Catching Homelessness: A Nurse's Story of Falling Through the Safety Net, is a powerful memoir written by Dr. Josephine Ensign, DrPH, MPH, FNP, and a current University of Washington professor. Catching Homelessness is set in Richmond, Virginia, the former capital of a Southern Confederacy and an inner-city with the lingering effects of white supremacy and racial division in the 1980s, a city with severe health inequity at the start of the homelessness epidemic. Ensign examines how her experiences as a homeless person had impacted her and her profession, revealing a critical look at the nursing profession, Homelessness, and the nation's healthcare safety nets.

Ensign, a nurse practitioner, a role she described as a "novelty" at the time, created her position running the CrossOver Clinic at the Richmond Street Center. The street center is a multiservice center for the homeless. Much of Ensign's initial views on Homelessness are shaped by the legacy of white people as "saviors"; the notion that the "homeless were exotic, impoverished, foreign" (Ensign, 2016, p.34). As a "pious" young, white, Southern, Christian wife––a role she describes as a "sort-of-arranged marriage…one that left me feeling detached, numb and mute". She builds strong relationships with her patients that shift her perspective on Homelessness––and, ultimately, her entire life (Ensign, 2016, p.40). In her opening chapter, she speaks about a black man named Lee dying of AIDS at the height of the AIDS epidemic. A man she was next of kin to, a self-described "CrossOver Clinic jester," a man she credits for getting her to where she is now (Ensign, 2016, p.201). In a later chapter, she introduces a man named Louie. A severely paranoid schizophrenic covered with head and body lice when she met him and credited patients like him that allowed her to develop "a sort of internal Geiger counter for unsafe, unstable patients" (Ensign, 2016, p. 85).

She tells stories about the river rats, a group of mostly white patients that lived along the riverbanks in Oregon Hill, a white, violent, and racist neighborhood.

Ensign speaks about how healthcare providers are taught to avoid getting too close to patients to keep a healthy emotional distance to avoid emotional burnout. She often ignored these teachings and got too close to her patients. Ensign (2016, p.16) writes the nursing business "brings us into the messy swampland of human suffering, illness, and death. It is impossible to erect walls or channel rivers within a swamp."

She writes about the emotional rollercoaster of keeping lists of dead people and picking maggots out of her patient's wounds, the anger she feels for what's happened to her patients, and feeling torn about caring. At the same time, the difficulty of being taken seriously as a nurse would lead her to "dress matronly" and carry a "white lab coat" for "an extra air of authority" (Ensign, 2016, p. 34). Her gender is often an obstacle. Being the voice of reason for the voiceless deemed her unchristian by the street center white male leaders like Buddy, unable to represent an organization only concerned with the working poor––the deserving poor rather than the "unworthy" homeless. Because of her nonjudgmental attitude toward expectant mothers seeking abortions and those with HIV/AIDS, she no longer fits the box of a "proper Christian woman with a humble spirit" (Ensign, 2016, p.146). She became homeless after being ousted from the street center, which stripped her of her identity and sense of worth.

It's clear to understand why Ensign wrote this book. Reading these complex stories of her patients evokes emotions. Ensign says, "stories that we comprehend are stories that we quickly forget. My goal is to establish a framework for the empathy required to bring about positive change for those who are marginalized. The margins can be illuminated to reveal more of the truth about our world" (Ensign, 2016, p. 81). A world that relies on what she calls "charity medicine" as a safety net—a system that she poignantly says causes further harm to an already vulnerable population.