Medical Outreach Program a Lightly Treaded Pathway to the Streets

“Truly I tell you, just as you did it to one of the least of these who are members of my family, you did it to me.” Matthew 25:40 

Threaded through the mission of San Antonio’s Catholic Workers House is the Scripture in Matthew that says when we interact with those considered lower in society – the outcasts – we are actually engaging with Jesus.

“Jesus in disguise,” Dr. Hans Bruntmyer, professor at the University of Incarnate Word School of Osteopathic Medicine (UIWSOM), called this.

The house doesn’t care if you’re living on the streets, feeling lost in society, or far from upper class – it allows anyone to enter through its doors.

That’s what it’s there for. A safe haven of sorts, where hospitality comes without a price tag and love comes without an agenda. Just a place to be. A place to enjoy a meal, engage in conversation, maybe even call home if someone wants to receive a phone call or a piece of mail.

The Catholic Worker House, in the Dignowity Hill Historic District, doesn’t consider its hospitality and volunteer work to be an act of charity. Instead, those who come through the door are seen as fellow community members worthy of respect.

Perhaps this concept of personalism is what UIWSOM was drawn to when it invited Chris Plauche, director of the Catholic Worker House, to be a guest speaker at its Street Medicine general meeting.

Street medicine is the practice in which medical professionals bring health care to those on the margins of the system. It is a hike out to the streets, a lightly treaded pathway to underpasses, grassy intersections, and camps where those experiencing homelessness sleep.

This rendition of a house call entails physicians and medical students walking up to an encampment. And even though there is no door to knock on, they stand back and ask if they may enter to offer health services.

“Medicine is the foot in the door to build relationship with these people,” said Bruntmyer, the man behind more than 50 passionate student members currently developing Street Medicine San Antonio (SMSA). He sees relationship as the key to helping people “get off the streets and back into society.”

SMSA, created to serve San Antonio’s homeless population, intends to help connect people with primary care physicians and find permanent housing.

This medical outreach program was inspired by the work in Pittsburgh of Dr. Jim Withers, founder of the International Street Medicine Institute, a nonprofit promoting street medicine expansion worldwide. As San Antonio’s program develops, students are learning from community workers like Plauche, whose stories of interaction with homeless people help humanize the population they will soon be treating.

Different by Necessity

The unconventional model of street medicine – the gritty backpacking practice bypassing office staff, waiting rooms, and distracting paperwork – is not counterculture by choice. To meet the marginalized, both SMSA and the Catholic Worker House have had to serve as the bridge between broken social and medical systems and unserved populations.

Withers devised the street medicine model because he was dissatisfied with the apathetic hospital system that can overlook nonpaying homeless patients and the failing structures allowing people to freeze and die on the streets without care. So he abandoned those structures and took to the streets.

A subversion from the norm, Catholic Worker House has not always been accepted for its services. Targeted by neighbors not liking “strangers” wandering their streets and city officials considering it a violation to serve food from an unlicensed location, the Worker House has had to fight legal battles to continue to feed up to 400 homeless individuals a day.

The biblical parable in Matthew addresses the hungry “strangers” showing up in hospital waiting rooms and suburban neighborhoods, disrupting the normal structure of social systems.

“For I was hungry and you gave me food;

I was thirsty and you gave me drink,

I was a stranger and you took me in;

Naked and you clothed me;

Sick and in prison and you visited me.’

Then they will answer Him saying,

‘Lord, when did we ever see you

hungry and feed you?’

Then He will answer them,

‘When you did so to the least of my family,

You did to Me.’” 

Matthew 25:35-40

UIWSOM, a 2-year-old school with a mission to serve the most vulnerable in their community, is appropriately located in District 3 in South San Antonio. This area has a high concentration of poverty and is close to intersections and bridges where homeless people sleep. Reflecting on descriptions of “the least of these” in Matthew 25 – the hungry, thirsty, homeless, naked, sick, imprisoned – Bruntmyer said “nearly every one of these things describes this population [of unserved people in South San Antonio].”

This awareness came with a sense of calling to bring street medicine to San Antonio and for SMSA to give people living on the streets the “care they need and deserve,” in essence caring for “Jesus disguised as sick, injured, naked, stranger … all these people,” Bruntmyer said.

To the Streets

One month shy of SMSA taking to the streets, students are catching on to the vision. On Jan. 24 students and a team of physicians will join the South Alamo Regional Alliance for the Homeless for the annual Point-in-Time count (PIT), a survey major cities conduct to gain an accurate count of its homeless population on a given night. According to the 2018 PIT Report, Bexar County accounted for 3,066 individuals living in homeless situations.

Following the direction of physician supervisors, EMT-certified medical students will evaluate medical concerns and perform basic treatment as needed. Beyond medical services, building relationships is the main objective, as teams will be meeting their patients on the streets for the first time. Bruntmyer believes once students build trust, they can provide more in-depth advice and medical services.

“A large portion of these people have just had the stuffing knocked out of them, and they feel like nobody cares,” Bruntmyer said. “If you go up to them and ask their name, that is huge.”

“Your name is who you are. And these people are never asked that.”

Acknowledging the humanity within the person, recognizing that they are someone’s child, someone’s spouse, is what brings them dignity, Bruntmyer said. And that’s what street medicine is all about: meeting people where they live, accepting them as they are, and treating them with the dignity they deserve.

As students involved in SMSA prepare to walk this lightly treaded path, they take notes on the cost of love from leaders who have gone before them. The story of the Catholic Worker House reminds them that giving services to a group of people left out of basic human services is a redrawing of social systems and that subversion can disrupt the norm.

But as these groups abandon social structures to provide care, they cling to the belief that caring for “the least of these” is actually caring for Jesus.

“Just as you did to one of the least of these … you did to me.” (Matthew 25:40)