Out of sight, out of mind. It's how so many homeless feel -- forgotten. It's not easy to get to where they are.
Dr. Eugene York spends time getting there.
"The perceptions of who a homeless person is often shattered," he said. "We realize very quickly that virtually all of us are several unfortunate events away from being in that same situation."
All have a different story. More than 560 people were counted as homeless in Berks County in 2018. That's from a point-in-time count on just one night, so the reality is it's likely many more.
In the spring of 2016, York had an idea, and the Street Medicine Program at Tower Health was born. Three doctors with backpacks left the controlled environment of the hospital and got out of their comfort zones..
"When we first went across the bridge, there were people who stopped in and said, 'I didn't know you guys cared. You're over there in West Reading, and we didn't even think you knew that we were here,'" Dr. Andy Donato recalled.
The term street medicine was coined by Dr. Jim Withers, who in 1992 in Pittsburgh, put on a backpack and started providing medical care to the homeless.
Dr. Jim O'Connell was a street doctor in Boston in the 80s. They stripped away the system, left the confines of a traditional medical building and went back to a time that resembled house calls, practicing "reality based medicine."
Doctors at Reading Hospital saw the need in Berks County.
"A lot of the patients that we were discharging, we really didn't have great plans for them," said Dr. Sarah Luber. "We were sending them with cab vouchers to street corners, and that didn't make sense."
"We're meant basically to bridge a gap until patients can either have the means to go to a primary doctor or, sometimes, it's a case of lack of trust of the system, and we try to help build that trust back up so that they are seeking care in a traditional format," said Tracy Davidheiser, a Street Medicine team member.
In turn, keeping hospital costs down. Some of the patients they treat on the street would have ended up in the emergency room, but the street visits aren't just about physical needs. They are asking, "How are you?" physically, emotionally, spiritually.
"I feel more empathetic to some of the day-to-day struggles, so before, even though I recognized the facts that it might take them two hours by bus to get to their appointment, now actually helping, to say, 'Well, let me work on the bus path with you and figure out how we can make this faster,' it's like, 'Wow, this really is frustrating,' and it takes it to a new depth of what it may be," Luber said.
"They have a great understanding of what goes on with these people here, and it's the camaraderie that they have with one another, and it's not doctor and patient. It's friend to a friend," said James Surita of City Light Ministries.
"Well, Dr. York, this is the second time I've seen him. I needed sleeping pills and he prescribed something for sleeping," said one patient. "Today, I saw him for a bad cold, and he's great. Right away, he does everything for me. I have no trouble with him. I love him."
In three years, the team has made just under 2,000 visits, sometimes diagnosing and treating a medical condition that would have been fatal. Sometimes, it's providing a backpack to someone who doesn't know where he or she will be sleeping that night, but is still getting to college classes, and a backpack for books just makes that easier.
The team visits soup kitchens, shelters, wherever folks are living. Sometimes, it's as simple as letting people know you care.
"I had an idea that was all one thing, and it's really not," said Donato. "Every story is different and everybody's tragedy is different and intractable. Some of them are just one bad break, and when people get back on their feet, it's awesome. When people get into a place, when they haven't been into a place in a decade, it feels very rewarding."
"Sometimes, I feel a little guilty myself afterwards, because I feel like I get so much more out of it than I give, and I think a lot of us feel that way," York said.
It's a success, the doctors said, because of the community support. The program is funded by grants and donations.
From the beginning, they teamed up with organizations who were already on the front lines and found where they fit in. There are now more than 50 volunteer doctors, nurses and staff getting back to the heart and soul of practicing medicine, remembering what it means to care for each other. That, they said, is street medicine.