Dr. Naheed Dosani – Approaching Homelessness from a Place of Empathy

Erin Davis: Welcome to REAL TIME, a podcast for and about REALTORS^®. I'm your host, Erin Davis, and it's great to have you sharing this time with us. We explore everything in this podcast from living green to marketing tips, design, and so much more.

On episode 21 of REAL TIME today, we're joined by Dr. Naheed Dosani to compliment REALTORS Care^® Week 2021. Dr. Dosani, a Toronto-based physician and humanitarian, has been making headlines, and more importantly, a real difference while providing palliative care to the homeless and vulnerably housed since 2014.

In this episode, we're going to explore Dr. Dosani's perspective on the state of homelessness in Canada, the impacts of health and social system inequities. We're going to talk about PEACH, and it stands for Palliative Education and Care for the Homeless and how Canadians, we, can seek humility and empathy in supporting marginalized people. Dr. Dosani, thank you so much for taking some of your precious time to be with us here today. It means a lot to our members and to me. Thank you for this.

Dr. Dosani: Thank you so much for having me on. I really appreciate it.

Erin: You are amazing. As a physician, you must've always wanted to help people, but tell us about your journey in medicine, Doctor, and what drew you to caring for the homeless and vulnerably housed in particular.

Dr. Dosani: I'm the son of two refugees who came to Canada in the 1970s from a country called Uganda in Africa. My parents came to Canada as refugees with nothing, fleeing war and persecution. My upbringing was really focused on justice, community wellbeing, and what social change could really inspire. I originally wanted to pursue maybe journalism, maybe law, but then found myself in healthcare and in medicine.

It was a turning point for me working as a resident doctor at the University of Toronto in my training. In my first year of residency, actually, where I met a man named Terry who presented to the shelter I was working at, and he presented in pain crisis because he had a widespread head and neck cancer. He had been on the streets for over 15 years. He had a longstanding mental illness, schizophrenia, and he was actually diagnosed with his cancer a year before at a local cancer center.

Unfortunately, due to his mental health, he wasn't able to follow up for appointments. The tumor grew, and so he started to experience pain, and he did what any one of us would do. He went hospital to hospital, ER to ER, walk-in clinic to walk-in clinic, seeking the kind of pain control that anybody in this country should have access to.

Terry was denied access to pain medicines. I could read this in the medical notes and the charts. Maybe it was because of stigma. Maybe it was because of bias, but he's found himself in our care on this day. I remember building a somewhat of a trust with him in the sense that he promised he'd start some pain medicines the next day.

I got to the shelter early the next day to work with him, and I couldn't find him anywhere, and I had found out that he had died. He had overdosed on a combination of alcohol and street drugs. He had turned to the best pain relief that he knew. It was too little too late. This was a life-changing event that showed me that people experiencing homelessness lack access to care, and particularly people who experience homelessness lack access to palliative care. It's a human rights issue.

Erin: I think that what you said that jumped out to me there was that he went hospital to hospital, and right away, people thought that he was just a guy there trying to get a fix. Would that be a summary of his situation before something like PEACH could have intervened?

Dr. Dosani: Yes. This is a great question because many people listening might think, well, he had access to healthcare because we all have access to healthcare. It's "universal" in Canada, but that's actually a common misnomer in the sense that there are still biases, stigma, and discrimination that exists in our healthcare facilities and in our healthcare programs for people who are unhoused, people who use drugs, people with mental illness, racialized folks.

I'm sure we're going to talk about this throughout the conversation, but while you may all technically have equal access to healthcare, it doesn't mean we have equitable access to healthcare, and Terry needed equitable, justice-based access to healthcare, and particularly palliative care.

Erin: Can you define the difference between equal and equitable perhaps in Terry's case or in some example that can illustrate that for us, Doctor?

Dr. Dosani: For sure. I love this contrast and comparison because I think it's such a crucial pillar of understanding when it comes to why this kind of work is so important. Our healthcare system is pretty good at being equal.

Most people in this country get the same things to be happy and healthy, but that doesn't work for everybody, especially for people who might need more like someone who lives on the streets or in shelters or someone who lives in poverty. People like this need equitable care. They need a health system that gives people what they need to be happy and healthy.

