The Longest Night: Discharged and Homeless

A hospital patient describes what it’s like to be homeless while recovering from surgery.

Tuesday, May 02, 2017

The Longest Night

Ken Martin, activist and vendor with the Washington, D.C.-based street paper Street Sense, shares his experience and struggle with the U.S. health care system as someone who was once homeless.

In 2014, Washington, D.C., resident Ken Martin was discharged from the hospital two days after heart surgery. Martin was homeless, and with nowhere to go, he recovered on the streets. The day after being discharged, Martin was back in the emergency department with a possible heart attack. After another surgery, he was discharged one day later and returned to the streets. Unfortunately, Martin’s story is not unusual. According to a report  from the U.S. Department of Housing and Urban Development, on a given night in 2016, nearly 550,000 people in the United States were experiencing homelessness. These patients face unique barriers finding access to care, recovering after hospitalizations, attending follow-up appointments, and getting medications, according to the National Alliance to End Homelessness.

As the provider of 35% of the nation’s charity care, academic medicine is all too familiar with the issues surrounding homeless patients. Medical schools and teaching hospitals across the country are addressing these challenges through a range of community programs.

  • At the Warren Alpert Medical School of Brown University, medical students organize health, legal, and housing services for the local Providence, R.I., homeless community.
  • A new project at Rush University Medical Center donates leftover food from its kitchens to an organization that feeds the local homeless population.
  • A program called UB HEALS (Homeless Health, Education, Awareness and Leadership in Street Medicine) at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo provides medical services to homeless patients. Twice a week, medical students, faculty, and social workers visit patients on the street.
  • Students and faculty from the Virginia Commonwealth University’s medical, pharmacy, and dental schools provide health screenings at local homeless shelters. Patients who need follow-up care are referred to a program that provides no-cost or low-cost services.
  • The Boston Health Care for the Homeless Program provides care from dental services to cancer treatment in shelter-based clinics, on the streets, and in hospitals for the local homeless community. The program is affiliated with several Boston-area medical schools and teaching hospitals, as well as with local nonprofit organizations and government partners.
  • The Comunilife program at Montefiore Medical Center in New York provides short-term housing for patients who have been discharged from the hospital but do not have a place to continue recovery. The initiative makes transportation available for follow-up appointments and helps patients find housing when they are ready to leave the program.