computer, where nanoseconds count and must be counted. He burns out and as he leaves, says he wants to go somewhere where the longest interval of time is a season.
Some clinics are more pro-life, charity, dignity, and agency than others.
Rehajm said...
I know this is supposed to be highlighting doctor empathy but I reject it. It’s these same assholes who have been perpetuating the same drug/homeless/mental illness crisis as 35 years ago when I worked in outreach in college. There is too much deference paid to the ‘rights’ of addicts-
Used to be anybody who shot up was looked down upon and treated as a criminal.
A month or two in county every time for addicts, prison time for dealers. Some addicts will go straight, some will go straight back.
My observation of young peripherals in SF bay areaand their cohorts, free 12 step meetings work, many rehab facilities suck and provide exposure to criminals, gangsters and haed core addicts with no intention of getting clean.
Yes, having worked in acute emergency mental health for 40 years with lots of homeless folks, we would see these self-congratulatory essays all the time. It is true that many downtrodden and homeless are neglected and not listened to or treated well by the institutions supposedly serving them, and a little kindness can go a long way.
Now try and scale that up and do it as a program for dealing with the homeless. You will quickly see that 90% of them are unchanged and unaffected. So by all means keep going and finding that 10% who can be helped and dear God, please help them. But stop with the condescension toward those who are doing what they can for the ungrateful 90% who deserve some services anyway but abuse the staff who bring them. You aren't fit to unbuckle their sandals and you aren't the f-in' savior of the world.
OK, whatever. This is massive problem that needs to be solved through GOVERNMENT action. The idea what the USA with all its money, and spending 35 percent of GDP on government at all levels, can't get Homeless people medical care and off the streets is absurd.
I get the impression some "Bleeding heart Liberals" love the homeless so they can express their "Compassion" not because they actually want to solve the problem.
THe homeless need more than "Random acts of kindness".
“I think the biblical reference is to foot washing, not soaking. Good on the doctors for foot soaking.”
What is it with the confusion about whether their feet are being soaked or washed? Maybe because most here can’t/won’t read the article in the NYT there is a notion that this is some spa for the homeless. I guarantee you that the majority of the feet being taken care of is for medical purposes. Even in the excerpt Althouse included was a reference to Betadine. No one here knows what Betadine is used for? You think that handling feet that have sores in various stages of infection is treated with some spa like foot soak? Or may you think the homeless have perfectly healthy clean feet?
Why are some commenters so stingy with giving these healthcare workers praise and admiration For doing what so few people would?
David Crosby got of the shit cold turkey in prison decades ago and is still here today to annoy us all with his obnoxious tweets…
'Hey, I thought you were supposed to be a doctor.... So what the hell you doin’ soakin’ feet?'
What the government pays him to do, he will do. It may wreck the community you live in, but he couldn't care less about that. He's a fucking "compassionate professional". And he makes so much money washing feet that he can afford to live well outside the community his "patients" are destroying.
Inga,
Really?
Foot washing, in my church, consists of going to a person with a basin and washcloth. Wet the cloth, wipe down one foot then the other. Perhaps 1minute total. Nobody puts their foot in the basin.
Foot soaking as described in the article involves putting feet into the basin and leaving them there to soak.
And you really can't tell the difference?
John Henry
rcocean said...
"OK, whatever. This is massive problem that needs to be solved through GOVERNMENT action. The idea what the USA with all its money, and spending 35 percent of GDP on government at all levels, can't get Homeless people medical care and off the streets is absurd.
I get the impression some "Bleeding heart Liberals" love the homeless so they can express their "Compassion" not because they actually want to solve the problem.
THe homeless need more than "Random acts of kindness"."
Back in the 70s the ACLU advocated a law that allowed any adult incarcerated in a mental facility without their consent could self release as long as they weren't criminally incarcerated in a mental facility. The law passed and here we stand. As per usual with do-gooders the unintended consequences of their compassion are devastating.
"I get the impression some "Bleeding heart Liberals" love the homeless so they can express their "Compassion" not because they actually want to solve the problem."
A small fraction of the BHLs love the homeless because their grift is getting paid millions to pretend to do something about them. Another small component sees them as useful ground troops, who can be registered to vote at various locations where their ballots can be harvested. These groups are tiny fractions of the BH of L, but the rest are just useful idiots.
Kidder, Soul..
My first after-degree project had Steve Wallach as Product Manager. He was the architect of the MV/8000 Eagle described in "Soul". Somewhere, I probably still have that spec, printed on fanfold pinfeed paper. Complete with the quotes.
Interesting guy. I described him as "A great team leader. Removed obstacles for us. But I would not want him as a neighbor."
Kidder, Soul..
My first after-degree project had Steve Wallach as Product Manager. He was the architect of the MV/8000 Eagle described in "Soul". Somewhere, I probably still have that spec, printed on fanfold pinfeed paper. Complete with the quotes.
Interesting guy. I described him as "A great team leader. Removed obstacles for us. But I would not want him as a neighbor."
I thought I recognized the name. Back in 1981 Tracy Kidder published The Soul of a Nee Machine, the first real look at life inside the high tech industry.l that was accessible to non-techies.
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