Excerpt from Rough Sleepers by Tracy Kidder, plus links to reviews, author biography & more

He wore his cellphone in a holster on his hip, and he carried a small flashlight, thin enough to hold in his teeth if he needed both hands to examine a patient. A flashlight remained one of the Street Team's essential tools for checking on rough sleepers. Some years back, one patient had asked how Dr. Jim would feel if his doctor came to his bedroom in the middle of the night and woke him up by shining a flashlight in his face. Jim took the issue to the Program's board of directors, a group of about sixteen, which included experts in health and medicine and finance, and several formerly homeless people. The board convened a meeting of about thirty rough sleepers who issued this advice, long since become policy: The wellness checks should continue, but when they woke people up late at night, Jim and his Street Team should first shine their flashlights on their own faces so as not to startle the patients.

• • •

The van stops under streetlights on Bromfield Street not far from Boston Common. It's like a small bus, with several rows of seats, mostly occupied by boxes of blankets, underwear, and socks. In the rear there's a small canteen, with boxes of sandwiches and condiments, vats of hot chocolate, coffee, and soup. Jim gets out, opens the back doors, and looks around for customers. He has a ruddy face and silver hair that falls almost to his collar and over the tops of his ears. He wears light-colored corduroy pants, a collared shirt, and clogs. He's six feet tall and trim and moves with an athlete's self-assurance that makes a task look easy, and his voice is full of energy and cheer as he waits on the customers at the back of the van.

A thin Black man comes wandering into the light, out of an alley.

"You got soup?" he asks.

"Yes!" says Jim, grabbing a Styrofoam cup and filling it from one of the vats.

"You got crackers to go with it?"

"Sure!"

"Isn't there a doctor who goes with you guys?"

"I'm a doctor," says Jim. Then he introduces himself, offering his hand.

"I want to change my doctor," says the man. "I hear good things about you."

"We'd be happy to take care of you. We'd be thrilled." The man should come to Street Clinic this Thursday, Jim says, adding that it's held at "Mass General"—the gigantic Massachusetts General Hospital, not far away, near the banks of the Charles River.

The van makes many stops. It encounters a mixture of people. There seem to be about half as many women as men, and lone women are rare, almost certainly because the streets at night are especially dangerous for them. There are many Black faces, but far fewer than white ones, and this is surprising. Homelessness afflicts Black and Latino people disproportionately both in the United States and in Boston, and one might expect that the same would be true of the city's rough sleepers. Jim has long worried that the van and other outreach efforts have consistently missed rough sleepers of color, and yet most of the van's drivers and their helpers are themselves Black and Latino. Over the years they have often searched for their own in the nighttime city. Maybe, Jim thinks, the Black and Latino communities are more willing than Boston's white world to harbor their homeless. In any case, once people have fallen to living on the streets, they have reached a certain horrible equality.

A young-looking white woman comes into the light on Washington Street, hopping on one foot and then the other, running her hands through matted, strawberry blond hair, all the while feverishly scratching her arms and neck and face. "That's what people will do on K2," Jim says softly, as the woman approaches. K2 is synthetic marijuana, which has notoriously unpredictable effects.

Her voice is loud and high: "Holy shit! I got lice! I was exposed to lice and I'm freaking out. I already got all the treatment and somebody stole it."

Excerpted from Rough Sleepers by Tracy Kidder. Copyright © 2023 by Tracy Kidder. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.