I am not a big church person any more. I was raised in a strict Christian household but I abandoned the church in my 20s. Although I have retained a tight moral code which was founded on my faith, I lack confidence in the politics of organized religion. Thus, it was peculiar to find myself standing in a church basement on a Tuesday afternoon with a 1/2 gallon of tea and a tote of 1st aid supplies.
Being a volunteer for Occupy Medical, a donation based mobile free clinic has put me in a lot of unusual situations. Normally, we hold our clinic in the park with a full staff every Sunday afternoon. We are not known to make house calls during the week. This was an exception to the rule.
The pastor had let another Occupy Medical volunteer (aka J) and me into the dining area in their basement. We had been summoned to conduct an emergency foot bath on an unhoused patient. We wiped down the area for treatment and set up the equipment. Our patient (aka Patient S) was in the bathroom taking advantage of the access of warm running water to clean herself up a bit. Warm water is luxury not to be squandered with this population.
When she returned to the foot bath area, everything was ready for her. The foot basins were warm and filled with an herbal antiseptic blend (approved by our lead wound care nurse). The chair was in place. The bandages were set out. The towels and replacement socks were neatly folded. A bowl of meaty stew, bread and baby carrots were waiting on the table for her, a loving gift from 2 of the church volunteers.
Patient S paused and drew back. I could see that she was hesitant to make use of the situation. She fought back tears. She did not want to ask so much from any one. It had taken a lot of coaxing just to get her to agree to see her feet in the first place. This attitude of feeling unworthy of even basic care is common among the people we treat.
Despite what we read in the press, most the homeless people that we serve ask for nothing. They have lost everything in life. All they have left in their pockets is pride. They want to be independent. I respect this attitude but in order for our patients to acquire more independence, we have to ask them to allow us to share our help just enough to get on their feet again. In the case of Patient S, the need was literal as well as figurative.
Patient S was suffering from frostbite. We have a warming center for the unhoused in our town. It offers a splendid service when the temperature dips below freezing. For various reasons, they missed a night. At the next Sunday clinic, we treated multiple victims of frostbite.
Patient S had problems with her feet even before the last freeze. She used to be a ballet dancer. Her feet were damaged from the toe shoes. She had lost a toe to an infection some time ago when she first became homeless. It takes a while to learn how to properly battle the elements when a tarp covered shopping cart is your only shelter.
Most of our patients were able to return to us weekly for foot baths and wraps. It takes between 1-3 months to recover from frostbite with consistent care. The doctor had ordered the footbaths and bandaging but Patient S missed 2 weeks. Her toes were black and swollen. The blisters were open and pieces of tissue had gone missing. She was in a lot of pain.
J and I helped her to her seat and spoke quietly to her as she settled in. J was an excellent advocate. She spoke only when necessary and listened attentively as Patient S talked through her anxiety. To survive on the streets as an elder requires physical and mental agility. To survive on the streets as a woman requires a show of strength. Patient S knew that if she lost another toe, she would be crippled. She would become a target. She wouldn’t survive. J’s compassion was good medicine.
I focused on getting her socks off. The discharge from the wounds had dried the fabric of her sock to her damaged tissue. I irrigated the wound with sterilized water and after 10 minutes of care, was able to urge her foot free. What I saw was worrisome. J and I exchanged glances. This was going to take some time.
An hour and 1/2 later, Patient S was all set. Her feet were soaked and bandaged. She had eaten a full hot meal. She had new socks on. She even let J call a transport to take her to the hospital for more extensive care.
J and I put away the supplies and walked through our sterilization routine again. Everything tidy and ready to go. I did a last minute inventory on our first aid tote to see what items needed to be restocked as J helped Patient S with her shoes. I closed my eyes and offered a brief, silent prayer for her.
“Please, God, please let her keep her feet. Let her be able to stand, to walk, and to run. I am not asking you to let her dance again but would it be too much to give her a chance to feel enough joy to want to dance? Even for a few minutes? Please?”
I pulled on my hat and coat and followed J and Patient S up the stairs to the parking lot. I hesitated at the door and drew a deep breath. It was comforting to be praying in a church again. I hoped some one was listening.