As of this month, I have been a public health nurse for forty-two years. Public Health nursing rocks. It requires compassion and a heart for advocacy and activism, as its foremothers and founders demonstrated. Here are images of a younger me at the 1993 March on Washington for Lesbian, Gay, and Bi Equal Rights and Liberation when I was working as a nurse practitioner at Baltimore’s Chase-Brexton Clinic. And me in 1982 in my first job as Hypertension Control Nurse with the Richmond Health Department and the Richmond Urban League. Taking the blood pressure of then mayor of Richmond, Dr. Roy West and shaking the hand of then governor of Virginia, Charles Robb when he declared a hypertension awareness month.
I love public health nursing and everywhere in this world it has taken me. No regrets on my career choice.
Yesterday, at a community homelessness resource and health fair where I was faculty preceptor for a footcare clinic with some of our medical and nursing students, I was reminded of the powerful role of libraries in the lives of people experiencing homelessness. Among the tables and tents offering warm winter coats, gloves, hats, behavioral health resources, pizza, bagels, coffee, haircuts, youth shelter and women’s day shelter services, and our footcare, the University Branch of the Seattle Public Library table was quite popular. Amidst the absurdity of a return to backward-looking book bans throughout our country and in a season of thanksgiving, let us remember that public libraries literally save lives.
It is not hyperbole to say that public libraries save lives, especially for people experiencing homelessness. Libraries give sanctuary and shelter, both emotionally and physically. Libraries yield quiet, peacefulness, community, heat, and, hopefully, air conditioning when it’s hot and smokey outside. Libraries have public restrooms, which are surprisingly scarce in Seattle as in most US cities. Harried parents can find respite in libraries with their bright, colorful children’s book sections, free access to the internet and computers, and children’s story hours. Children, teens, adults, and older adults, no matter their race, ethnicity, gender, sexual identity, differing abilities, socio-economic and housing situations, can all find stories of people like them who deal with challenges they face and who find ways to not only survive, but endure, resist, and thrive.
If you are fortunate enough to be comfortably and stably housed, please remember that not all of our community members have these basic necessities. When visiting public libraries, try to practice tolerance for all people who seem different to you. That extends to people who ‘appear’ to be experiencing homelessness.
A growing number of public libraries throughout our country and internationally are hiring social workers to assist library patrons from all walks of life to access needed health and social support. Whole Person Librarianship is a library-social work collaboration hub with resources and a map of social work-supported libraries. A recent and excellent book is Libraries and Homelessness: An Action Guide by the librarian and homelessness advocate Julie Ann Winkelstein–available, of course, in many public libraries.
I’m honored to be in such good company. I am taking my workshop, The Meaning of Home, on the road throughout Washington State in 2024-2025. If you/your library or other group wants to book me for this in-person or virtual workshop, contact Sarah Faulkner (see below for her e-mail address).
In winding down an academic career in anticipation of having more uninterrupted time for my writing and advocacy work on homelessness, I’m faced with what to do with the boxes and piles of research materials, field notes, correspondence, and my ‘digital assets,’ including this personal website and my digital storytelling videos. And then there are the hundreds of personal journals I have kept since I was eleven. What to do with all this stuff?
I have worked at a public university for the past thirty years, during which I have researched and written four nonfiction books on various aspects of homelessness. My relationships with university librarians in support of this work have been collegial, mutually respectful, and rewarding. So when university archive librarians asked me to consider donating my research materials, I didn’t hesitate to say yes. Here is where I can donate ‘all this stuff!’ But wait. It’s not as simple as boxing it all up and sending it to them as if it was used clothing.
The university archive librarians are walking me through the process of sorting, organizing, and inventorying all of the materials I plan to donate. Since I do not have any university research colleagues who have gone through this process, I turned to my author colleagues through my membership in the Authors Guild. On the guild’s community forum, I posted a question as to advice and resources on donating author materials to a university archive. I’ll summarize some of the best replies but without specific attribution.
