For this doctor, the first step is finding his patients
IT'S JUST AFTER 10 O'CLOCK ON A warm, cloudless night in Pittsburgh as three figures carrying backpacks trudge down a dimly lit street. Turning a corner, the group's leader, Dr. Jim Withers, spots two derelicts snuggled up against a concrete wall. "How you doing, Richie?" asks Withers, kneeling beside one of them, a gaunt man with a matted beard.
"All right, I guess," says the man.
Withers listens while Richie, a 47-year-old former pharmaceutical salesman from New Jersey, describes his assorted ills. After checking Richie's eyes and blood pressure, Withers moves down to his feet, using athlete's foot powder and clippers to beat back the fungus and overgrown toenails. With a brief word to his companions, who are attending to the other man, the doctor then sprints down the street, returning minutes later with two small cartons of milk. "Thanks, Doc," says Richie, chugging the gift. "I appreciate what you're doing."
Thanks to Withers, Pittsburgh's homeless are receiving one benefit that has pretty much passed out of the lexicon of medical care: house calls. For 3½ years, Withers, an internist and teaching physician at Mercy Hospital, has walked point for Operation Safety Net—a group of two dozen doctors, nurses and ex-derelicts who set out in teams of three or four each night with food, clothing and medical supplies to succor the wretched of the city, finding them in store entrances and subway stations, on air vents beside churches and in darkened warrens along the downtown rivers.
"When you come out of medical school, you feel you're one of the ordained," says Withers, who is 38. "It's a real rush. All the Latin terms, the white lab coats—it gives us leverage. Treating the homeless is a way of getting back our humanity."
Withers first hit the streets in 1992 at the invitation of a friend, Mike Sallows, who at 40 is now a salaried employee of OSN but who was himself homeless for six years in the mid-'80s. "I asked him to come out on the street with me," says Sallows, a blues guitarist at the time, who met Withers at a shelter where the doctor wanted to provide medical care. "He accepted—no hesitation at all. Sometimes we'll be out in below-zero weather 10 nights in a row, and he never complains. He gets down to their level, suffers with them, feels some of what they feel."
Withers learned the Hippocratic oath from his physician father, Donald, and his mother, June, a nurse, who reared three kids on a farm in Hanover, Pa. "My father would go out in all kinds of weather," says Withers. "One time when I was about 10, he invited me to come along in a blizzard. We got stuck and had to get a lift from a truck driver. I was scared, but my dad made his house call. That kind of dedication inspired me."
As a teenager, he traveled with his family to Nicaragua, Guatemala and Saint Lucia, where Jim helped his father do medical missionary work. "Being that close to my dad's work, I knew I would be a doctor too," he says. He met his wife, Gayathri, now 38, in 1981, when he was at the University of Pittsburgh medical school and she was studying for a Ph.D. in chemistry at nearby Carnegie-Mellon University. They were married in 1984 in her hometown of Nellore, in southern India. The two have returned to India four times since then, including a 1994 trip to Calcutta during which Withers visited with his hero Mother Teresa.
The couple and their four children (Christopher, 10, Jonathan, 8, Gregory, 5, and Jeneni, 13 months) live in a three-bedroom home in a working-class section of Pittsburgh. In the driveway sits the doctor's lone concession toward a life of doctorly affluence: a red, '89 Alfa Romeo, bought used for $10,000. "For Jim," says Gayathri, "going out on the streets is a culmination of a lot of things in his life. It's who he is."
If he has his way, it will also, apparently be who his kids are. On Father's Day, Withers took his eldest son, Christopher, on one of his forays downtown, where they encountered a man with an open wound infested with maggots. "Christopher watched the whole treatment," says Withers. "I think it affected him, because the next morning on the refrigerator I saw a picture of a maggot with a big smile."
Back on the streets, Withers, Sallows and physician's assistant Louisa Tome find an 80-year-old man known as Grandpa in an alley, slumped against a brick wall and clutching two plastic bags filled with all his worldly possessions. Withers runs a flashlight over Grandpa's ulcerous leg, which is marked by a runny sore. "Yeah, got a few maggots in there," says Withers matter-of-factly as he extracts the wormlike larvae and bandages the leg.
Withers has recruited staff at Mercy Hospital as OSN volunteers, which has let him cut back his own street duty from three times a week to just once and allowed him to do more fund-raising. From time to time, he likes to give young doctors an object lesson in compassion. Recently he brought a destitute man with a gangrenous leg into the ER and proceeded to soap, shower and dress him in freshly laundered clothes. "They saw," says Withers, "that underneath all that dirt and grime there was a real person—and that by treating the homeless we also heal ourselves as a profession."
RON ARIAS in Pittsburgh