In justice-based health systems, that takes us one step further where our systems are rearranged in a way that people are empowered and supported with the resources to make their own healthy lifestyle choices when they want, how they want, where they want. It's an empowering way.

We need to go from equality to equity to justice. Unfortunately, Terry didn't have access to equity-based palliative care or justice-based palliative care. That's why he died. His death has become – I carry it with me everywhere I go. It's in my heart right now, Erin, and it's a big reason we do the work we do.

Erin: His death and that brief ships in the night that you had with this man has turned into a catalyst for your life.

Dr. Dosani: Yes. A turning point, a life-changing event that led to me becoming really focused on the issue of homelessness and healthcare. I spent my entire residency learning more about the intersections of healthcare for people experiencing homelessness, and then later applied for a palliative medicine residency at the University of Toronto, where I spent my entire training program figuring out how we could make and inspire a change.

In July of 2014, with colleagues at the Inner City Health Associates in downtown Toronto, we developed the PEACH program, Palliative Education and Care for the Homeless, a mobile street and shelter-based palliative care program that provides healthcare for people, whether they're under a bridge, on the street, in a shelter, so no person falls through the cracks. It started a very basic with myself and a street nurse named Namarig Ahmed driving around in a Honda Civic. I just actually got rid of that Honda Civic very recently. I had that for a long time.

The program has grown, and in 2021, we have a pretty robust program. We care for between 120 to 130 clients at any time. We have a health navigator on the team. We have a nurse coordinator, five palliative care physicians, a PEACH psychiatrist. We also have had iterations of peer workers, people with lived experiences on the program, and integration with our home and community care colleagues, including physiotherapy and PSW supports to really meet people where they're at.

Erin: Incredible, and without being too precious, you literally grew PEACH from the pit, the whole, the deficit that was on the Toronto streets in terms of the state of palliative care for the homeless and vulnerability. How many other people were paying attention to this when the whole issue of Terry and your residency coincided, Doctor?

Dr. Dosani: The issue of homelessness and healthcare – and particularly access to palliative care – has actually been written about around the world for quite some time. It's not a new concept per se. A lot of people around the world have written editorials and commentaries and the literature and even popular media articles about the fact that we need to do better, but what was lacking was a real robust view of how we can clinically create models to make this happen.

In most jurisdictions across North America, Europe, and Australia, there is access to community-based palliative care; but what doesn't actually happen is that those community-based programs orient themselves towards people who live in respite shelters, drop-ins, rooming houses, and really where unhoused populations reside; but also bringing it together with a trauma-informed approach to care, recognizing that many people who live on the streets and in shelters have experienced significant loss and trauma.

Also recognizing that people who live on the streets and in shelters also are people who use drugs, and a lot of the time, they don't get access to palliative care because the requirement for access to palliative care is stopping the use of drugs. We know that doesn't work. Abstinence doesn't work, so we provide harm reduction palliative care. I think it's the combination of those concepts that make PEACH unique.

Erin: Well, PEACH is unique, as a matter of fact, in all of humility. I really want you to blow your own horn here, Doctor, it has been brought to the attention of cities worldwide, has it not?

Dr. Dosani: Yes, we're really lucky and feel honored to be part of a network of family of programs that exists in cities all around the world, right here in Canada. Colleagues in Victoria, Edmonton, and Calgary, to name a few, have developed programs that feature mobile supports and mobile programs for people who are in need of palliative care and provide palliative care for structurally vulnerable people. The model has actually been replicated in cities like Seattle and Brisbane, Australia, and even as far as ways as England as well. This really is a global health issue. It's this intersection of the need for palliative care and the need for homeless healthcare intersecting together. It really makes a lot of sense.

I think it's important for us to reflect on the fact that people who experience homelessness are 28 times more likely to have hepatitis C virus, five times more likely to have heart disease, four times more likely to have cancer. The average life expectancy for people who live on the streets and in shelters is actually 34 to 47 years old. When you look at the life expectancy of Canadians, that can range from between 77 and 82 years old. Homelessness cuts a person's lifespan by half. It is a terminal diagnosis of the social determinants of health, how we live, learn, work, and play. This is really how we conceptualize the issue.

Erin: 34 to 47. That's an incredible number just to stop and look at. It's almost as though being unhoused or vulnerably housed in itself is a deadly disease.

