Tracy Kidder is one of the preeminent non-fiction writers of his generation, and in this book he uses his prodigious gifts to shine a light on the plight of the homeless. This book should be required reading for everyone so that they can get some insight into a painful problem in American society, and the author's skill for storytelling makes it a compelling page-turner of a book.

Tracy Kidder just keeps delivering again and again!  Lyrical, pragmatic, and full of humanity and grace, this portrayal of Dr. Jim O’Connell’s quest to love and care for people experiencing homelessness in Boston transports the reader to another reality.  Because that’s what life for this unhoused population is—a totally different reality that requires different skills, different coping mechanisms, expectations, and desires.  Yet it is still fully human and fully relatable.  O’Connell and his team, as communicated through Kidder’s unflinching account, provide a compassionate look at the subject as a social issue within systemic constraints.  Each individual has a story which, when taken together, are a recipe for a sour cocktail of bad luck, bad choices, and bad systems.  The reader emerges with a tempered admiration for O’Connell’s seemingly endless mission to make vital connections with these affected individuals and provide truly patient-centered care.  The book tackles difficult questions of cause and effect, a cost-benefit analysis of the work, and what a realistic outcome could look like (rather than a purely idealistic one). I found Kidder’s prose to be like a closely-woven tapestry:  separate and interconnected human-centered stories loosely weaving across and around a timeline of the evolution of O’Connell’s work.  One leaves with the impression that we could all be in this together—that this work is approachable and doable, if we would but pull together to see it to its completion.  I highly recommend this book (and all Kidder’s work, if I’m being honest) to anyone who is interested in ideals lived out through actions, and anyone interested in the complex work of healing individuals experiencing homelessness.

Rough Sleepers by Tracy Kidder is a deep-dive into the world of the unhoused and a doctor who spent his career ministering to this population. Dr. Jim Connell, a Harvard Medical School graduate, had many options in the field of medicine, but his decision to lead a grant for homeless patients in the Boston area led to his life-long calling to serve this group and the myriad issues that accompany these circumstances.

Kidder follows Dr. Jim and his community of doctors, nurses, addiction specialists, housing specialists and administrative support, showing us what it is like to be on both sides of this equation. The program that started with a grant expanded into a mobile Street Team that visited the homeless with needed supplies, a Thursday morning clinic housed at Boston's Mass General Hospital, and several facilities that offer temporary shelter and medical treatment for those in need of physical or mental health treatment and detox.

Also woven through this narrative are the stories of individuals Dr. Jim worked with, many of whom became part of his life. Extensively featured is Tony Colombo, a large Italian-American man with a heart for serving others, even when his own physical and mental needs loomed large and eventually took his life. Tony's story serves as a specimen under the microscope where we are safe to look from all angles and explore the question that so often comes to mind, "how does someone end up living on the streets?"

I was drawn to this book because of my empathy for the unhoused and my hope for solutions. However I discovered, as Dr. Jim did through years of dedication and service, that answers are elusive and what works for one does not work for all. He and his team saw the repeated cycle of addiction and self-destruction that comes with past trauma. One universal theme for the people he worked with was a dark and painful past. It would seem that all the dysfunction stored up inside these broken souls is too big to be contained in a place called home. Also, they found that housing isn't always "the solution." Many of the patients the team found housing for ended up getting evicted because they would have others over and continued their drug and alcohol abusing-lifestyle. Others did not know how to live in a home and needed training and coaching on the tasks of running a household. And then there were those who preferred to be outdoors in the harsh Boston winters, where their jobs consisted of staying out of trouble with the law and trying to survive. This group is a community, often helping one another, offering what protection they could, and even sleeping together for warmth. The mortality rate is high, but even those whose lives are disregarded hold their own yearly memorials for those they lose.

The administrative floor that houses Dr. Jim's office is lined with framed portraits of many of the lives he served. He found that most loved having their picture taken and hung on a wall as a reminder that they too existed and had a life, however troubled and transient it was. This book, while full of research and findings, is also full of stories and lives, including the life of an amazing person who made an exponential impact on a population so often pushed aside. My one wish was to see the portraits of those described in the book; to see them as Dr. Jim did, and recognize them not as a problem to be solved but as individuals who deserve health, healing, and, if not a home, a place in our communities.

I recommend this book to anyone who has ever passed by an unhoused person and wondered how they got there. It is a starting point to understanding, if not a solution tied up with a bow. Many thanks to NetGalley and Random House for an ARC of this important book.

Rough Sleepers hits the shelves, today January 17, 2023.

I have long been a fan of @tracy_kidder and his work. I read Mountains Beyond Mountains in college and it was formative to my academic journey, my career path, and my life philosophy. So I was thrilled to get an Advanced Reader Copy of Rough Sleepers. I also have a history of working with the unhoused, particularly during my college years, and so this book felt very much up my alley. Big thanks to Kidder, @randomhouse and @netgalley for this opportunity.

