The Man I Knew

The person I’d like to lift up was a far too young man, a light-skinned African American man widely known on the streets as “Red.” He came by the name honestly—he had a reddish cast to his skin. His real name, we came to learn only after his passing, was Michael Owens. I knew “Red” when I was managing the Health Care for the Homeless project in Nashville’s Downtown Clinic. He came in all the time—pretty much daily—just to see who was in the waiting room and at the front desk, just to check in as if to say, “Tag you’re it. I’m here today and I want to just reconnect with y’all.”

And he did that.

He’d often bring a soda, pastry, or candy bar for his favorite person in reception, usually a woman. And he often came in a little tipsy and occasionally said inappropriate things, for which we’d correct him and then he would, typically with a very genuine and contrite spirit govern himself accordingly.

He always called me “Doc,” even though as I told him early on that I was an administrator, not a clinician. But he didn’t care. We made the simplest of connections, I think, in that he wanted me to be “Doc,” perhaps because I was the only male within my age range typecast for certain cultural stereotypes. And so we went on with our little understanding.

The thing about Red that was so wonderful was he always wanted to know about how my day was going, what was going on in my life, and I always left our conversations feeling nurtured and cared for. And then as much as I could, I returned that gesture, and I think we both just really enjoyed the rapport we had, as limited as it was and as underdeveloped as it was.

And I guess that gift is something I will hold in my heart for as long as I live.

A Benevolent Presence

I really don’t [know much about his past]. I’d known him about a decade at the time of his passing, but I don’t even know where he was from originally. Not being a clinician, I really had no reason to know anything about his health care and his health status, but my impression was always that he lived with an intellectual disability.

His repertoire of social engagement was very circumscribed, and he never really seemed to let folks get close to him. But he exuded warmth, and he seemed to enjoy the warmth that we shared with him. I think the Downtown Clinic was something of a home for him.

He was a regular guest of the Nashville Rescue Mission, and in wintertime when Room In The Inn’s seasonal shelter was in operation, he would sometimes go out to one of the congregations, but I think he was a pretty steadfast guest of the Mission and seemed to have a fairly circumscribed orbit near Music City Center. Pretty ubiquitous.

I could be coming back on my bicycle from a meeting in the middle of the day and he’d be there in the alley and greet me. I could get to the clinic in the morning before we opened the doors, and he’d be standing in line out front socializing…

He wasn’t comfortable with his lack of housing and poverty, but he was a very good-natured fellow and certainly seemed to make the best of a situation that was inherently traumatic. He never talked about religion or his family… When folks are on the streets or in shelter, a lot of times not sharing a whole lot is safer and wiser, so that you’re kind of protected emotionally and otherwise. People can use things in harmful ways.

I think he kept really close to the vest in terms of who he was, but he was just really benevolent, kind presence. Even though we didn’t know him well, and most of us didn’t know his name until we read in the newspaper about the accident that took his life.

One Day in October

Tragically, earlier this fall [2019], he stepped out onto 8^th Avenue South in front of the Downtown Clinic—apparently without looking—and was hit by a city bus. He died instantly. We will miss him very much, even though most of us didn’t know his name.

Anecdotally, I would say that a higher percentage of people on the streets are hit by moving vehicles. Accidentally, and—we’ve also heard of cases—where it seemed like a fairly aggressive thing. Someone who might have been lying in a roadway that someone ran over on purpose, on rare occasions.

It’s a tough thing.

I have a very harrowing memory of a woman in her early 50s. She sells The Contributor, [a homeless paper], near my church. She was just very despondent around the holidays and had a half a pint of vodka with her, and she’d had two sips. We had to prevent her from running into traffic because she was hoping to do herself in that way, so there’s the whole question of accident or on purpose… By all accounts, Red just wasn’t looking. Buses come flying down 8^th Avenue South there, and there’s a lot of people.

In his simple fashion, he was an agent of grace in my life. I’m a person of faith, and I would say that he manifests the divine for me as a steadfast, caring presence. And in a rather mysterious fashion as well, given that I know so little about his life and background, so there’s kind of that element of mystery as well that I tend to associate with the divine. You really don’t know what God is like—if God is a personal or cosmic presence, a field of force in the universe, etc. But Red, of course, was a very embodied personal presence that was just a steadfast agent of grace.

More About “Red”

• Alund, Natalie Neysa. “Pedestrian Struck and Killed by Nashville Public Transit Bus in the Gulch.” The Tennessean. October 10, 2019.
• Metro Nashville PD. Twitter Post. October 10, 2019.

Owens may have suffered from an undiagnosed cognitive impairment. Cognitive disabilities are functional impairments associated with brain disorders resulting from mental illness, trauma, chronic substance use, or developmental disabilities. These impairments can present serious obstacles to accessing care for patients without homes, who can be perceived as “difficult.” 

Furthermore, cognitive disabilities can complicate providers’ abilities to make accurate diagnoses as well as patients’ competence to participate in treatment decisions.

These impairments are not uncommon in patients without homes; rather, people without homes have high rates of cognitive disabilities of all etiologies. Homelessness itself may exacerbate or lead to such conditions: evidence indicates, for example, that a positive correlation exists between time spent experiencing homelessness and severe head injuries, a cause of cognitive disabilities.

Additionally, these conditions often co-exist with physical disabilities—one-fifth of surveyed adults without homes in New York City shelters reported having a disability or disease that impeded their functioning. The result can be situations in which, as reported by one brain-injured client, such patients feel that, “I can’t myself and no one else can help me.”

Owens’ treatment is an example of how personnel of homeless services organizations can successfully forge connections with patients with cognitive impairments. People with such disorders may feel misunderstood by providers, and in Owen’s case, his likely condition co-occurred with substance use disorder.

However, the reflective listening of Friskics-Warren is part of the nurturing approach necessary to help develop effective plans of care for people without homes who have cognitive disabilities. Though that treatment did not prevent Owens’s death, it did improve his quality of life.

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