48 pages 1 hour read

Tracy Kidder

Rough Sleepers: Dr. Jim O'Connell’s Urgent Mission to Bring Healing to Homeless People

Nonfiction | Biography | Adult | Published in 2023

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Part 4

Chapter Summaries & Analyses

Part 4, Chapter 1 Summary

Kidder describes Jim’s life and character in more detail, including his gentle and kind nature that rarely—if ever—erupts. He does recount one instance where a patient gets physically aggressive with a nurse, Suzanne Armstrong, and Jim yells at him to stop. Kidder then explains that Jim’s father, a WWII veteran, never graduated high school and spent years stocking shelves at a liquor store. Jim’s mother struggled with mental illness and, after her sixth child, required extended hospitalization, which strained his family and kept her away from her children—which she certainly didn’t want, Kidder writes. Jim’s background informs his work in the Health Care for the Homeless Program, which continues to grow.

Part 4, Chapter 2 Summary

As medicine becomes increasingly competitive, privatized, and corporate, the Health Care for the Homeless Program grows with more freedom, as it’s not beholden to rigorous standards in the same way as standardized business models. This means that the team is free to spend time with their patients, getting to know them even if they aren’t receiving treatment. Harrison, for example, won’t let Jim check his vitals—but Jim is able to see when Harrison’s health begins to fail. Jim refers to this kind of exploratory medicine as “upside-down medicine” (91).

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