title: The Kenneth B. Schwartz Center at Massachusetts General Hospital hematology-oncology department: hope for the homeless.
abstract: Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded the Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient and support to caregivers and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum during which caregivers discuss a specific cancer patient, reflect on the important psychological issues faced by patients, their families, and their caregivers, and gain insight and support from their fellow staff members. A homeless man with head and neck cancer presents to the emergency room: a sad and familiar story. But this story is redeemed by his 35-year friendship with a priest, a man whose unconditional love and support became critical to the patient's care and treatment. The patient had lived for 30 years in homeless shelters, had problems with alcohol abuse, and was notoriously noncompliant with medical caregivers. He could not speak due to his disease, was illiterate with limited intellectual capacity, and had neither a job nor a family. Despite huge and apparently insurmountable problems for the patient, the oncology team was able to carve out a package of care, successfully communicate, and mobilize a support network to allow successful completion of chemoradiation therapy. The team developed a strong commitment to his care and an affectionate bond, which very positively affected all of those involved. We discuss issues of access to cancer care, and the special problems presented by homeless patients.
authors.affiliation: Department of Medicine, Division of Hematology-Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114-2617, USA. rpenson@partners.org
authors.forename: Richard T
authors.initials: RT
authors.lastname: Penson
authors.forename: Laura A
authors.initials: LA
authors.lastname: Fergus
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Haston
authors.forename: John R
authors.initials: JR
authors.lastname: Clark
authors.forename: Andrew
authors.initials: A
authors.lastname: Demotses
authors.forename: James J
authors.initials: JJ
authors.lastname: O'Connell
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Chabner
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Lynch
mesh_terms: D000368:Aged; D001900:Boston; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006703:Ill-Housed Persons; D006769:Hospitals, General; D006801:Humans; D008297:Male; D016522:Oncology Service, Hospital / Q000458:organization & administration*; D010348:Patient Care Team; D018802:Patient-Centered Care; D010817:Physician-Patient Relations