Rough Sleepers: Dr. Jim O'Connell’s Urgent Mission to Bring Healing to Homeless People

Jim meets Tony (Anthony) Columbo in 2016 while working at the Street Clinic—a clinic for unhoused people to receive medical treatment at Massachusetts General Hospital. Dr. Jim notices Tony’s large stature and sees that he is sweating while wearing layers of clothing. Tony tells Jim that he served 20 years in prison and has been living on the streets since. Jim asks if he uses drugs, and Tony replies that he’s been taking Suboxone, a narcotics therapy used to help people quit opiates. The reason he’s being seen today is for a new prescription, which Jim writes and then pays for. The script costs $120. Jim often gives money to his clients. He feels conflicted about prescribing the drug, but Tony tells him he usually avoids clinics for this reason. Jim decides to write the prescription so Tony will hopefully continue care.

The Street Team meets twice a week—once on Mondays for long meetings to review their patients and again on Thursdays, ahead of the Street Clinic. The team fluctuates but usually includes psychiatrists, nurses, doctors, recovery coaches, administrators, and assistants. The team reviews their caseload—including their patients’ ailments, decisions, and current circumstances. Jim also uses this opportunity to help members of the Street Team learn the same lessons Barbara McInnis has taught him—those of compassion and patience. One key member of the Street Team, a psychiatrist named Dr. Bonnar, shares with Kidder that 90% of the patients treated by the street team “ha[ve] been afflicted by substance abuse or mental illness or both. And at least 75% ha[ve] suffered the physical and psychological effects of severe childhood trauma” (72). Kidder reflects that, even though Jim and his team are working against these statistics, repair is possible.

Jim meets with Tony again a year later. Tony expounds on Jim’s admirable qualities—calling him the cornerstone of the Health Care for the Homeless Program and professing his respect for him. As Jim treats Tony, Kidder details the many struggles Tony faces, like losing all forms of his identification—and the wisdom he possesses about drug use and life on the streets, such as knowing which drugs are most popular. Jim consults Tony about which drugs are being used in various cocktails to better treat his patients.

Jim also reflects on two college professors who were driven to houselessness because of mental illness. These men, Harrison and David were, according to Jim, the smartest people he’d ever met. Jim didn’t think he’d grow as close to another patient. Tony, however, is different.

Kidder describes an annual memorial the Street Team holds for patients who have died within the year. Jim, and the many unhoused people they treat, hold the memorial in a concrete area on the grounds of Mass General, which is named Mousey Park after a man who’d slept there for many years. Kidder records the picturesque scene as Tony attempts to conceal alcohol from Jim, whose hair blows in the wind.