Think through what materials you want to maintain access to for current and future work. Decide on copyright transfer and how open or closed (restricted) you want the collection to be. Public universities like the one I work for want archived materials to be as widely accessible as possible. They do allow restrictions (like length of time until they are open) on sensitive materials such as personal journals.
Some authors donating their materials to university archives are so embarrassed by earlier work (like for their MFA degrees) that they destroy those writings. Other authors consider the inclusion of earlier, perhaps messier and less mature writings as an honest part of their writing life and include them in their archive donations.
Allow more time than you think it may take and try to work closely with a university archive librarian throughout the process.
An advantage of donating one’s research and writing materials while still relatively healthy is the peace of mind (not to mention a less cluttered living space). And, knowing that we won’t be burdening our family members with deciding what to do with all the boxes of detritus after we die.
The point of an archive is that you have material that is of interest and help to future researchers. It is based on the quality of your materials and not on how famous you are or may become.
Encampment in U District Park, 2021, photo credit: Josephine Ensign
The lived experience, the direct and unintentional (as in not stunt journalism) experience of homelessness, is increasingly used and prioritized in policy and program realms. While much of this is good, I think it needs to be examined more closely.
As someone with the lived experience of homelessness when I was a young adult in my then hometown of Richmond, Virginia, it is a concept that I wrestle with. What counts as lived experience, who decides what counts, and is lived experience something that automatically turns people into, as referred to by Pathway UK, experts by experience?
I find it encouraging that there is a growing understanding of the importance of people with the lived experience of homelessness needing to be included in real, not token, ways for more effective program planning and policy-making. An example of this locally is Marc Dones, a Black non-binary person with the lived experience of homelessness and mental illness (bipolar disorder), who was named the first director of the King County Homelessness Regional Authority. This week Marc announced that he is leaving his position. People with the lived experience of homelessness have long been employed as outreach workers, but not many have become leaders like Marc and Derrick Belgarde, an Indigenous man, and CEO of the Chief Seattle Club. Representation and visibility matter. They matter in terms of informing better programs and policies. They matter in terms of countering negative stereotyping and social exclusionary practices of people experiencing, or having experienced, homelessness.
A recurring issue in terms of people with the lived experience of homelessness working in some aspect of homelessness, especially in direct service work, is the danger of being retriggered, relapsing if clean and sober, not maintaining professional boundaries, and burning out. In trauma work, there is the phenomenon of trauma mastery, of a person being drawn to working with people in difficult situations similar to those they experienced and felt powerless to control. In trauma mastery, people, frequently unconsciously, return to sites of trauma wanting to ‘do it right’ this time, to have control and mastery of the situation. Too often, this sets people up for unreasonable expectations of themselves, co-workers, and their clients. As Jenn Adams, who works with vehicle residency outreach programs, told me, it takes years of support and even therapy to gain perspective on one’s own experience of homelessness. She points to mentors and work supervisors who check in with her, identify possible triggering situations, and help her maintain healthy boundaries in her direct service work.
In my discussion with Derrick Belgarde about the increased focus on people with the lived experience of homelessness, he said, “I’m a firm believer that lived experience should always lead in any field…The best ones are ones who can actually relate.” He followed this by talking about the fact that there is a spectrum of different types of homelessness that people experience. He says of these experiences, “They’re all traumatic and horrible and awful, but they’re all totally different, and I’m only an expert in one.” He added, “There needs to be more diversity in these decision-makings because they don’t think about that. I see a lot of the lived experience movement making grounds in homelessness work today, but a lot of them, I don’t think, come from the type of homelessness we’re trying to solve in the downtown core.”
The 2022 National Health Care for the Homeless Conference and Policy Symposium, billed as being held in Seattle and in-person for the first time since the pandemic, was held in the swanky Hyatt Regency Bellevue near a high-end shopping center at the beginning of May. The venue was ironic given the fact that Bellevue officials work hard, mainly through more aggressive policing and criminalization of homelessness, to keep the city sanitized, especially compared with Seattle.
