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Poor homeless man or refugee sleeping on the wooden bench on the urban street in the city, social documentary concept, selective focus

Dr. Jim Withers: The People’s Street Physician

Meet the man who brought health care to the homeless and started the “street medicine” movement.

Melancholy and despair hover above a homeless man as he limps down the dark streets of Pittsburgh in 1984. This evening he found warm shelter under a condemned and broken bridge. He found company there. An infection on his right foot has been slowly growing making it difficult to walk. He limped up to three men and painfully sat in the corner. He didn’t say anything, but they looked to be starting a fire. He’s getting a fever. Finally, some luck. One of the three men by the fire pit walked up to him, holding a leather messenger bag.

“Let me see that,” said the stranger.

He hardly understood; it’s been so long since someone was kind to him. But what could this other man, in the same rags as him, possibly do to help?

“I’m a doctor,” the stranger continued.

The homeless man pulled up his pant leg as the stranger grabbed medical gloves from the leather bag.

“Thank you, doctor,” he replied, feeling something, he hadn’t felt in years … hope.

The stranger is Dr. Jim Withers. As if a doctor dressed as a homeless man practicing medicine in the middle of the night isn’t awe-inspiring enough; it’s how he got there that completes this true story.

The Making of a Caring Heart

In 1957, a particularly average American small-town brought us a particularly above average Jim Withers. In Hanover, Pennsylvania, the town physician and a nurse had a baby boy who would grow up to become a physician, an instrument of change, and a powerful advocate for good.

The boy accompanied his father on house calls. Being the only doctor in Hanover, there was never a shortage of patients. He would also ride with his mother, delivering meals to the homebound or elderly who qualified for the Meals on Wheels program. Even then, he understood the basic difference between people who had things and people who didn’t. Spending hours delivering meals and witnessing people at their most hopeless molded his values and strengthened his moral compass. This is what he would dedicate his life to: caring for the broken and forgotten.

Throughout this period, the Withers family took medical trips to Nicaragua and Guatemala. Seeing the world, both the good and the bad, left an indelible, positive impression on him. “I remember talking about how most of the health issues faced by the people in those two countries were tied largely to political turmoil — and poverty,” Dr. Withers told Jeff Sewald of the Pittsburgh Quarterly.

After high school in Hanover, Withers chose the University of Pittsburgh to begin his higher education, a reputable institution of higher learning. Throughout his studies a series of mentors led him to the conclusion that he was different from them. He considered health care sacred, not the means to gain wealth and status. He felt the medical culture seemed to have lost their idealism.

“The very structure of the traditional health care system dehumanizes the people we have pledged to serve. It has put distance between the practitioner and the patient,” said Dr. Withers.

More Than a Doctor, a Movement

After graduating from the University of Pittsburgh, Withers elected Mercy Hospital’s internal medicine residency program, as it glistened with possibilities. Being a mission-driven, values-based nonprofit organization, Withers would fit right in. In 1984, he joined the hospital as a physician and instructor. It may not have been the Guatemalan jungle, but he was surrounded by urban poverty, often treating complex, co-occurring mental health and substance use disorders, including alcohol and other drug use.

But a lot of the would-be people who needed his attention resisted, distrusting and sometimes fearful of outsiders. Dr. Withers began going incognito, dressing as a homeless man and working in areas with dense homeless populations. Some conditions and illnesses can be a cause of homelessness. According to a 2015 survey conducted by the Mental Illness Policy Organization, the most commonly diagnosed are mental health disorders, predominantly chronic schizophrenia. Other illnesses occur later as a result of prolonged exposure and living on the streets. These include diabetes, hypertension, dental and periodontal diseases, malnutrition, parasitic infections, degenerative joint diseases, infectious hepatitis related to intravenous drug use, and liver failure.

Even though Dr. Withers did his best to hide his extracurricular activities, by late 1992, Mercy Hospital discovered his operation. To his surprise, he wasn’t reprimanded. In fact, he was welcomed and supported by the hospital’s then-CEO, a Sister of Mercy, who likened his work to that of the health system’s founding Sisters of Mercy who walked the streets, ministering to the sick, poor, and uneducated — a valued work of mercy. Dr. Withers was soon joined by a few nurses. Pittsburgh Mercy, the larger, community health and wellness system to which the hospital belonged, helped him expand and improve the program that became Pittsburgh Mercy’s Operation Safety Net®. Today, the program offers outreach, engagement, case management, and links to integrated physical and behavioral health care, housing and other vital human services.

“What I was really interested in was changing the way medicine is practiced. I wanted to change how doctors approach their work and the people they serve,” continued Withers.

In 1993, Pittsburgh Mercy gave its blessing and support for the program through a Care for the Poor Fund grant. Over the years, Withers and his team have provided care and housing assistance for more than 10,000 people. His mission included an improved health care delivery model that looks at the needs of the whole person and focuses on humanity, empathy, and innovation.

The Emergence of “Street Medicine”

To expand his program, Dr. Withers mounted a solo expedition, first around the United States and then overseas. His goal was to survey and connect with other groups similar to Pittsburgh Mercy’s Operation Safety Net. The problem was universal, everywhere. Doctors attempting to reform the system had no support, fighting a battle on every front. He already knew that if everything went as planned, they would never be alone again. He would connect them.


In 2005, Dr. Withers and Pittsburgh Mercy’s Operation Safety Net organized an international educational event dedicated to the advancement and care of the homeless population. The International Street Medicine Symposium hosts experts from around the world to run workshops and give lectures. They present outcomes, strategies, innovations, and breakthroughs in the movement to provide quality care to the homeless.

In 2009, a select few medical professionals from the symposium, with start-up support from Pittsburgh Mercy, combined their knowledge, network, and expertise to create the Street Medicine Institute. This body is dedicated to reforming health care for the homeless. Withers’ movement took hold and has spread to over 80 cities within 51 countries.

A Voice for the Invisible

Through his efforts to advance the cause, countless lives have been helped. Many more “strangers” are rendering aid to the homeless, finding them in back alleys, along urban sidewalks, beneath bridges, and wooded areas.

Advanced by Dr. Withers, this crusade for medical equality continues as others join and devote their lives to the cause. In 2015, he was named one of CNN’s Top Ten Heroes, and today you will find him in the same front lines, speaking up for those who have no voice.

A force for good dedicated to helping his fellow humans, Dr. Withers sets an example for us all to be our brother’s keeper.

Learn more about the work of Pittsburgh Mercy’s Operation Safety Net at www.pittsburghmercy.org.

Find out more about his work and the Street Medicine Institute by visiting www.streetmedicine.org.

 

Photos courtesy of Pittsburgh Mercy’s Operation Safety Net.



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