If being homeless is akin to being in a burning house – where everything is going to pot and you can’t think straight under all the pressure – being sick while homeless is like having a helicopter dump gasoline all over the burning house. Nothing gets better. Everything is amplified.

We generally take for granted how instrumental our housed environments are to our wellness and our recovery. Even beyond the amenities of having shelter, a clean blanket, a warm and dry place to be, the feelings of being safe, of finding familiarity, can have a huge impact on just feeling better overall. Having that one place that’s yours to recover. It’s no secret that hospital patients’ health tends to improve or fail just based on how their environment is arranged (with similar results on staff).

For individuals who are low-income and below-poverty, health care is often seen as expensive and therefore unnecessary outside of the most visible and advanced circumstances. In some families (mine included), you generally don’t go to the doctor unless you’ve been hit by a bus. Between the ages of 15 and 24, I only saw a dentist once. Unfortunately, this attitude can even carry over into housed life. I wish my father and I had gone in for full check-ups. We didn’t know he had cancer until three years after we had secured a home.

In the consistent inconsistency of homelessness, the two critical elements of staying healthy – sleeping right and eating right – are extremely difficult to maintain. Sleep can be compromised by the stress of homelessness, evening interruptions that come with commune living, and shelter structure. Eating well but inexpensively is more challenging than getting fast food on the value menu. Sleep and eating habits are also primary factors in childhood growth. Kids who don’t eat or sleep well don’t perform well in school, which essentially sets them back in just starting life on the right foot. One mother was reluctant to tell her children’s teacher that they were experiencing homelessness, but ultimately had to because both her kids kept falling asleep in class. Think about the multitude of health needs for children in general (dental visits, physical check-ups, eye care, etc.). Getting at least the basics of their immune system balanced should be a given.

Without adequate food and rest, homelessness can ravage the immune system. Additionally, exposure to the environment can greatly accelerate a simple bug into a full-blown illness. I found out first-hand.

Edited Journal Notes, Mar. 2008

I woke up yesterday morning feeling feverish, but I ignored it and went to school. Between my first and second period I bolted to the bathroom. My body was trying to evacuate everything through any means possible. Without being too gross, both ends of my digestive tract felt raw. I was miserable. At the nurse’s office, they called my father to pick me up. He collected me and we went back to the Pound.

“We’re broke flat, but maybe I can pull some money out of the account to get you some Gatorade and medicine. Shit, don’t barf in here!”

[Edit: The account my father is talking about was the account the shelter establishes at its headquarters for all residents to bankroll income toward a first- and last-month’s rent once housing is secured.]

Back at the Pound, my dad went to hunt down our caseworker and ask for his approval to make a withdrawal. I slumped in the sofa in the living room and waited for Dad to come back. I was dully aware of the door swinging open and Dad storming inside. “Okay, kid, let’s go.”

“Go? Where?” I moaned. “God, just let me die.”

I guess I shouldn’t have said that because Dad got all worked up and started barking, “You’re not gonna die, moron. C’mon, we’re taking you to this clinic I heard of.”

Later, strapped in Betsy with my head lolling to one side, I groaned, “I thought you said you were going to pull some money from the account for medicine?”

“Yeah, well, guess who’s being an asshole?”

Even with a fever it was no stretch of the imagination. “Our caseworker? How’s that?”

“Says we can’t take any money out of our own account. He knows we’re broke, I deposited that cash there, and now we can’t touch it?!”

We took me over to a local free clinic. I was taken in and then I laid down on the patient’s counter. The clinician asked my dad to step out for privacy.

She poked my stomach.

“When did the vomiting start?”

“Today.”

“And you felt fine yesterday?”

“Yeah.” Oh, how I’d taken it for granted.

“Are you sexually active?”

“What?” I hadn’t even had my first kiss yet. Not that I was going to tell the clinician that. “No, I don’t even have a boyfriend!”

“Well, you don’t always need to have one for that.”

“I’m very sure it’s food poisoning or the flu.”

“Mm, okay.”

Oh, God.

At the end of the day, there wasn’t much that could be done beyond telling me to “go home and get some rest.” Easier said than done. We went to the local park. Dad set out the old blanket we kept in Betsy’s trunk and I flopped down on it like a bear rug. We were lucky it was a warm, sunny spring day. Dad said the vitamin D would do me well. I think we both knew the real reason. We couldn’t be back at the Pound until 5pm.

“You know, when most kids get sick they look like sick kids. Seeing how messed up you look, I think this is your first time being grown-up sick,” Dad said. I just groaned my concurrence.

Today – two days later – our caseworker asked if I was still sick. I’m recovering (obviously. I’m writing again). My dad said our caseworker approached him and said we could get our funds now if we wanted. My dad argued we should have had them two days ago.

The caseworker replied, “Well, I was going to let you have access. Here, you need the money. Go ahead, go get it.”

I can’t imagine a more stupid and thoughtless thing to say. All I can think right now is how nice it would have been to feel better a couple days sooner. I know there’s going to be make-up work when I get back to school.

—

I was sick, but I had the basic sanitation and shelter to recover. People struggling with homelessness on the streets do not have these luxuries. The shame of Los Angeles, Skid Row, is notorious for being a Petri dish of infections and diseases that normally don’t appear in developed countries. About three years ago, an outbreak of tuberculosis spread among denizens of the tent city. Just last fall, the CEO of the Union Rescue Mission, Andy Bale, was exposed to E. Coli, Strep, and Staph infections. The infections were severe enough to cripple him.

In a country that’s lauded for being among the richest in the world and second only to China in the number of billionaires, why are we so destitute in our compassion? For a nation prided on equality and alleged equal opportunity, America’s wealth gap among its own citizens is nauseating. Walk down an urban street and it’s clear that the most disadvantaged individuals in homelessness are those who are ill or disabled in some way. They’re usually victims patient dumping. This shouldn’t be the way you treat anyone.

But if no one cares, what are you supposed to do?

Don’t get sick. Don’t break a bone. Don’t have irregular blood pressure. Or asthma. Or poor vision, hard hearing, a cavity, or – God forbid – a mental disorder. Because, according to our society, if your immune system isn’t hacking it after living in such a close-quarter environment on little sleep and minimal nutrition, then you have no one to blame but yourself.