Featured, On The Fringes, Pleural Space
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Beneath the Silence


We lug our oversized backpacks into the van and climb in, slamming the doors with such haste that the chaos mere feet away is smothered instantly. What had just been a moment of mayhem dissolves into one of pure silence. Ben doesn’t start the car. I don’t need to ask him why. This group has never been short on chatter, but for once the outreach team is resigned to stillness.

I stare blankly out of the pristine van window, avoiding unpacking the glaring paradox of this vehicle’s price compared to the net worth of each of our unhoused patients’ belongings. The encampment is being swept, which means our patients will once again be forcibly removed from their makeshift homes by police, and the uncertainty hanging in the air regarding where they will end up next is tangible. I can’t help but feel the deflation envelop me as we are once again forced back to square one. Typically the brightest part of my day, the barking from all of the dogs occupying the encampment take on a more ominous tone. I turn from the window to face the rest of my team, intent on breaking this silence but unsure how. After a half-second glance at their faces, I shift my gaze back to the outside world. The silence is what we need right now.

It is moments like these that force me to question how our small team will ever have the power to make a meager dent in battling the homelessness crisis in Los Angeles. We drive around the west side for hours each day, working tirelessly to keep tabs on our patient population, only to have our progress shattered when encampments are swept away by law enforcement. One swift decision made by people more powerful than us can drastically damage momentum that has taken weeks, sometimes months, to foster.

When a sweep occurs, patients typically have no idea where they will move to next. This is what happened today. We are forced to drive away from what once was an encampment full of life and love and even hope, completely lost on how we will locate those patients again in the future. It feels like we do so much to keep up with the complexities of our patients’ situations, yet it’s not really enough.

For every setback that our team faces, there seems to always be a perfectly-timed glimmer of hope that is equal in magnitude — something that tells us we just might be doing something right.

Two days following the latest sweep, the outreach team cannot seem to find one of our frequent fliers at his usual tent spot. A mixture of acceptance and defeat washes over me as I amble back towards the van until the voice of a different patient cuts through the silence: “He’s only not here because he just moved into the bridge home. I only wish he had taken me with him!” In an instant I feel the pent-up tension in my body dissipate — that bridge home takes him one step closer towards permanent housing. At our next stop around the corner, another patient proudly shows us his paintings that he has started selling on the street, and I am taken aback as he proclaims each one as an original piece. Brilliant lines of yellow and green contrast starkly with the dark canvas backgrounds, as if to depict the fleeting moments of joy which cut through the harsh reality of living on the street. I briefly consider purchasing one myself — they are just that stunning. Here we are, having just witnessed one of the largest encampment sweeps during our time together as an outreach team, yet I would be remiss to ignore these little nudges insinuating something deeper. Maybe we really are still heading in the right direction.

After leaving our patient with some supplies and admiring his paintings for a moment longer, we head back to the van, walking with a lightness that has been hard to come by these last few days. We slam the doors shut, and for the first time since Monday, my coworker turns on the radio. It takes no verbal confirmation to acknowledge the collective mood shift. I lean my head against the window, for once content with the lack of words exchanged between myself and my coworkers. In the best way, silence is what we need right now.

Image Credit: “IMG_4906” (CC BY 2.0) by WarOnTomato

Kaitlin Toal Kaitlin Toal (3 Posts)

Writers-in-Training Intern and Contributing Writer

Geisinger College of Health Sciences


Kaitlin is a medical student at Geisinger College of Health Sciences, class of 2027, interested in primary care and addiction medicine. She is from Malvern, PA and attended Northeastern University for undergrad. Outside of school, Kaitlin loves running, volunteering, cooking, reading/writing, and playing piano!