A Compassionate Care Center, Right in the Heart of San Francisco

On a summer day, after morning traffic had eased and the early fog started to burn off, San Francisco’s Castro neighborhood was quiet on the corner of Duboce Avenue and Market Street, where Maitri Compassionate Care Center is located.

In addition to being the city’s only AIDS hospice center, Maitri provides 24-hour medical care and respite services for people currently living with HIV or AIDS. It also provides recovery care for people following gender-affirmation surgeries.

It would be easy to miss the entrance to the center if not for a giant red, green and blue mural depicting flowers, stars, cats, dogs and a circle of people holding hands. The mural also features a portrait of a man named Issan Dorsey. Dorsey has been referred to as the “bad drag queen” who changed his life and the lives of many other people when he became a Buddhist Zen teacher and monk. In 1987, he opened the doors of his own home to care for a man dying of AIDS. That act of care nearly 40 years ago was the founding act of Maitri.

“We were founded at the height of the AIDS epidemic when people in power refused to say the word AIDS, when people were dying on the streets,” said Tomas Moreno, Maitri’s development director.

What originally began as a small, grassroots effort to provide compassion and care for people in their final days has developed into the robust center it is today because of advancements in medications. “As AIDS and HIV was no longer a death sentence, people came here to get better,” Moreno said.

In addition to providing care for people living with HIV and AIDS, the center has become a safe recovery space for people undergoing gender affirmation surgeries during a time when the LGBTQ community is under attack.

Most recently, the Trump administration has issued executive orders to dismantle protections for transgender people, including banning access to some gender-affirming care, in particular for people under the age of 19.

“People are being singled out,” Moreno said. “Children are being singled out for being trans on the nightly news, and it’s really, really scary.”

With funding through Housing Opportunities for People with AIDS and the Ryan White HIV/AIDS Program, as well as the help of private donations and support from the public health department and the city of San Francisco, Maitri has kept its doors open, providing care for lower-income and housing-insecure clients living with HIV or AIDS.

Many of whom are elderly, as the epidemic is disproportionately affecting older people. A loss in this funding would greatly impact the level of care that Maitri is able to provide to its clients, which is why the center continues to push for sustainable, grassroots funding, including donations.

It’s even expanded its services to include pre- and post-op care for gender-affirmation surgery on a free or sliding scale for people from all across the country and Canada. All of this feels especially important at this moment, and in this particular place.

The cost of living in San Francisco is extraordinarily high, and it is home to some of the nation’s highest rates of income inequality. Providing a place to stay, in this case, is a form of health care — and what Maitri provides goes beyond a place to recover.

“People really do become family here,” Moreno said. “You see Maitri neighbors really pushing each other to quit smoking, to eat less dessert, to have more salad. To just be better together.”

Wanda O’Connor is one of those people. She came to Maitri through a referral after a spinal injury, and has been in the center recovering for nearly a year and a half.

During the time she’s been here, she’s quit smoking cigarettes, undergone top surgery and has plans for bottom surgery, and made amazing friends. She said Maitri has been a blessing, calling it “the best kept secret ever.”

For her, the attention, care and understanding that Maitri’s staff have given her is beyond what she ever received in the hospital. And it all seems to be effortless. “This place is like a well-lubricated machine,” O’Connor said.

The center works hard to keep its clients engaged and feeling a part of a community. There are daily meals, weekly bingo games and art groups, a piano that’s available for playing, and annual holiday parties. Plus, there’s access to ongoing resources, such as on-site therapy and classes or workshops from outside partners or programs.

It’s a giant ecosystem that Moreno said has continued to grow, so much so that they now have the Branch aftercare center, which enables former clients to stay connected with the people and offerings at Maitri.

“Branch doesn’t actually stand for anything,” he said, admitting that it’s a play on the center’s name, “Maitree,” which is a Sanskrit word meaning unconditional acceptance and loving friendship. “My tree, my branch,” he said jokingly.

And it really is a branch, connecting many people who have passed through the center. For O’Connor, her branch takes the form of supporting people who are just arriving at Maitri, and helping to assure them it’s likely a very different experience than where they just were. “I’ll sit down and talk with them about my experience” she said, but “then they find it for themselves.”

O’Connor is such a strong advocate for the center, she said that if she were to choose a place to die, she would choose Maitri. “I’m not gonna die anytime soon,” she said, “but if I had to, this would be the place I want to die.”

Geary Holst, a former client at Maitri and a member of the Branch program, thought he would be spending his last days living in the center.

Holst came to the center after having a heart attack. He was living with HIV, recently diagnosed with Parkinson’s disease, and was fairly confident that when his doctors sent him to Maitri, it was for hospice care. But he bounced back. “It just showed me how to live again,” he said.

Now Holst lives two blocks down the street from the center, stopping by multiple times a week to see people, sit down for a meal or attend an event. He spends the holidays here, decorating the tree at Christmas, sharing a big Thanksgiving meal.

“Halloween is a hoot,” he said, adding that people get dressed up and the Sisters of Perpetual Indulgence, a group of drag queen activists and performers, show up and help with the festivities.

Holst compares his relationship to Maitri as one would to their “grandma’s house,” because it’s a place people can feel comfortable and accepted — with different personalities all mixing together.

For many, it’s a place not just for receiving care, but for getting a second chance at life, for thriving. And that’s not just for Maitri clients, but staff as well.

Monique Dupree, Maitri’s head of nursing, and Molly Herzog, the director of client services, joined the Maitri team after careers in nursing and social work, respectively. They’ve both fallen in love with the work they do at Maitri, and in particular, the people they work with.

“They’re amazing,” Herzog said. She wears a shamrock necklace that a former client made for her, citing it as one of the kinds of tokens the staff receive for the care they give.

She calls it a “community of love,” saying that the staff and the clients care for each other. One such client, she said, would always be sitting in the living room when she came in for work, and every morning he greeted her with “Here comes Molly. She brings sunshine out every morning!” It was a beautiful and special way to start every day, she said.

For Dupree, her gratitude for finding a place at Maitri is reinforced every time she thinks about what the center provides. Like the name Maitri suggests, acceptance, friendship and compassion are at the heart of everything they do for clients. “It’s all about being there in people’s most vulnerable moments,” she said, “even if there isn’t anything to say.”