Kidder is an exceptional storyteller, weaving together Dr. Jim's life with that of the abysmal state of public health and housing in this country with the stories of the rough sleepers he met and got to know through the years. It was both touching and frustrating. Beautiful and tragic. And while Dr. Jim's work is exceptional and so important, it is also clear that there are limits to what a single person can do.

I really enjoyed this, though at times it was hard to read. I think some of the best books, particularly nonfiction, fall into that camp. It can be both painful and inspiring, and a reminder of how much work there is left to be done. And how complicated it all can be.

An insightful look at a man at the end of a long career of doctoring the unhoused, the transitory homeless of shelters, and the so-called rough sleepers who avoid the temporary shelters, sometimes for decades. One questions whether his program will survive without him. Kidder also focuses on individual rough sleepers, their challenges, their peculiarities, their stench, and their personalities bringing to life their essential humanity and the difficulties of day to day interactions and the impossibilities of housing those with the deepest issues, whether of personality, drug/alcohol addictions, their choice of friends, or even their ignorance of the most rudimentary facets of living housed. There but for the grace of God may go you or I should adversity unfold in our lives. An examination to make you think, especially about the challenges to becoming or staying housed.

Rough Sleepers by Tracy Kidder

This book will answer many questions you may have about the homeless. Why are they living on the streets? What organizations are available to help them? Do they choose this lifestyle? How do so many end up here?

Author Tracy Kidder introduces us to Dr. James O’Connell of Boston, who spends the bulk of his medical career helping this faction of our society. He is part of the Street Team which goes out by van to see the needs of the rough sleepers. He refers the ill and most needy to Mass General and McInnis House for treatment and respite.

While most of the book is about Jim, there are other doctors and nurses mentioned. A good portion is also about one of the favorite rough sleepers, Tony Columbo. I feel a few examples of the rough sleepers would have sufficed, but Kidder gets goes beyond that until the story feels somewhat repetitious.

There may be answers here to put more than a bandage on the rough sleepers’ issue. With all the available resources in our country, we should be able to solve this dilemma. Thanks to #RandomHouse and #NetGalley for my ARC to review.

Many of us turn away from unhoused people but Dr. Jim O'Connell and Tracey Kidder have not. This at times tough to read look at the unhoused of Boston is a tour not only of the streets but also of the people who live there and who try to help. O'Connell is at the forefront, taking Kidder along as he works with his clients. And, Kidder introduces some of them as well. This is a long term problem for society writ large and one we won't ameliorate (it will never be solved) without facing it square on as O'Connell has, Kidder, a journalist, has a way of telling the story without flinching. Thanks to Netgalley for the ARC. Excellent read,.

In Rough Sleepers, Kidder introduces us to Dr. Jim O'Connell, a Harvard-educated physician who has devoted his life to serving the homeless population of Boston. In doing so, O'Connell has turned the medical model on its head; he and his team travel in vans to reach their clients, they work with them to obtain housing, and they focus on listening to patients, taking all the time they need for each person. IN addition, rather than a doctor prescribing what he or she feels needs to be done, they let the patient bring up what they'd like to address.
This book gives me hope for humanity.

Tracy Kidder has written some amazing, thought-provoking narrative non-fiction books, and he continues with Rough Sleepers. The story of a program in Boston to provide care for the homeless population, this book draws you in right from the beginning and keep you right through the end. The conversational style makes it easy-to-read, but the subject matter is not easy at all. It has made me consider how I look at the unhoused that I come across, what assumptions I make, and how my behavior is affected by what I see. This is a tremendous story of how one person (or small group) can make a huge difference to others around us. Thank you to Netgalley and Random House for the advance digital copy!

An exceptional look into the life of Dr. Jim O’Connell and the dedication he put forth into bringing not only medical care to the homeless of Boston, but humanity as well.

Kidder paints a compelling portrait of the difficulties in caring for the “Rough Sleepers” or chronically homeless of Boston. Dr. Jim and the Street Team have spent their professional medical careers providing check ups and preventative care to the city’s most hardened and yet most vulnerable population.

Written with both grace and compassion, Kidder focuses on several “old classics” as they navigate the struggles of finding permanent housing, managing mental health crises, and simply struggle with the stress of previous life choices that led them to a life of sleeping on the streets.

Highly recommended for anyone in the medical field or anyone who has compassion for lesser seen and highlighted populations of our cities.

Huge thank you to Netgalley, Random House, and Tracy Kidder fir an advanced reader’s copy in exchange for an honest review.

I haven't ready anything from Tracy Kidder for awhile and forgot how good he is. Upon reading the first chapter I pre-ordered this book for my dad. Kidder presents a humanitarian view of the homeless and helps us to understand just how complex this situation is (really for many starting in early childhood). The compassion and dedication of Dr. Jim and his team is inspirational. Homelessness is a growing problem in this country that we ignore or overlook or even condemn and I think this is an important read to help us to retain our own compassion and humanity. The homeless are not the problem, by systems and society are.

