美国国家公共电台 NPR--'Rough Sleepers': How one person can make a difference caring for the unhoused

'Rough Sleepers¹': How one person can make a difference caring for the unhoused

Transcript²

NPR's Sacha Pfeiffer talks to author Tracy Kidder about his new book, Rough Sleepers, which profiles Dr. Jim O'Connell, who runs an organization called Boston Health Care for the Homeless Program.

SACHA PFEIFFER, HOST:

The title of Tracy Kidder's latest book comes from British slang, "Rough Sleepers." It's a 19th-century term for people who sleep in rough conditions like on the street. And the book tells the real-life story of Dr. Jim O'Connell, who leads an organization called Boston Health Care for the Homeless.

JIM O'CONNELL: Most people do not like to use homeless as a noun. It's as an adjective. So it's - it describes a state. Now, the current thing that people say is people experiencing homelessness. And that's kind of the proper way to say it now. Most important is to make sure we're not stigmatizing³ or treating people as other than us.

PFEIFFER: For nearly 40 years, Jim O'Connell has treated men and women living under bridges and on abandoned loading docks in one of the richest cities in the country. Kidder told me that spending time with O'Connell exposed him to a world he hadn't known existed.

TRACY KIDDER: People making do with - you know, on park benches, in ATM parlors⁴ - one of Jim's patients actually managed to rent a storage locker⁵ that he lived in, if you can imagine, in the winter. There were tents on the outskirts⁶ of cities. But still what you see out there is real - really bad disease, you know, people dying way before their time.

PFEIFFER: Jim, Tracy is making me think about what you've talked about many times over the years, is that when you started in this field, you were seeing conditions like trench⁷ foot among homeless people, which you had assumed might not exist in a modern-day society. What else surprised you about the health problems that homeless people routinely deal with?

O'CONNELL: Oh, there was much that surprised me. The first thing was I was struck by how many common everyday illnesses were prevalent among homeless people, but they had been neglected for years. Most people had not seen doctors or nurses for many, many years. So there were the common illnesses. But then I also saw what I think is attendant to homelessness, is several exotic things that I wasn't at all prepared for - scurvy⁸, for example. I remember seeing that and people with infestations⁹, with lice and scabies, wounds that had maggots on them - all these things that I had seen pictures of in textbooks but never really had a chance to see here in a city like Boston in our - in the hospitals where I was training. So it was quite - you know, I was quite taken in.

PFEIFFER: What's your current thinking on how important finding housing for homeless people should be versus¹⁰ addressing their other, deeper problems?

O'CONNELL: Housing is the absolutely critical and necessary part of solving this homelessness problem. So for - from our perspective, when housing first became part of the realm, it meant that all the people that we've been seeing on the streets for 20 years, 25 years, all of a sudden went to the top of the list. You know, instead of having to get on medication, get sober, do all that to be able to qualify for housing, they became the top of the list. And they went into housing, and it was like a miracle. And we were able to - you know, if we'd been caring for them on the streets, we were able to now do home visits to them, take care of them in their homes. And it was - we were just ecstatic.

What we learned over time, though, was for the group of people that are chronically¹¹ homeless, living out in the shelters and on the streets for a long time, they bear a huge burden of co-occurring medical and psychiatric and substance-use disorders¹². And those don't just go away when they get into housing. However, we've learned that you really have to provide a lot of support to people, and Housing First is supportive housing. So it's housing plus a support. And I think for most of us, the struggle has been how do you fund that support? How do you make sure there is enough, you know, medical and social and other supports to keep people in their housing?

PFEIFFER: Tracy, a common thread you found in your reporting about many people living on the streets is they had been through horrific trauma¹³, often in childhood, abuse so sickening that I'm reluctant to even describe some of it out loud. And that does permanent damage. How big a factor would you say that is in your view of why people sometimes end up homeless?

KIDDER: Well, I think it's a pretty big factor. One of the psychiatrists¹⁴ on Jim's street team, who's now retired¹⁵, once told me that he figured that about 90% of his patients suffered from mental illness or substance abuse or both. And he figured that something on the order of 75% had not just bad childhoods, but really traumatic ones. And I heard some stories that just are just so appalling¹⁶ you can scarcely believe that anyone would treat children that way. If I had - if there were one thing I could do to - you know, to try to end homelessness, it'd be try to find some way to end this horrifying¹⁷ fact. And we now know, of course, that that kind of abuse, that kind of trauma early on leaves - does leave its imprint¹⁸ on the body. I mean, it's going to make people unhealthy in various ways.

PFEIFFER: Jim, Tracy's book shows you sometimes wrestling with whether you're making a difference or at least a positive difference. How much do you think your work of almost four decades has changed the overall health of Boston's homeless population? Are you able to measure your success in your view?

O'CONNELL: That's a question, Sacha, that tortures us almost daily because, you know, when you look back - and I would say when I first started, I thought we understood homelessness. I thought it was going to be a relatively¹⁹ temporary emergent problem that we would fix quickly. And it has become seemingly intractable in our society. So when we look at outcomes, you know, we realize that we're dealing²⁰ with a population living in a city like Boston, with all of our wonderful hospitals and community health centers. And this population has a mortality rate that looks more like a third-world country. And we've been trying hard to bend that curve. And I think we've been able to do a little bit, but when I step back, probably not much if you hold us to that standard. We sure are not capable as doctors and nurses to end homelessness. We can do our part to advocate for it, but we're just taking care of people while we're all trying to figure out how to solve this bigger problem.

PFEIFFER: Tracy Kidder's latest book, "Rough Sleepers," is about Dr. Jim O'Connell, who heads Boston Health Care for the Homeless. Tracy and Jim, thank you very much.

KIDDER: Thank you, Sacha.

