Operation Safety Net

May 5, 2012 Updated: May 8, 2012

ATLANTA—When James Withers was in medical school, his teachers told him to keep an emotional distance from patients. He tried. He failed.

Withers was about to see a child who had leukemia, when a little African-American girl accosted him in the hospital hallway. “I know where you can steal popsicles,” she whispered. This was his leukemia patient, and he grew to love her. Withers confessed that his heart broke when she passed away.

Later, Withers put aside nearly all the formal trappings of the medical professional and founded Operation Safety Net—a group of Pittsburgh doctors who go into the streets to give free medical care to the city’s poorest people.

Operation Safety Net is affiliated with the city’s Mercy Health System, and when Dr. Withers visited Atlanta in April to speak at the Global Humanitarian Summit at Emory University, he shared stories of the group.

Withers said he longed to set aside the conventional structure of healthcare and connect directly with patients.

“I think the only way for me to do that was to completely let go of the sword of the power position that I was in, and so I started dressing like a homeless person,” he said.

With his new duds, the doctor met the masses. “Street people were gracious enough to welcome me into their campsites and their abandoned buildings where they live,” he recalled.

Withers said his new patients didn’t just share their health problems, they showed him their “strength of character” and “how they survived in very difficult circumstances, so we became friends.”

Withers said he believes in building solutions from the bottom up. Once he and other clinical volunteers began treating people on the streets, they also were able to help them find housing. He said 800 people who fit the definition of chronic homelessness when he first met them now have places to live.

It all started with medical care, “then scrounging together a little bit of a job or some benefits. But when housing first became a reality, the federal government began to find that kind of housing to place people in directly off the street into an apartment,” said Withers. “So I do a lot of home visits now to people I used to know under bridges.”

Withers said once people have a place to live they begin to blossom. “It’s marvelous to see them reinventing themselves and reconnecting with the community, and the longer they’re housed the stronger they get, the more likely not to fall off the life raft again.”

The relationship between the lowest rung of the ladder of mental health care and street people is like that between spouses after a bad divorce, according to Withers. “They just don’t talk to each other,” he said. “There’s a lot of pain associated with the way you’re treated.”

As a medical doctor, Withers believes he has an advantage over a psychiatrist or other mental health care provider. He says he is able to address deeper emotional issues from the side, by talking about blood pressure or any issue.

“You have to meet people where they are,” he said.

Sincere, loyal relationships are the key, in his opinion. Withers said that even with a person who has profound mental illness “they can read the fact that you care about them, that you respect them, that you won’t control them, and then they open up like flowers. Often times then you gain influence. At critical times when they need a friend they know they can turn to you and we can create a community that can respond.”

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