THE MAN doesn't say how long he's been living on the streets with a gaping hole in his belly. He just tells the doctor that he doesn't have any colostomy bags, and hasn't had them for a while.
Dr. Bon Ku, tending to him behind a few plastic shower curtains, wastes no time. He gets on the phone and tells a colleague at Jefferson that he's sending "a gentleman" over for a few bags to hold him until his surgery in a few days.
"Thank you, Doc. Thank you," the man says when he leaves.
Outside, the movement of Suburban Station is a constant, sometimes dizzying, blur past the cramped, storefront few passers-by notice.
But to the hundreds of homeless that the Hub of Hope has connected to shelter, housing and treatment programs, it's a lifeline. Sometimes the only one they have.
In two years, the underground winter walk-in center has become a warm place for many of the station's chronically homeless to sit unbothered and unjudged.
A place to get a welcome cup of coffee, tepid, not hot. That's a necessary precaution so it's not used as a weapon, workers say.
And a place for those who want a one-stop shop for all the services needed to get off the streets - including desperately needed health care.
Dr. Ku, besides volunteering at the Hub, is an emergency room physician. He cares for many of the city's homeless, sometimes repeatedly, in the Jefferson ER.
"It's incredibly frustrating to discharge a homeless patient from the ER back to the street," he says. "We just haven't done a very good job at tackling homelessness."
For a few years, he's been pushing for a place for homeless patients who aren't sick enough to admit, but are too sick to recover on the streets. Unbelievably, Philadelphia doesn't have one, he and other health workers told me.
That's nuts. But also just one reason why the Hub is so vital to some of the city's most vulnerable. Staffed with case-management professionals, peer-recovery coaches and medical and behavioral-health professionals, the Hub is nothing short of salvation to people like 43-year-old Jamal Tinsley.
"Mr. Tinsley, how are those pants fitting?" Hub project coordinator Karen Orrick called out toward a room usually used for psychiatric evaluations. Every inch of the cramped Hub has a dual purpose.
"I dunno [long pause], maybe [longer pause] a little tight," said Tinsley. He's a big guy with boyish eyes, who lives in a nearby boarding house. He comes to the Hub nearly every day.
"I wish it could stay open all the time," he said.
I'm with Mr. Tinsley. There are lots of organizations throughout the city working with the homeless. Many work in collaboration with the Hub, a partnership between Project HOME and numerous city and nonprofit agencies. But it doesn't take long to see the gap that the Hub has filled, if just for a few winter months.
Every night I visited, the cramped quarters were packed. One night a dreadlocked man slept on a red plastic chair in a corner while case workers at desks steps away talked with others about housing options.
Another night, an elderly woman said she'd been locked out of the room where she usually slept. Don't worry, reassured a case worker, they'd find her a place. The woman breathed an audible sigh.
Steps away, a man who said his name was Dave sat patiently with a cup of coffee and a newspaper while he and several others waited for a medical exam. The exam is required for a homeless person to be eligible for permanent housing.
"My own place," Dave said.
On Friday, the Hub closes for the season.
The doors open again in December.