Caitlin Whyte (Host): Welcome to the very first episode of In Their Words. I'm your host, Caitlin Whyte. And today marks the beginning of a journey into the lives and stories of individuals whose experiences have the power to reshape our perspectives, stir our emotions and ignite our empathy.

In a world often dominated by noise and haste, In Their Words invites you to pause and listen. Listen to the stories that often go unheard. The voices that are often silenced. Through Laura LaCroix's journey, we embark on a quest to uncover the humanity that binds us all. A journey that leads us from the streets where hope flickers to the corridors of a hospital where compassion takes on a new form.

At the heart of our story today lies the profound connection between Laura and a remarkable individual named Jimmy, a Street Medicine patient whose story etched itself deeply into her heart.

 Through Jimmy's journey, we gain insight into the relentless struggles faced by those battling homelessness and addiction, as well as the unwavering determination of individuals like Laura LaCroix, who dedicate their lives to fostering hope and healing. Jimmy's presence left an indelible mark on Laura, forever shaping her approach to her work as a nurse and later as a unit director at UPMC Carlisle. His story serves as a poignant reminder of the countless lives touched by the exceptional staff at UPMC Central PA's

Host: street Medicine Program.

Laura LaCroix: So, I met Jimmy, oh my, over five years ago now when I was doing Street Medicine out in Allentown. He was new to being homeless in our area. He was previously homeless in the Wilkes-Barre area. And he came to the St. Paul Soup Kitchen, where we were running our weekly Wednesday Street Medicine Clinic. And he had come in because he needed post-op followup. He had a toe amputation that had occurred due to frostbite. And instantly, this man had the biggest smile, and we just hit it off right then and there.

We talked about him being new to homelessness, all of his other healthcare issues that he had going on, talked a little bit about his family, although he was pretty vague about it during our first interaction. But we laughed, we laughed nonstop. And before he went back to see the provider in the little closet that he would go into, he said to me, "You know what? I'm going to ask you to marry me one day." And I just laughed and he went on to see Brett, my physician assistant.

 So, Jimmy became a regular. He started to come in at least once a week just to check in with us, chit chat, talk about his, you know, health care needs. At that point in time, we didn't see him out at his encampment. He wouldn't tell us where he lived. He had another stint where he ended up in the hospital and we followed up with him inpatient. And he eventually opened up to tell us that he was out by Kmart in Allentown. And we went out and he was living in this box truck. And it had been abandoned for a really long time and he had it built up really nice. However, he would have fires inside of it. He would have the little Sterno canisters. And his drink of choice was Vlad, the Vladimir Vodka, just horrible stuff. So, we were always really, really worried that he was going to either freeze to death in the box truck or catch it on fire.

Lo and behold, at one point in time, it did actually catch on fire. The fire police were out there. The police were out there. He only came out slightly scraped with a little bit of burns. And he moved into a baseball dugout. And I saw him in that baseball dugout every week for the next six to seven months. And it was him, another gentleman, and my outreach worker. My outreach worker would always go off and chitchat with the other gentleman who was down there. And it allowed, you know, and he, after months, finally started to open up, "You know, Laura, I wasn't a really good guy. You know, I was a drug dealer, and I did this, and I did that in Wilkes-Barre."

And he said he had family, but he didn't have anybody that he called family. He had one female friend who lived out by Quaker Town, but he didn't touch base with her at all while he was homeless because he was extremely embarrassed. And it took me weeks before we were finally able to convince him to actually get in contact with her, just so that way she knew that he was alive and that he was okay. So, we did. We got them to rekindle their friendship. He's starting to get really sick though. We would see him out. His abdomen was getting really huge so we didn't know if he was suffering from cirrhosis of the liver. His eyes were always bloodshot. He always had an empty bottle of Vlad. So, we started actually talking with him about what are your plans? Are you going to be cremated? Do you know where you want to be buried? Do you have next of kin that we need to notify? And even though he had that friend, he did not want her to be the one that was contacted.

Host: In the whirlwind of her daily rounds, Laura's thoughts always seemed to circle back to Jimmy. He wasn't just another patient. While she tended to other folks, Jimmy's story was this undercurrent, this hum, reminding her of the bigger picture, what street medicine was all about. Even as she carried on with her work and with struggles within her own life and family, Jimmy's struggles and hopes were right there beside her.

Laura LaCroix: So, a couple of months later, I had to leave Street Medicine in Allentown. My stepdad was diagnosed with stage IV lung cancer, so I moved home to take care of him. But before I did that, I went around and personally told all of my homeless folks that I had grown so close to, you know, during those three years of my time, that I was going to leave-- and I'm going to cry now. He hugged me so hard in that dugout. It was so cold. His nose had that bluish purplish alcohol nose going on. He wreaked of vodka. And he was so upset, he was shaken. And I remember not being able to feel my fingers and toes, but just like totally not paying attention to the environment at all, because it was all about the man that was standing in front of me. And he kept saying, "I know. I know you need to go take care of your stepdad." He goes, "But I'm just going to be very selfish and tell you that I can't lose you. We're supposed to get married." He says, "I'm supposed to get out of this homeless situation. We're supposed to get married." I was married, by the way. But we ugly cried for a good 15, 20 minutes until Bob, my outreach worker, came and grabbed me and said, "All right. We got to go." so, I left.

