NONFICTION - Sept. 4, 1994

NOT ALL OF US ARE SAINTS: A Doctor’s Journey with the Poor by David Hilfiker M.D. (Hill & Wang: $23; 232 pp.) “I came to the inner city (to practice medicine) in part because I believed that poverty in our country was more a matter of injustice than personal characteristics or bad luck, . . . I came, in other words, with hope: If poverty were the result of oppression, then even a small group of affluent people could make a difference.” This belief brought Dr. David Hilfiker from a small family practice clinic in rural Minnesota to the ghettos of Washington, where he worked and eventually lived in Christ House, a medical recovery shelter for homeless men. “Not All of Us Are Saints” is an account not only of his experience but also a plea for greater understanding of the complex problems facing poor and homeless Americans. Hilfiker’s writing is amazingly honest. He never flinches from unearthing his own motivations even when the result is less than flattering. One patient in particular, a mentally deficient alcoholic man with severe health problems, provokes Hilfiker to examine prejudices--both his own and society’s. “When a middle-class black person or a white person of any class comes into the office, I pay more attention. I pay a different kind of attention. Perhaps it is simply that in these other patients I can see myself or someone closer to me.” This is a difficult thing for many people to admit, let alone someone who is committed to helping low-income people.

Where “Not All of Us Are Saints” falters a bit is in scenes with dialogue and description. Hilfiker’s strength clearly lies in his passionate exploration of our culture and of his own heart, since too often the writing becomes stilted when actual people are involved. This doesn’t, however, detract much from what is ultimately a brave and caring look at some of the terrible problems in health care today.