Operation Safety Net
Podcast #81 — Aired January 25, 2016

Since 1992, Dr. Jim Withers has been treating homeless individuals where he finds them: in the streets, alleys, and under bridges. Dr. Withers is the founder of Operation Safety Net and this week on BetterWorldians Radio we’ll speak with him about his important work. Dr. Withers will tell listeners what inspired him to reach out to the homeless population and how it is changing lives.

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Dr. Jim Withers
Founder, Operation Safety Net

Dr. Jim Withers is the founder of Operation Safety Net. Dr. Withers received his undergraduate degree at Haverford College, and completed his medical school training at the University of Pittsburgh. He founded Operation Safety Net, the first full time, comprehensive medical service of it's kind for the un-sheltered homeless in 1992. Operation Safety Net is a program of Pittsburgh Mercy and Trinity Health, serving in the tradition of the Sisters of Mercy. In 2005, Dr. Withers established the annual International Street Medicine Symposia to foster collaboration in the care of those sleeping on the streets. In 2008, Dr. Withers created the Street Medicine Institute to focus on helping communities establish Street Medicine programs. Dr. Withers is on the teaching faculty of the Mercy Hospital of Pittsburgh Internal Medicine Residency and a Clinical Assistant Professor at the University Of Pittsburgh School Of Medicine.

 

Episode Transcript

Raymond Hansell
Hi, welcome to BetterWorldians Radio. BetterWorldians Radio is a weekly broadcast whose mission is to uplift and inspire you to make the world a better place. Im Ray Hansell. BetterWorldians Radio is brought to you by the family team that created the popular social game on Facebook called A Better World. It rewards players for doing good deeds, while helping to raise money and awareness for charities. So far over thirty-five million good deeds have been done in A Better World by more than three and a half million people. These good deeds include expressions of gratitude, acts of kindness, sending notes to real world sick kids, just to name a few. This week were speaking with the, with Doctor Jim Withers, the founder of Operation Safety Net. Doctor Withers received his undergraduate degree at, Haverford College, and completed his medical school training at the University of Pittsburgh. He founded Operation Safety Net, the first full time, comprehensive medical service of it's kind for the un-sheltered homeless in 1992. Operation Safety Net is a program of Pittsburgh Mercy and Trinity Health, serving in the tradition of the Sisters of Mercy. In 2005, Doctor Withers established the annual International Street Medicine Symposia to foster collaboration in the care of those sleeping on the streets. And in 2008, Doctor Withers created the Street Medicine Institute to focus on helping communities establish Street Medicine programs. Doctor Withers is on the teaching faculty of the Mercy Hospital of Pittsburgh Internal Medicine Residency and a Clinical Assistant Professor at the University Of Pittsburgh School Of Medicine. Hi Doctor Withers, welcome to BetterWorldians Radio.

Jim
Thank you.

Raymond Hansell
Youre very welcome. Were very honored to have you on today, this is an amazing story, Im sure our listeners cant wait to hear it. Now you began your providing medical care to homeless individuals in Pittsburgh way back in 1992. So what inspired you to do that?

Jim
Well it came out of my teaching experience, actually with medical students and residents and I felt like something was very much missing in the care that we were able to provide in a busy hospital or clinic, and recalled making house calls with my dad when I was a kid, and how connecting with people, going to where they were gave us a lot more, not just insight, but also a sense of connection with people. And I so I thought, you know, we need to bring that back and we need a different kind of classroom. The classroom that I thought we needed, particularly in an area where there were a lot of people suffering from poverty and other situations like homelessness. I was looking for an environment where they would see what it looked like from the outside of the hospital, from the point of view of people who werent doing so well. I also wanted, you know, folks that were disconnected, that we could learn from them, why they were disconnected, maybe even discouraged. And the third thing about the classroom that I wanted was people who were, frankly, kind of difficult. Because I didnt think we would learn as much if everything went smoothly. We needed to connect with and understand the reality of people whos lives were complicated and have the time actually to sit, listen, and understand that. So as I looked at the folks who were coming through the hospital, the folks living under the bridges seemed to be more and more interesting, as far as, what they might be able to teach us.