Dr. Dosani: Totally. Then when you throw in the addition of a life-limiting illness, like cancer or end-stage kidney disease, or COPD, or liver failure, for example, you really see mortality go up. We recognize that to be on the streets, to live in a shelter is already taking years off of your life. Then when you have another medical illness, it's clear why access to healthcare is key, of course, but access to palliative care is an important component of any approach that supports healthcare of people experiencing homelessness and focuses on human rights, and of course, people's dignity and their quality of life.

Erin: Back with Dr. Naheed Dosani in a moment. He's a man who, with his team, makes a difference on the streets of his city, throughout the country, and the world. We're going to talk about that and so much more on this special edition of REAL TIME that comes while we're marking REALTORS Care^® Week.

REALTORS Care^® is a national guiding principle celebrating the great charitable work done by you as a member of the Canadian REALTOR^® community. Help raise awareness for the causes closest to your heart and home by sharing your story. Using #REALTORSCare on your favorite social media platform.

As we return now to our chat with Dr. Naheed Dosani, I asked him what impact this PEACH program has had and just what he has seen with his own eyes.

Dr. Dosani: It's a fair question. What does the PEACH program really do? At the outside, it's important to recognize that we provide medical care, and those pieces are key. We also, because we're a palliative care program, prioritize people's pain and symptom management, and particularly their quality of life, which is bread and butter for what palliative care and healthcare programs really do. It's so much more than the medical model. It's about meeting people where they're at.

When I talked about trauma-informed care, that's really supporting people and connecting with people. It's allowing people to heal, even if they're really sick, giving people a hand to hold or someone to talk to when no one else is around. It can also be very practical, particularly when working with this population. Palliative care is not just providing the medical care, it's actually ensuring people have the basic necessities of life, like a roof over their heads, so finding housing is a huge part of what we do. Securing food for people. Ensuring people have money in their bank account. People have social supports and human connections when they need them.

There's an aspect of this that's psychological or even emotional or spiritual care in nature to recognize that there's a higher power or something out there that's driving our soul and our will so that people can heal. Each team member, depending on their discipline, leverages these different components of that holistic biopsychosocial-spiritual model to make this work.

Erin: You mentioned the spiritual aspect of it. How do you get up every morning knowing that this is what you're going to be doing? Is it the hope or the difference that fuels you, or how do you do it, Dr. Dosani?

Dr. Dosani: I think that's a very fair question too. At the outset of that question, I will say that a lot of the time I have difficulty, and I'm going to be just vulnerable with you for a second, Erin, to say that this is not easy. Our team sees a lot of suffering in different ways. Remember, we're dealing with people who have fallen through the gaps again and again and again, and then towards the end of life, are fallen through the gaps again at a time when no one should ever fall through the gap.

If we can't get the dying part right to help people, how are you going to work on the living part? It's frustrating. It's sad. It's heavy at times, but on the flip side, what drives me is that in just a short amount of time, just a few years, a few people who care in healthcare and social services have come together to develop a model of care that inspires change, a new way of thinking, a new way of being, and we're doing it. Then we're doing it in a lot of cities across Canada now, and now people around the world are doing it. Like, what's not to be inspired by?

The other thing that really drives me is that this work is not being done in isolation. It's not like I'm doing my clinical work and then going home and hanging out, it's tied to advocacy. I could never imagine doing this work in an isolated way. It's connected to advocacy around anti-homelessness policies, around ending poverty, because a lot of Canadians don't realize that homelessness is a human-made problem. It was created by humans, and it can be ended through policy choices, like housing first or housing for all, which actually saves the system a lot of money.

I advocate in a systemic and structural way at a population level. That makes the clinical work make a lot more sense because you know you're working on something better.

Erin: We're going to get to that in terms of integrating it with our message here today for REALTORS Care^® Week. Let me go back to the personal for a moment, and just as you open the door to vulnerability, which of course, shows such great courage, what kind of life does this leave you with? Do you have time for your own personal life?

