By Cynthia Ryan
Homeless With Cancer
On the streets, cancer has a different face
By Cynthia Ryan
Inside, I found the Rev. Rachael Martin, the assistant pastor. “Homeless people get sick just like everybody else,” she told me. But the instability that comes with being homeless, she explained, “causes a whole slate of other issues, from not having proper identification to not having transportation you can count on.” Martin’s definition of homelessness is admittedly broad, including “anyone who doesn’t have a home, or a place they can permanently call their own.”
It’s hard to pin down exactly how many homeless individuals are dealing with cancer, in Birmingham or elsewhere across America. There were 2,273 homeless people living in the Birmingham metropolitan area in January 2009, including individuals with and without some kind of temporary shelter, according to Michelle Farley, the executive director of the Metropolitan Birmingham Services for the Homeless, which renamed itself One Roof in September. Of this total, 611 fell into the category of “chronically homeless,” meaning they were “single and/or unaccompanied, homeless, and suffering from some type of disability, which could be related to cancer, or not,” says Farley. “We simply don’t know.”
Doctors often aren’t aware their patients are homeless—and don’t know how to help those who are. Stefan Kertesz, a physician at the University of Alabama in Birmingham who studies the health care needs of the homeless, believes that doctors have a responsibility to ask their patients about the logistical challenges they face outside the clinic.
According to Kertesz, “Respect and trust should be something we bring to our communications with every patient.” For the homeless, he explains, such trust could make the difference between patients confiding in a doctor about their living situation or not. And such knowledge is crucial to assessing how best to help those with a serious illness who, at the end of the day, lack a safe place to lay their heads.
FEAR OF THE MEDICAL SYSTEM
Leaning on her aluminum cane for support, Edwina Sanders stuck out her hand to greet me. A stage IV breast cancer patient, Sanders was 45, and the first of many survivors to whom Martin, the assistant pastor, would introduce me over the next several months.
Sanders’ palm was dry and peeling, and it was cold to the touch. “Miss Ryan,” she said, “I’m so cold, my hands and my feet, they’s flaking off from the medicine.” Medication aside, Sanders wore no gloves and her shoes looked more suitable for a spring day than a frigid morning just 10 days before Christmas.
From the other side of the table where we were gathered inside the church, Martin commented that Sanders had been sleeping on the floor of her sister’s house since her breast cancer diagnosis several months earlier, and the place rarely had electricity. Fortunately, Church of the Reconciler had found her a secondhand mattress and box spring.
(photos: © Sylvia Plachy)