Takeaway
Lead with trauma-informed, dignity-first care: clarify the patient’s priorities and take the time to build a trusting relationship.
Creative Arts in Medicine | October 27, 2025 | 1 min read
By John DeCarlo, Hofstra University
Confounding malaise
They say the gears of justice turn slowly—
But exceedingly fine.
The wheels on his cart—
Makeshift home—barely turn.
His legs move exceedingly slowly:
Left foot. Right foot. Left foot. Right foot.
His head hangs downward toward his chest—
As if his will has been broken.
In the poetic vernacular, this is a type of “found poem”—as I was driving down a major turnpike near work, I stopped at a red light and noticed a man who was unhoused slowly pushing a collection of belongings in a cart. What struck me the most was the downcast position of his head.
I thought about the questions that arise when caring for patients who are unhoused. Do we have personal identification or any medical history? Do they suffer from any physical ailments? Do they have a mental health condition? Would they accept a place to sleep in a public shelter or in a hospital treatment program, or would that cause distress? What is the best care plan? Attempting to answer these questions requires a respectful and holistic approach to the overall well-being of the patient.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.