Dr. Dosani: Balance is really important. Sometimes when you're in the thick of these cases and you're in it deep with people who are dealing with such strife, it's hard to see that, but wellness and resilience is really important. We're hot off the heels of the COVID-19 pandemic. We're still in the COVID-19 pandemic. Let's be real right. More than ever before, health workers have been pushed in a way that we haven't been pushed before. I don't like calling it burnout because I think that places the blame on colleagues.

I think a lot of people, including folks who work on the PEACH team, including myself, are at times facing moral injury and even compassion fatigue, because this work is heavy, because it's hard, we're not getting breaks. Specifically for people who work on the front lines of homelessness because the policy solutions are not being put into place to prevent homelessness.

Our work and our services are being accessed more than ever before. That's a scary thought, but I got to say that there's hope. One of the things that we do as a team to support each other is to support our grief. We recognize very early on in this journey that people working in healthcare and in social services, providing a palliative care for people in the community needed help and support around their grief and their loss experiences, particularly when we were supporting clients who ended up dying.

We developed these things called grief circles. There are actually ceremonies that happen when a client dies. We will descend on a respite shelter or drop-in. We will hold a minute of silence. We will light a candle, and then we will cry together. We'll laugh together. We'll tell stories of what it was like to care for the person that we cared for. Then we'll think about how to not just remember or reflect on that care, but how to renew and reinvest in each other. We call it the 4Rs, and then we'll hold that moment of silence and put that candle out and go out and do it again.

During the COVID-19 pandemic, we had these grief circles virtually, and actually, the PEACH program got utilized in the city of Toronto to actually hold these grief circles for health workers working in the COVID recovery models, maybe not working in palliative care, but people who are working just in the healthcare models for people experiencing homelessness because of all the overdose deaths that we saw during the COVID-19 pandemic. Do I think grief circles are the answer to your question? No, it's scratching at the surface, but we need to develop safe, structured ways for people to address their grief, and me having that space through the grief circles with the PEACH program helps a lot.

Erin: Good. It's good to hear that there are ways to take care of you because we've all been so loud and rah, rah and banging the pots and pans, and it's quieted down, and then you start wondering who is taking care of the caregivers.

We're so grateful to Dr. Dosani for sharing his passion and commitment today towards helping the most vulnerable among us. His chat with us is complimenting REALTORS Care^® Week. There are incredible stories that you can access by following REALTORS Care^® on Facebook, Instagram, and Twitter, and using your own #REALTORSCare. Now, back to Dr. Naheed Dosani.

Tell us, Doctor, how has the pandemic impacted Canada's unhoused and vulnerably housed populations specifically? You mentioned the drug overdoses. In what other ways because so many of us have just been tied up with our own dramas and mourning and challenges during this time?

Dr. Dosani: People experiencing homelessness were hanging by a thread before the pandemic, and that thread essentially snapped. People were disconnected from their social and healthcare supports via their respite shelters or drop-ins, and many of these facilities and institutions that support people who are unhoused had to close or reduce services due to physical distancing. Remember, this was before we had a vaccine. This was very hard for people. We ended up seeing more people than ever before on the streets and in parks.

What we did see to be positive about things was an incredible response that was collaborated from our health facilities and health workers to social care agencies, to activists, to government agencies, to faith groups, who in different cities and towns across Canada said, "We need to respond to support people experiencing homelessness and to make this work to save lives." We saw the development of hotels, and motels, recovery programs.

I had the distinct pleasure and continue to be the medical director for the Region of Peel's COVID-19 Isolation Housing Program. The development of these programs that we saw spread up all across Canada. This was an amazing feat. It actually showed me that there's a lot more ability for us to collaborate and make magic happen than we thought. Before COVID, it was always, "There aren't resources, and we can't make that happen." Look, COVID showed we could do it. I always say, "COVID has proven we can cure homelessness if we really want to." That's really exciting.

On the flip side, and it's more of a negative tone, I also saw the increase in criminalization of poverty through and through. In cities like Toronto, the people I care for used to maybe get ticketed if they were panhandling. Now, we saw actually violent encampment clearings by the City of Toronto and Toronto Police. This happened in many cities across Canada, where they were actually sending drones, horses, police, and militarized operations to remove people.

