Before medical school, my only exposure to the homeless community was a one-time volunteer gig to help do a homeless census in North Dallas. Back then, I was uncomfortable and on edge. What could I say that wouldn’t sound privileged and ignorant?
Now, three years later, I am a coordinator for Homeless Outreach through Medical Education (HOME), a pop-up student-run clinic that goes to different places in Fort Worth twice a month to do free health screenings for homeless individuals. HOME gives University of North Texas Health Science Center Texas College of Osteopathic Medicine students the opportunity to interact with patients and develop physical exam skills; it also gives a population often reticent to seek care the chance to have positive interactions with health care providers.
When I got started, I felt limited because I could not do anything significant for my patients. In the face of a 450 mg/dL blood glucose, I was armed with patient education and good intentions, but it wasn’t enough for me.
Then in early August, the head coordinator of HOME asked me to see a patient with back pain. I was petrified I was going to mess up. Everything I learned in osteopathic manipulative treatment (OMT) class and in the soft tissue clinics was gone. I am a teaching assistant in our Osteopathic Manipulative Medicine (OMM) lab, I’ve worked more than 20 soft tissue clinics, and I love OMM, but for the first time, I was being asked to work on someone that had a real and severe problem. Furthermore, this patient was a homeless man with little access to health care and this was my chance to finally do something substantive. Naturally, I panicked.
I employed my best stalling maneuvers, trying to buy time for my brain to get back online. I worked on releasing the paraspinal musculature with soft tissue while explaining osteopathic manipulation to the patient who listened intently. But somewhere amid the panic, I forgot that my patient was homeless. The only difference between my patient and the people that I treated in the past, was that his dysfunctions were a lot more severe than the others.
Fear replaced by hope
The rest of treatment progressed with me using counterstrain to treat his psoas followed by muscle energy for a posterior innominate and a sacral torsion. It was moving the sacral base that finally allowed L5 to slide back into place and change was stark. The treatment took a long time, but he was patient with me. He did not complain once, even though I had asked him to turn from prone to supine to check landmarks several times. By the time I was done, my fear had been replaced with hope that he could feel the improvements I had felt with my hands.
When I asked him to get up and see how he felt, his pain was significantly reduced and his walking was nearly normal. He was thrilled and grateful for the treatment. I hope every osteopathic student gets to experience their own moment like this because it made every single second of studying OMT worth it.
That first patient was just the beginning. Others had seen me treating him and had formed a small line of people who also wanted treatment. Now we have patients who will track us down every two weeks regardless of where we set up for the day.
It is through treating these homeless patients with OMT that I am able to see that they are some of the most wonderfully caring and giving people I have had the pleasure of meeting. If you ever have the opportunity to talk to an individual who is homeless, make sure to give them a chance to share their stories because they will change you and how you see the world. In return, treat them with the dignity, compassion and, of course, with OMT.