O'CONNELL: Sacha, thanks so much. Appreciate it.

(SOUNDBITE OF MUSIC)

1 sleepers   

n.卧铺（通常以复数形式出现）；卧车( sleeper的名词复数 )；轨枕；睡觉（呈某种状态）的人；小耳环

参考例句：

• He trod quietly so as not to disturb the sleepers. 他轻移脚步，以免吵醒睡着的人。 来自辞典例句
• The nurse was out, and we two sleepers were alone. 保姆出去了，只剩下我们两个瞌睡虫。 来自辞典例句

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 stigmatizing   

v.使受耻辱，指责，污辱( stigmatize的现在分词 )

参考例句：

• Laing regards the concept of mental illness as both unscientific and stigmatizing. 菜恩认为精神病的概念是不科学的和诬蔑性的。 来自辞典例句
• The existing social benefits are considered to be stigmatizing and repressive. 现存的社会福利被指责为是无价值的、残暴的。 来自互联网

4 parlors   

客厅( parlor的名词复数 )； 起居室； （旅馆中的）休息室； （通常用来构成合成词）店

参考例句：

• It had been a firm specializing in funeral parlors and parking lots. 它曾经是一个专门经营殡仪馆和停车场的公司。
• I walked, my eyes focused into the endless succession of barbershops, beauty parlors, confectioneries. 我走着，眼睛注视着那看不到头的、鳞次栉比的理发店、美容院、糖果店。

5 locker   

n.更衣箱，储物柜，冷藏室，上锁的人

参考例句：

• At the swimming pool I put my clothes in a locker.在游泳池我把衣服锁在小柜里。
• He moved into the locker room and began to slip out of his scrub suit.他走进更衣室把手术服脱下来。

6 outskirts   

n.郊外，郊区

参考例句：

• Our car broke down on the outskirts of the city.我们的汽车在市郊出了故障。
• They mostly live on the outskirts of a town.他们大多住在近郊。

7 trench   

n./v.(挖)沟，(挖)战壕

参考例句：

• The soldiers recaptured their trench.兵士夺回了战壕。
• The troops received orders to trench the outpost.部队接到命令在前哨周围筑壕加强防卫。

8 scurvy   

adj.下流的，卑鄙的，无礼的；n.坏血病

参考例句：

• Vitamin C deficiency can ultimately lead to scurvy.缺乏维生素C最终能道致坏血病。
• That was a scurvy trick to play on an old lady.用那样的花招欺负一个老太太可真卑鄙。

9 infestations   

n.（害虫、盗贼等）群袭，出没，横行( infestation的名词复数 )

参考例句：

• The arrival of warm weather raises the specter of disease and increased rat infestations caused by rotting garbage. 天气转暖使人们担心垃圾腐烂会引起疾病传播和鼠群猖獗。 来自《简明英汉词典》
• Piperazine citrate is the drug of choice in the treatment of Ascaris infestations. 枸橼酸哌嗪治疗蛔虫感染是最好的药物。 来自辞典例句

10 versus   

prep.以…为对手，对；与…相比之下

参考例句：

• The big match tonight is England versus Spain.今晚的大赛是英格兰对西班牙。
• The most exciting game was Harvard versus Yale.最富紧张刺激的球赛是哈佛队对耶鲁队。

11 chronically   

ad.长期地

参考例句：

• Similarly, any pigment nevus that is chronically irritated should be excised. 同样，凡是经常受慢性刺激的各种色素痣切勿予以切除。
• People chronically exposed to chlorine develop some degree of tolerance. 人长期接触氯气可以产生某种程度的耐受性。

12 disorders   

n.混乱( disorder的名词复数 )；凌乱；骚乱；（身心、机能）失调

参考例句：

• Reports of anorexia and other eating disorders are on the increase. 据报告，厌食症和其他饮食方面的功能紊乱发生率正在不断增长。 来自《简明英汉词典》
• The announcement led to violent civil disorders. 这项宣布引起剧烈的骚乱。 来自《简明英汉词典》

13 trauma   

n.外伤，精神创伤

参考例句：

• Counselling is helping him work through this trauma.心理辅导正帮助他面对痛苦。
• The phobia may have its root in a childhood trauma.恐惧症可能源于童年时期的创伤。

14 psychiatrists   

n.精神病专家，精神病医生( psychiatrist的名词复数 )

参考例句：

• They are psychiatrists in good standing. 他们是合格的精神病医生。 来自辞典例句
• Some psychiatrists have patients who grow almost alarmed at how congenial they suddenly feel. 有些精神分析学家发现，他们的某些病人在突然感到惬意的时候几乎会兴奋起来。 来自名作英译部分

15 retired   

adj.隐退的，退休的，退役的

参考例句：

• The old man retired to the country for rest.这位老人下乡休息去了。
• Many retired people take up gardening as a hobby.许多退休的人都以从事园艺为嗜好。

16 appalling   

adj.骇人听闻的，令人震惊的，可怕的

参考例句：

• The search was hampered by appalling weather conditions.恶劣的天气妨碍了搜寻工作。
• Nothing can extenuate such appalling behaviour.这种骇人听闻的行径罪无可恕。

17 horrifying   

a.令人震惊的，使人毛骨悚然的

参考例句：

• He went to great pains to show how horrifying the war was. 他极力指出战争是多么的恐怖。
• The possibility of war is too horrifying to contemplate. 战争的可能性太可怕了，真不堪细想。

18 imprint   

n.印痕，痕迹；深刻的印象；vt.压印，牢记

参考例句：

• That dictionary is published under the Longman imprint.那本词典以朗曼公司的名义出版。
• Her speech left its imprint on me.她的演讲给我留下了深刻印象。

19 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

20 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。