Community nursing concepts and issues in MacDonald's work

¶ … Souls: A Family Story from Southie by Michael Patrick MacDonald. Specifically, it will contain a book report on the book. "All Souls" is a memoir about MacDonald's family and the Old Colony housing project in South Boston. It covers any number of issues, but that includes community nursing and the concept of community. MacDonald's life was traumatic, but he returns to Southie as an adult because of the strong sense of community he felt there, and that says a lot about the people of South Boston.

The book's main topic is life in the community of South Boston, and how it affected MacDonald's family and the families around them. He shows the community as hard working, but very flawed. The people are poor, enmeshed in drugs and violence, and they receive little support from the police or the medical community. He is portraying a community and how it reacts to negative outcomes. The book is not directly related to community nursing, but there are situations throughout the book that indicate the medical community is not very supportive of the residents of South Boston. Early in the book, he writes, "Ma had no health insurance, and Medicaid was a year away. The hospital turned the baby away. Ma says the hospital had filled its quota of what they called "charity cases," and didn't need to take any more that night" (MacDonald, 1999, p. 19). The baby died, and that indicates the level of commitment in the medical community. They turned away a baby who needed treatment, something that would be unthinkable today.

He also describes his older brother Davey's treatment at the Massachusetts Mental Institute, also unthinkable today. At fourteen, he received shock treatments, and he was "never the same again" (MacDonald, 1999, p. 43). Health care treatment appears and reappears throughout the book, and usually in a negative way. It is clear that in MacDonald's youth, the health care community really did not care about the poor, and while that is not the central theme of the book, it is apparent even so.

The author is excellent at communicating the concept of community. He makes it quite clear that the people in the housing project are poor, but they have an extremely active social life and know each other like family. This is not a "normal" middle class community. The kids get into trouble; they smoke, do drugs, and cause mischief. Most of the families are on welfare and food stamps, so they all have that in common. Most of them are Irish and proud of it, which they also share. Some of the most important issues they community faces are the busing riots of 1974, when they protest their children being bused to Roxbury, a Boston black community. It brings the community even more together, and the author's mother volunteers for a city official to help with the protests.

One of the ways the author portrays the community is how involved the family becomes in a short time. He writes, "On some days I sat for hours at the window, watching the comings and goings on Patterson Way. In no time at all my own family had become part of the moving picture of the street" (MacDonald, 1999, p. 68). The community drew them in, and they became a working part of it, which is one reason the author missed it and wanted to move back after he left, as he told the reporter at the beginning of the book. It was a part of him, and even with its problems, it was a family community that felt like home to him.

This is an important book because it combines the history of a neighborhood with the history of a family. It also clearly illustrates the proud nature of the people living in the projects. Their neighborhoods are not the best, but they will not admit they have any problems to the outside world, because they are extremely loyal to their neighborhoods and neighbors. Michael quickly learns the "rules" of the neighborhood when he moves into the project, and those include not ratting on people to the police, and ignoring the drugs and gangs in the area. Throughout the book, he shows this pride a loyalty in many different ways, from the way that they dress to the way they do not report murders and other crimes. To do so would betray the community, and they refuse to do this.