roseanna means of health care without walls

There’s been an incredible uptick of interest in public health since the Covid-19 pandemic. So we wanted to talk with a woman (and CNN Hero) who’s had a long and widely admired career in public health. We wanted to ask: What’s it like to work in public health? Dr. Roseanna Means, who created Health Care Without Walls to care for Boston’s homeless women, recounts how work with refugees in Cambodia forever influenced her life. “I wanted to do something that involved social justice and something that’s going to be more meaningful,” she said, telling us she ultimately decided to give up a prestigious cardiology fellowship as a result. “I thought they were going to take my stethoscope and break it in the public ceremony.” For anyone considering a career in public health, it’s an inspirational story.

Read more: A Boston Doctor Opens a Clinic to Help the Pandemic’s Most Vulnerable Homeless Women

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COLLEEN: There is an entire generation of young people growing up with remote learning, curb-side Covid tests, mRNA vaccines…

SUE: …so it's perhaps no surprise there is an incredible interest in public health

BROWN PRESIDENT CHRISTINA PAXSON: Let's reflect on the transition you are going to make, from college students to college graduates.

COLLEEN:That's some tape from commencement at Brown University…

SUE: …where there's been a massive spike of interest in public health degrees, especially among students of color.

COLLEEN: Over at Tufts University, applications to its master's of public health program have tripled.

SUE: Across the country, there's been a 40% increase in applications to graduate-level public health problems — that’s according to the Association of Schools & Programs of Public Health.

COLLEEN: That's incredible.

SUE: It really is.

COLLEEN: Welcome to The Story Exchange. I'm Colleen DeBaise.

SUE: And I'm Sue Williams.

COLLEEN: So today, we're speaking to Dr. Roseanna Means, who has had a long and widely admired career in public health.

SUE: We wanted to ask her: why work in public health? And what's it been like, these past 2 years?

ROSEANNA: The pandemic was really, really scary. Because I'm trained as a physician and I've done a lot of public health over my lifetime.

SUE: Roseanna is the founder of Health Care Without Walls in Boston.

ROSEANNA: When I first heard about the pandemic —

COLLEEN: — back in early 2020 —

ROSEANNA: — I remember writing to my siblings and saying…

COLLEEN: “This is big.”

ROSEANNA: “Bigger than people think. Go stock up.” So I'm responsible for all the toilet paper and paper towels that got pulled off the shelves (laughs)

SUE: What got us interested in Roseanna is her work with populations in need.

ROSEANNA: Health Care Without Walls provides free walk-in acute and episodic care to women who are homeless or marginally housed.

ROSEANNA (talking to patient): I’m getting maybe 140 over 100. So you should go back today, take your blood pressure medicine and take it tomorrow.

ROSEANNA: We do this all because it's mission-driven, and because women deserve better than what they're getting now. Not my best elevator speech, but…end of a long day.

SUE: Roseanna is an attending physician at Brigham and Women’s Hospital.

COLLEEN: But, years ago —

SUE: — safe to say in the 1970s —

COLLEEN: — when she was a student at Bennington College in Vermont —

SUE: — sort of an artsy, hippie school…

ROSEANNA: I was sitting at my desk in my dorm room. It was very quiet. All of a sudden, out of nowhere, I heard this voice that just said, “You will be a doctor.” No preamble, no flashing light, no thunderbolts, no lightning. It was just, that's it. And it was over. I just was so surprised because I wasn't religious. I don't drink. And I remember thinking, “Okay, that's what I'm going to do.”

COLLEEN: Wow. So…that was that. She left soon after to go pre-med at MIT, eventually graduating…

ROSEANNA: …top of my class at Tufts.

SUE: She planned to become a cardiologist.

COLLEEN: But then, during her residency, Roseanna really got her first taste of public health.

ROSEANNA: As many people know, we were involved in the Vietnam War up until 1975. When the United States pulled out, the Vietnamese invaded Cambodia, and that allowed a dictator named Pol Pot to come to power.

SUE: Pol Pot, as we know…

ROSEANNA: …committed absolute atrocities and genocide against his own people.

COLLEEN: Here's ABC News.

ABC NEWS: The nation was a forced labor camp, the conditions inhumane…

ROSEANNA: So thousands of Cambodians were fleeing to the Thai border, and many of them were losing their limbs to landmines that had been set along the way.

