This book is an interesting read about homelessness and the care they need. Jim had to earn trust and seek out people most will ignore and not actually "see". Amazing to see love and selflessness being portrayed.

Kidder has a talent for singing the song for unsung heroes, and I think he displayed that well here. I like that this book focused more on mini-vignettes and stories about the patients served. I can see where this would be frustrating for people coming in wanting a bit more of an academic look at healthcare in the unhoused population - or even a straight linear marathon. For me, both focusing more on qualitative data and telling those stories in a more circulative way honors the overall lessons from the street team - you have to know people as people before they trust you enough to be your patient, and you better enjoy pushing that rock up the hill!

I started reading this book, but I didn’t finish it. The thing is, I had previously also started reading Stories from the Shadows: Reflections of a Street Doctor, by Dr. Jim O’Connell himself. And I strangely found myself reading the same thing in this book. It’s like Tracy Kidder took Jim’s book and put it in the 3rd person. I was shocked by this - why publish the same content under a different title and author? - but had it explained to me that the original book is very niche and this new book will give Jim the exposure his work deserves through a major publisher. Ultimately, if this book gets you to read about the doctor’s work for the first time, then it’s great. But if you’ve already heard of him, I’d get his first person account instead. But certainly don’t bother reading both, or you’ll get a strong sense of deja-vu!

Rough Sleepers is the story of Dr. Jim O’Connell, a compassionate man who rose to the challenge of caring for the unhoused in Boston. Putting aside a prestigious fellowship to run "The Program", short for the Boston Health Care for the Homeless Program, Dr. Jim and his team have continued to help countless individuals that are down on their luck. Rough Sleepers spotlights a problem in this country, where the unhoused are given such mountains to climb that they can never summit.

Author Tracy Kidder brings the community of the homeless in Boston into sharp focus, telling the stories of both the rough sleepers and the people who have made it their mission to help them. There is a small amount of statistics and background information, but the bulk of the book is about the Program and its people. To that end, the book is compelling, especially when the author discusses the inequities in the system. The only real failings regarding Rough Sleepers are the organization of the material, as well as the dichotomy between too much detail in places and not enough in others. The author throws in details about Dr. Jim's personal life randomly, like mentioning that he has a wife and young daughter, though the last mention is that he works many hours because he is single. Some of the unhoused are given a passing glance, while others, like Tony, are mentioned prominently.

Overall, Rough Sleepers gives readers a look into the unhoused and a working solution that has evolved over time. I would give the book three and a half stars if the rating system would allow, for the lack of organization and missing details.

Disclaimer: I was given an Advanced Reader's Copy by NetGalley and the publisher. The decision to read and review Rough Sleepers was entirely my own.

This book. This book!!!

This was the first time I've read Kidder and I was not disappointed. As someone who grew up in a small rural town with little exposure to homelessness, moved to the big city and saw the unhoused daily, to now living somewhere in the middle, this book does such important work of putting into words what people are experiencing every day.

This book goes to show just how far having compassion and being kind to others can go. So many people today are one medical issue/lost job/break up away from houselessness and we all like to think "oh that would never be me" but the stories of the folks in this book show just how fast that can happen.

I think Kidder being a Veteran also ads a layer to this story - not necessarily mentioned, but more felt and perhaps reflected in how the telling of the story was handled. There is such a huge homeless Vet population and it's heartbreaking to think that people who gave up years of their life for this country are cast off and left to deal on their own.

My second Tracy Kidder book and it did not disappoint. I throughly enjoyed the story of Dr. Jim O'Connell and his journey helping the homeless population-a population where many see as individuals who can be discarded or umimportant/burden to society. A great story that proves that great humanitarians still exist.

