“So you’ve been the ones seeing James* on the weekends?” his brother said to me in the crowded funeral chapel hall. Flowers and childhood photos filled the space around us, as family members greeted each other and exchanged stories.
I first met James 3 years ago when I began volunteering with Street Med STL. His friendliness and kindness struck me immediately. His soft-spoken manner offered a calming presence in a chaotic space. At each weekly visit, I slowly got to know James. I noticed how he often picked up snacks for others with mobility issues. He frequently offered to help our team carry supplies and he led us to folks most in need of our care. He also provided some of my most memorable experiences, such as witnessing one of my first procedures in the field. Due to a severe infection and his reluctance to attend the ER, our team had to incise and drain an abscess in his arm. I watched in awe as he stoically managed the pain of the incision.
When I learned of his passing, I felt heartbroken. After years of checking in on our patients,one gets to know them and really, really care about them. I was aware that in our country, the compounding experience of homelessness significantly lowers someone’s life expectancy by decades. However, seeing these statistics play out in the communities we know and care for so deeply is devastating. I will never forget how powerless I felt witnessing how the perils of living outside cut James’s life so dramatically short. His life mattered. His kindness mattered. And he––and all those we lose––will always be more than a number.
In the aftermath of his death, James’s family invited our team to his visitation and funeral service. I was worried my attendance might intrude on this family’s space for grieving, as leading up to the event, I felt like a stranger who could not have known James as they did. Nevertheless, I wanted to pay my respects to him. That day, I met his brothers, who shared such a strong resemblance to James, each carrying his unmistakable smile. I hugged and cried with his mother, who told us about James as a boy and how he was inseparable from his cousin. The same cousin who died during his teenage years, leaving James lost in grief. She was able to provide the history that we never understood–explaining his pathway to homelessness. And I got to fill in some of the gaps for his family, sharing our knowledge of his time living on the streets. I told them about his calm presence in the encampments and about his unyielding compassion for others—always giving even when he had so little and was himself struggling.
James’s death was tragic and avoidable. One wonders what more investment and support for unhoused St. Louisans could have done for James. Over time, I have realized that this is what sets street medicine apart from our healthcare system. We go directly to those in need, to repair and rebuild the trust they lost in medical care long ago. We offer our patients radical acceptance and work with them in partnership to understand their unique experiences and goals. And when we lose a patient, we continue to honor that life and in James’s case, seek to comfort their families and communities. This unique and holistic approach can allow our care for our neighbors to transcend clinic walls and sometimes, even death itself.
On December 21st, National Homeless Persons Memorial Day, we will honor James’s life, along with the lives of all of our patients lost this year. He unfortunately was not the first and will not be the last. There will be others we will find on our Saturday morning outreach, having died in the night, alone in their tents. Homeless Persons Memorial Day always occurs on the winter Solstice, which is the longest night of the year. It marks the struggle and plight of the homeless, who often remain stranded and unrecognized by the rest of society. On that night, Street Med STL will release a lantern for each patient we have lost. James deserved so much more, but I hope that sharing a bit of his life and kindness through this blog post will allow his warmth and impact to continue on, like a glowing lantern in the night.
*To honor those who have passed, we sometimes choose to tell their stories. However, we have changed the names and some slight details to protect their privacy.
Maisie Bradley | M.D. Candidate | Class of 2029
