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This is a story of how physicians worked together with a local residential program for homeless and marginally housed people in Palo Alto, California, providing care for people of the streets, the parks, and the shelters.

We had finished the mental health questionnaire, but the man I had interviewed could not get up from the street corner where we sat. His uncontrolled diabetes overwhelmed him. “Gotta eat,” he said. “Can I just sit a while here and eat? Then I’ll be on my way,” his gaunt face asked while his thin fingers fumbled through his bag for a cup-of-soup. His breaths gasped, exhausted by the effort. His eyes surveyed the street then found mine for an answer to his request.

“Please, stay and eat.”

He was sick. He was homeless. It looked like it might start raining.

In preparation for the opening of a local residential program for homeless and marginally housed people, my colleague and I had been conducting mental health interviews for Palo Alto’s unhoused population. The process for selecting candidates to become residents at the new center was underway. We interviewed candidates over a 4-month period. We met more than 200 individuals from the San Francisco’s mid-peninsula, each with a unique and often tragic story. Each story broke all expectations of how people become homeless. We met unemployed computer engineers living in their cars. We met political refugees unable to translate their professional skills into US licensing standards. We met single mothers with children fighting for a place to sleep in the shelter system. We met severely mentally ill persons who had never been picked up by the state’s welfare system.

We met them on the streets, in the parks, at the homeless drop-in center, and in the shelters.

“Never thought I’d end up like this,” the man said after his soup had given him enough energy to sit upright. He talked awhile about his experience of homelessness. He told me about nights by the creek, under the bridge with that cold, mocking rain oppressing his very movement. He told me about lost pride and having to stand at a stoplight with a cardboard sign asking strangers for money. He told me about how his failing health and advancing age made the struggle against the elements more doubtful.

“And all winter long, that rain, laughin’ at me.” His teeth clenched. His eyes narrowed. “Just laughin’ at me.”

Down the street, construction commenced on the new homeless center. The project was, at that time, just weeks from completion. Eighteen rooms for families adjoined 70 single occupancy rooms that were built and were getting their “final touches” while the homeless people eagerly waited. The housing units rose above a first-floor service area that would be devoted to essential services including social work, medical, and mental health. All services would be included in one center with the intention of transitioning unhoused individuals from homelessness to permanent housing.

But to create and sustain such an immense community project requires partnerships between invested individuals, programs, and potential clients. The story of the partnerships in instances like this one is often never told. Occasionally, heartwarming outcomes might be reported in the local newspapers—or, rarely, in professional journals. The opening day ribbon-cutting ceremony might be a local news feature. But the struggle and commitment of the partners is often an untold story. It takes planning, effort, and deep and abiding collaboration to get a program in place to help a homeless man get out of the rain.

He sighed, still too weak to get to his feet, then continued. “I guess I give the rain something to laugh at.” His hand gesture alluded to his body’s weakness. He had been a great athlete in his youth. He had worked hard, physical jobs most of his life. And he could not pinpoint any event or circumstance that had led to his current situation. He never had a problem with alcohol or drugs. He never had problems with the law. But as problems developed with his health so did they develop with his economic state. Fading health seemed to accompany him on his path to his daily interface with the sun, the wind, and the rain—the mocking rain.

The local center was the culmination of inspiring ideas and tireless efforts and great collaboration—true partnerships among diverse (and maybe even unlikely) colleagues, working together with a common goal. Years in the making, with heroic, aspirational, and sometimes comical stories of how the partners strategized, sacrificed, and even sparred with each other to establish the community resource.

After we talked a long while, my conversation partner strained to rise and straightened his hat. His bag of belongings swung over his shoulder, he paused before starting back to his stoplight with his cardboard sign.

“A man my age shouldn’t be living like this.” He had told me that he did not want to let his hopes get too high about getting housing at the center. He was accustomed to disappointment.

“But I would like to be inside when that rain starts coming to laugh at me again.” He stared straight ahead with a stiff smile on his face as though he could see what he was saying while the words came out.

“Then I could be laughin’ at that rain instead of that rain laughin’ at me.”

The Opportunity Center of the mid-peninsula had its official ribbon-cutting ceremony on September 17, 2005. Eighteen families and 70 single people moved from the street into housing, and services were opened to homeless persons from the area. The outcomes were published in medical and social work journals. The opening gala was in the local news. But the partnerships that laid the foundation for those outcomes never received particular attention. The successes and failures of the process were not articulated or documented, so they cannot serve as a lighthouse for similar projects to follow. This narrative shines light on the process of academic-community partnerships that have brought about novel resources to address needs and fulfill goals of mutual importance—even if the goal is simply getting a few people out of the rain.