First Words

Upside-down medicine

Jim O’Connell’s practice is built not on profit but on giving his patients—the unhoused of Boston—whatever time they need.

Every so often in life we meet an individual, seemingly through serendipity, who is so genuine in character or so inspirational in outlook that we end up reexamining major pieces of our own life. After such encounters we wonder if we might’ve missed something crucial in our development or schooling that would’ve made our kindness toward others more beautiful. We toy with the idea that perhaps God blesses people quite unevenly..

When I first met Jim O’Connell some years ago, I did some of this internal assessing as I was sizing up his nature. Here I was sitting across from a guy who seemed like one of the best listeners I’d ever met. He was clearly secure enough to set his own ego aside and listen patiently, curiously, and with a kind of nonjudgmental attentiveness. If the first duty of love is to listen, as Paul Tillich once proposed, then Jim was full of love for this latest stranger in his life.

Dr. Jim, as many people call him, is a smart man with an agile mind. He’s quiet and self-­effacing, almost to a fault. His energy is high, his manner gentle. Even when he gets angry at a societal injustice, his voice rarely climbs above the whispery tone that reveals his calm center. For more than 40 years, this Harvard-educated physician has practiced what he calls “upside-down medicine” on the streets of Boston. It’s not a practice built on a revenue-generating model but one that provides patients with whatever time they need. He is founder and now, four decades later, president of Boston Health Care for the Homeless Program. It’s the largest and most comprehensive enterprise of its kind in the nation, serving upward of 15,000 unhoused people.