Bringing the Personal Perspective to Homeless Care – Harvard Gazette

In 2019, when David Velasquez heard that Massachusetts General Hospital was convening a task force on homelessness among its patient population, he wanted to help.

MGH Emergency Department resident Alister Martin welcomed Velásquez, telling him there was a lot of work to be done and all willing hands were welcome. But as he listened to Velasquez’s story, Martin realized that his new colleague brought not only passion to a tangled societal problem, but also a valuable perspective: No one needed to explain the challenges of poverty to him. and homelessness.

He told me his story, how he had struggled with homelessness. It was clear it wasn’t just an academic problem for him, said Martin, now an assistant professor of emergency medicine at Harvard Medical School. It was clear. This is a guy who is coming for the right reasons.

Velásquez grew up in Southern California, the son of asylum seekers from war-torn Central America. This spring he graduates from the School of Medicine after seven years on Harvard campuses. The first in his family to go to college, Velásquez wasn’t satisfied with a single Harvard degree, let alone two, taking a break between his third and fourth years at HMS to earn a master’s degree in in public policy from Harvard Kennedy School and one in business administration from Harvard Business School. The dual degrees, he said, are tools to extend his medical career beyond the clinic into politics and business with the goal of reforming a health care system too often inaccessible to the fringes of society.

When asked about his childhood, Velasquez describes an environment far removed from the white marble and granite of the HMS Quadrangle in Boston.

When his family came to the United States in 1993, they lived for a year in a church in East Los Angeles that took in undocumented immigrants. Velásquez was born after that time, but his parents still had economic problems, limited by primary education to poorly paid jobs.

Velásquez remembers that the family lost their house in 2009 and the six of them, their parents, three brothers and himself, were living in a motel. He also remembers his father outside a Southern California Home Depot hoping a contractor would give him a day’s work, and his mother, whom he considers one of his heroes, working constantly cleaning people’s houses.

Despite his parents’ commitment to hard work, money was always short and healthcare a luxury. He recalls that his father once made the difficult decision not to take Velásquez’s sick mother to the doctor because she needed gas to go to work the next day.

Having a child at Harvard hasn’t proven to be a shield from life’s financial pressures.

In 2019, the money ran out and his mother and father had to give up their home and move into a motel for several weeks. Later that year, his father had a heart attack, which he survived but left him with a $120,000 medical bill.

Velasquez helped the family overcome this difficulty, consulting lawyers in Boston who advised them to insist that the hospital comply with California’s requirements that its hospitals provide free care to those who cannot afford it. Velasquez flew home after her OB/GYN rotation that year to speak with hospital administrators and handle paperwork.

There were many times when my parents got sick and never went to the doctor because my dad needed gas the next day to go to work, said Velasquez, who starts his internal medicine residency at Brigham and Women’s Hospital. There were neighbors who had their legs amputated due to uncontrolled diabetes, etc. This finally taught me that there is a bigger issue here that I need to understand and think about.

Velásquez’s parents’ journey to the United States began in Nicaragua in the late 1970s, when his father, at the age of 19, began to fight against the dictatorial regime of the Somoza family, which had ruled Nicaragua for decades. In 1983 he took up arms again, joining the Contras in opposition to the Sandinista government, which had taken over.

After the war ended with the election of Violeta Chamorro in 1990, her father left the country out of concern for his own safety, eventually traveling to Mexico where he met Velásquez’s mother. In 1993, eager for a better future, they came to the US asking for asylum because they could not return to Nicaragua. It took eight years, but the request was finally granted.

Velásquez started college at the University of Southern California, planning to become an engineer. The transition to college was almost overwhelming and she struggled with self-doubt, thinking about dropping out during her first year.

I almost dropped out my first semester, not for academic reasons, but because I didn’t believe in myself, Velásquez said, adding that he uses that experience today when he talks to students from similar backgrounds. Children who come from non-traditional backgrounds don’t necessarily believe in themselves and have self-confidence. I often tell students two things: you can do it, but not alone.

Velásquez attributes his success so far to the support of many around him. In addition to her family, friends, and classmates at Harvard, several mentors, including Martin, have provided valuable examples, opportunities, and advice.

Velásquez reconnected with Martin during the pandemic at GOTVax, an effort to bring COVID-19 vaccines to communities where the need was greatest. Martin was an organizer of the effort and Velásquez led its East Boston branch, helping deliver 1,000 vaccines to people in the community.

Later in 2021-22, when Martin was a White House Fellow, he hosted a panel discussion on health care access and decided to have Velásquez as the sole panelist.

He’s incredibly driven and passionate, but underneath he’s very warm and funny, Martin said of Velasquez. What really surprised me was how effective he was right off the bat, how people really enjoyed working with him and how well he fit in.

Velasquez’s mentors haven’t been limited to faculty members. When he was 19 and an intern at Glendale Adventist Medical Center, a nurse named Matt helped him through a pivotal experience: the first time she performed CPR on a patient whose heart had stopped and who was eventually revive

At just 19 years old, the idea that he could affect another person’s life in such a profound way took Velásquez away from his engineering path and fueled a nascent interest in medicine.

The patient has no pulse and we started CPR. I go second, and we keep going back and forth. He regained his pulse five, seven times and was finally resuscitated, Velasquez said. I remember coming home and talking to my roommate about how, if I, as a 19-year-old without many skills, could contribute in any way to helping that patient come back to life, how much could I do with the field of medicine. ?