Skid Road: The Intersection of Health and Homelessness
After years of caring for the homeless in the streets and dilapidated motels of Richmond, Virginia, nurse Josephine Ensign became homeless herself.
Many of her patients were prostitutes—some as young as 15—and her conscience no longer allowed her to adhere to her clinic’s policies. Though she was Christian, she was fired for referring many of these women for abortions, for not making AIDS patients “account for their sins” before they died, and “no longer being a Christian woman with a humble and teachable spirit.”
“That fall I spiraled down,” she later wrote about the experience. “[I] lost the vestiges of my faith, my marriage, my job, my home, my sanity—more or less in that order.”
“I also lost my son,” she continued. “I spent six months couch surfing, living in my car and abandoned sheds before moving to Baltimore to go to graduate school. . . . Sometimes it takes radical change to get your life back.”
Now, Ensign is using her own experience of homelessness as a young adult, as well as her thirty years as a nurse practitioner, to help homeless people and healthcare workers in King County tell their stories.
Made possible by a Washington Stories Fund Grant from Humanities Washington and other sources, Skid Road: The Intersection of Health and Homelessness is a digital project that weaves together videos, photographs, essays, oral histories, and a book in order to chronicle the experiences of those living and working with homelessness in King County.
“Modern healthcare and education have traditionally not done a good job of bringing in the anchor of the humanities: the critical, reflective writing, thought, and practice,” she said. “Getting a more personal look into the experiences of King County’s residents will deepen the public’s understanding of just how complex the problem of homelessness is.”
The roots of Skid Road began with her desire to recount her own past in her book, Catching Homelessness: A Nurse’s Story of Falling Through the Safety Net. Now a professor in the University of Washington’s School of Nursing, Ensign brought these storytelling lessons into her classroom, encouraging her nursing students to take an active role in telling their own stories.
“We know from growing research that [storytelling] helps people feel empathy, develop a narrative, and form a professional identity,” she said. “This helps people think through the very complex issues about why they are motivated to do the work they do.”
Many of her students will go on to work in the healthcare field and be at the forefront of the Seattle’s homelessness crisis. An East Coast transplant, Ensign has lived in Seattle for the past twenty years, and part of her initial motivation to start Skid Road came from a desire to get to know her adopted city and its history.
“[Seattle] is a pretty unique city in that our historical roots go back to industries like sailing, fishing, and logging, where people were effectively homeless in a lot of cases.”
Now, facing the pressures of rising inequality and rents, Seattle has found itself with the third largest homeless population in the nation.
“Modern healthcare and education have traditionally not done a good job of bringing in the anchor of the humanities: the critical, reflective writing, thought, and practice.”
A problem with roots as complex as the policies implemented to combat it, homelessness is often stigmatized. Part of what motivated the Skid Road project was a belief that the healthcare system should act with greater empathy and understanding towards homeless people, and that the key drivers of this change would be action on the part of people already working at the intersection of health and homelessness. Her students are poised to be those drivers.
Through interviews with her students, as well as social workers, nurses, and doctors, Ensign has already seen the effects of personal reflection and storytelling firsthand.
“Helping [healthcare and social workers] think through the very complex issues about why they are motivated to do the work they do, and what’s effective long-term, helps prevent professional burnout and makes healthcare workers more effective.”
Though telling stories can be motivating, Ensign also hopes that the completed project, with its capturing of stories from Seattle’s current moment, will serve as a resource for policymakers.
“Are we going to reinvent the wheel, or are we going to go back and look at what did not go well? Looking at these historical trends, we can inform current and future policy and create more of a narrative by bringing in the individual’s voice.”
For the healthcare workers, these interviews remind people why they went into the field, making experiences in their career and the patients that stuck with them resurface in their memory. For people who have experienced homelessness, telling their stories is similarly emotional.
“When people are given space, time, and attention, and are really listened to deeply about the things that matter, they often burst into tears.”
Check out Skid Road: The Intersection of Health and Homelessness here.