“healing the homeless”
Pulitzer Prize-winning author Tracy Kidder takes us on a virtual ride through the streets of Boston to introduce us to the “rough sleepers” and the people who care for their medical needs. If you have concerns or are simply curious about the homeless people on the streets of your community, you will want to read this book.
The Boston Health Care for the Homeless program has served thousands of people for 30 years. Mr. Kidder rode on the program’s outreach van with the director Dr. Jim O’Connell, whose one-year commitment turned into a 30-year mission. Caring for the “rough sleepers”-those who sleep on sidewalks and doorsteps of Boston’s streets- wasn’t what he envisioned when he completed his medical residency.
For five years, as Tracy rode along the late-night trips with the Harvard-educated physician, he not only came to understand the program but more importantly the people it served. Though they were alcoholics, drug addicts, ex-cons, or mentally ill, he came to see them as Dr. Jim and the other staff see them, as human beings with complicated stories of how they ended up on the streets and what keeps them there.
The narrative reads like a novel as he tells us the backstories of people society has written off, but the doctors, nurses, counselors, and therapists treat with dignity and respect. He describes their frustration as the rough sleepers shun the care they offer or relapse after seeking care, as well as the lack of financial support from the political powers.
One rough sleeper, Tony, forms a special bond with Dr. Jim and we learn the most about him. Mr. Kidder related his story bit by bit to a shocking climax, as we finally learn what drove him to the streets and kept him there for so long.
Rough Sleepers is not an easy book to read but is equally hard not to read. I found myself cheering for the staff when they get someone off the streets and into a small apartment but grieving when one is lost to disease or a drug overdose.
Content warning-this is a true story about people with rough lives. So, there is frank mention of drug and alcohol use and sexual encounters of various kinds.
I understand Dr. O’Connell is still the director of the Boston Health Care for the Homeless program, and still teaches and writes about care for the homeless.
Thank you, NetGalley and Random House for sending this book for review consideration. All opinions are my own.

3.5 stars. This is a fairly typical work of Tracy Kidder, kind of in the same vein of his book about Dr. Paul Farmer. This book profiles Dr. Jim O'Connell, who graduated from Harvard Med. School...after being somewhat of a 'non traditional' student. Dr.O'Connell went on to care for the homeless population in Boston....& this is great coverage of that cause & the team members who Dr. O'C worked with, beginning at the start of his career & continuing to near present day. Kidder gives a picture & voice to some of the homeless themselves too. It's a good presentation ....I actually listened to it & it was easy to listen to & keep up with.
I received an e-ARC of this book from the publisher Random House via NetGalley, in return for reading it & offering my own fair/honest review.

3.5 compassionate stars, rounded up
“It’s such a privilege to take care of people, to have an opportunity to know them over time and learn their stories and the courage that they live with."

Rough Sleepers is a nineteenth century British term for the homeless that evokes more empathy than ‘homeless’. Tracy Kidder followed Dr. Jim O’Connell and the Boston Health Care for the Homeless team for years. The thoroughly researched story he shares is both well-organized and personal.

Kidder profiles Dr. Jim’s thirty plus years working with Rough Sleepers in Boston. Dr. Jim learned to gain the trust of the homeless by listening. “When you work with people who’ve had so little chance in life, there’s a lot you can do. You try to take care of people, meet them where they are,…figure out what they need, how you can ease their suffering. I was drafted into this job, I didn’t pick it, but I lucked into the best job I can imagine.” I respond, God bless him and the other angels who do this work.

Rough Sleepers gives some statistics, gets into the nitty gritty complex medical care of homeless people. There are no magic solutions. The ‘Team’ was always trying to get permanent housing and some rough sleepers would continue to drink and use drugs to ease the pain of their severe trauma.

I particularly liked following the sad, tender story of Tony, always trying to look out for others. I did not expect easy solutions to the complex problems of homelessness. My only complaint is that the book ended very abruptly. It did give me a better sense of empathy for all who have suffered so much and a great appreciation for all who are the helpers.

Thanks to Netgalley and the publisher for providing an ARC of this book in exchange for an honest review.