I attended the conference and spoke with David Peery, a Miami, Florida, Black lawyer with the lived experience of homelessness during the Great Recession. David is the current co-chair of the National Health Care for the Homeless Council’s National Consumer Advisory Board (NCAB). I asked him if the NCAB folks have conversations about what ‘counts’ as someone with the lived experience of homelessness. He said that they follow a guideline of recent experience of homelessness within the last five years or longer ago if the person has stayed involved in direct homeless service provision, like being a peer outreach worker or in policy and advocacy work on homelessness. “A lot of times people who were homeless become judgmental about currently homeless people–unless they understand trauma-informed care,” he explained.
So while the lived experience of homelessness in homeless policy-making and programming is important, it should be more carefully examined and understood.
Although I love words and writing, there are many times when visual information is more effective at conveying complex ideas, facts, and emotions. That is why, for many years now, I have created digital storytelling videos about health and homelessness in Seattle. I use these videos in teaching and in my public scholarship. Recently, in a Stories-in-Motion online course I am taking through the StoryCenter, I created this StoryMap (free version for frugality and simplicity), “Skid Road: Stories of Homelessness in Seattle.” It is a work in progress (isn’t everything?), meaning I will add to it over time. It also happens to be more personal, weaving my story into the bigger story of homelessness in Seattle.
Writing residencies and retreats are essential for maintaining and deepening my writing and creative life. If you have never taken one or you are planning to take time away to write, I’ll share my experience and advice for making the most of a residency or retreat.
First, finding and applying for your first writing residency can be a daunting endeavor. Word-of-mouth advice from other writers and artists you know is an excellent place to start. Many wonderful writing residencies welcome beginner, middling, and more established writers, so it is good to read their descriptions before deciding to apply. As with submissions of work to literary magazines, most writing residency programs require an application fee, although more places will waive the fee if you write and make your case. Look at any scholarships they may have available and see if you and your work are a good fit. Another effective way I go about learning about potential writing residency programs is to read the acknowledgment section of your favorite books/authors, especially if they relate to your own work.
Try not to despair if you aren’t accepted to your dream residency program the first (or second, or third) time you apply. When I became a serious writer, my dream writing residency was Hedgebrook on Whidby Island off the coast, where I live in Seattle. I applied four times before being accepted for a month-long residency in October 2014. It was an amazing and acutely difficult experience. Amazing in their being true to their practice of radical hospitality, difficult in that I had to commute there and back weekly to teach (not recommended). Plus, my elderly father died in the middle of my residency. I loved the combination of having my own cottage (Owl) and gathering each evening in the farmhouse to have delicious dinners with the other four to five writers in residence. Here is a photograph of me (taken by a writer/photographer in my cohort) from the bedroom window of my cabin.
This past year I had a three-week residency at the Virginia Center for the Creative Arts (VCCA) in the Blue Ridge Mountains of Virginia. VCCA is for artists of all kinds, so I was there with twenty or so writers, composers, sculptors, and visual artists. We each had our own room and a separate studio space in an old dairy barn. My studio, which is where I ended up writing and sleeping, was in the old milk room. One writing space feature was one wall of corkboard with pushpins. I used it to play around with the structure of my current book project. I loved being in community with a wide variety of artists, with a mixture of established, well-known ones and people just starting out. Here is a photograph of the VCCA barn/studio space. My milkbarn writing studio is in the left foreground.
I ended 2022 with another three-week writing residency closer to home at Centrum, in Port Townsend on the Olympic Peninsula. For this residency, I had a three-bedroom cabin at Fort Worden and quickly established one bedroom for reading/sleep, one for writing, and one for messy creative art projects: bliss. A deer slept outside my door every night. Beaches nearby for long walks and thinking through the chapter I was writing extended the bliss. The setting, combined with December Pacific Northwest darkness and snow, made for a more introspective experience which is what I needed.
Even before I ventured out into the writing residency waters, I took annual fall or winter week-long solo writing retreats at a rented cabin on the Salish Sea one Orcas Island north of Seattle. I continue that practice in an old log cabin with no internet or cellphone connection/reception. This setting is more conducive to deep-dive, generative writing or to immersing myself in a book manuscript for edits. The photo at the very top of this post is the view from my writing desk there.
