In a little area outside our free clinic in Miami, ten of us sit together in a group. The air is thick and unmoving. Some wear torn shirts while others arrive in stylish outfits. A few have not had the chance to shower in weeks, but all show up, bringing their full selves to the group. These are the people who call the streets home, men and women who sleep on concrete and navigate a world that often pretends they do not exist.
I am a fourth-year medical student on a street medicine rotation, and twice a week, we hold wellness sessions at the free clinic for people experiencing homelessness. These sessions are not therapy in the traditional sense. There are no patient charts, no diagnoses, no billable hours. Just stories of pain, survival, laughter, addiction, betrayal, and hope. As a future physician and aspiring psychiatrist, I have come to believe this is one of the purest forms of healing I have witnessed.
During one of these sessions, a man recalled having three of his friends die in the last year: one from an opioid overdose, one by suicide, and one from an untreated foot infection. I could tell by the way he spoke that he carried a lot of grief. He said he did not want to be fixed, that he just wanted someone to know his story. And we did. We sat with him in silence and solidarity. The woman sitting next to him reached over and placed a comforting hand on his shoulder.
Not every moment is solemn. In fact, there are also many moments of joy. One regular had been searching for a job for years, facing countless rejections. The day he came in beaming, exclaiming, “I got the job!” after being hired as a cashier at Winn-Dixie, the whole group erupted into cheers. We celebrated as though we had all been hired with him, sharing in his victory as if it were our own.
Healing happened in that moment, not because we prescribed anything, but because both pain and joy were given witnesses. I have learned in these sessions that treatment is not only what happens inside an office. It can also look like ten people in a little gathering, choosing to listen instead of walking away.
But listening is political, too. Some of the people who sit with me during our wellness sessions have cycled through jails, psychiatric wards, and ICE detention. They carry not only trauma, but the diagnosis of being “unwanted” by society. Some people might label missed appointments, skipped medications, or refusal of treatment as noncompliance, but I am learning that these choices are often acts of survival, like skipping an appointment to guard belongings or refusing sedating medications to stay alert against theft or assault. The homeless people I have met have faced challenges I have never had to face. It can be easy to blame their situation on poor decisions, but I have yet to meet a homeless person who did not start life disadvantaged.
Street medicine has taught me that the most radical form of psychiatric care is to make space for the person who has been told they do not belong anywhere. In the hospital, healing often happens in orderly lines: individual patients waiting in chairs, coordinated schedules, forms stacked in neat piles. But on the street, we heal together in groups: face-to-face, in shared stories, with care that flows between everyone present.
Alina Kang is a fourth-year medical student at the University of Miami Miller School of Medicine, applying to psychiatry residency programs. Originally from Tokyo, Japan, and raised in California’s Bay Area, she earned her B.S. in general biology with a minor in cognitive science from the University of California, San Diego. During medical school, Kang has been actively engaged in community service through organizations such as Miami Street Medicine, Doctors Within Borders, and the Miller’s Disability Alliance, where she worked to expand access to care and advocate for underserved populations. Beyond medicine, she enjoys playing piano, practicing yoga, and scallop diving in the Crystal River.
