A few weeks ago I wrote about my internal conflict with how I relate to the homeless.

I have gained some additional perspective while on the TEACH service, which has a sizable homeless patient census. Conversations with my colleague Brittany have also allowed me to express my struggle to someone else, and I get to learn about her perspective as well.

Most of our homeless patients have problems with substance abuse. We had one patient who was an alcoholic and smoker in congestive heart failure. He doesn't take medications because he can't afford them. I understand you can't give what you don't have (courtesy of Dr. Garcia), but medications cost $4/month and $10/3 months at Wal-mart and Target. How much do alcohol and cigarettes cost?

The homeless man I pass often when running under the bridge is usually smoking cigarettes or drinking beer. He has a personal landfill of cigarette butts and beer cans under that bridge.

This makes me very comfortable with my decision to not give out money. Though I know not all homeless have problems with substance abuse, it doesn't mean that giving them food instead of money is any less generous. I would much rather give people food than cash.

I'm not claiming that I'm going to start doing this regularly, but it's something that I intend to try.