Next up for me is one of these solo writing retreats on Orca Island, followed in late spring with a group writing retreat at Ghost Ranch, New Mexico.
Here is some advice I have (and what I remind myself of before my next residency or retreat):
If at all possible, try to ease into and back out of your residency or retreat time. If you can add a buffer day before and after when you aren’t frantically working or writing (or taking care of loved ones, young and old) and try to make the travel to/from as pleasant as possible, that can enhance your overall experience.
Grant yourself grace by following your body’s needs in terms of sleep, exercise, and food. Entering a writing residency or retreat space often requires some decompression time, at least a day, so don’t expect to accomplish a lot of writing that first day.
Take and use a writing journal (separate from a personal journal) and write about your writing. For instance, I’ll write about a particular difficulty or decision-making I’m facing in my current writing project. Oftentimes, just by the act of writing, ideas and solutions occur to me.
Formulate a basic intention for your residency or retreat ahead of time but try to avoid drafting overly ambitious, anxiety (and guilt) producing to-do lists.
Get to know your surroundings by taking long walks and exploring new places. My own rhythm on residencies and retreats is to write all morning, pack a light lunch and go for a hike (oftentimes thinking through what I’ve written and what to write next), and return to some ‘light writing’ or editing or scribbling out ideas before bed.
My former late and great writing mentor, Waverly Fitzgerald, had those of us in her Shipping Group (a writing support and accountability group) do an end-of-year review of our writing. Being an accountability group focused on ‘shipping’ pieces of writing and writing-related grant applications, it ended up being more of a tally sheet: useful when starting out on my writing life. But I soon craved a deeper, more holistic approach to an annual check-in with myself about more aspects of my writing life. Many examples and templates are available, but I’ve settled into the following that I developed based on many of them. In case you find it helpful, here are my categories, including a few examples from my completed 2022 writing life in review:
Creative Writing: Blog posts, Way Home book proposal, and completed seven chapters
Accomplishments: My Skid Road book was named a finalist for the Washington State Book Award (thank you!). University of Washington Press buying the paperback rights for my Skid Road book and publishing it in February 2023 (paperback cover above). Book contract from John Hopkins University Press for my next book manuscript, working title: Way Home: Ways Out of Homelessness.
What got left behind: My answer to this is personal and related to my ‘day job,’ so I’ll skip it here—but I encourage you to dig deep on this one. Some things deserve to be left behind, and some you may want to recover.
How can I make my writing life easier? As mentioned above, my answer to this is personal and related to my day job… But try to be honest with yourself.
How did I spend my time in terms of writing? Except for day job drama/trauma, I was focused on writing my Way Home book manuscript…
How did writing make me feel? Encouraged and hopeful–this is an important question, so take your time.
Difficult writing moments: As above, all related to my day job, which I choose (for now) not to share. Again, be honest with yourself when answering this question. And remember that ‘difficult’ is not necessarily a bad thing. But some ‘difficult’ moments are righteously bad and deserve to be left behind and not repeated…
Favorite writing moments: Reading the opening excerpt of a recently completed chapter for my Way Home manuscript at the Virginia Center for the Creative Arts (VCCA) for the other artist and writer fellows and knowing that it is powerful.
How do I want my writing life to make me feel this year (2023)? Excited, engaged, challenged, fulfilled, and hopeful.
Areas of focus: Finish a good, solid draft of my Way Home book manuscript for delivery to JHU Press. Continue expanding my Skid Road/Way Home oral history interviews to support my book.
Schedule shifts and necessary ingredients to be successful with my area of focus this year: continue to prioritize my writing every day as necessary to complete my book manuscript. (also, one related to my day job and the leaving behind category above…)
Tuna came one day, scratched at our door, begged for food, and never went away.
The Meaning of Home Photo credit: Josephine Ensign/2016
Tuna came one day, scratched at our door, begged for food, and never went away.
Home is where the cat is.
–male resident of Tent City III
Home is never permanent, but I know it is where I find safety.
–female resident of Tent City III
…home is a place one belongs to, a place of safety and a gathering point for reestablishing social connection.
