What Street Medicine really means
“Hey! How y’all doing tonight!?” we call up from the embankment on the side of the road. Slowly, a few people peek their heads out of the concrete of the highway overpass. To the everyday passer-by, or to the unsuspecting medical student, these highway overpasses seem desolate in the urban jungle. But to the discerning eye, to the street medicine team and our reach-out liaison, signs of life are more than evident. A cardboard box folded in a particular way, a plastic bag in the corner of a concrete pylon, a half full jug of water are all the signs of people living on the street. Not all homeless people live out in the open; some need to be searched out from their discreet, humble lodgings. Either way, they all need the same things that you or I need: shelter, sustenance, medical care, human interaction.
The Street Medicine team, through Mercy Care Atlanta, is an amazing organization of doctors, nurses, social workers, and street liaisons, who go out into the streets of Atlanta on clinic visits, to give primary care and psychiatric checkups to patients, or clients, who do not have the means, resources, or information to get medical care in a more traditional setting. Mercy Care has been extremely gracious in accepting the medical students of the greater Atlanta area involved with HSTAT to volunteer in month-long shifts with the team, to gain experience and a new appreciation of a unique facet of primary care. Senior students in MD, DO, PA, and Nurse Practitioner programs may apply to join a select group to assist the primary care physician, advanced care practitioner, and/or psychiatrist as they meet with their clients. Clients can be new patients, passing through Atlanta on their way to places far and wide, or they can be long-time patients who live on the same side walk for months.
I got involved with Street Medicine and HSTAT at the same time. I heard about this program almost serendipitously, and I immediately thought that this was an initiative I needed to be part of. In medical school, we get limited experience with primary care, but almost no exposure to homeless health. Our experience at Grady Hospital gives us a very good, unique opportunity to catch a glimpse of medical care for particularly vulnerable populations, but it is actually limited. I learned very quickly that a similar populations actually present quite differently on the street compared to the hospital ER. That was an eye opening experience for me – I learned that the setting of a patient meeting can very significantly alter the course of the interaction.
Everyone who rotates through street medicine gives of their time and talents to the street medicine team. But what they take away can be very different. Some people take away new skills: listening to lungs and hearts while traffic whizzes by; performing musculoskeletal exams on patients lying on the sidewalk; interpersonal communication with a population with unique barriers. Others take away a new appreciation for working in a standing clinic, with no limit to the resources at their disposal, when working out of a backpack and van on the street medicine team. Yet others find a new career path, hoping to build street medicine programs at their future residencies/hospitals.
Whatever you take from your time volunteering with the street medicine team, know that you are making an impact in this vulnerable population. These individuals are people first, and patients second, and often a simple conversation, showing that someone cares, could be all the “medicine” they need at this particularly difficult juncture in their lives.