There is a commonly used quote in the world of street medicine: “Go to the people. Live with them. Learn from them. Love them. Start with what they know. Build with what they have. But with the best leaders, when the work is done, the task accomplished, the people will say “We have done this ourselves.” – Lao Tzu.
My involvement in street medicine has brought me a teacher, mentor, role model, and friend in Dean Carpenter, NP. Dean exemplified every aspect of this quote. He was a leader by example, inspiring confidence, autonomy, and trust in his patients, and humility, empathy, and compassion in his volunteers. Dean was an endless stream of quick wit and approachability with boundless knowledge of obscure medical facts and limitless dark humor. As we walked, biked or drove through the streets of Detroit bringing medicine to the people–rain or shine, sleet or snow–everyone knew Dean by name. Patients would call out “Doctor Dean!” as we approached, and he would proudly and lightheartedly correct them, “It’s Nurse Dean,” before having a seat on the ground beside them, truly meeting his patients in their element. Dean passed away this August, leaving us far too soon, wishing for more time to learn from him and to serve our patients alongside him. Dean was the heart of street medicine in Detroit, serving hundreds of patients and inspiring hundreds of future physicians. In the time I had the privilege of knowing Dean, the experience of working alongside him shifted my future goals and altered my leadership style. He taught me so much about medicine and about life, impacting how I serve the underserved, and how I lead my volunteers to do the same as Detroit Street Care President.
I learned from Dean that we must advocate with, rather than for, our patients. Dean emphasized the importance of providing resources, acting as allies, and expressing empathy rather than sympathy, thus facilitating effective care and providing tools to improve health and standard of living. I apply this lesson directly to my patients, and indirectly to my leadership style as Detroit Street Care President. To be an effective leader, it is my responsibility to provide my team with the resources to succeed. I act as a sounding board, problem solver, support system, and collaboration facilitator, willing to pitch in whenever, wherever, and however needed. I steer the boat when necessary, but feel my greatest responsibility lies in rowing alongside my team, advocating with, rather than for, my team members. Similarly, in the shelters and on the streets, we empower our patients to steer their health care by providing resources and support, while facilitating autonomy in a world where so much control has been stripped away from them.
Dean placed great emphasis on the importance of providing foot care to our patients, which reaps multifaceted benefits. For our patients, foot care serves as an avenue of empowerment, comfort, and selfcare. For our volunteers, the act of providing foot care instills humility, respect, and understanding. Dean’s emphasis on the importance of foot care taught me there is humility in service which must be learned through hands-on experience. To honor this strong sentiment, following Dean’s passing, I started a monthly foot care clinic at the shelter to broaden the spectrum of care we provide, pass on this lesson of humility, and facilitate the provision of comprehensive care.
Dean’s humanity, generosity, and compassion were unparalleled, and his leadership style was one of empowerment and humility. He taught us it is our job to make the “invisible people” visible. We must act as leaders within the medical community to educate and advocate for our underserved neighbors. In efforts to accomplish this, the DSC team has presented our mission to the Michigan Osteopathic Association and Michigan Cancer Consortium, and I serve on the leadership team of the Street Medicine Institute Student Coalition where I have the opportunity to help street medicine teams around the world develop and improve. Our job as street medicine providers does not end where responsibilities typically would with any other patient population. We must go above and beyond standard care to provide a wide range of resources, some far more social than medical, and strive for constant improvement.
Serving the underserved is an enormous privilege from which we as providers reap so many benefits. The practice of street medicine is an extremely purpose-affirming experience, and it is my biggest source of hope and happiness to lead this incredible, selfless team of future physicians.