The Kindness of Strangers

Dr. Mimi Doohan Treats the Homeless Where They Live

Paul Wellman

I t’s Monday night in Isla Vista and St. Athanasius Orthodox
Church is serving up its weekly dinner for the homeless. A dozen or
so bedraggled-looking souls wander onto the tidy, concrete patio
for what will likely be their first and only square meal of the
day.

Tonight the crowd consists only of men, and they largely keep to
themselves, carrying plates piled with food to the picnic tables
and eating quietly. Milling about in his clerical blacks and white
collar is the church’s rector, Father Jon-Stephen Hedges, a
broad-shouldered, distinguished-looking man in his late fifties.
There is also a dark-eyed social worker named Jennifer Ferraez, who
surreptitiously gauges the well-being of each guest.

Fifteen minutes into the meal, 46-year-old Mimi Doohan drives
her minivan into the church’s parking lot. Ferraez walks over to
greet her and, after talking a minute, they approach a pair of men
sitting on the grass.

Doohan is a family practice physician with gray-brown Shirley
Temple curls and piercing light green eyes. Wearing jeans and a
pink cotton sweatshirt, she crouches to greet the men at their eye
level; Ferraez stands a few feet away.

“Hi, I’m Dr. Mimi,” she says with simple, authentic warmth.
“What’s going on?” Hiking up his right pant leg, a blue-eyed man
from Lompoc describes a problem with his leg, which is swollen and
has a pussy sore the size of a quarter. Doohan examines it. “Looks
like staph,” she says. “How long have you had that?” “Five days.”
“Do you have any other health problems?” “Yeah, lots. I’m
HIV-positive, and I have chronic pancreatitis,” replies the man,
whose name is Vincent. Doohan — the mother of two teenagers and the
wife of City College math professor James Doohan — finished her
residency training in 2005 and now has a growing family practice in
Goleta, just a few miles from her home. She has privileges at both
hospitals in town and just began delivering babies at Cottage in
association with obstetrician Ayesha Shaikh. Her career is on the
rise.

So why, you might ask, is she squatting on an Isla Vista
sidewalk after hours to examine the leg of a former drug addict who
lives in a tent near Costco? After speaking with her and observing
her work, I discovered Mimi Doohan is a soccer mom with personal
insight into the soul-sapping nature of homelessness. She has a
history that could have permanently damaged her psyche. Instead,
perhaps miraculously, she made it to adulthood with ambition,
intelligence, and a need to create a system for providing care to
people at the very edge. That vehicle materialized two years ago in
Santa Barbara as the nonprofit Doctors Without Walls (DWW).
Tonight, it is Vincent and his companion Rick who have fallen into
the DWW bailiwick, teetering on the edge of serious, potentially
fatal illness.

Having determined that Vincent needs antibiotics and evaluation
at the emergency room and having secured a volunteer to take him
there, Doohan turns her attention to Rick. He is a physically small
man in his sixties with a dark beard and forest-green eyes. Though
it’s 59 degrees out, he wears a heavy winter coat with the hood
up.

“I understand you’re having chest pain,” Doohan says in a soft
voice. Rick stares into the distance and doesn’t answer. Doohan
tries again. “Vincent here has to go to the emergency room. Maybe
you can go together,” she suggests. He pulls deeply on the last
eighth of his cigarette, bringing the burn line perilously close to
his lips. “Do you ever feel it in your jaw?” Doohan asks about his
chest pain. He nods. Finally. “Do you ever feel it here?” she asks,
pointing to his heart. Again, he nods. Then he stands, turns, and
retrieves his shopping cart and begins walking toward Embarcadero
del Mar. Hedges notices and intercepts him. Ferraez and Doohan
catch up. It’s a huddle now, all hands on deck to keep Rick from
disappearing into the night with unstable angina and, as they soon
discover, suicidal depression. “We can’t let you do this, Rick,”
says Ferraez. “I’ve got my own life,” he says. “I’m tired of
living.” “Didn’t you just say you would go to the hospital?” “I
don’t like hospitals,” he replies. Then, recognizing the
inevitable, Hedges pats him on the back and says, “Just get through
the night healthy, okay, Rick? We’ve got something to talk about
tomorrow.” Rick stares into the distance with tearful eyes, then
continues on his way. “Remember we have to talk tomorrow, okay?”
Hedges calls after him.