COLLEEN: Roseanna heard that organizations like the International Rescue Committee were desperate for help.

SUE: And she decided, she couldn't just stay in Boston.

ROSEANNA: You didn't take a residency at Harvard Teaching Hospital and say, “Oh, well, I think I'll just take three months off and just go to some third world country and do some good work.” You just didn't do that, except that I did that.

COLLEEN: When Roseanna arrived in Thailand…

ROSEANNA: I was assigned to Khao-I-Dang, the refugee camp on the border.

SUE: Her first day at the camp…

ROSEANNA: …literally, my first day in the camp, we arrived by truck, and I stepped out. And I see there's a 12-year-old boy who is having his leg amputated with a guillotine, no anesthesia. He had stepped on a landmine and his foot had been shredded. And that was my introduction to refugee camp.

COLLEEN: It was the type of thing they don't teach you in medical school.

SUE: And it changed her, forever.

ROSEANNA: And so I just thought, “Okay, I want to do something that's going to help people who have lost everything.” That was a big moment for me.

COLLEEN: We'll tell you what Roseanna did next with her career, after a brief break.

COMMERCIAL: The Story Exchange is a nonprofit media company dedicated to elevating women’s voices. For more on women leaders in public health, check out our video featuring Anne Kauffman Nolon of Sun River Health. "I love knowing that we're caring for so many people. It blows my mind. For our staff, through COVID, through ups and downs; this is a work of love that doesn't ever go away." It's on our website at thestoryexchange.org.

COLLEEN: We've been sharing the story of Dr. Roseanna Means…

SUE: …who has dedicated her career to helping marginalized women get the care they need.

ANDERSON COOPER: Tonight we're recognizing some incredible acts of compassion.

COLLEEN: That's Anderson Cooper of CNN, which named Roseanna a CNN Hero back in 2011.

SUE: One of the many recognitions she's received.

COLLEEN: When Roseanna came back from working in the refugee camp…

ROSEANNA: I was so impressed with how strong the Cambodians were in the face of all this.

COLLEEN: She decided that prestigious cardiology fellowship that she had applied for and gotten accepted into…

SUE: …just wasn't going to cut it.

ROSEANNA: I wanted to do something that involved social justice and something that's going to be more meaningful. And again, people just didn't do that. You didn't give up a cardiology fellowship. I thought they were going to take my stethoscope and break it in the public ceremony.

COLLEEN: Roseanna began volunteering at homeless shelters and clinics, while setting up her own primary care practice focused on women’s health.

SUE: She was naturally drawn to people who were falling through the healthcare safety net.

ROSEANNA: It's so stigmatizing to say that you're homeless. And so people suffer in silence and they don't get the things that they really deserve.

COLLEEN: While working as a volunteer…

ROSEANNA: …my training was women's health. I really wanted to help the women.

SUE: Roseanna noticed something unusual: Where were the homeless women?

ROSEANNA: The women that were experiencing homelessness were not coming into these clinics in the numbers that actually I knew that were out there.

SUE: She began to realize…

ROSEANNA: The women did not always want to be in the same waiting rooms as the men. And I will say up front, the majority of homeless men are men who have had a difficult life and are good people. However, there were also, among those men, guys that beat up the women, or raped them, or held them at gunpoint, or made life so difficult for the women that they just did not want to come into the clinics.

COLLEEN: In 1999, Roseanna founded Heath Care Without Walls to care for these women, in women-only shelters and clinics.

ROSEANNA: There was a women’s shelter where the director let me come in once a week with my blood pressure cuff and my stethoscope and just sit there, like this, and say, “Does anyone want their blood pressure taken by a doctor?” And it was very slow at first.

SUE: A decade later, Roseanna and a team of volunteers were working at 12 shelters all over the Boston area.

ROSEANNA: At the very basic level, we provide walk-in medical care. Almost anything you would treat in a primary care office, we can do.

SUE: Her team also helps women apply for housing, food, and government benefits.

SOT: It usually takes about two or three business days for them to reply back to her, correct?
-OK, and I’ll give you this all in writing.
-Thank you. Gracias.

ROSEANNA: I think people think about homeless persons as the crazy person talking to themselves, or they're actively shooting up in the sidewalk, or they're sleeping on the steps somewhere.

COLLEEN: When it comes to women…

ROSEANNA: The stereotype is the bag ladies who carry everything with them, but secretly, they have a million dollars in their mattress.

