The Gateway Cookie

“Hi there, we are out here with Street Med STL – we are just wondering if anyone needs any medical care?” While we frequently see friends we have known for some time, it is not uncommon to meet a new face. This new face was young, but wore the marks of someone with significant life experience.

“Nah man. I’m good.” He replied, looking at me skeptically.

“I am glad you are doing well. Can I get you a giant cookie? We have some big ones, and they are some of the best I have ever eaten.” 

“Chocolate chip?”

“Sure, I think we have some left.” I dug into my bag, pulling out one of our affectionately named GACs (Giant Ass Cookies). For months we have been supplied with these through a generous community partner, Crumbl Cookie in Wentzville. Each week they kindly donate cookies – our GACs – which we use on outreach.

I sat with our friend as he began eating his cookie. “You know, it takes a lot of self-control for me not to eat these every week.”

“Yea, this is pretty dope… so are you like, a real doctor?”

“I am.”

“Can I ask you about something that has been bothering me?”

Bingo.

It is not hyperbole to say that Crumbl cookies have dramatically improved our ability to connect with patients. Though we had brought many treats before, nothing seems to get people engaged like a GAC. Many patients we encounter are naturally distrustful of organizations and institutions – many have been burned before. Consistently showing up helps. Creating low-barrier and no-obligation options for care helps. And so do, apparently, cookies.

In this instance cookies represent something – a token of goodwill. A gift without need for reciprocity. A bridge to a conversation that might otherwise be hard to have. The cookie is just an object, a reason to talk and share space. In that space people can read you. People can catch your body language. They can see if you are going to ask them about something they don’t want to talk about, make them sign some form, give away their information, fill out a survey, etc. But, just to sit and enjoy a cookie… that opens a whole world of non-threatening conversations. Those conversations lead to the harder ones, that people have been afraid to have.  And just maybe, if all goes well, we met a new neighbor, a new friend, and a new patient to help.

All that from a cookie.

Thanks Crumbl Cookie in Wentzville, your donations matter more than we can ever repay!

 

Nathanial Nolan, MD MPH MHPE
Nathan Nolan is an infectious disease doctor in St. Louis with a passion for serving marginalized communities. He is the founder of Street Med STL. In his little free time, he can be found hanging with his fiancée, Valerie, and their pets.