Raymond Hansell
Thats interesting.

Jim
So thats how I decided to work with them.

Raymond Hansell
Now you sometimes actually dressed as if you were homeless yourself in order to gain the trust of the, of the people that you were about to work with. I assume that was probably very effective when you were approaching people in that kind of situation you just described. Can you talk a little bit about those early experiences?

Jim
Well, you know, I actually didnt know how to bridge that gap and enter into that world, and so, I found a man who used to be homeless, he was taking blankets and food out to people, and I asked him if he would take me along with him. And he said, well as long as you dont dress like a Doctor. And you got to behave yourself. He was really a great asset to gain the trust of people. I didnt know what not dressing like a Doctor meant, so I went to my church library and I found a book that actually described how to dress like a homeless person.

Raymond Hansell
How about that.

Jim
And so, Fifty-Two Ways to Help the Homeless. And there I was in the backyard putting dirt in my hair and my three little boys came out and said, what are you doing daddy? Looks like fun. And so I explained that I was going to do the people who didnt have homes and they said can we come along? And I said, not this time.

Raymond Hansell
Not this time.

Jim
And when I showed up Mike said, well you got the look. And so I didnt tell the hospital really, I didnt tell my malpractice carrier, I just started making these nightly visits and it just opened up a whole new world for me. And thats how I got started.

Raymond Hansell
So what kind of medical services did you, or do you provide?

Jim
Well it was not anything that there was any training for, really on how to do this. It was almost like experiences Id had in third world countries where the infrastructure just isnt essentially there.

Raymond Hansell
Right.

Jim
A lot of things are limited by lack of insurance, legal issues, and then mental health problems and those kinds of things. So the key is to start where someones, there own concern is, and work with that. But I saw wounds, and blood pressure issues, and diabetes out of control, pregnant women, old people with really sick conditions and I realized I couldnt necessarily get all these people into care immediately. So Id have to start doing something about it.

Raymond Hansell
Right.

Jim
So I began putting bandages and medicines in my backpack and just started treating all these things.

Raymond Hansell
And how did people respond to you?

Jim
It was very interesting, they first, because of the way I was dressed, they were skeptical about who I was. But, very quickly through Mike I developed a lot of enthusiastic people in the street who would look forward to me, they called me Doc Jim and they were referring me to other homeless camps and things like that. So it was very heartwarming, because even though many of them were discouraged. And some of them, I remember a guy who just broke down crying saying I cant believe someone cares that were still alive out here.

Raymond Hansell
Yeah, I know.

Jim
But yeah, I was quickly their Doctor, and off we were.

Raymond Hansell
And what did that teach you about how to best care for them? I mean you probably learned some lessons along the way, can you share some of them with us?

Jim
Yeah, I mean, nothings really new, its that a lot of its been forgotten in the busyness of the structure of healthcare.

Raymond Hansell
Right.

Jim
But each person had their own story and once a person, unless you understand their life, youre really not going to understand their health. And that doesnt happen instantly, were very busy and people get processed and listening to story and then having people believe that you really care about them, motivates people powerfully to want to change. And so many people look at populations like the folks on the street and say, oh they dont want to be well, they dont want, they dont care about themselves, and the truth is theyre just overwhelmed and trying to survive day by day, and they become very helpless. Once they realize that youre for real and youre there and youre committed to them as a whole person, not just as a left kidney or something.

Raymond Hansell
Right.

Jim
Then really magical things happen. So as Doctor Boaster said, one of our great Doctors in America, Its more important to know what person the disease has, than to know what disease the person has.

Raymond Hansell
Isnt that interesting. Now your work eventually actually grew into Operation Safety Net, one of the nations first targeted, full time, street medicine programs. Could you speak about how that all came about?

