A, one of our street patients recently died in unclear circumstances. We started his follow-up more than three years ago but at that moment he had probably been living on the street for ten years or more already.

Under his lovely smile, his vague and ever repeated stories, and his constant refusal of help, we assumed the presence of hidden wounds, resulting from family circumstances and exile. We’ll probably never know.

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Last year, we tried compulsory hospitalization to get him out of that dangerous routine. Unfortunately, without success. The procedure was not prolonged. In the end, the street proved fatal for him.

Psychiatric patients living on the street are particularly vulnerable because of their mental health problems but also and especially because they’re living on the street for years. Compulsion is often the only way the get them out of that situation, to allow them to survive and get better in the long run – often much better.

© P-Y Jortay

This sort of situation, which our teams often encounter, tells us that we should never forget the importance of procedures. They can save patients and eliminate their risks. Therefore, in the interest and for the survival of our patients we must all in the Brussels region ask ourselves to what extent our methods are adapted to these procedures.

This is what Françoise, a volunteer doctor, remembers of A whom she met regularly during his life on the street:

“I must say that his death affected me deeply…feelings of regret, of course (…definitely…!) …but in part also of sadness…intense… no doubt the other side of affection, friendship…

And then those small attentions for us…such as “cleaning” a spot before we sat on it…cute and funny, considering the context!

He insisted on shaking our hand. I’m surprised to see how that contact is etched in my mind, probably because the rest of our communication was so limited. His past, his story, he hardly ever talked about it. His answers to our questions were fragments, difficult to understand, and always the same. After that, he froze, locked in silence, probably a sign of a post-traumatic syndrome. Difficult to treat on the street…

Confronted with his death, a feeling that the system failed. In fact, medically speaking, he did not have to die. He was surrounded by people who cared for him. The different teams of street workers, the neighbourhood residents, the regulars of the Gare du Nord…as well as the station staff, the security agents; they talked to us about him, were concerned for him, also because of the ongoing building works.

Patients like him strengthen our sense of humanity. For that, we can be grateful to A.

Thanks, A! You had something endearing, you had a dose of joy and vitality in you. Your lovely smile when we came to see you, your look, a bit naughty, always glad to see us, your firm handshake. And even your small attentions for us. But still, some despair every time you said: “need nothing”. A force of nature!

You should not have died that day, A.

So many people cared for you.”

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(*) We make every effort to respect the privacy of our patients and our professional secrecy. Nevertheless, we want to bear witness to how they have to survive and how we work together to reintegrate them. Therefore, the names of places and people are deliberately omitted or changed and real-life situations are placed in another context. There is no direct link between the photos and the stories above.

© P-Y Jortay - Street Nurses 2021