Each Christmas, Grandpa would give Jim Withers $50 to help with the holidays. It was an awkward gift because Withers is a fully employed adult—a medical doctor in little need of financial support. 

Grandpa and Dr. Withers were not even related. In fact, Grandpa was an 85-year-old homeless man who was too paranoid to reveal his true name. He lived under a bridge with maggots in his legs and his bags of belongings around him like a large security blanket. In the time that they knew each other, Grandpa gifted Withers not just with cash, but with lessons of humility and grace.

At first glace, it might appear that Withers would be the giver, as he goes to care for the homeless out of his love for Christ. But as Withers discovered, grace isn’t earned or given from on high. It can show up in circumstances when we least expect it—a free, unexpected gift. 

Grandpa taught Withers how to receive grace, even though it felt uncomfortable at first. Grandpa is just one of the patients that Withers has encountered as part of Operation Safety Net, a group that provides medical care to the men, women and children living under bridges and on the streets in Pittsburgh.

Withers’ office is small, with a bookshelf crammed with texts on medicine and poverty. Photos of patients cover his bulletin board, and his trademark medical backpack sits in a corner. He speaks thoughtfully and passionately about his work.

Grandpa was one of Withers’ early patients; one of the first to show him that a deeper healing can take place when the doctor and the patient care for one another. 

“I had all kinds of plans for treating Grandpa. But he refused to let me. Every time I tried, he refused,” Withers said, his blue eyes seeming to focus on something beyond the walls of the room. “But while I was planning, we began to share a deepening relationship of trust and love. I learned to accept him for who he is and share his path.” 

Withers’ 21-year medical mission is his way of following Christ. He models his approach after Jesus’ ministry, recognizing that Christ’s healing approach was one of “house calls”—seeing, loving and healing people wherever they happened to be.   

As a result, he is straightforward and compassionate with strangers. “I respect my patients’ reality. They don’t have to force themselves into my medical box,” he said. “I use the mission tools I’m most comfortable with—a stethoscope, scalpel and bandages.” 

When Withers began his work on the street, there was no organization for him to work with or use as a model—in Pittsburgh or elsewhere. He knew it could be dangerous to just venture out into the streets and start treating people. So he spent time preparing for his new work. 

He began in a place that felt most natural: the library of Second United Presbyterian Church of Wilkinsburg, Penn. He checked out the book 52 Ways to Help Homeless People and started reading. He discovered that ministry to men and women on the street doesn’t just help those being ministered to, but transforms those doing the ministry. 

Not only did he follow the book’s advice and prepare himself by forgoing showers and shaving for a time, he also obtained the help of Mike Sallows, a man who had been homeless for seven years. Mike is a vocal advocate for people who are living on the streets. 

“Mike said he would take me to the streets if I didn’t dress like a doctor and act like a jerk,” Withers remembers with a laugh. “With Mike’s help and the grace of the people on the street, the new endeavor just felt right.” 

Over time, Withers, Sallows and the patients they encountered created a model for reaching people who had been invisible to the medical community. Street medicine became Withers’ passion. 

He sees himself as an ambassador—helping health professionals navigate direct care in the streets and accompanying street people to doctor’s offices and emergency rooms to help them navigate the unfamiliar world of the medical community. But he’s quick to point out that he doesn’t do it alone. He is supported by the Mercy Health System as well as local churches. 

Despite its own struggles in an economically challenged community, Second United Presbyterian church has supported Operation Safety Net by providing blankets, socks and hats as well as prayer. As an elder, Withers also shares his ministry stories with other PC(USA) congregations. He has spoken at the East Liberty Presbyterian Church’s Good Samaritan worship service and was recently surprised when Operation Safety Net received a $1,000 donation from those who attend.

“The amazing thing about this is that the Samaritan service is largely attended by homeless persons. It’s not the first time they have done this,” he said.

Two decades after he began his work, Withers is still passionate about street medicine. In addition to the group he leads at Operation Safety Net in Pittsburgh, he also started the Street Medicine Institute, a group that he hopes can change the world for the better.

The Street Medicine Institute is starting a global movement in healthcare—one that will insure that the “least of these” get the care that they deserve. Currently 80 communities from places like Calcutta, Russia, Denmark and Great Britain are affiliated with the Institute.

Many of the groups are “homeless” themselves because of lack of support from the established medical community. The philosophy of street care seeks to value the most vulnerable, a radical departure from mainstream healthcare business model.

“Christ was so inclusive in his ministry. We seek to be the same way. Street medicine is symbolic of this inclusiveness,” Withers said.

The Street Medicine Institute holds annual conferences for caregivers from around the world. People of different nationalities and faiths gather together to share insight and encouragement. The Street Medicine Institute seeks to educate healthcare workers on best practices in street medicine and improve the level of street care around the globe. 

While the street care movement continues to grow, Withers remembers the early lessons that Grandpa and other taught him. While Grandpa refused treatment at first, he eventually got so ill that he needed hospital care.

“I was able to help him navigate a healthcare system that wasn’t ready for someone like him,” Withers said. “Grandpa was intelligent and indomitable. He taught me that to truly care for people you must recognize and honor the reality of their situation and respond with love.”

Withers continues to provide care on the streets of Pittsburgh. Grandpa taught him not to make plans for his patients on his own, but to share the path of each. Sometimes he gives the gifts of grace and healing. Other times he receives them. He does both with a grateful heart.