Jim
Yeah, I realized that this was really turning into something and a couple nurses in the hospital started volunteering from some other parts of the city, paired them with their own former homeless partners, phones calls came into the Secretary at the Department of Medicine and she loved it actually, she felt they really connected with her sense of mission. And so we kind of had to come out of the closet by the end of 92. Fortunately the Sisters of Mercy had a grant that was able to hire two of the outreach workers and a secretary, and we became official in 1993 as Operation Safety Net.

Raymond Hansell
Oh okay. How would you describe how street medicine differs from, you know, medicine that so many people experience that are provided in traditional hospitals or doctors offices?

Jim
Well, Im sorry thats a really good question. You know, you have to be careful when you ask me that question.

Raymond Hansell
Okay, thats right.

Jim
I could go on for a long time. I think in some ways we try to do the best medical care that we can under the circumstances out there.

Raymond Hansell
Yeah.

Jim
But its definitely bringing care to the person, as opposed to making the person come to the care. And I mean thats obviously a physical concept, but its also kind of existential because, you know, even when you come into the doctors office or emergency room or whatever, youre there but youre not really often being listened to and the context of your health isnt being understood, and so we commit ourselves to each individual. I mean its not just a medical contract, its a commitment to whether youre freezing that night.

Raymond Hansell
Yeah.

Jim
Or what you need to get into housing.

Raymond Hansell
Yeah.

Jim
Or other issues like that.

Raymond Hansell
Right.

Jim
And so its a whole person commitment which feels really good if youre able to do it as a healthcare worker. So our volunteers, and our staff, and our health system actually, Pittsburgh Mercy health system is I think really been benefited by the ability to get that relationship with people who really need us. It makes our careers much more meaningful.

Raymond Hansell
More rewarding. Thats amazing. Were going to take a break right now, when we return well talk more with Operation Safety Net founder, Doctor Jim Withers. By the way if youre enjoying the episode of BetterWorldians Radio today, please be sure to subscribe to our show on iTunes, wed love it if youd give us a five star review and were always listening to your feedback. So let us know what you think. Well be right back.

Raymond Hansell
Youre listening to BetterWorldians Radio. Were speaking with Operation Safety Net founder Doctor Jim Withers. Doctor Withers Operation Safety Net takes on more than just medical care, could you talk a little bit about the housing program?

Jim
Oh sure, yeah. I mean the essence of what I now call street medicine is being replicated across the country and actually around the world, is that when youre out there and you really see whats going on, these folks become very significant to you. Then you just naturally advocate as a group to whatever is going to improve their lives, because just treating a blood pressure in isolation isnt really as effective as addressing the other global things. So we began to get people insurance, and get them appointments and those kinds of things. Then we realized that a lot of them were just dead in the water on where to go for housing, and so we began putting people in apartments. That accelerated in the early 2000s when federal money was matched with what you could come up with locally to provide apartments for people. And so we began to put people in apartments and initially it was quite an adventure, still is sometimes, but we learned a lot and we use teams like they do throughout the country to help people make that transition. I love that work because now weve housed over thirteen hundred chronically homeless people in apartments.

Raymond Hansell
Oh my goodness, thats fantastic.

Jim
And I take my students with me, and we make house calls like I made with my dad and we celebrate, oh you got your GED or you connected with your daughter, those kinds of things. And that for the, especially for the students, they see the face of success and they dont get this negative image that people always have of the people.

Raymond Hansell
So how does Operation Safety Net help during severe weather, were going through some very cold weather now and headed into the winter deeper months. So what do you do during those times?

Jim
Again, along the same philosophy of gosh we got to do something, this goes all the way back to 93 when we had eleven days of minus twenty wind, or not wind chill, just minus twenty temperature, and it was a life or death. And so with the other agencies we started the severe weather shelter. We staff and run that with help from the county and other partners, and when its bitterly cold we open up and people who cant or wont access other shelters seem to be very able to access ours. So we save, I think thats how we save probably more lives than anything else weve done. And if they actually dont come in, we still patrol the streets, everybody gets sleeping bags, boots, etc. Those who really are at risk we have to take legal action, get them off.

