Fabrizia  Faustinella is a physician and film maker. She grew up in Italy and moved to the United States where she practices as an internist in the Texas Medical Center in Houston, Texas. Her career goal is improving the health of the patient population through service, education, research and scholarship. The care of the undeserved and the homeless has inspired her to write about her experiences in several patient-centered essays which have been published in academic and literary journals alike. Dr. Faustinella is also a film writer, producer and director with an interest in social problems. She has received national and international recognition for her short movie productions. She recently wrote, directed and produced The Dark Side of the Moon, a feature length film-documentary about the root causes of homelessness and the hardship of street life.



Fabrizia Faustinella

I experienced the desire to become a physician at a young age. I thought that there was nothing better than restoring people to good health and making them whole again; giving them back to their families and to the life they had before. I wanted to save them all. I wanted to save the world. But eventually, I came to realize that this was not possible. The downsizing of my dreams led to a deeper search for meaning in life. Often, I saw how small kindnesses could go a long way. Small kindnesses show that we care, that we see and value the person in front of us, and have healing powers that go beyond prescription drugs and surgical interventions. As I provide care, among others, to a large number of homeless people, the importance of warmth, sympathy and understanding becomes even more apparent and necessary in the face of their tragic life circumstances and their struggle for survival. Their stories have inspired me to gather testimonials and interview people out in the streets, which led to the development of a film documentary, entitled The Dark Side of The Moon. The documentary explores the root causes of homelessness and the challenges of street life, along with societal biases and prejudices towards homeless people. It also shows how a difficult upbringing, amidst abuse and neglect, can have a devastating impact on the cognitive and physical development of a child, perpetuating the tragic cycle of homelessness.

           Last year, I was invited to attend a conference on “Homelessness in Western Society” where the  documentary  was shown to the attendees. The viewing was followed by a discussion and Q&A session. The expert panel was comprised of physicians, social workers, politicians, and representatives from a number of organizations with expertise in the subject matter. Among them there was also a slender young man in his twenties who had experienced homelessness and was now living at a shelter. He was enrolled in a special program aimed at training people to reenter the workforce. The young man was carefully listening to what was being said. One of the panel members, a university professor in an elegant gray suit, stated that it was not good to give people out in the streets food or money or any other item that could have made their lives a little easier, as to discourage them from panhandling and push them to seek help at local shelters and at the various city homeless organizations. I noticed that the young man didn’t look happy, and he asked to make a comment. The microphone was handed to him. He said that he understood how some people could and would misuse money and buy cigarettes or alcohol or drugs rather than food, but not everybody was like that. He said that people out in the streets appreciated some help, a cold bottle of water in summer or a warm cup of soup in winter; he said that often the shelters are full and there is not enough room for everybody, so it was not realistic to think that all people out in the streets would be able to find reasonable accommodations to spend the night or soup kitchens for a meal. He cleared his throat and said, stammering a little, that when he was out in the streets on a very cold winter night, somebody drove by and handed him a blanket, and that made a big difference for him.

           After his intervention there was silence. I saw people in the audience nodding; others looked puzzled. After all, everybody was there for the same reason: finding ways to put an end to homelessness and do the right thing. The young man stepped down from the podium. He walked toward the exit of the conference hall, looking down, seemingly in deep thought. He did not return. I couldn’t help but feel bad for the young man. Hearing that kind gestures should be discouraged because they don’t contribute to solving the root causes of the problem, it did seem harsh and heartless. Why deny food and water or an extra item of clothing to a human being struggling out in the streets? On the other hand, it is true that I also have sometimes regretted donating money, as it became painfully apparent to me that it could be used indeed to buy drugs and alcohol instead of food. I’ll never forget the pregnant woman at the bus stop, passed out and clearly intoxicated, coincidentally after I had left her cash, as she rejected the sandwich I wanted to give her.  Should we then really refrain from giving money out to the needy? Someone told me once that it’s still the right thing to do and it’s up to the person receiving it to spend it wisely. But what if, for whatever reason, they can’t or don’t want to spend it wisely? With all those conflicting thoughts in my mind, I excused myself and got up from my chair, as I was in a hurry to leave. Family and work commitments had made my schedule very tight. The conference was coming to an end anyway and I had a plane to catch. So I retrieved my luggage from the hotel concierge, got in a taxi, and went to the airport.

           It was a full flight. I was one of the last passengers to board the plane, and I found myself stuck between two people. A younger man was sitting in the aisle seat. He seemed exhausted and ready to fall asleep. To my right, in the window seat, there was an older man with thick-rimmed eyeglasses. He had a jolly, round face with rosy cheeks. He was wearing a blue shirt, nicely ironed, and jeans. He looked neat and clean, unlike the younger man to my left, who looked like he had jumped out of bed a few minutes before getting to the airport. I wondered if he even had brushed his teeth.