SUE: The reality is that many women have lost jobs or been evicted — some are going to school or juggling multiple jobs but still can't make ends meet.

ROSEANNA: And the other stereotype is that people choose to be homeless because they don't want the responsibility. And I've done this for over 30 years. And I've never met a single person who I thought really wanted to be living this horrible lifestyle. It's not something that people choose to do.

COLLEEN: During the worst of the Covid-19 surges, dressed in full PPE…

SUE: …Roseanna provided medical care to hundreds of homeless women whose rate of infection was 35% higher than the state average.

ROSEANNA: Everybody was depressed, and anxious, and scared. I mean, we were all depressed, and anxious, and scared, too.

COLLEEN: Many overnight shelters fully shut down as a result of the pandemic.

ROSEANNA: It also made us realize that we needed to get our own place; that we have been going into the shelters for so many years in providing services.

SUE: In the summer of 2021…

COLLEEN: Roseanna raised $80,000 dollars through a Broadway-themed fundraiser.

SUE: And she opened Health Care Without Walls' first freestanding health clinic for homeless women in downtown Boston.

COLLEEN: All of her work is supported by grants and donations.

SUE: Here's WCVB.

DOUG MEEHAN: There are currently as many as 4,000 women in the city who are considered homeless and on average Dr. Means treats about half of them. She says this new clinic is a gamechanger when it comes to providing gap health care for those who need it.

ROSEANNA: Yeah, this location is so fabulous because we're literally one block from the Boston Common. We're so accessible to the women, and it's clean, and it's safe, and it's private. And they're very, very welcome.

COLLEEN: I recently caught up with Roseanna.

SUE: She must be exhausted.

COLLEEN: Yes. Like a lot of healthcare professionals, she tells me she sometimes worked 80 hours a week during the pandemic.

SUE: Incredible. And she's nearing retirement age!

COLLEEN: That's right. So now that Health Care WIthout Walls is in good shape, she's actually stepped back from her role there.

SUE: I don't picture someone like Roseanna ever retiring.

COLLEEN: No, not at all. She's actually still at work on another baby of hers…literally a baby.

ROSEANNA: And so the social workers at Brigham and Women's came to me and said, “Well, we have a dilemma. We have a whole bunch of women who are pregnant and have high risk pregnancies, but some of these women, they're literally homeless.”

COLLEEN: The program she developed is called Bridges to Moms — it's for the moms who have no place to go, when they're discharged from the hospital, with a newborn.

ROSEANNA: Instead of, like, what my experience was — there's my husband waiting, there's the car seat — they get in a cab, they go down to the state housing office, and they wait and wait and wait for their number to be called to see if they will be on the street that night or are they going to be in a shelter.

COLLEEN: The goal is to provide these women and their babies with the support they need — whether that's housing or transportation or food. And so far, Roseanna says it been a big success.

SUE: How much time is she spending with Bridges to Moms?

COLLEEN: Only about 30-40 hours a week — she jokes it's a side hustle.

SUE: When we visited Roseanna, we were struck by how much energy and dedication she brings to the job; how she is so genuinely interested in each and every patient she sees.

COLLEEN: All of which, of course, is needed for a career in public health.

ROSEANNA: What keeps me going is that every interaction I have with the women, the ladies, as I call them, there's a piece of my heart that goes with each of them. They have endured much more hardship than I have ever endured. And yet they have an incredible amount of courage and resiliency and spirit and faith. If I can bring one little moment of light into their life, even for a little bit of time, that's what keeps me going.

COLLEEN: We thank Roseanna for sharing her story.

SUE: And we thank you for listening.

OUTTRO: This has been The Story Exchange. Join us next time to hear more stories about innovative and inspirational women doing the things you’d never dream of. Or…maybe you would. If you liked this podcast, please share on social media or post a review wherever you listen. It helps other people find the show. And visit our website at TheStoryExchange.org, where you’ll find news, videos and tips for entrepreneurial women. And we’d love to hear from you: Drop us a line at [email protected] — or find us on Facebook. I'm Colleen DeBaise. Sound editing provided by Nusha Balyan. Interview recorded by Bestor Cram and Mathew McClean. Production coordinator is Noël Flego. Our mixer is Pat Donohue at String & Can. Executive producers are Sue Williams and Victoria Wang. Recorded at Cutting Room Studios in New York City.

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