He was always afraid that he was never going to see his 58th birthday. And luckily, that year before my leaving, we were able to bring him a cake, and we sang him happy birthday. And I got it all on recording, you can hear him in the background. All he wanted was milk to drink with his cake. He was trying to give us all his milk, but I was really happy that I was able to spend that birthday with him because I did not think that he was going to make it through another winter in that dugout because he would get so drunk on that vodka. And, you know, the blood gets so thin, I was afraid that he was going to end up with more amputations, which did eventually happen.

The next amputation that occurred, they took half of his foot. I was back home. I was living in Perry County, but I was listed as his emergency contact, and I was not aware that that had happened. So, I got the phone call that he was being transferred to a nursing home up in Bethlehem, and I loaded my little munchkin up in that car, and we drove all the way up to Bethlehem. And I met with the Street Medicine team up there to try to come up with a game plan, like what was going to happen next with Jimmy, because he was not going to be able to continue on this path. So, they told me that they had a social worker that was going to help him get disability, but I knew the SOAR application process for the expedited disability. So, I like ran around all over the nurse's station and got copies of medical release forms and had Jimmy sign all of them and we filled out every place that he's ever been to in the hospital so we could expedite the process quicker.

So, I would say about six months later, a couple trips of him being in and out of that nursing home, he was finally granted his disability. He ended up losing some toes from the other foot at that point in time. And eventually, he ended up losing almost the full half of the other foot also.

Host: As Jimmy's journey through took a heartbreaking turn, marked by the loss of a part of himself, Laura's dedication remained an unwavering force. Even when the road ahead seemed shrouded in shadows, she was relentlessly working to guide him towards a new beginning. With every step that Jimmy took toward his recovery, Laura was beside him, not as a nurse, but as a friend who saw past the scars and saw the unbreakable spirit that defined him. She navigated through bureaucratic mazes, knocked on doors, and lent her voice to amplify his.

Amidst the challenges, amidst the setbacks, Laura's determination to find Jimmy a place to call his own was a testament to the power of compassion and the unyielding belief that every individual, no matter the trials they faced, deserved a chance to rebuild and rediscover their sense of home.

Laura LaCroix: But now his check was coming in and he was living in a hotel. And he was in a wheelchair and he could barely get in and out of a shower chair to manage himself. And he would have checks written and he would ask the housekeepers to go and withdraw his social security funds. And he was drinking it all away. He was throwing all of his money away in the hotel room and on vodka. So, Street Medicine called me and they're like, "Laura, we need you to come over here and talk some sense into your friend, Jimmy." So, I had my mom with me that day because I was moving from Lebanon over to Perry County. And I was like, "We're going to make a stop in Allentown," totally not on the way. And my mom sat in the car while I went in and sat with Jimmy. And I looked at him and I said, "I'm no longer your nurse. So, I can be upfront and brutally honest with you." And I, in a less professional manner, said to him, "What the heck are you doing? You're throwing your money away and you're wasting away in this hotel room. You need to get yourself together and get out of here. Why are you not looking for an apartment?"

So, we had that drunken conversation and he told me how much he loved me. His famous saying to me was, "You're my number one girl. You're my number one girl." He would be in the hospital and in nursing homes and these women would walk in and he would tell him how beautiful they were and all this other stuff. He was a real Rico Suave. But then, he'd always turn to me and he'd be like, "But you're my number one."

I don't know if it was my conversation with him or what happened, but they did. He finally got himself into some subsidized housing. And at that point in time, he had gotten so sick that he was finding himself in the ICU. And I was driving up to Bethlehem to see him in the hospital.

He ended up having a heart attack and he was actually a DNR, except for when the ambulance was called, like they revived him, they resuscitated him in the ambulance. And then when he crashed again in the ER, they resuscitated him again, not knowing he was a DNR. So now, I was medical POA. Somehow I became medical POA. So, I was on the phone with Street Medicine being like, "Okay, guys. What are his wishes? Because I have no idea." So, they educated me on what his wishes were and I started making the trips up to the ICU in Bethlehem. And finally, they put him on hospice.