–Madeline Ostrander, At Home on an Unruly Planet: Finding Refuge on a Changed Earth (p. 79)
Think of words that describe ‘home’ to you. Nouns, verbs, whatever words come to mind. Write them down. Circle the top five that are the most important. Now, pretend you live through a series of unfortunate events: loss of a job, fire, pandemic, and insurmountable medical debt. You lose one important item or word from your list for each of these four events. Say goodbye to each one as you cross it off. You are left with only one aspect of home that you carry with you into homelessness. For many people, that remaining aspect of home is family, beloved pets, safety, or privacy. For many people who actually experience homelessness, they are forced to give up everything that matters to them, everything that represents home, including a sense of belonging, of community, of a place to nurture and maintain health. Of dignity and self-determination. For other people experiencing homelessness, they have never had a true home, or at least a safe, secure home, to give up, thus making their exit from homelessness that much more difficult. Of course, the causes of homelessness are much more complex than just a series of unfortunate events. This list of events is based in reality since all of the events do contribute to homelessness. Not enough people know that spiraling medical debt is a leading cause of homelessness in the US, a factor unheard of among our industrialized county peers due to our profit-driven healthcare system.[i][ii][iii]
This meaning of home exercise, although incomplete and imprecise, can help people discern the difference between a house and a home. A home is much more than a house, a shelter. This exercise can help people realize some degree of what homeless people have had to give up and what they can regain with enough community support. Looking at success stories and people’s stories of what contributed to their experience of and exit from homelessness can help deepen our understanding of this complex issue. Stories from people with lived experience help inform us as individuals and as a society as to how we can build on individual and community strengths, on lived experience insights, to greatly reduce homelessness, if not outright solve it.
[i] Jessica E. Bielenberg et al., “Presence of Any Medical Debt Associated With Two Additional Years of Homelessness in a Seattle Sample,” Inquiry: A Journal of Medical Care Organization, Provision and Financing 57 (December 2020): 46958020923535, https://doi.org/10.1177/0046958020923535.
Note: This is based on results from my ongoing series of community-based “The Meaning of Home” workshops I have done with a variety of groups, including residents of Tent City III, high schoolers, faculty members, graduate students, and attendees at writing workshops. See more of this work here.
Over dinner recently, my husband asked me if I was still writing blog posts. I replied, “No, not really.” When he asked me why not, I recounted how I had started writing this Medical Margins blog back in 2010 as I was processing my elderly father’s final illness and the insanity of the US healthcare system, especially related to end-of-life care. In my blog, I then moved on to trying to rekindle a passion for the rather problematic (to me) profession of nursing. Then, I became interested in the health humanities and the somewhat insular academic world of narrative medicine. And, always, homelessness. Fast-forward to today, and my writing time and energies go towards writing books on homelessness and health.
City Hall Park, Seattle. June 25, 2022. Photo credit: Josephine Ensign
I am a part-time, nine-month employee and professor. I live for my summers off now when I have uninterrupted time to write and be a grandmother. This past summer, I made good writing progress on my next book, tentatively titled Way Home, about the contemporary landscape of homelessness in Seattle and King County. Refining and tightening my storytelling approach to writing (with terrific assistance from an editor), I edit out passages I might love but which do not pass the “So what?” test. I keep these darlings in a Word file titled “Extra.”
COVID caught up with me this summer, along with a bad bout of COVID rebound, and yet I pushed myself to continue writing. Some of these fever-induced passages ended up in the “Extra” file. Here is one I like, although it most likely will not make it into the final book manuscript. The photograph, however, likely will.
Consider the shopping cart. Constructed of wire and plastic and supported by four wheels, the cart’s purpose is to carry store merchandise before and after purchase. The shopping cart, developed during the Great Depression by an American man for use in grocery stores by housewives, becoming super-sized and non-gendered, an exquisite symbol of capitalism. The shopping cart, appropriated by people experiencing homelessness, serving as container and conveyance for their remaining belongings, a somber symbol of the fallout from late capitalism.