Raymond Hansell
Now Project Help gives homeless individuals legal assistance. What are some of the unique legal needs of people experiencing homelessness?

Jim
Well its often times the histories that they have are very complicated. There may be some crisis that led to situations that then led to fines, and not, you know, other legal issues that happen, minor crimes and things like that that theyve gotten for pan handling or just being out there. And so these wonderful lawyers, we have a number of law firms, they sit down, and much like we do as doctors, just listen to the folks and they untangle the stuff. And its sometimes surprising that with the legal, the lawyers skill you can break an impasse and just change a persons life and get them into housing and other things.

Raymond Hansell
Thats fantastic. Now Operation Safety Net offers fourth year medical students a rotation in street medicine. Id love to hear about that.

Jim
Yeah, I mean I do focus on fourth year medical students, and I couldnt even describe to you the depth of meaning that has for me, and it just grows year and year. We also have nursing students and pharmacy students and social worker students, and any, pretty much any kind of student that wants to connect their learning to it, we try to find a way. But the fourth year students Ive been doing since the beginning almost and they get a month under bridges. They do follow folks into the ERs and their appointments and they get really invested in the people that they serve. I have doctors who are heads of department now, because Im getting a little older, who say, that was still the best thing I ever did in medical school and its changed how I look at every patient. So I think that medical education, healthcare education when combined with street medicine has the potential to, as I had hoped, to have a positive impact on healthcare training and practice far beyond the streets.

Raymond Hansell
Thats amazing. I wanted to share a story and get your reaction. I have, were outside of Philadelphia, which is probably not too dissimilar to your experience in Pittsburgh and so weve got a homeless population and whenever we go downtown for a dinner or something in the way of entertainment or a show or something, theres always parking and walking, and across of my experiences you run across people, and I really made an effort the past few years, of really sort of carrying some bills that I can provide to people, something bigger than a one, maybe a five, or a ten, or a twenty dollar bill or something like that. And I actually keep an eye out, and I see these people you know huddled in street corners, against a wall, and dressed as warmly as they can in the wintertime, and usually with a cardboard or something or other, with a Sharpie written where its like homeless, cant find a job, out of work, lost my family, need a ticket to New York or some other city, and instead of just sort of dropping something in their hand, Ill spend a moment and Ill just ask them a question or two and encourage them and give them something. And the look, the look that I got from these people, it takes your breath away, its, one person actually expressed it and said, Ive been on the street for four months, nobodys done anything like that. So I think most people just sort of look at them as if it was a fireplug, or a street sign, they just walk past. But I think if you engage them, my experience has been if you really treat them with dignity and ask them a question or two or give them a kind word and something like this, its meaningful, I mean thats. Now this is just me speaking as not a medical person thats solving a problem or a lawyer thats trying to crack through some bureaucracy, but just doing something and not asking them for anything in return, not saying dont buy anything but this or for that, heres the food, but just putting that in their hand is, seems to have a profound impact. Have you experienced that kind of thing from your point of view as well?

Jim
Yeah, you put your finger on probably the most important thing of all. That was also something that struck me so much, especially in the beginning, that people are shocked that youre looking at them and talking with them as a fellow human. And sometimes people almost cant handle that because theyve been shamed and ignored and cast aside for so long that, you think about it, its almost like being a leper in the biblical kind of sense. And Ive worked with folks with leprosy in other countries and its the same kind of feeling, like oh my God, you looked me in the eye and you actually asked about me or you hugged me. You know, as far as the issue with people asking for money, and how far to engage people, those are big topics, and Ive struggled around those for years. I think I generally dont give money in my work because it would turn into a thing. But sometimes I do, and it just depends if my heart tells me. I have to feel comfortable with myself in a situation. But when you do and you actually talk to someone like that, then you realize that the real profound part of this is connecting as human beings, material stuff is actually not as important.

