Memorable Patient Encounter

“I live in the swamp”

An encounter with a homeless patient made me rethink how to help the poor.

About 10 years ago, I joined the staff at the Florida Lions Eye Clinic in Bonita Springs, Fla., which examines patients free of charge if they have no insurance and income under 200% of the federal poverty guidelines. I still work there today, and I clearly remember one woman I saw about seven years ago who changed the way I thought about my patients.


“Jennifer,” a 45-year-old woman, came in for a complete eye exam after breaking her six-year-old glasses. She was short and dressed in slacks and a blouse — overall, nothing that distinguished her from the other patients we saw in the clinic.

Her exam was unremarkable, and we prescribed new bifocals and referred her to LensCrafters’ OneSight program to get free glasses.

It wasn’t until we asked where she lived that we realized something was different about her situation. After a brief hesitation, she responded, “I live in the swamp.”

I asked her what she meant, and she said she had been homeless for eight years and camped out in the swampy area in Fort Myers. She said she had to walk through knee-deep water during the summer’s rainy season to her encampment where she slept. Living there was the only way to protect her minimal belongings from being stolen by other homeless people.

Jennifer’s story touched my heart — I knew we had many disadvantaged people in the area, but I hadn’t realized how many homeless there were, especially in the Fort Myers area. To further assist her, we gave her two pairs of donated eye glasses, supplied by our Lions Club, for distance vision and reading.

Howard Freedman, MD, performs pterygium surgery on a patient at the Florida Lions Eye Clinic in Bonita Springs, Fla.


I first became involved in the Florida Lions Eye Clinic after learning how many impoverished people lived only 30 minutes from my home; I used to travel the world on ophthalmology mission trips to help the less fortunate, but when I found out how many needy people were nearby, I wanted to do something for my neighbors as well.

Jennifer’s story about living at an even more extreme end of society added another layer to that, and it led me to contact a local soup kitchen. We began doing vision screenings there and handing out donated pairs of glasses to the patrons. We also arranged for transport from the soup kitchen to our clinic, so the attendants could more easily access our services.

While I personally haven’t seen Jennifer since that eye exam, it is possible she has visited one of several doctors we have at the clinic. Our Lions Clubs screen hundreds of needy people annually in Florida.

We are very fortunate to have the free Lions Eye Clinic where we can provide free eye exams, treatment and even surgical care in our small operating room for local-anesthesia cases, such as pterygium surgery and laser surgeries.

If other ophthalmologists want to give back to their communities, I strongly recommend they join groups, like their local Lions Clubs, to help the needy. OM