July 1, 2016
By Jeremy Northup, Calla Kainaroi, and Alexandria Bright

Tonight there was bologna and cheese, one box, about 20 sandwiches or so amidst other boxes of expected peanut butter and jelly. As we’ve come to learn, and probably shouldn’t have had to learn, it’s easy to get tired of eating peanut butter and jelly sandwiches night after night. As we were passing out granola bars, mouthwash, sandwiches and socks, we could hear Dr. Jim Withers inside the mobile medical unit providing an informal orientation to the newest batch of medical students beginning their four-week rotation with Pittsburgh Mercy’s Operation Safety Net. “Our salvation is working with the most excluded first.”

Over the past seven months, a few of us from Point Park University’s Clinical-Community Psychology Graduate program have been engaged with advocate ethnography in Operation Safety Net, immersing ourselves in work that Operation Safety Net does, cultivating relationships with both the staff and the people that they serve, taking note of all the ways the staff attempts to pay attention to and care for those that are among the most excluded—those who sleep on salt-stained, frigid cement on the coldest of Pittsburgh nights, those who would otherwise refuse medical care, having been harmed or ignored by medical and psychiatric establishments. At the same time, we are chronicling the stories and experiences of those who live on the street or are at risk of finding themselves on the street, doing our best to attest to the multiplicity of perspectives.

As a research methodology, advocate ethnography isn’t interested in adding to the stacks and queues of unread academic papers. Instead, it is interested in using research to transform, to agitate, and to incite social change. Advocate ethnographers use a variety of different methods: cryptic notes or jottings intended to be reminders for later on, perhaps quickly penned in the back of an SUV as we drive from one camp to another; they may eventually expand into narrative notes, a chronological and more detailed explication of the events witnessed. In addition, advocate ethnographers engage in open-ended interviews, attempting to understand what it is like for both the workers of Operation Safety Net and the people they care for. To give voice to and to advocate for others, it is of the utmost importance that, as researchers, we are as sensitive as can be, as careful as possible, to have fidelity to the experiences as lived by those who experienced them. To advocate well, we must first listen and then listen some more, act in service, and bear witness.

On the median, Dave stood. We pulled over to ask him and his friend if they needed anything–medical care, food, water, socks, the things we typically have available if necessary. Dave responded fairly quickly that he could really use some medical care, that he was “all messed up.” We told him to cross the street and meet us in front of the library, that over there the medical students could take a look at what was going on and assess the situation. We stood there in the afternoon, caught in both the glare of the sunlight and those who walked by, as Dave lifted his pant leg, pulled down his sock, and exposed a wound that had become infected, dangerously so. After consulting one another, the medical students decided that Dave needed to go to the hospital; they were worried that the infection wouldn’t subside without IV antibiotics that could only be administered if Dave was admitted. The five of us out on rounds that night were split down the middle as best as possible—some going to the hospital with one of the medical students, advocating for Dave, making sure that he was able to get the care that he needed and wasn’t turned away.

As Dave, the medical student, and I (Jeremy) walked into the hospital, I was afforded a view that I hadn’t otherwise seen. I watched as security guards sighed and quietly made noises signifying annoyance at Dave. I saw the passive aggression enacted by admitting staff as they handed across a stack of forms that Dave, had I not been there to help, wouldn’t have been able to fill out properly. I sat with him, surrounded by the dull hum of reality television and oppressive white lighting, talking and waiting. I learned about his family, his kids, his childhood. After a few hours and some needed convincing provided by the medical student on rotation, he was admitted. Being able to sit there with Dave, keeping him calm, continually alerting him as to what was going on and where he was, and making sure he was afforded the care he needed in that moment, I may have been conducting research in one way or another, advocating as well, but even more importantly I would argue, he wasn’t there alone.

The authors are all graduate students in Point Park’s Clinical-Community Psychology program engaged in advocate ethnography in conjunction with Pittsburgh Mercy’s Operation Safety Net.