One day last month, a man hurried into the Catholic Worker free clinic off Kensington Avenue. He had heard a terrible rumor: His friend Johnny was dead in one of the heroin encampments in the neighborhood.
This was not unusual for Mary Beth Appel, a nurse practitioner and longtime volunteer at the rowhouse health clinic. Part of her job, at the heart of Philadelphia's overdose crisis, is sorting the rumors of the dead. Figuring out who made it into recovery, who is in a jail cell or a hospital bed, and who is gone.
This has always been a part of Appel's job. It has to be, in a place like Kensington, which has been plagued so long by poverty and drugs and diseases of despair.
Now fentanyl kills with ease, and more and more, when someone comes by the clinic, asking about a friend, it turns out the rumors are reality.
Appel dialed the Medical Examiner's Office about the man from last month. Yes, the forensic investigator told her, there was a John Doe found under the train bridge on Tulip Street. The people sleeping in the tents and on mattresses there called him Johnny. The investigator was running his fingerprints.
This is often the first step toward identifying the dead in a city where 1,217 people died of overdoses last year. So many of them come in with nothing, without even a name.
And sometimes, investigators turn to people like Appel, or the outreach workers at Prevention Point, or the St. Francis Inn, a soup kitchen. In the depths of this crisis, the outreach workers who have long worked to help people in addiction and poverty have increasingly become their representatives in death. They answer panicked calls from relatives looking for missing loved ones. They track down rumors for patients. They help the Medical Examiner's Office find loved ones, who sometimes were in varying degrees of estrangement with the dead. Sometimes the soup kitchen helps bury the deceased, in donated plots.
"We do our best to help them figure out who's who," Appel said.
The forensic investigator e-mailed Appel a photo of Johnny, to see if she could identify the restless man who used to sweep the tunnel under the Tulip Street bridge. She recognized his face but didn't know his name. The people at the clinic told her she had revived him with Narcan in the bathroom of the soup kitchen. She couldn't place the incident. They happen so often now.
But the fingerprints eventually came back, with a name: John Stevenson. He was originally from Havertown. He did some time in prison. The records showed that only two people had called him during a 2009 stint in jail. His mother, he had told people on the avenue, had died of an overdose before him.
There was no one to claim his body. All he had left were the people on the avenue.
In Johnny's case, his friends knew only fragments of his life. Others who have died were close with dozens who attend the clinic and the soup kitchen, who often have no space to mourn or memorialize their friends. No closure. Often, people on the avenue can't get to their friends' funerals, or aren't invited.
So they hold makeshift ones, on the street corners outside the soup kitchen, where the funerals are conducted not from an altar but from folding chairs and milk crates.
"There has long been an undercurrent of grief in this community that hasn't found a place to be expressed," said Johanna Berrigan, the clinic's cofounder. She and Appel are working to provide that place, at the request of their guests — a place for people to mourn.
The guys who sit on the folding chairs and crates, like Fred Early, who's been coming to the soup kitchen for years, came up with an idea: a march to the Catholic Worker house on Lehigh Avenue, where they would plant wooden crosses with the names of their friends who are gone. They've come up with 30 names so far. So many now dead of an overdose, some dead from violence, some from illness. Like the woman whose body Father Mike Duffy from the soup kitchen prayed over in the street, as he waited for paramedics. The list is growing.
It will include Johnny.