I have had the pleasure of working with amazing people in the various Healthcare for the Homeless community clinics over the four decades of my career as a public health nurse/family nurse practitioner. Physician Assistant and former military nurse Mark Aytch is one of these people. Especially on this Memorial Day weekend, I want to call out a compassionate and committed veteran. Mark was a military nurse on three tours of duty in Rwanda, the First Gulf War, where he was stationed in Kuwait, and then in Bosnia. He returned to the US, settled in Seattle, and worked as a nurse and then PA in our area VA hospital before focusing on care for people experiencing homelessness and extreme poverty. I worked with Mark at the 45th Street Homeless Youth Clinic where I volunteered and then worked as a nurse practitioner for sixteen years.

When I interviewed Mark on March 22, 2017, we worked together at the youth clinic. The t-shirt he is wearing in this photograph represents some of his work as an activist, in this case, the No New Youth Jail movement--advocating for a different approach to the then-large King County Youth Detention Center with its overrepresentation of Black young people. Too many of the young people we worked with in the clinic cycled between homelessness and detention. Too many of them were recruited from the streets into active duty, only to return to the streets but now with significant PTSD and physical injuries. I'll never forget the evening one such homeless young man came into our clinic clutching a note from the VA documenting his head injury but saying they couldn't provide follow-up medical care--could we please help him. Heartbreaking and infuriating.

Of his early work, Marck stated, "I started working at the VA Hospital. There’s lots of crossover between the homeless community and the veteran community. And I was seeing Vietnam vets with poorly treated or untreated posttraumatic stress disorder walk out of my office just as I was seeing, you know, 21-year-old Iraqi vets walk into my office with poorly treated or untreated PTSD."

Homelessness rates among US veterans have been a national disgrace for a long time, all the way back to the Civil War. During President Obama's two terms, he made housing veterans and providing better healthcare through the VA priorities. The Department of Veteran's Affairs began specialized homeless programs, including in the Seattle area. As a result, homelessness among veterans was reduced but has begun to creep back up since the COVID-19 pandemic.

Mark ends his interview by saying, "My patients often say they feel invisible. I wish more people would just say 'hi,' or say 'no, I don't have money,' But don't ignore them."