A Trip to Hell and Back

Doohan isn’t a saint, nor is she trying to be. But she
understands better than most the humiliation and fear that are the
accessories of homelessness. When she was eight, her mother, a
Holocaust survivor, began descending into a slow-motion but
devastating mental breakdown. After divorcing Doohan’s dad, the
prominent Bay Area psychologist Claude Steiner, she moved the
kids — Mimi and her younger brother — into the house he bought her
off Berkeley’s Telegraph Avenue. It was the late 1960s, when women
almost always got full custody of the kids in divorce cases.
Jobless and living in a house paid for by her ex-husband, she began
to let anyone who wanted a roof over their head move in with her
family. Doohan recalls having to step over a span of sleeping
bodies sprawled across the living room on her way to school. Her
mother had essentially given up the daily tasks of mothering, so
Doohan’s thick, curly hair was perpetually matted. Her clothes were
dirty and torn in places. When one of the female house inhabitants
was given money to take Mimi shopping for clothes, she pocketed the
cash and told Mimi to wear several dresses on top of each other and
walk out of the store. These were the clothes she wore every
day.

After about a year, Doohan’s mother became convinced the house
was inhabited by witches and put the children in the family’s
Volkswagen bus and began to drive. Without any clear destination,
they hooked up with other wanderers and formed a caravan,
ultimately landing in Colorado. But along the way, Doohan and her
brother were briefly abandoned. The car they were riding in pulled
up to a Boulder street corner and the driver ordered them out. Then
he drove away. Standing on the corner, Mimi’s brother began to cry.
She tried to comfort him while figuring out what to do. Hearing the
happy voices of young people nearby, she began walking toward them
and quickly encountered a group of college students. They gave the
children food and called police, who put them in an emergency
foster care home. Doohan still remembers that family and the home
they offered her and her brother, however briefly; the cupboards
were stocked with food. There had been a plan to buy them new
shoes. “Throughout all this, what I remember was people being kind
to us,” Doohan recalled. “And I wanted to grow up and be one of
those people.”

The following day, her mother retrieved them and resumed their
trek to nowhere. Soon, she joined a Colorado cult of faux farm
workers called “the Bear Tribe.” Together, the family picked fruit
with other cult members during the day and slept in a small shack
at night. Then Doohan’s mom disappeared. The children, aged 9 and
6, were now penniless orphans living with strangers under a tin
roof. “This was definitely all my fault,” Doohan recalled feeling
at the time. “I felt like a dirty, worthless kid.” It wasn’t until
she cut her foot and was taken to an emergency room that Doohan
remembered her dad had given her a method for reaching him. If you
ever need me, he had told her, “Call information and ask for Dr.
Feelgood in Berkeley.” It was a special line set up specifically
for Doohan and her brother. Right away, he retrieved them and took
them home to live with him. With her dad, a semblance of normalcy
resumed, although, given the time period — the late ’60s — and the
location — Berkeley — no one’s life was truly normal.

Doohan loved academics, especially math and science. When she
was an undergraduate at UC Berkeley, she met her husband Jim, a
Santa Barbara native who had a dream of living here as an adult and
teaching at City College. Both super-smart, the couple pursued and
achieved simultaneous Ph.D’s in molecular biology from UCSB. After
their children were born, Doohan was accepted at Stanford
University Medical School and commuted between Santa Barbara and
the Bay Area for years while she finished her training.

When the Student Is Ready, the Teacher
Appears

Doohan has a knack for finding loyal mentors and hanging onto
them like precious gemstones. One of them is her residency
professor from Contra Costa Regional Medical Center, Mark Stinson.
Stinson is a family practice physician known internationally for
his expertise in disaster relief. He flew into New Orleans as
everyone else was trying to get out. When the 2004 tsunami hit
Southeast Asia, he hopped a plane to Sri Lanka as the rest of us
were standing around our television sets, slack-jawed and
horrified. And when Doohan was ready to launch a medical nonprofit,
Stinson flew here to help brainstorm its structure and mission.
They decided it would provide outreach not only to the homeless but
also to victims of natural and manmade disasters. Street medicine,
field medicine, and wilderness medicine are the same, Doohan said.
“It’s life support in all settings.”

Her other mentor is Jim Withers, the internist who is pioneering
the practice of street medicine in America. Withers began treating
the homeless on the streets of Pittsburgh 15 years ago, and his
work has become a model for doctors in cities and towns across
America. Doohan learned about his organization, Operation Safety
Net, at a conference in medical school. His approach to caring for
the homeless cut through the layers of her adult
mother/wife/physician self and spoke to the girl who’d been
abandoned to a bunch of strangers pretending to be Indians.
Accompanying him on his midnight rounds beneath Pittsburgh’s
bridges, Doohan discovered her calling. Withers is DWW’s unofficial
mentor too.

The central idea behind DWW is to establish a bank of Santa
Barbara physicians willing to volunteer their services either at
Casa Esperanza or on street rounds to the unsheltered homeless; in
the process, they will learn how to practice field medicine and how
to jump in if a disaster were to occur. The organization’s board of
directors now includes some of Santa Barbara’s most accomplished
physicians and attorneys. They’ve even managed to secure
malpractice insurance for the group’s physicians. Santa Barbara
internist Dennis Baker, who was one of the first DWW volunteers and
is a dedicated board member, provides care every Tuesday night at
Casa Esperanza.