“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” ― Margaret Mead spoke this quote decades before Jim O’Connell graduated from Harvard Medical School. He had a short time until his residency at Mass General Hospital ended and Dr. O’Connell began his well-earned and potentially lucrative career. Then the hospital’s chief of medicine invited Jim to take a ‘gap’ year helping develop an organization bringing health care to the city’s unhoused population.

Author Tracy Kidder takes this inspirational story that turned from his boss’ request into Jim’s calling. Kidder’s book follows five years of O’Connell’s and colleagues’ mission to serve thousands of homeless patients, providing empathy, medical care, socks, meals, laughter and tears. Homelessness is one of America’s biggest issues wrapped in mental illness, PTSD and other trauma along with our country’s lack of affordable housing. Instead of ignoring the issue, this team chose action, underscoring that we can all make a difference in our own community and even the smallest acts change the world.

This is an eye-opening book about the homeless population in Boston. A community of loving people has dedicated their lives to serving the homeless, which they call "rough sleepers." This book will introduce you to human beings living and surviving on Boston's streets. I became connected to these people through the eyes of their caretakers and was very invested in their lives and journeys. I consider this a must-read if you have ever generalized or written off people who are homeless. Everyone will benefit from hearing the stories in this book. I loved it. It was a five-star read for me!

In Rough Sleepers, best-selling author Tracey Kidder tells the story of Jim O'Connell, a man finishing his medical degree 40 years ago and taking a year off to provide aid to the homeless, which changed his life. He has spent the rest of his life supporting and creating systems to help the homeless. His outreach van provides food, clothes, medical checkups, and encouragement to go to the shelters. Soaking of feet and listening to woes can go just as far as providing healing as any service. It can heal the soul of the patient as well as the doctor. We follow the trials and tribulations of Jim, his co-workers, the people he meets on the street, and how the program has evolved.

This is a timely narrative as more and more people are squeezed out of their homes and have no resources to assist. People like Jim keep the worst from happening, and the program seems like it would be good to expand in most communities. People avoid shelters and assistance for various reasons; the program helps the most vulnerable.

When Dr. Jim O’Connell graduated from Harvard Medical School, he deferred a prestigious fellowship in order to help develop an organization that would bring health care to Boston’s unhoused population. The project was only supposed to last for a year, but through it, he discovered his life’s work. Tracy Kidder spent five years with Dr. Jim as he provided care for the city’s most vulnerable residents. In addition to staffing a street clinic, where he would see patients from the city’s homeless shelters regularly, he also drove an outreach van at night, bringing soup, sandwiches, and treatment to the city’s “rough sleepers”, those who have no shelter at all. Interspersed among the heartfelt stories of the patients are observations about the problems that exacerbate homelessness, such as ever diminishing affordable housing, scarce mental health services, and all the roadblocks that make it excruciatingly difficult for people to transition from living on the streets to being housed. This is an illuminating book- and a must read for fans of Kidder’s Mountains Beyond Mountains, who will find this account equally engrossing.

Tracy Kidder writes fascinating narrative nonfiction. His latest book relates the story of Dr. Jim O’Connell and the Boston Health Care for the Homeless Program. This innovative program treated countless “rough sleepers” and has served as a model for other Street Teams. Should be read by anyone interested in one of today’s worst social issues.

Rough Sleepers should be mandatory reading for all medical students. And people living in cities or creating policies for the city. Actually, everyone could benefit from reading the hard truth about the homeless. I know many of my preconceived perceptions were blown out of the water. The people who worked with Street Team are angels and should be given so much more funding and help. Thank you Tracy Kidder for writing this book.