One report done by the media here in Toronto, they removed 60 people from parks in Toronto and spent $2 million. That equates to about $33,000 per person. Imagine if that money was just spent on housing. Well, in one way, we saw the rise of empathy, compassion, and collaboration is magic to respond to the needs of people experiencing homelessness. Our cities and police forces across Canada actually criminalize poverty in a way that I've never seen before. This should be concerning to people who are listening to this discussion.

Erin: Now that our eyes are open, what would you suggest we do so that we don't see a clearing like we saw before, but that the city gets to reclaim the open spaces and safe spaces for families? Where's the compromise? Where's the common ground, Doctor? What would you have done?

Dr. Dosani: Well, I think we need to really ask ourselves about these incredible programs that have been developed across the country. These COVID recovery models are potentially new best practices that will allow us to help people off the street and give them a pathway and then provide social and healthcare supports for them. Then, of course, hopefully, support and empower them to be on a pathway towards housing from those sites.

Many of the leases on these COVID recovery models across Canada are actually ending very soon. I would be really disappointed if cities across Canada and our country said, "Yes, that was COVID. COVID's over now. Go back to the streets and in shelters. Go back to how things were." No, our legacy, the silver lining of a post-recovery world is that we can actually end homelessness.

I think we also need to really think about some of the assumptions we make when we're having these conversations. Some of the politicians made statements that these people were making parks dangerous. Well, in actuality, there's very few reports of that. When you look at the data, there was accusations that they were starting fires. There was, again, very little data to prove that. There's a lot of bias and stigma and discrimination that comes into that.

The other thing is just to recognize that these are people with complex issues, complex feelings of hurt, and loss, and trauma, or sometimes mental illness, other physical illnesses. We need to build relationships with them. Of course, there is a desire to get people housed and connected, but if people don't feel safe with their options, we need to listen to them.

Instead of putting the onus on people who are in encampments to find the solution, let's put them back on our politicians who have to respond to these feelings and just say it's their duty to make these spaces safe. That means increasing the amount of affordable housing supply in this country and making sure that this housing supply is high quality and safe for people because housing is a human right.

Erin: You've also said that housing is healthcare. Can you explain this and why you believe this, Doctor?

Dr. Dosani: I think in 2021, we're pretty much in agreement that the social factors that impact healthcare impact health outcomes. This includes people who don't have a home, people who don't have money, people who don't have access to food, security, and so homelessness or houselessness, the state of being itself is a risk factor on health.

I shared some of these statistics earlier with you just to say that just not having a home itself is a serious and often life-limiting disease. It can take 50% of a person's lifespan away, so when you actually provide housing, and then you also provide access to social and healthcare supports, people can dramatically heal from their mental health to their physical health, just feeling dignity in society and feeling a sense of purpose. You can really work to heal people, even if they're really sick.

When we say housing is healthcare, we're trying to really frame housing as a healthcare issue because it actually has impact on healthcare outcomes, not to mention the outcomes that it has on society. It saves money. We know through the Housing First study done called the At Home/Chez Soi demonstration project, which was a three-year study done in Canada between 2014 and 2017. We know that for every $1 that went into housing for people with severe mental illness, Canada got $1.87 back. Not only does it make people feel better, it saves us money in the long run. It has the potential to save us millions and even billions of dollars over the years. That's what we mean when we answer that question.

Erin: Coming up, using social media to spread the word, and how the doctor uses various platforms to lift himself up and get his message out. You can do it too. When you volunteer your time, make a donation, or raise funds for a cause you truly believe in, you're making a difference in your community. Post that inspiration and have an impact by sharing your story online using #REALTORSCare.

Now, you've got a big following on social media, Doctor, which you use to help destigmatize homelessness and poverty. Do you think the message is getting through? How do we go about becoming better informed about these issues?

Dr. Dosani: I'm always honored to be supported by a community that just really cares. I'm actually blown away at the emails and messages and tweets I get and posts on Instagram and people commenting about how they believe in this issue too. They believe that health equity is crucial to a brighter future, but the reality is if you go and survey most Canadians, many people still believe that people who experience homelessness are lazy. Many people believe they did it to themselves. Many people believe people are choosing to be on the streets and in shelters.

Having cared for so many people over the years, I've never met one person who wanted to be in the situation that they're in. Don't get me wrong, some of the people I care for may have made a bad decision, a decision you and I might not make perhaps, but really, there are structural factors at play that cause homelessness.