So, I was going up to see him in his apartment. And I wasn't allowed to bring food. He would always, you know, make me something or pull something out that one of the hospice nurses had brought him. And he would just sit there in his little room and he would just smile, "Gosh, you're beautiful. So beautiful. You're my number one girl." And even after five years of working on that relationship with him, and me being gone, because there had been a stint about a year and a half where we didn't talk or anything, he had that photo of me and Nani, one of the PAs, up in his room, and he said, "I look at that thing all the time." So, he had been on hospice and he ended up in inpatient hospice when he passed. And the Street Medicine PA, Nani, called me to let me know. They had his funeral on Wednesday before Thanksgiving, but that's just the first story.

Teri Haddad, who is one of the directors for PBS, she did our Street Medicine video with us. Her husband owns a funeral home, and she's very street medicine-dedicated. And they were able to talk the family into allowing a funeral to happen for those of us, you know, that wanted to be there.

Host: When asked how Laura felt about leaving the Street Medicine Program, she knew that it was in the extremely capable hands of her colleagues, other nurses and outreach workers who dedicated their lives to helping those whose voices often go unheard.

Laura LaCroix: With UPMC, the transition was much easier, because I know that I have left it in very good hands with Stephanie and Simone, they're amazing outreach workers and I know that their mission and vision truly surrounds the epitome of what street medicine stands for. They're not above, going to the people and being out there in, you know, the snow and the rain, and they are all about building that relationship with our clients. We don't ever, ever push on them, what we think that their goal should be. Obviously, like with my friend Jimmy, we'll be like, "Hey, if you ever want to go into rehab, we're always here to support you. We can always get you in there." But if it's a hard no, then we accept them for who they are and where they're at. And I know that Steph and Simone have the ability to do that. You spend all that time breaking down those barriers, and really focusing on building that trust and rapport with them that there's always that fear that somebody's going to come in and break a promise. And a lot of our homeless folks, they tell me all the time, "I don't want a do-gooder. Don't bring me somebody that's just going to be a do-gooder. If you're somebody who just comes out on Christmas to drop off hot turkey because it makes you feel good, that means nothing to us. And we would rather you not come at all. " And so, I was always worried, was somebody going to step into my position without the right intentions? It has to be mission-driven. It has to be something that comes from deep inside of you and it's not about the limelight. And I know that, I know that UPMC Street Medicine is in good hands.

Host: Now, Laura is working as a Unit Director for the Postoperative Acute Care Unit at UPMC Carlisle Hospital. She still makes a difference every day, but there are moments that make her look back on her time with Street Medicine and how it has forever shaped her perspective.

Laura LaCroix: Any homeless person that comes in on my floor, I am in that room and I'm like, "Hold on, let's peel back these layers. What can we do for you? I got people I can connect you with."

Host: As we draw the curtain on this inaugural episode of In Their Words, Jimmy's story stands as a testament to the incredible impact of UPMC in Central PA's Street Medicine Program. Founded on the unwavering belief in equitable access to healthcare, this program has become a lifeline for those often forgotten by society.

Through the eyes of Laura and her journey with Jimmy, we've witnessed the embodiment of compassion, resilience, and the unbreakable bonds formed in the face of adversity. UPMC Central PA Street Medicine goes beyond the traditional scope of healthcare. It's a beacon of hope that extends its reach under bridges, onto the streets, into soup kitchens and shelters.

This program isn't just about medical care. It's about addressing the social determinants of health, recognizing the intricate connection between well being and our surroundings. Statistics paint a stark picture, a glaring disparity in emergency department visits between the homeless and the housed. The Street Medicine Program strives to bridge this gap, offering primary care, addressing emergent health issues resulting from a lack of preventative care and acknowledging the basic needs that Maslow's hierarchy reminds us all of.

Crucially, this podcast episode also sheds light on the invaluable support of the UPMC Pinnacle Foundation. Their dedication to community wellness initiatives and commitment to providing the best health care possible is the driving force behind programs like Street Medicine. Their pillars of community health, workforce development with a focus on diversity and inclusion, and population health mirror the heart of what we've witnessed today, a community coming together to uplift and heal.

As we continue, we extend our gratitude to the remarkable Laura LaCroix, to Jimmy, and to all those who tirelessly work to make street Medicine a reality. Thank you for joining us on this journey, and we look forward to sharing more poignant narratives with you on In Their Words. 

This podcast is brought to you by the UPMC Pinnacle Foundation and UPMC in Central PA. UPMC in Central PA has seven acute care hospitals with 160 licensed beds, over 160 outpatient clinics and ancillary facilities and more than 2,900 physicians and allied health professionals, and approximately 11,000 employees in Central PA. It is a healthcare hub serving Dauphin, Cumberland, Perry, York, Lancaster Lebanon, Juniata, Franklin. Adams and parts of Snyder Counties. The UPMC Pinnacle Foundation exists to provide resources to meet the needs of our most vulnerable patients, promote health and lifelong wellness in our communities and support our workforce so we can attract, train and retain the best and brightest talent at UPMC in Central PA. To make a difference and join their philanthropic mission, visit UPMCPinnacleFoundation.org.