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Lopez: A renegade M.D. administers aggressive treatment on Skid Row streets.

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The team gathered at 4th and Crocker streets and headed south, into the blue-tented netherworld of social collapse, armed with life-saving drug-overdose kits and injectable, long-acting anti-psychotic medication.

“We’re trying very aggressive treatment on the streets,” said Dr. Susan Partovi. “Housing definitely saves your life, but there’s a small sub-group of people who won’t accept housing because of their mental illness.”

She figures that if she administers medication that lasts a month and can help stabilize patients — with their consent — they’ve got a chance.

“They don’t think there’s anything wrong, and they think they don’t need housing,” Partovi said. “They don’t think rationally, and so once you treat their delusions and their irrationality, they start to realize, ‘Oh, I do need resources.’”

California is about to be hit by an aging population wave, and Steve Lopez is riding it. His column focuses on the blessings and burdens of advancing age — and how some folks are challenging the stigma associated with older adults.

Partovi, who began practicing street medicine in 2007 in Santa Monica, has never been shy about her lack of patience with the official response to the entrenched humanitarian crisis. In 2017, I shadowed her as she walked through Skid Row with County Supervisor Kathryn Barger, advocating for broader authority to assist those in obvious acute mental and physical distress, even if they refused help, and despite opposition from civil rights attorneys and others.

By administering long-acting meds, Partovi—author of the just-published “Renegade M.D.: A Doctor’s Stories From the Streets”—is once again pushing boundaries. She’s acting out of a belief that her approach is medically sound, and with frustration sharpened by her street-level view of the countless bureaucratic cracks and canyons in the system. She’s driven, too, by an uncompromising compassion for homeless people who are so sick, she can sometimes predict who will die next.

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Critics might say a person in the throes of impairment isn’t competent to give consent for a month-long dose of medication, and that such meds are neither a panacea nor a substitute for intensive ongoing case management. But to Partovi, the slow pace of intervention — along with multiple daily deaths on the streets — add up to a human rights violation and a moral failure, so she’s stepping into the breach.

But she’s not a psychiatrist, and her street medicine team’s approach is not fully embraced by the L.A. County Department of Mental Health. DMH has psychiatric street medicine teams operating in several parts of the county. The Skid Row unit —which is led by Dr. Shayan Rab and includes psychiatric nurses, social workers, and addiction counselors, and sometimes conducts sidewalk court hearings for those who resist treatment — was featured in a September 2022 article by my colleague Doug Smith.

He told me he has used both short-term and long-term anti-psychotics, depending on the situation. The risks posed by medication are not as great, he said, as the risk of being homeless, sick, and untreated.

“The need is so dire, and the patients are dying at such a young age, and the lack of available psychiatry is so marked,” said King, who leads a street medicine team through Westside streets four days a week and often works with a psychiatric nurse practitioner. “We’re not doing this in any sort of cavalier fashion. We’re doing it very thoughtfully with a mind to knowing our medications and knowing our diagnosis and treatment are based on a ton of experience and a lot of exposure to working side-by-side with psychiatrists in the field.”

In 2020, I wrote about a formerly homeless Santa Monica woman whose life had been turned around after King treated her for her addiction and physical and mental ailments. The treatment included a long-acting injection the woman agreed to, and when I met her, she was living in a hotel before moving into housing arranged by the outreach team.


When I met with Partovi last month on Skid Row, her team consisted of Dr. Steven Hochman, an addiction specialist; David Dadiomov, director of USC’s psychiatry pharmacy program; and social worker Sylvia Meza. It was Meza who established this nonprofit outreach team — it’s called SUDIS, for Substance Use Disorder Integrated Services — and brought in Partovi as medical director last year.

Dr. Steven Hochman, left, Dr. Susan Partovi and Sylvia Meza check on the well-being of a man in downtown L.A.
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Chats and reflections on the present moment.

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Lydia Polgreen

Credit…Will Heath/NBC, via Getty Images

It is a rare thing in our rapidly secularizing country to be confronted with piety and devotion in popular culture. So it was a surprise, and a balm, to watch a man who prays daily and talks openly about his devout faith storm a bastion of earthly godlessness: “Saturday Night Live.”

I am referring, of course, to the comedian Ramy Youssef, who hosted the show on what he described in his opening monologue as “an incredibly spiritual weekend,” noting Ramadan, Easter and the arrival of a new Beyoncé album.

“I’m doing the Ramadan one,” he quipped, to peals of laughter, unspooling a very funny bit about how loving Muslims are. Youssef has mined his experience as a believer among the profane in gentle standup specials and a namesake sitcom. His entire monologue glowed with a welcoming warmth — Muslims, he seemed to say: We’re just like you.

In a country that is supposedly obsessed with diversity and inclusion, it is remarkable how rare it is to hear from a practicing Muslim in America.

Surveys by the Institute for Policy and Understanding, a nonpartisan research organization focused on Muslim Americans, have consistently found that Muslims are the most likely group to report religious discrimination in the United States. According to a Pew survey conducted in 2021, 78 percent of Americans said that there was either a lot or some discrimination against Muslims in our society. Muslims are no more likely to commit crimes than members of any other group, but crimes in which Muslims are suspects get outsized media coverage, research has shown.

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It is no surprise, then, that Islamophobia is perhaps the most tolerated form of religious prejudice. Right now, Senate Republicans appear to have persuaded several Senate Democrats to vote against a Muslim judicial nominee after smearing him, with no evidence at all, as an antisemite.

Many of the skits that toyed with religion on “S.N.L.” on Saturday were funny — Ozempic for Ramadan! Genius. But part of me winced through them as well, because I saw in Youssef something that other members of minority groups have had to do to “earn” their place in the safety of the mainstream: the performance of normalcy, of being nonthreatening and sweet, the requirement to prove that your community belongs in America just like everyone else’s.

I loved Youssef’s monologue, in which he bravely pleaded, “Please, free the people of Palestine. And please, free the hostages. All of the hostages.”

“I am out of ideas,” Youssef declared toward the end of his monologue. “All I have is prayers.”

To which this nonbeliever can only say: Same, Ramy. Same.

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