           The older man greeted me with a smile. Very politely he asked me if the sun coming from the window bothered me and if I would have preferred to have the shutter lowered. I told him to do whatever worked for him best, as he was watching a football game on his PC, and it would have been difficult for him to see the action through the glaring screen. He lowered the shutter and thanked me. Then he added that he had eye surgery not too long ago to fix a problem with his retina and that the sunlight was still disturbing him, but he wanted to make sure that it was fine with me to close the shutter. How kind of him to have so much regard for others, I thought.

           After the plane took off, the flight attendants came by to ask what we wanted to drink. The older man next to me said he was fine and didn’t ask for anything. I thought he might have had a bottled drink with him or maybe he wanted to avoid fluid intake as not to have to get up and go to the bathroom too often. Eventually he pulled a bag of salted peanuts out of his briefcase and started eating them. Inevitably something got stuck in his throat, triggering a dry cough. As one of the flight attendants passed by, he got her attention and asked, very politely, if she could please bring him a glass of water. While talking, he kept on coughing and clearing his throat. It was obvious that he badly needed something to drink.

           The flight attendant said, with a broad grin on her face, that she was not assigned to that area of the plane, and she would have to find her colleague and asked her to bring the water. She added, “Well, if I remember, I’ll get it for you, but I might forget . . .” her white teeth showing from side to side. She was all dolled up, wearing a bold red beret, a flashy necklace, an unreasonable number of jingling bracelets, her blue uniform studded with pins and a large broach in the shape of a big heart on the upper right side of the jacket. She moved along, all smiley and bouncy, and disappeared, never to be seen again. Her colleague never came with the water either. I thought that she must have forgotten to tell her about it. The old man never said anything and didn’t try to get the attention of the flight attendant anymore. The cough eventually calmed down.

           We were getting close to landing. During the taxi phase that same flight attendant with the red beret took the microphone in her hands and thanked everybody for choosing that particular airline. Then she said that she wanted to dedicate a beautiful song to all of the passengers on board; she said she was a singer and was waiting for her breakthrough. So she started singing. I don’t remember the lyrics word by word, but the message was something like: “Let’s be there for one another, let’s make the world a better place, let’s bring love into our lives and be kind to our neighbors.” Everybody cheered and clapped and commented on her crystalline voice, cheerful demeanor, and seemingly kind spirit.

           The old man and I exited the plane at the same time and walked together to the terminal. After a few moments of silence, I blurted out the thoughts that had been swirling in my head for some time:

           “Sir, I just want to tell you something. I want to say that I cannot believe that the flight attendant didn’t bring you any water. How busy was she? Why did she even have to ask her colleague to do that? And how could she really forget to do something so simple? She didn’t have to walk that far to get the glass of water and bring it back to you. It’s an airplane, for God’s sake, not Tiananmen Square! I’m sorry I did not have an extra bottle of water for you . . . And then she sang that song all full of altruistic sentiments. What was that all about if she can’t even bring a glass of water to a passenger who really needs one! You know what? She totally failed to perform her job duties, she was unkind, and then she sang about the importance of being there for one another.”

           “Oh, no worries. I noticed that but, you see, she’s one of those people who are busy saving the world and can’t take care of a small, inconsequential starfish.”

           “A starfish?” I asked with what it must have been a puzzled look on my face.

           “Yes. Have you heard the starfish story?”

           I shook my head and raised my eyebrows.

           Then he started:

           “There was a boy on a beach picking up starfish and throwing them back in the ocean. An old man questioned him about it and said that there were too many of them to really make a difference. The boy then threw another starfish back into the surf and said: ‘I made a difference for that one.’"

           “You see? People think of humanity as a whole and don’t see the individuals crossing their path . . .”

           It occurred to me that the story exemplified the different philosophies of life that I had seen clashing earlier in the morning at the conference. What the young homeless man said was an attempt to call the attention to the plight of the single individual, the starfish, as opposed to focusing exclusively on the problem at large and ignoring the human being in front of us.    Also, what he was saying is that we should give people the benefit of the doubt and not always assume the worse. So it became more apparent to me that in order to do good we have to keep an open mind. Our small acts of kindness don’t save the world, but they still make a difference, in that moment, for that specific person. Although this might feel like a drop in the ocean, we should not be deterred from trying. Each life we touch matters, even if it is only one, and there is where saving the world should really start.