A Man and His Mission: Dr. Jim Withers
Dr. Jim Withers, of Operation Safety Net, makes house calls to the homeless and envisions street medicine as a mission of mercy on a global scale.
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Dr. Withers listens to Ron Painter’s chest before diagnosing him with bronchitis.
Photo by Martha Rial
Of course, it wasn’t always so easy, Withers reflects. At first, before he was known to people on the streets, he was ignored, chased away and even threatened with violence. The memory of once having a shotgun pulled on him is “so raw for me,” Withers stresses. On top of that, he felt like an “outcast” among some of his former colleagues when sneaking off to treat homeless people at night.
Some expressed doubts about his career path—even his sanity—especially when he started dressing less like a physician and more like the people he served.
Withers resolved to concentrate on the people who needed his help, whom he had come to “love and care about,” even if it meant forgoing some of the trappings of a traditional medical career. In spite of the challenges of his profession and choosing a less than conventional career path, he and his former wife, Gayathri, successfully raised four children—Jonathan, 23, a scholarship student at Harvard University; Christopher, 24, a first-year medical student at New York Medical College; Gregory, 20, an undergraduate studying the Persian language at the University of Pittsburgh; and Jeneni, 15—in Wilkinsburg and sent them to a public school.
Withers drives a modest car. Throughout the course of two days’ worth of interviews, he doesn’t even wear a watch. The bookshelves in his office are lined with volumes by and about poets, revolutionaries and other rebels—Annie Dillard, Martin Luther King Jr., Che Guevara—but Withers didn’t find his inspiration in the pages of books. He grew up surrounded by people who cared about social justice.
As a child, Withers accompanied his mother, June, a nurse who made home visits and volunteered her time delivering Meals on Wheels. He also joined his late father, Dr. Donald Withers, who made house calls in their hometown near York, Pa. He says he found the example set by his parents to be “inspirational even before I had any medical knowledge.” The patients, he goes on to explain, “obviously loved my dad. It was very human. They were very comfortable with each other. It still sticks with me.”
Withers’s undergraduate experience at Haverford College, a small, elite liberal-arts school with Quaker roots and a tradition of social activism, reinforced the values he gained from tagging along with his father on rounds.
As soft-spoken and gentle a man as Withers is, he’s still taking a stand today, a stand against indifference, intolerance and the attitude that, in medicine: “It’s all about me, and you as the patient need to come to me on my terms.” The point of practicing street medicine, he says, is the opposite: “I’ll honor who you are and come to you.”
Wouldn’t it be so much easier to see patients in a clean, well-lit place, like an emergency room or doctor’s office? Of course, Withers says. “I would love to have my patients show up in a place with an examining table. You have to be adaptable and fluid, though, or you’re not relevant.” Fewer homeless people are being treated on the streets or in the hospital emergency departments than in years past. Operation Safety Net has helped countless people obtain care from primary-care physicians in the private office setting. Yet some local doctors are finding that they enjoy the challenge of street medicine.
Dr. Michelle Barwell, a psychiatrist, started working with Withers in the late ’90s when she was a medical resident. “The work is hard,” she stresses, but it’s rewarding for those who can learn to “find joy from small gains.”
Barwell recalls a woman with bipolar disorder who, with the proper medicine, got off the streets and moved into her first apartment. She also remembers a man she treated for years who wore nothing but camouflage—until one day when he came into her office wearing regular clothes. “Everybody got excited,” she says. “It’s the small stuff like that. It keeps you going despite some of the disappointments.”
Not all of Operation Safety Net’s accomplishments are small joys: According to one study from the 1990s, the group’s work with the homeless saves between $200,000 and $300,000 per year in emergency-room costs at local hospitals.
Building on Operation Safety Net’s success in Pittsburgh, Withers hopes that street medicine will take off as a global movement, and he says he already sees the signs of that happening.
Many of Withers’s former medical students (he’s a faculty member at the University of Pittsburgh School of Medicine) have started careers of their own in street medicine. Dr. Patrick Perri, one of his former students, is now helping lead a team of 16 full-time street doctors and 30 nurses through Boston’s Healthcare for the Homeless Program.
Another offshoot of Withers’s work is the annual International Street Medicine Symposium (ISMS), a conference he and Operation Safety Net program director Linda Sheets co-founded in Pittsburgh in 2005 so that street medicine practitioners worldwide could meet and share best practices. Withers sums up his feelings this way: “I think we’re reaching a point in our society where we have to decide whether we’re in it together or going our separate ways. Street medicine has the capacity to challenge conventional prejudice, or it could pull us together.
“Perhaps,” he goes on to say, “it could facilitate a new and unified vision of community and commitment to each other.”
Geoffrey W. Melada is a frequent contributor to Pittsburgh magazine. This article is dedicated to his father, the late Gary A. Melada, M.D.