I never really differentiated between people who are homeless and rough sleepers, but I definitely see the difference now. Rough Sleepers is about a program in Boston that tried to get Rough Sleepers off the streets, find them homes and medical care and follow through with those things. Tracy Kidder writes about Dr. Jim O’Connell, a Harvard trained doctor who dedicated his life to serving the most needy on the streets of Boston. The position he accepted for a year before he went onto to a fellowship in cancer research became his life’s work. His first duty was to wash the feet of the homeless. It was a medical necessity, but also a lesson in servitude and humbling himself. Dr. Jim learned that traditional medicine didn’t work with this population. He needed to earn their trust before he could treat them. After his first year, Dr. Jim delayed the fellowship a year, then another until he gave it up for good. His calling was working with the people others walked by, sneered at or refused to treat. He made a difference one person at a time. The last part of the book description says it all: In this book, we travel with O’Connell as he navigates the city, offering medical care, socks, soup, empathy, humor, and friendship to some of the city’s most vulnerable citizens. He emphasizes a style of medicine in which patients come first, joined with their providers in what he calls “a system of friends.”

Rough Sleepers is a powerful book, a book that highlights one city's attempt to try and solve a social problem, people living on the street, that many countries cannot solve. Tracy Kidder's book is narrative non-fiction and written in such a way that it pulls the reader in. It becomes personal and relatable as we travel along with Dr. Jim meeting the people he meets and treats. It puts a human face on the people that are often ignored. This is a book that not only highlights the issues that the rough sleepers live with, but also introduces us to the unsung heroes that have dedicated their lives to working with them, healing them and supporting them.

The reader will see how government and bureaucracy have failed the homeless and low income families. When low income housing disappears because buildings are upscaled, and the tenants are displaced and unable to find affordable alternatives, where do they go? How for profit medical systems fail this population, often refusing to treat them. When governments reduce or cut spending for mental health, close psychiatric hospitals, and provide little or no treatment for PTSD in veterans, we end up with more homeless. It is easy to blame the the poor and homeless. "They are lazy, they are addicts, they won't accept help, there are places for them to go but they won't go there, etc." We don’t want to know who the homeless are because its easier that way. I am ashamed to say that I have thought this way and said the same things a time or two, but after reading the stories about some of the people Dr. Jim has worked with, I hope my attitude has changed and that my actions will show it. Has the program that Boston developed solved the problem of homelessness and rough sleeping? No, but it is a start, showing that some things will work, but there is a long way to go. This book was a difficult one to read. It does not have a happy ending. It does not solve the problem. It educates, tries to humanize the situation and shares some success stories, enough to give a glimmer of hope, but also demonstrates that there is a long way to go

Rough Sleepers documents the work and life of Jim Connell, MD, as he navigates a healthcare and insurance system that has left the unhoused or rough sleepers out in the cold. We meet some amazing people, learn about their challenging circumstances and the people that are working hard to create caring communities. Another inspiring and motivational. book from Tracy Kidder.

**I received an electronic ARC from NetGalley in exchange for a fair and unbiased review of this book.

Wow what an incredible journey the author took us through - there were definitely moments of sadness and moments of hope that the author did a great job of depicting in his wording of various events. I was so glad to be able to learn about homelessness and his march to helping bring this issue to light, not only from a medical perspective, but also from his own personal perspective. It was certainly not what he was envisioning as a pre-med student.

A haunting look at the population of unhoused people in Boston, and the doctor and his team who serve them. See my full GoodReads review here https://www.goodreads.com/review/show/5425667714

This is a remarkable achievement in so many ways. The story of Dr. Jim O’Connell, who started college at Notre Dame and then Cambridge University in England majoring in philosophy. He dropped out and taught school for several years until a terrible accident he witnessed motivated him to Harvard Medical School at age 30. He imagined a lucrative career in upscale medicine, but was talked into a new program working with the homeless. Jim agreed to one year on the streets of Boston and he stayed for over 30 years.

“Rough Sleepers” covers multiple aspects of the homeless life and Dr. Jim’s many contributions to improve the programs. I remember working in downtown San Francisco and learning a tiny bit about the homeless and their routines. This book opens up their world and their humanity.

I received a free copy of “Rough Sleepers” for my honest voluntary review. For anyone who has a desire to begin to understand the complicated world we live in and the wide variety of people and problems that exist in it, this would be an excellent reference.