In a previous post, I talked about how, for some people, the streets become the first place where they truly feel like they belong. That idea has stayed with me because I think it challenges a lot of assumptions people make about homelessness and addiction. It also made me think about another side of this work that I don’t often talk about, and that’s what happens when the people you’re supporting aren’t strangers.
When you work in a small community like I do, it’s almost inevitable that you’ll end up caring for people you know. Some are people I went to school with, some are people my brothers grew up with, some are people my family has known for years, some are my family, and some I’ve met through Council, community events, or simply because our lives have crossed paths over time. Living and working in the same community means those lines are bound to overlap.
Working in healthcare, especially in mental health and substance use, I’ve always tried to navigate those situations carefully. The last thing I would ever want is for someone to avoid seeking care because they know me outside of work.
That was especially true when I worked on the psychiatric unit. There is already so much stigma attached to accessing mental health services. People worry about being judged. They worry about someone recognizing them. They worry that people will look at them differently once they know they’re struggling. Those fears are understandable, and they’re a big reason confidentiality is such an important part of healthcare. Confidentiality isn’t just a policy. It’s one of the foundations of healthcare. In a small community, protecting someone’s privacy becomes even more important because our lives overlap in ways they might not in larger centres.
Depending on the situation, I would often let the person decide whether they wanted to acknowledge that we knew each other. Other times, if it felt appropriate, I would wait until they weren’t surrounded by friends or family before introducing myself and reassuring them that anything discussed would remain confidential. There have also been times where I’ve offered people the option of seeing another nurse if they were uncomfortable with me being involved in their care. Sometimes they accepted that offer. More often than not, they were relieved to see a familiar face during what was likely one of the most difficult moments in their lives.
Knowing someone personally doesn’t give me permission to know more about their life than they choose to share with me professionally. If anything, it requires me to be even more intentional about maintaining those boundaries.
Over the years, though, I’ve realized there’s another lesson hidden in these encounters. It’s very easy to believe that because we know someone, we understand their story. The truth is, we usually don’t. We know the version of them that existed when our lives happened to overlap, but we rarely know everything that came before or everything that happened after.
I’ve always found it interesting that even within my own family, my brothers and I can remember the same events completely differently. We grew up in the same house, with the same parents, and experienced many of the same things, yet our memories and perspectives often aren’t the same. Our personalities, relationships, experiences, and the meaning we assign to different moments all shape how we see the world. If that’s true within a family, imagine how much we don’t know about the people around us.
I remember when someone whose life had intersected with my family’s over the years became one of the people I was supporting. I wasn’t sure if they even knew who I was, and I certainly didn’t want to assume that because I knew their family, I had any place in their life. One day, I saw them sitting alone on the sidewalk, so I went over and sat down beside them. I asked if they knew who I was, and I was surprised when they smiled and said, “You’re Faye’s daughter.”
It was a simple exchange, but it reminded me how complicated our connections to people really are. We often think we know someone’s story because we’ve known them for years, because our families know each other, or because we remember one chapter of their life. In reality, we’re usually carrying around our own version of who they are, not the whole picture.
That conversation also gave me the opportunity to explain something that I think is incredibly important. I told them that I would never share anything about them with anyone without their consent. I wanted them to know they never had to worry about me discussing their care with family, friends, or anyone else simply because our lives had crossed paths outside of work.
Over time, they came to trust me. Every now and then they would ask me to pass along a message or share something with a family member. Those moments weren’t meaningful because I knew them personally. They were meaningful because trust had been built through respect, consistency, and clear boundaries.
People often assume they understand why someone is struggling because they know where they grew up, who their parents are, where they went to school, or what they were like years ago. They connect the dots using the pieces they’ve seen, often without realizing how much of the story they’re filling in themselves.
The reality is that by the time someone is sitting across from me, they have lived thousands of experiences that I know nothing about. There are losses they may never speak about, relationships that shaped them, trauma they don’t have words for, moments that changed the direction of their life, and battles they’ve fought quietly for years before anyone else noticed they were struggling.
Sometimes those stories come out over time. Sometimes they never do. Either way, it isn’t my job to fill in the blanks with assumptions.
One of the questions I’m asked most often is how someone could seemingly choose substances over their children, their family, their home, or everything they once had. I understand why people ask that question because, from the outside, that’s exactly what it can look like.
The reality is that addiction is rarely about choosing one thing over another. By the time someone reaches the point where they’re living outside, cycling through shelters, or using despite devastating consequences, their story has usually been unfolding for years. What we’re seeing isn’t where their story began. It’s simply the chapter where our paths happened to cross.
That doesn’t excuse the harm addiction can cause. Families are hurt. Children are affected. Relationships fall apart. Those realities deserve to be acknowledged. What I’ve learned, though, is that judgment rarely changes someone’s direction. Connection does.
When people feel safe enough to trust you, they begin sharing parts of themselves that they’ve often carried alone for a very long time. Sometimes those conversations lead to treatment. Sometimes they lead to healing. Sometimes they simply remind someone that they’re still worthy of compassion, even if they don’t believe it themselves. Not every story ends the way we’d hope. I’ve lost far too many people over the years, and those losses never really get easier.
One of the hardest parts of this work is that my nervous system is on high alert for my entire shift. Every radio call, every raised voice, every person who doesn’t respond when someone checks on them, every knock on my door has the potential to become someone’s worst day. It’s difficult to explain what that does to a person over time, especially when many of the people you’re caring for aren’t strangers. Maybe that’s part of why I’ve learned to hold people’s stories a little more carefully.
Knowing someone’s story isn’t the same as knowing their whole story. Most of us only ever see the chapters people are willing, or able, to share with us. The rest we fill in with assumptions, often without even realizing we’re doing it.
If this work has taught me anything, it’s to stay curious a little longer, judge a little less, and remember that every person is more than the worst thing that’s happened to them. We may never know everything that brought someone to where they are, but we can always choose how we meet them when they get there.
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