The following is an extract from Coming Home for Good – my autobiographical book on homelessness, spirituality, identity and belonging – describing some of my experiences of an itinerant lifestyle choice as a young man in America:
In ’87, money became scarce. I saw myself as “road-wise” rather than street-wise, and lived for the open road. City life’s never been my thing. But when times were tough, I stayed in the cities to donate plasma for $5-$10 a time (depending on the city), which they’d let you do up to twice a week. The clinic would take a pint of blood, centrifuge it to separate the plasma from the red cells, and infuse the red cells back into the donor’s bloodstream.
I have no idea what the screening procedures were like back then, but all the street people used to do it for a quick buck, and I became one of them.
At one clinic, while I was there, they treated and dressed a really nasty, infected ulcer that had developed on my elbow from a simple graze I’d sustained while messing around with a football in a field with Joel and Mikey in Portland. I found that every little scratch I got – and you tend to get a lot when you’re sleeping rough – became infected. The elbow wound was so bad, I still bear the scar quite visibly 3 decades later.
The same thing happened to two symmetric wounds on my back that originated as simple scratches from the split rings on my metal frame rucksack when I walked or hitched with my shirt off in the southern heat. Two decades later, in a physical assessment class as part of my nurse prescribing course, a medical lecturer demonstrating an examination of my back was trying to guess the cause of my scars and surmised I’d had some kind of thoracic surgery. I took great delight in revealing the real, obscure cause was my distant history of hitch-hiking.
My nutrition – and therefore immunity – was no doubt pretty poor, not to mention hygiene. I was never a proud, image-conscious young man – well, except in my younger punkier days, with my all-black clothes and hair. Showers weren’t necessarily a priority when travelling, although I would find rivers to wash in, and one time discovered I could sneak into a high-class golf club through the back door to use their showers. That was luxury!
Homeless people are generally prone to infections, even if their hygiene is good. Like the rest of the population, many are keen to keep themselves clean and tidy, while others tend to let themselves go if their lives and energy are consumed by chasing the next beer or bag of heroin, or their minds distracted by psychotic illness or depression.
Many have health conditions like hepatitis that affect their immunity, which in turn may also be compromised by poor nutrition.
When I was travelling, my weight dropped to about a stone lighter than for most of my young adult life – giving me a BMI of 18 (in other words, quite underweight) – and about 2.5 stone lighter than my current (healthy) weight.
For all these reasons, homeless people have high rates of respiratory, skin and wound infections.
Incredible to think, looking back on the elbow episode, that I’m now running homeless clinics myself, treating wounds, infections and other health problems; that I’m prescribing antibiotics, dressings and nutritional supplements. Who’d have thought it when I attended that plasma clinic in ’87? Certainly not me.
Homeless people tend to have great difficulty accessing healthcare – even in the UK, where they don’t have to have an address to be registered with a GP – although not all surgery staff realise this, unfortunately. Systems are difficult to navigate; making doctors’ appointments is difficult even for people with the most organised lives; and healthcare often isn’t top of the agenda for people in chaotic, vulnerable circumstances.
Despite the eternal, infernal funding challenges in the voluntary sector, I find it incredibly satisfying, working for a charity outside the NHS, to be able to offer informal, friendly, drop-in clinics, making healthcare accessible at venues where homeless people congregate; not being restricted to 10-minute consultations.
Talking of nutrition, I learned to raid the skips just after McDonald’s had closed at night, for free, freshly discarded burgers while they were still warm! That was such a treat.
“Dumpster diving” as it’s known in the US, or “skipping” in the UK, has hit the media in recent years as high-profile cases have heightened public pressure to reduce food waste by supermarkets and to legalise the practice of taking discarded food from skips – to criminalise supermarkets, not the poor and homeless, for this mad situation. It’s been encouraging to see more scope being given for charities to at least accept food that’s going out-of-date.
The other draw to the cities on my travels was the free meals in soup kitchens and hostels, which tended to be pretty grim, to be honest.
In one hostel, lying on a mattress on the floor of a grimy, bare room shared with a male stranger who had wanted to have sex with me, I clung on to my rucksack in my half-sleep, not trusting anyone.
But in every soup kitchen and hostel, the soup and sandwiches were a welcome relief to an empty stomach. Most were run by Christian missions and I’m forever grateful to all of them.
Some of these mission halls insisted on visitors listening through a gospel talk before being given food. Not too sure of the ethics of that now. And I’m not sure how receptive those raucous crowds with ravenous stomachs could have been to the messages being preached.
However, little bits of what I heard made me think, and I ended up debating and arguing one-to-one with some of the preachers. By this time, I had an interest in Buddhism and didn’t much like these Christians’ dualistic ideas of heaven and hell, God and Satan, good and evil, but something was beginning to chip away at me.
But I had no doubt that, if there were a God, then I was a sinner and needed saving. My understanding of sin, if there were such a thing, was simplistic. My stealing, lying and deceitfulness, my general sense of being a bad person, constituted my sinfulness – if God was real. It was self-evident that my lifestyle constituted one of sin before the Christian god.
If I could be convinced of the existence of God, I’d need no convincing of my sin. But if I continued in my atheism, I could continue in the dubious freedom of my amorality….
Coming Home for Good is available here, in print and on Kindle.
Comments and reviews always welcome!
Thanks for reading,