We need to destigmatize homelessness from "a person who did it to themselves" kind of view or blaming people for their situation and start looking at things structurally because we know that there is not enough affordable housing in this country to support people. We know that there has been a weakening social safety net at the federal, provincial, regional, and city levels over the last three decades around healthcare, social assistance, PharmaCare, social supports. This has led to this trajectory of people experiencing homelessness.

We're seeing a growing trend of people who are older and frail, who are experiencing homelessness for the first time after the age of 50. This is a growing trend. This is one of the elements of capitalism on steroids. We really need to think about that. I hope that through my posts on social media, we're able to send those messages across and sometimes telling a compassionate story that derives empathy from people. Sometimes it's just using capital letters and yelling because you just think there's no other response. There is no other way to respond. It depends on the day, maybe the hour.

Erin: Yes, right. Are you seeing progress in terms of people's perspectives or willingness to help? I'm thinking, you don't have to be a Dr. Dosani or a Nurse Ahmed or somebody with a degree in order to help you. Are you seeing more people saying, "What can I do? I want to dive in."

Dr. Dosani: I think the COVID-19 pandemic shined the light on inequities in a way that we have not seen for quite some time. People are more aware of these issues. That might be a silver lining of what happened during COVID. The fact that despite the inequities we saw, we did see more focus on these discussions, and that is power in and of itself.

I was blown away to see the response when cities, like Halifax and Toronto and other cities, actually criminalized poverty and supported violent encampment clearings. We saw the public come out, actually step out to support their unhoused neighbors. We saw people tweeting, posting on social media. We saw outrage, so yes, I do believe there's progress, and people's perspectives are changing.

In terms of how Canadians can become better-informed, I think there's often a desire to go out and act, and I'd say the first step is to become informed, so to listen first. I'd encourage people to visit homelesshub.ca, the York University Observatory on Homelessness, which is a great repository of information on homelessness, both social health and other spheres.

I'd also encourage people to check out the Canadian Alliance to End Homelessness, who is doing excellent work to advocate for strategies and pathways to ending homelessness through policy, through real change on the streets, in shelters, in our communities. Their website is a really great resource as well.

I think those two resources have been helpful for me. Also just seeking out locally, who are your local respite shelters, drop-ins? Who are the activists who are doing this work? Follow them, support them, support their causes in your local communities because they need your support to derive health equity in your community.

Erin: That may go hand-in-hand with this next question for you because, of course, as you know, this episode is complementing REALTORS Care^® Week 2021. During this, real estate boards, associations, and their REALTOR^® members are making a collective impact volunteering in supportive housing and shelter-related charities right across Canada. Your advice to any organization, institution, or individual, Doctor, looking to volunteer their time or resources, go to homelesshub.ca, Canadian Alliance to End Homelessness. Anything else that you can recommend?

Dr. Dosani: Look, first, the REALTOR^® community is a very special community. I'd first appeal to them by saying REALTORS^® are as much or more than anyone else, a person who understands how much a home can mean to a person. There are thousands of Canadians who are dealing with life-threatening illnesses, the illnesses of not having a home, or what that means for them. You can play a real role. You can actually support the creation of new affordable housing. You can help on a policy level. Can you help local charities?

REALTORS^® in Canada are often community leaders and influencers. Can you help to create and support community leaders who are working to end homelessness? Can you help to rally their communities, their communications, and their actions? REALTORS^® are also respected voices on housing issues. When the Canadian Alliance to End Homelessness or other institutions or organizations worked on policy, can you be powerful? Can you be influential? Can you join us in our campaigns?

Then finally, a lot of the time, the solution is really supporting people with resources. Many of the campaigns that we're working on need money, need support, donations. There's a bazillion REALTORS^® in Canada, you guys are awesome. Your money and supports can really actually make a huge change. I think any opportunity to speak out around policies that will create a more affordable housing supply or directly support through in-kind support, these campaigns will make a huge difference, we need you.

Erin: What a great message. How do we go about ensuring, Doctor, that our support is meaningful for both parties? That we gain empathy and perspective as volunteers, not just showing up and getting that reward of making a difference? What's your recommendation there to find that support meaningful for both sides?

