In the Gaps by Brian Klausner, MD Book Review

 

When you write a book review for someone you don't know, it's relatively straightforward and simple. You read the book, you feel the feelings (or don't), you articulate your reaction(s) and experience(s) reading the book, make a recommendation or not, and move on. Sometimes, there's an email or tag thanking the author. However, when someone you know or know of writes a book (please understand; I'm not claiming to "know," Brian) and it is incredibly moving, and you mark the whole thing up, dog-ear the pages, underline and star things, you find it difficult to articulate the gravity and impact of their words.

First of all, I am a lover of books, obviously. I love words, and I love using a lot of them in broken sentences and fragments, imposing periods so that the reader must pause. I'm sure most people who read my reviews or blogposts find this annoying, but it's the way I write and think. I finished Brian's book months ago and still cannot put the words and feelings it stirred into complete sentences.

I first "met" Brian at Wakemed a few years ago (okay, many years ago) at a conference I attended for Nursing continuing education credits. It was a Social Determinants of Care conference, and Brian was one of the speakers. It should be noted that he didn't want or seek the limelight for the new and impactful small things his team was doing. In fact, most of the presentations and speakers at the conference were people who were working alongside him, finding tents for those without shelter and trying to find ways to keep insulin cold for patients who were diabetic and didn't have a refrigerator in the middle of a NC summer. I recently saw he had a book out and could not wait to get my hands and post-it notes on it.  

 Okay, okay the book, the BOOK!...Brian starts at the beginning—his beginning—which is vulnerable, humble, and refreshing. And then, he builds. One by one, he paints a human face on the term "homelessness." He does it in such a way that forces you to humanize a term that our society dehumanizes, based on his interactions, observations, and assessments as both a person and a Provider. 

The next time you pull up to the stoplight and see the man begging for money, your thoughts will go right to Brian's book. You'll find yourself wondering about the little boy or little girl that still lives within that grown man or woman. You'll find yourself wondering about the difficult trials and trauma that led this grown man or woman to this cold corner, standing alone and reaching out with their eyes and hands. 

Brian dances between the very poignant challenges facing the homeless population today and the very murky and often hidden challenges they also carry. He does not shy away from the financial toll and burden this part of our community bears on the healthcare organizations caring for them, when they have literally nowhere else to turn. He doesn't shy away from sharing how complex and multi-faceted caring for them is when they allow themselves to be cared for. He doesn't shy away from the burnout and psychological impact these types of patients have on their Providers and Care Teams. He doesn't shy away from the human side of them. No, Brian is a Provider, a human, a writer, a believer in the significance of seeing people. Face to face. Right in their eyes. Right in their struggles. Present.

As a result of being close to the suffering of those experiencing and enduring chronic homelessness, Brian does a compelling job of sharing his thoughts, feelings, and experiences. He is also able to take the 30,000ft view of the issue buried under layers and layers of complexity and identify variables, data points, points of impact, and overarching themes that run deep and affect outcomes. 

Brian offers an unbiased view of the multiple overarching and cross-functional, complex challenges that make this vulnerable and often hidden population difficult to reach. He provides details of specific programs, efforts, and initiatives that have proven successful in the past, while gently reminding his readers that every person is unique despite having multiple similarities and indicators that raise concerns that continue after patients leave the building. He provides information, including specific evaluations/assessments and questions used that may help identify a patient as higher risk or needing earlier intervention in words a non-medical professional can understand. He talks about the impacts of legislation, policies, and programs in a way that isn't caustic or offensive. He does a good job of sticking to the facts and not trying to convince anyone of anything. Well, besides being a voice for the voiceless. Brian discusses the financial costs associated with these patients who fall through the cracks, who are not able to be compliant, trying to gain momentum with leaders and organizations to understand that even though addressing these issues is costly, the cost of not addressing them and helping them is far greater. 

I'm still sitting with this book and these words. I'm sure that I could pick the book up again in a year and glean different insights and feelings from it. If there were a required reading list for humans, I would advocate for Brian's book to be on it. 

I could say that I strongly urge you to read Brian's book if you live in NC. But the truth is, human suffering as it relates to chronic homelessness is an evergreen issue. It crosses county lines, state lines, and country lines. It affects every community. Furthermore, homelessness has a name. Many names. Many faces. Brian does an incredible job conveying that homelessness has so very many stories. Stories of good people losing it all, losing spouses, childhood trauma, grief, and pain. Many stories, many people unnoticed. Unseen. Hidden. Carrying burdens and shouldering the weight of the world in ways many of us cannot begin to imagine.  

I dare you to read In the Gaps and not feel a stirring in your own soul. A stirring to see others. To do the difficult thing and acknowledge someone who has a lot stacked against them. To have compassion instead of fear. To have respect and kindness instead of disgust. To know the name of the man on the corner. To leave your judgment on page 1 forever. Because, when I say that In the Gaps is a gift to those of us who have no idea what homelessness is like, I really mean it is a Light in the dark, showing the impact that a small group of dedicated people can have on one person at a time. 

Maybe success for the book (sorry, Brian) isn't me, the reader, or you, the reader, doing some grand gesture or making a million-dollar donation to an organization because we feel so led (but please do, I'm sure Brian would put it to good use). Maybe success for this book is you and I, making eye contact with the person on the street and seeing them. Acknowledging. Noticing. Remembering. Feeling compassion for them. Surely that's something all of us need and yearn for from one another. Surely in this difficult time with so much struggle and division, we can agree on that. We all deserve to be acknowledged. Noticed. Seen. Remembered.  #inthegaps #brianklausner #readingchangesthings #openyourmind #lovedoes #homelessness #bethelight #humanity #loveoneanother #dosomething