Janelle Goetcheus always thought that she would go to Congo after she became a doctor. After all, she had worked at a remote hospital in the war-torn African nation when she was a University of Indiana medical student in the 1960s.
But Goetcheus ended up practicing medicine in a place she decided needed her even more: Washington. She is the chief medical officer at Unity Health Care, a provider of services to people in the District who are underserved medically.
"We don't see too many well homeless folks," Goetcheus said. "They have a lot of chronic illnesses. Some have acute medical problems. Trying to manage themselves in a regular shelter without medical support is very, very difficult."
In 1985, Goetcheus and her husband, minister Allen Goetcheus, established Christ House, a 33-bed facility in Adams Morgan that offers 24-hour nursing coverage for homeless men with medical issues.
Until 2016, there was no such place for women.
"It's something that's been missing from the landscape of services for homeless women in the District," said Schroeder Stribling, chief executive of the charity N Street Village.
In April 2016, N Street Village opened Patricia Handy Place, a women's shelter in Chinatown. By partnering with Unity Health Care, N Street ensured that of the 213 beds there, 13 are for women who need special medical attention. These women may have been recently discharged from a hospital but need their surgical dressings changed regularly. They may have a complex assortment of medications they need to take. They may be receiving cancer treatment.
"If a woman has a brain tumor and is undergoing chemotherapy/radiation therapy, the hospital can't hold her throughout that time," Janelle Goetcheus said.
The medical respite beds are useful for something as routine as preparing for a colonoscopy. Imagine that experience if you were without a home.
People who live on the streets are prone to circulatory problems. Veins in the lower extremities begin to break down. Small wounds become big ones.
"They need dressing changes, not just once a day," Goetcheus said. "Depending on the depth of the wound, sometimes they need it several times a day. The Unity nurses who are there become expert at caring for these types of wounds.
"If you don't [care for them], then they can get gangrenous and end up with an amputation. If you take care of them adequately, you can prevent those kinds of complications."
There's another benefit: Women who are cared for in N Street Village's medical respite program are less likely to use the expensive services of a hospital emergency room.
"We always say we make up our budget in terms of the money we've saved," Goetcheus said.
Unity Health Care has a presence in Patricia Handy Place beyond the women in the medical respite program. Four mornings a week and two evenings a week, a physician or nurse practitioner is on hand in a clinic for any woman who wants an appointment. On the weekends, a nurse practitioner sees to the needs of the women in the medical respite program.
There's also a Unity clinic at N Street Village's flagship location near Thomas Circle.
"So many of the 1,500 women who cycle through this building in a year are going to feel much more comfortable about seeing a doctor if it's just somebody upstairs," Stribling said. "That sense of ease or comfort is better for them here."
The hope is that women will avail themselves of those services, then take advantage of N Street Village programs that lead to a stable home.
Goetcheus and her husband live in Christ House — and raised three children there. Working with poor people, she said, has been a "deepening" experience.
Still, I said, your parents must have freaked out when you went to Congo.
"They were more worried when I came to Washington," she said. "Here you were in the capital of the United States, seeing these tremendous disparities."
Although people in Congo were poor, Goetcheus saw hope there, a belief that people felt they would be able to rise.
"I always say that the difference in poverty here in the United States is you've got people who've grown up in a very rich area looking at all this stuff," Goetcheus said. "They know they don't have a chance. I look at the children and see that they begin to experience the hopelessness that their parents experienced. I think it pulls the hope out of you, this kind of poverty."
N Street Village and Unity Health Care try to put some of the hope back in.
This is the last column I will be writing about N Street Village during our Helping Hand fundraising drive. We can still count your donation toward our goal of $200,000. To give, visit PostHelpingHand.com and click where it says "Donate."
To give by mail, make a check payable to N Street Village and send it to N Street Village, Attn: Helping Hand, 1333 N St. NW, Washington, D.C., 20005.
For previous columns, visit washingtonpost.com/johnkelly.