Dr. Dosani: For sure. I reflect on two concepts here. The first is that sometimes when we go out to do good for communities that experience structural vulnerabilities, sometimes we project what we feel is the best thing for a community on that community. I'd ask you to not project what you think is best for people experiencing homelessness, but seek out the answer to that question, "What is it that the community I live in needs?" You'll learn.

If you support your local shelters, respites, drop-ins, housing agencies, case management programs, they'll tell you like, "We need money today because we are out of our compassionate funding," or, "We're doing a sock drive, people need socks, we need socks. We don't need shirts, we need socks." Very specifically. Listen to the communities that do this work and what they need, and they will guide you.

The second concept is reflect on your vulnerability. I will say that COVID-19 put us all in very unique situations where we all had this experience, where no matter – whether you lived in a home and felt very supportive, or you live on the street, or in a shelter, everyone felt vulnerable during this time. It was hard not to because of this virus and this pandemic.

I know people were thinking about what their mortality or their death might look like, people were thinking about like, "What if I go to hospital?" Tap into that vulnerability. I know that many people have moved on, and life is moving on, but don't lose sight of what it was like to feel vulnerable, because if you tap into that, you have the potential to derive empathy and compassion for a community in Canada that does not have a home and do not have homes because of structural issues. Tap into that, tap into your empathy and compassion. I know you'll find the way.

Erin: That's amazing, it really is the strength and vulnerability. Many people just moved on from it, said, "Okay, what's next? We're going to be okay."

Remembering how we felt the most vulnerable, we felt most of us in our lives. Thank you for reminding us of that. As we wrap up our chat for today, Doctor, and thank you again so much for your time. It's amazing to look at the calendar. It's felt like the longest year, and yet it's amazing that 2021 is almost done. What has been your biggest takeaway from this year of so many images? How are you hoping to finish it off?

Dr. Dosani: I learned that despite our best efforts in society, even in the midst of a serious pandemic like COVID-19, we may have tried to all be in it together, but we were not. Some of us were in yachts thriving through this pandemic, and others were in life rafts barely surviving. What I do appreciate is that we can have a conversation about this. I can say this to you, Erin, and this resonates, it's hard to deny that that's true. We saw the outcomes on people's experience during COVID-19.

The silver lining for me is at least we're having the conversation. At least inequity is on the radar for people. Look, we're doing this recording. It shows me that we are moving towards a society where we are thinking about the impact of a lack of housing for social assistance rates, PharmaCare, and the need for PharmaCare for people.

We're thinking about food insecurity in unique ways and other kind of social inequities that really are impacting people in our communities. It's everybody's business. Everybody's responsible to derive equity and justice for the people around you.

Erin: Do you think it's possible?

Dr. Dosani: I do, I really do. There's something called the spirit level, and there's a famous book that was written about it that societies that are more equitable, people actually tend to be more happy, there's less crime, the spirit level rises.

Actually, I'm hopeful of the fact that people recognize that when we are more connected, when we are more socially supported, and when people are not marginalized, people do better in all aspects of the world and in society. If this little dive into the world of palliative care, and what it's like to support people who experience homelessness gets us there or one step towards that place, then I think this was a good time. I think this was totally worth it.

Erin: Oh, what a great conversation. Thank you so much for honoring us with this. Thank you, Dr. Dosani, so much.

Dr. Dosani: Thank you, Erin, really appreciate it. To all the REALTORS^® out there, thank you so much for everything you do, I appreciate your time.

Erin: As we do appreciate yours, Doctor, not that there's a lot of it.

Learn more about Dr. Naheed Dosani and how you can help him make a difference right across Canada, and as he stresses, locally, where you are. Again, that website he mentioned is homelesshub.ca, and check out the Canadian Alliance to End Homelessness.

REAL TIME is a production of Alphabet^® Creative, Real Family Productions, and Rob Whitehead. I'm Erin Davis. We invite you to join us for our next episode of REAL TIME, brought to you by The Canadian Real Estate Association when we'll sit down with the incredible Stefan Swanepoel, a leading visionary of real estate trends. It promises to be exciting, and you don't want to miss it, and so you don't because we know you're busy. Subscribe to our channels on Spotify, Apple, and Stitcher, and we'll talk to you again soon on REAL TIME. Thanks for coming by.