University of Toronto
Class of 2019
I wish I could say what I learned in class prepared me for this conversation, but unfortunately, it did not.
Moments after completing an online module at home titled “Health and Homelessness” for the Community, Population & Public Health course as part of the pre-clerkship curriculum at the University of Toronto, I stumbled across who I thought was a homeless child – a small, skinny figure in a hoodie, with a Tim Hortons cup placed in front.
The moment I saw this individual, I was shocked that a child was alone and asking for money, yet that no one seemed to notice. In a state of panic, I walked past this individual and walked around the block in an effort to collect my thoughts and calm myself down.
I have to help this kid, but how?
How ironic that I had just completed an online training module in dealing with and addressing homeless patients and yet here I was, at a loss as to what to do next. Should I call 9-1-1?! It’s unsafe for a child to be out here alone. What resources do I have? I wish I were a social worker right now… As I racked my brain, I realized that I did not have the answer to the question of how I could help the child, but that I had to at least try. I took a deep breath, prepared in my head how to approach this individual, and walked back.
“Hi, my name is Mei, are you all right? You look very young, do you need help?” I asked, as I knelt down beside the child. I had originally thought he was a boy around 10 years old, but when the child looked up, I realized that those knowing eyes belonged to a girl with short hair. “Yes… and I’m not a child, I’m much older.” In the next fifteen minutes, I tried asking about her dwelling (“I don’t stay in shelters because it’s unsafe for me there”) and about what she needed (“I don’t want food because I have diarrhea”). I proceeded to ask about her health needs (“I go to the ER to get the help I need”) and what I could do to help (“I need money for medications to treat my diarrhea”). Yes, I gave her change, but to me, that barely made a dent in the heavy burden of the cycle of homelessness that she knows she is in. “I can’t get a job because I don’t have a place to stay, no place to clean myself, no address to put on a resume. I’ve got no family – my mom committed suicide and I don’t want to know my dad.”
Whatever ideas I could summon up – shelters, social workers, aid programs – she had already thought of and tried. After a few more minutes, she thanked me for the change and got up and left.
There was nothing more I could do at the time, and I felt utterly and hopelessly useless. This feeling was a stark contrast to how accomplished I had felt only moments ago, after completing the homelessness on-line module and “solving” the case studies. But when the real case happened, I did not solve anything. While I loved the module and it certainly helped me gain cultural sensitivity and a basic understanding of marginalized populations, reality is nothing like the safe environment of a classroom. There is often no solution in sight and certainly no cookie-cutter formula for dealing with real, complicated individuals.
This experience, however saddening, was an important reminder for me as a busy medical student to keep pursuing my interest outside of the classroom – to volunteer, to spend time outside the university bubble, and to keep in touch with the real world. Because that’s where my patients will be: in the real world.
Richard Doan, MD, FRCPC
I agree with John Nichols — your openness to be challenged by the situation you faced and to respond with compassion are just great. As a psychiatrist who does street outreach to people who are homeless, I can assure you that many can be helped to find housing and to lead much more comfortable and fulfilling lives. It’s a team effort that takes time and patience, but the rewards for all are fantastic.
The University of Toronto offers great clinical electives regarding the treatment of people who are homeless, and maybe you’ll be inspired to take one of these over the next few years.
Congratulations on your attempt to get to grips with the real world. Of course it can be quite scary but this is where yoy really learn, especially when it gets you asking questions and looking for answers.