Last November, Mark Stinson led a three-day DWW-sponsored
training in field medicine for Santa Barbara doctors, nurses, and
social workers. So far, though, Doohan is the only DWW physician
doing medical street outreach. For decades, social worker Ken
Williams had been the main advocate for the homeless going to the
hidden places where Santa Barbara homeless actually live to offer
them care and support services. Now there is someone else. But for
the time being, she is limiting herself to the comparatively small
homeless community in Isla Vista. As her team has grown, they have
started going out into the nearby parks and fields — places where
homeless too sick or too frightened to venture out can be
found.

The Isla Vista Team

Since she first began attending the St. Athanasius dinners on
Monday nights, Doohan has formed a tight-knit team with Ferraez and
Hedges. Their system works like this: During the week, Hedges and
Ferraez keep an eye on the various homeless individuals they know,
often the same people who show up for the Monday night dinner.
They’re always on alert for a signal that someone might be willing
to accept help, to transition to another way of life. When they
notice someone has a medical need, they call Doohan on her cell
phone, and together they decide what action to take.

No one knows exactly how many homeless
people live in Isla Vista, but a rough estimate put it at about
100. Four of the regular dinner guests have required
hospitalization. One person, Tom Turner, recently died of lung
cancer at Sarah House. (Ferraez was there at the end, holding his
hand and singing to him.) Another one is still receiving hospice
care there. And Rick, the man with chest pain who walked away from
Doohan and Ferraez, recently managed not to lose his left eye,
thanks to the diligent networking of Hedges, Ferraez, and
Doohan.

After Rick was assaulted by a fellow homeless person — someone
who has since been arrested — Hedges noticed that Rick’s left eye
was covered with an opaque film. The eye was weepy, red, and
painful. Hedges called Doohan, who said Rick needed to get to the
ER immediately. Eye infections can spread to the brain. Hedges
offered to drive Rick to Cottage, but Rick refused again. Still, he
did check in with Hedges every day at the church and several days
later agreed to go.

Doohan suggested calling ophthalmologist Mark Silverberg and
asked the specialist to meet Rick in the ER. As soon as Silverberg
saw Rick, he admitted him to the hospital. During his brief stay,
Rick’s condition was stabilized with antibiotics, rest, and regular
meals. But two days was apparently all Rick could take of
civilized, albeit hospital, living, and on the third day, he left
against medical advice (AMA). Ironically, after Rick left Cottage,
he accepted help from an Isla Vista community member and volunteer,
Jenny Jett. Jett drove him to a follow-up appointment and convinced
him to stay at her house, where he continues to recover. His eye
hasn’t healed and may never totally heal. But Rick is alive, and he
still has some vision in the injured eye. And he’s off the streets.
People who work with the homeless understand that victories must be
measured in tiny increments. As far as Rick is concerned, this was
a home run. Both Doohan and Baker understand the worst thing an
idealistic doctor can do is treat a sick homeless person once and
never see that patient again; knowing where to send them for
follow-up is critical if a program like DWW is to provide quality
care. The same applies to keeping good medical records. “We need to
be integrated into the system, not antagonistic and independent,”
Doohan said of the organization’s work. “And we have good systems
in Santa Barbara. What we don’t have is medical street
outreach.”

There have been other interventions on behalf of Isla Vista’s
homeless that Doohan has spearheaded with her team as well. There
was the case of Alan, the wrangler forced into retirement when a
horse kick fractured his skull and ribs. He lives in a storage shed
without windows or running water. He struggled with gastritis for
over a year. When Hedges introduced Doohan to him last September,
he’d lost 30 pounds in three months, was vomiting regularly, and
had no appetite. Doohan admitted him to the hospital and cared for
him for a week. He is now recovering in his storage shed from
pneumonia and complications of surgery to remove his gallbladder.
Doohan asked a group of UCSB pre-med students interested in street
medicine if they would look in on him three times a day and bring
him food and water. “It’s not just about the pills you take,”
Doohan said of the healing process. ”Sometimes it’s about comfort,
regular meals, and security.”

Many elements of DWW are still being developed. There are
financing questions, questions of administration, and even some
philosophical debates. What is clear is that Doohan will never be
satisfied to bask in her successes and simply relish the life she
and Jim have created. There is the voice of an 8-year-old girl
inside her — a little barefoot girl with matted hair, wearing a
ratty, shoplifted dress. This girl, this Mimi Steiner, will never
forget how horrible it felt to be alone and cold with no place to
go. And she won’t let Doohan forget either.

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