Diagnoses are Stereotypes: Go Where They Are

Kaiser Permanente, The Permanente Medical Group, The Permanente Federation


Dustin L Larson

Fall 2008 - Volume 12 Number 4

https://doi.org/10.7812/TPP/08-022


I found Steve resting up against a window ledge outside a soup kitchen. He was on the periphery of a group of about 30 adults who were milling around outside the kitchen waiting for breakfast. Most of the people were engaged in conversation; a few were involved in playful antics reminiscent of a grade school playground. In retrospect, I think I approached him because he was where I would have been: on the outside, alone, not in the middle of the crowd. I introduced myself as a medical student writing a paper about homelessness and health care and asked if he would be willing to answer a few questions. He didn't say a word and started shuffling down the street, face downcast, hidden deep in the hood of his sweatshirt. I tentatively followed.
A coarse, graying beard and a thin, dirty nose were the only features of his face I could discern as he turned away. I couldn't think of anything remotely intelligent to engage him so I asked if he was cold. He stopped, turned, and looked directly at my eyes, then dubiously replied, "I am sweating out here." His clothes were meager and threadbare and he did not appear to have excess corporeal insulation—wholly inadequate for the temperature and wind chill that morning, in the low 20s Fahrenheit.

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