Facing Homelessness at Christmastime

I never give money to people on the street. I became convinced years ago that it was not a helpful thing to do. I am the physician for many homeless people in Memphis, Tennessee, and I know that giving them a few bucks does next to nothing to solve their long-term problems.

Still, last week, as I walked down Michigan Avenue in Chicago, I opened my wallet. It was beginning to snow, and the Christmas lights decorating the street glimmered against in the late-afternoon sky. It was beautiful. The streets were incredibly crowded with shoppers, tourists and commuters hurrying to their next destinations. As we waited to cross a street, my wife, Mary, nudged me and pointed to a woman sitting on the curb with an empty glass jar asking for money. She was rocking back and forth in the cold. I looked over and felt sorry for her, but I was ready to move on.

“Look at her leg,” Mary said.

It was awful. I’d seen open wounds like hers on people in the streets of India, but never in America. Her right lower leg was one big exposed, infected sore. It was as bad as anything I’ve ever seen in my office—and I’ve seen a lot. Her sign said, NEED MONEY FOR BANDAGES. I was drawn to her.

“What are you doing for your leg?”

“I just got out of the hospital. I’m going back to see the doctor in a couple of days.”

She never really looked at me.

It seemed to me that she was on the verge of losing her leg. As we talked, dozens of people passed by without really seeing us. The thought of taking her to our hotel room crossed my mind. Instead I reached into my wallet and pulled a twenty-dollar bill and stuck it in her jar. She thanked me profusely, and then Mary and I walked on. I continued to think about her. The next morning, we had breakfast with my brother who lives in Chicago. We told him about the woman. He said, “She used to sit down closer to the river. She’s been out on the street for a long time. Her leg looks awful, doesn’t it?”

There was no way she was faking her wound. But it made me wonder. I know no one would choose to live like that. Years ago, I was treating a patient and noticed his WILL WORK FOR FOOD sign in his backpack. He was plenty smart, so I asked him why he panhandled instead of working.

“I have a permit, and I make five times what I did with a real job.”

“A permit?” I asked.

“Yeah, you can’t beg without one or the cops will harass you. It’s free, but you have to go downtown to get it.” That was all news to me, but it didn’t surprise me that he made more money begging than working a minimum wage job. Still, that isn’t how it’s supposed to be. Not in America. I’ve learned that it’s actually hard to become homeless. To find yourself truly alone so that you have nowhere to turn when you can’t pay rent, you have to burn every bridge with every person who has ever loved you. Addiction and mental illness often accompany homelessness, making it even more difficult to inspire sympathy from friends and loved ones. That said, I know how difficult and expensive it will be for the woman with the leg wound to buy her medicine and bandages. I don’t regret giving her money, even if she’s been sitting on Michigan Avenue for a year.

Still, the moral dilemma of giving money to someone sitting on the street of an American city is something few of us ever come to grips with. Yes, we worry the person will just go buy beer. At the same time, we aren’t fully comfortable with just walking by, because there seems to be an unwritten tenet that no one in America should be forced to beg. On that, I think we could all agree.

Still, I am disturbed that I have no real solution to the problem. The root causes that lead people to beg are complicated, and I am just not sure what I am to do. And I don’t know anyone who is. But we could start with asking the questions and try to do more than shrug our shoulders at the complexity of the answers.