LECOM students participate in Healthcare for the Homeless initiative

“May I wash your feet?” I’d never asked anyone this question before, and I was nervous.

If we weren’t in the basement of a church—which was serving as an overflow homeless shelter—I might not have known the man I was speaking with was homeless. His boots were ragged, but they were clean, and his shirt was stained, but it was also buttoned up and tucked in. I realized this man had probably been on his feet all day. He was likely cold, tired, hungry and in need of kindness from a fellow human being. So I smiled at him and asked him to take a seat.

I was helping this man as a member of a small group of medical students from the Lake Erie College of Osteopathic Medicine (LECOM) in Erie, Pennsylvania, who have been coaxing the socks off of patrons of a homeless shelter each Monday night. The service event is part of the Healthcare for the Homeless initiative, a project funded by the Student Osteopathic Medical Foundation (SOMA Foundation). It began in 2014 as a collaboration between Sarah Edwards, OMS III, a community nurse and a LECOM professor.

Why feet?

Poor foot hygiene—exacerbated by excessive standing and walking, ill-fitting shoes and macerated skin from wet socks—predisposes homeless individuals to a number of health issues, according to the American Academy of Family Physicians. The purpose of the Healthcare for the Homeless initiative is to use foot care as a way to connect individuals with health services. During the event, nurses are on hand to help patients if needed, and a local hospital provides an onsite mobile clinic where patients can have a comprehensive medical visit with a physician.

People in the shelter who want to participate are guided to a row of plastic chairs where their shoes and socks are removed and their feet are soaked in a small tub of warm water. Crouched on a knee, students use washcloths on tired, achy feet while making conversation with the people they’re serving.

A mutual trust develops when one stranger washes another’s feet, and it facilitates open communication. By demonstrating genuine interest, empathy and respect, students are able to elicit important health information while making correlations as they inspect a person’s feet and lower legs. These discussions can lead to focused health education on the prevention and treatment of diabetes, hypertension and peripheral vascular disease.

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The discussions also, at times, encourage patients to get much-needed care. Engaged by a discussion on diabetes, the woman who couldn’t feel you touching her toes might opt to have her blood sugar tested. Once informed that his peripheral pulses are weak, a man may be willing to have a nurse check his blood pressure. Even if the individuals at the homeless shelter do not use the available medical services, each leaves with a fresh pair of socks and the knowledge that a stranger cared enough to ask: “May I wash your feet?”

During our preclinical years, medical students are introduced to a vast wealth of medical knowledge. Through study, lectures, exams and standardized patients, we are trained in the foundations of medicine. But the tremendous investment of time and energy needed to obtain that knowledge can leave us feeling disconnected from humanity. Many students fight this by using their burgeoning medical knowledge to help others.

We know that practicing medicine requires a human connection that cannot be taught in a classroom or a lab. But perhaps it can be learned during a charity fundraiser, an afterschool program, on a medical mission trip, or at the feet of stranger in a warm basement on a cold night.