Raymond Hansell
Yeah, I think that has been my experience the more Ive done it, the more convenient, the more comfortable I am with it, the more I sort of get a feel of the person and the situation. I think so often we want to just kind of stigmatize these people in such a way that theyre all there for a reason, and theyre going to use this money in a bad way. I dont get the sense that thats universally the case, Im not sure that somebodys not doing something that is helpful. But I think often that the big connection is that somebodys looking them in the eye, touching them on the shoulder, patting them on the back, giving them words of encouragement and handing them something that they didnt expect while literally thousands of people walk by as if they didnt exist. So its, I think everybody actually can do something, and you know, when you think about when you give a tip at a restaurant, or you hand somebody something and that same money put in the hands.

Jim
Yeah, you ask the waitress or whoever, hows your day? And you really mean it, that really is, thats so small but its so important. And I agree with you.

Raymond Hansell
Well I really appreciate the opportunity to talk with you about this today because its been on my mind for some time. So tell our listeners how can they help support Operation Safety Net?

Jim
Well as you mentioned Operation Safety Net is a program thats doing great things in Pittsburgh. And we have a website Operation Safety Net dot net, part of Pittsburgh Mercy healthcare system and we could use donations, monetary and locally if you give us a call ahead of time, other kinds of donations. If youre interested in, this is a concept that across the country and beyond, then the Street Medicine Institute is also in need of help. And that website is Street Medicine dot org. The two are compatible at different levels. Locally in Pittsburgh we do need some clinical volunteers, especially in the wintertime. So give us a call. If youre in a city where you dont know if theres a street medicine program, I probably know at this point and you can contact me there.

Raymond Hansell
Okay, thats great. So, we ask this question at the end of every one of our episodes. I know youll have some good answers for us, youve pretty much answered it all along the way. But how, what is your hope for Operation Safety Net and how it can really help to make it a better world?

Jim
Well my hope is that Operation Safety Net will continue to become the value system that we have thats embedded in our health system, will begin to really pull people together to care for those who are vulnerable. And we do that across other populations, but I think its, our way of thinking needs to change as a community, as a society, and I think that just by doing the work in an inclusive way, Im hoping that well begin to work more humanly with each other. I also have hopes for the Street Medicine Institute that it will become stronger and able to make this a global vision, which its already become in six continents, but were just starting and I think we can actually unify ourselves across the globe by connecting on the same value systems that transcend religion and race and those kinds of things. Its just got legs.

Raymond Hansell
Its got great legs. And I think theres a mission that were all on here to do good and to promote doing good thats beginning to feel contagious and I hope that it does catch on all over. I think were seeing more and more of it at BetterWorldians Radio, and we encourage our listeners to get involved in any way they can at one level or another. So Doctor Jim if I may, Doctor Withers, Id like to thank you for joining us today on BetterWorldians Radio. Its been a great episode.

Jim
Thank you.

Raymond Hansell
Youre very welcome. You can learn more about Doctor Withers great work by going to the website for Pittsburgh Mercy, thats PMHS dot org. And by the way, right now as I mentioned before, our game on Facebook is one hundred percent free through the end of this month, through January 31st, the only currency accepted are your acts of kindness and other social good that you can do in the game and in the real world. Were challenging our players to perform an additional one million good deeds by the end of that period, and theyre very close. When they complete that A Better World will release funds to provide new coats for children in need nationwide through our partnership with Operation Warm. Were getting very close to achieving that goal, but we still need your help. So go to Facebook dot com A Better World to play and learn more. As we end our show each week we like to share our mission here at BetterWorldians. We strive to make the world a better place by encouraging the very best in everyone. We focus on positive thinking, positive values, and positive actions. In short, our mission here is to bring out the BetterWorldians in everyone, so that we can all make it a better world. So until next time, be a BetterWorldian.