I enjoyed this book very much. It was a nice change from other books that I have been reading. I never really knew the sad plight of the homeless. It helped me to look at the homeless in a different light. Everyone needs to read this book to help understand what hardships they go through and maybe have a bit more compassion. I enjoyed meeting those who tried to help them and their friendship with so many of them. I highly recommend this book. I thank NetGalley for a free preview.

Very interesting reads about a physician who stated This is what I was trained for. I wanted to take care of people who were sick. And, oh, my God, have I landed in a world where people are sick.” Fascinating read about the homeless medical program his has run for decades in Boston. The title refers to the people we get to know, those homeless who sleep out in the street, behind dumpsters, in doorways, abandoned building. Those who take to time to read this will definitely come away with deeper (in some cases new) understanding of the multitude of reasons for homelessness and addiction. Dr. Jim a very dedicated, interesting, driven man and the Program have done so much to deal with a situation whose causes are very complicated, seemingly unsolvable. He does what he can, he listens, he advocates, he cares.

ROUGH SLEEPERS by Tracy Kidder (Mountains Beyond Mountains) is subtitled "Dr. Jim O'Connell's urgent mission to bring healing to homeless people," described as "a glimpse of a world hidden in plain sight." Kidder once again provides superb narration about a selfless individual; in this case, he is telling the amazing story of a doctor who has dedicated nearly 40 years to befriending and caring for the homeless in Boston. Kidder himself spent roughly five years researching the Boston Health Care for the Homeless Program, at times riding along with volunteers and paid staff as they brought medical care to the streets. Writing that "a country-doctor approach for an urban population — this was the kind of doctoring that could bring in suspicious patients," Kidder emphasizes the importance of listening to the homeless patients (for more, see his piece for the New York Times, link below). Filled with many anecdotes, ROUGH SLEEPERS is both troubling and extremely inspiring; it received a starred review from Kirkus and was selected as an Amazon Best Book of January 2023. 

NYT article:
https://www.nytimes.com/2023/01/05/magazine/boston-homeless-dr-jim-oconnell.html

The Street team would go around Boston and help the homeless people by giving the homeless people medical care. This team helped 11,000 homeless people per year. Each member of the street team carried a doctor's bag. They would temporarily get them off the streets. The van that the street team used had blankets, underwear and socks. It had sandwiches, hot coffee and soup. It had several rows of seats inside. The street team did wellness checks on the homeless at night while they were sleeping. They would shine a flashlight on them to wake them up and check their health after. They would find people in distress and bring them in.

Dr. Jim O'Connell gave me all the feels, especially the empathetic ones. What an amazing man, who has given so much of himself to assist those who most need assistance. His tireless pursuit to help those who have become unhoused is remarkable. I really enjoy narrative non fiction, and this book hit the sweet spot. It was so well written, and i felt my heart tugged over and over again. This book, which could have been boring statistical drivel, instead gave a humane look at those who are treated inhumanely. I not only enjoyed this (which seems weird to say given the topic) but i also feel like i learned some important lessons, about others and myself.

Tracy Kidder is a past master at writing engrossing, and engaging narrative prose about unpublicized people who accomplish worthwhile activities and achievements. He makes the complex simple, and the commonplace fascinating. This book, Rough Sleepers, does not disappoint. Dr. Jim O’Connell is a doctor who has treated homeless people in South Boston since 1985. The term “rough sleepers'' is his term for those homeless people who sleep outside or in makeshift shelters. He and his colleagues, mostly nurses, work many hours a week to help these individuals whose life expectancy is much shorter than those of us who have stable housing. This is his story, and it is a moving and interesting tale.

Back of the book has good references for anyone wanting more information.

Rough Sleepers
by Tracy Kidder
Pub Date: January 17,2023
Random House
Thanks to the author, publisher, and NetGalley for the ARC of this inspiring book. The powerful story of an inspiring doctor who made a difference, by helping to create a program to care for Boston’s homeless community—by the Pulitzer Prize–winning, New York Times bestselling author of Mountains Beyond Mountains
I found this to be a very readable book, although quite sobering as well. I highly recommend this deeply felt book full of insights and empathy.
5 stars

A stunning, heart-stopping, exciting, powerful book. Brilliantly written…inspires me to become one of “a system of friends”.

I received a complimentary ARC of this excellent Memoir/Biography from Netgalley, author Tracy Kidder, and Random House Publishing. Thank you all for sharing your hard work with me. I have read Rough Sleeping of my own volition, and this review reflects my honest opinion of this work. I am always pleased to recommend Tracy Kidder to friends and family. He writes in-depth, deeply researched depictions of life in our world.

Rough Sleepers follows Dr. Jim O'Connell and his cohorts as they work out a system of bringing medical care to the many homeless souls in Boston, Massachusetts. It is a road map to assist the homeless that most cities of any size can follow to provide basic medical care to those who have fallen through the cracks of American life. It is a map we are compelled to follow.