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48 pages 1 hour read

Tracy Kidder

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

Nonfiction | Biography | Adult | Published in 2023

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Index of Terms

Continuity of Care

Continuity of Care, as defined in Rough Sleepers, describes a practice wherein care providers continually see patients to establish relationships with them. For the Street Team and the health care providers in the Health Care for the Homeless Program, this practice is critical to successful care. Continuity of care contrasts with standardized health care across the nation—for the Street Team and its patients, it’s crucial that each person see the same set of providers to establish the trust, compassion, and understanding so critical to successful care for this population.

Homeless

Kidder and the Street Team use the terms “homeless” and “homelessness” in contrast to “unhoused” and “houseless,” which are presently common terms to refer to people who do not have consistent shelter. “Homeless” and “homelessness” refer to a variety of circumstances. People without shelter aren’t always chronically “homeless.” Sometimes the term refers to people who might not sleep in the streets but sleep on couches or in shelters. Because this term is so ambiguous, the statistics that represent the many people in this category might not always capture them.

Some activists advocate for using “houseless” and “unhoused” instead of “homeless”: “The term ‘homeless’ makes the spaces [unhoused people] do call home sound illegitimate, when home represents far more than a location. Instead, home is friends, family, and community” (“Why ‘Houseless’ Instead of ‘Homeless?’LA Community Alliance).

Redlining

Redlining is a policy used by lenders to refuse loans for properties deemed “unsafe” or as belonging to neighborhoods with too much risk. This practice is historically racist, keeping income from flowing in impoverished, predominately Black neighborhoods. It originated from maps where banks deemed predominantly Black neighborhoods too risky for investments.

Rough Sleepers

A 19th-century term used to refer to people who sleep in the streets, rough sleepers are unhoused and remain chronically houseless, usually declining to stay in shelters and fashioning makeshift homes or sleeping in various spots outside. Rough sleepers are the primary demographic with whom the Street Team works and whose stories become central to Kidder’s narrative. Rough sleepers in Massachusetts generally die “at about ten times the normal rate,” according to Kidder (56).

Sisyphean

This term describes an effort that, ultimately, feels futile. It refers to a Greek myth where a man named Sisyphus is condemned to push a boulder uphill and never reach the top. French writer and philosopher Albert Camus argued that purpose is found in struggle: “One must imagine Sisyphus happy” (Camus, Albert. The Myth of Sisyphus and Other Essays. Librairie Gallimard, 1942). The term is used in the narrative to describe the insurmountable reality of houselessness—the poor health, death, and trauma that the Street Team faces for years with no end in sight and the joy in finding small victories despite overwhelming statistics.

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