For more than four decades, Cathy Crowe has walked a tightrope, balancing work as a street nurse in Ontario with hardline activism that's often positioned her at odds with every level of authority.

Through the 1990s, Crowe butted heads with the Toronto Police Service over officers’ use of force against people living on the streets. In the early-2000s, there was an outbreak of tuberculosis among Toronto’s homeless population and she rallied a campaign to break the government from inaction. In 2002, she helped organize a hidden-camera sting to reveal shocking conditions inside a church that was sheltering the homeless without adequate resources.

“We went into one of the church shelters on that winter night and saw a hundred bodies just lying on the mats on the floor, sixteen inches away from each other in a dark, airless room,” Crowe writes in A Knapsack Full of Dreams: Memoirs of a Street Nurse.

The book shares a full life. But without a doubt, Crowe tells the Straight, if she could relive just one day of her career, it would be October 8, 1998.

“I was watching television, watching the news of the ice storm in Quebec and eastern Ontario,” Crowe recounts of the months leading up to that date. Working as a street nurse at the South Riverdale Community Health Centre, she knew that the number of street homeless in Toronto and neighbouring cities had increased substantially in recent years. “We were seeing horrible, overcrowded shelter conditions,” she says. Now many of those people were stuck in the path of one of the deadliest winter storms the province had ever experienced.

Crowe and other activists established the Toronto Disaster Relief Committee (TDRC) and then used it to build a large coalition of groups that would support TDRC’s call for governments across Canada to declare homelessness an official and, crucially, man-made disaster.

On October 8, 1998, “we had 150 endorsements...we held a press conference, and then we marched,” Crowe recounts.

When they made it to Toronto Metro Hall, their numbers and momentum were so great that security was helpless to stop the group from forcing its way into council chambers.

“And immediately, the committee passed a motion,” Crowe says. Other cities followed suit, and then the Federation of Canadian Municipalities and the Big City Mayors’ Caucus were convinced to endorse the declaration.

A few months later, in early 1999, Canada’s federal government created the National Homelessness Initiative and then established the Supporting Community Partnerships Initiative.

“That all came out of that. And it wasn’t just Toronto. It was all across the country that people were doing this work,” Crowe says fondly. “That’s when you have what I call ‘movement muscle’, when you can pull things together like that.

“That was the moment in my career that changed me and, I think, made a difference,” she adds.

A Knapsack Full of Dreams, which was published with FriesenPress last June, is a wonderful mix of Crowe’s adventures as a street nurse, an account of her tireless efforts as an activist, and an urgent call to action on homelessness across Canada.

Crowe notes that, sadly, its publication could not be more timely.

“Twenty-five years ago, I never would have expected homelessness to be worse than it was when I first started this work,” she says. “After all the advocacy and inquests, et cetera, homelessness is worse in pretty much every community.

“More tent cities are erupting and being squashed," she adds. "There are more new disease outbreaks, there are more homeless deaths at a younger age. And it’s no longer just Toronto and Vancouver, any longer. It’s everywhere.”

The book emerged from a difficult time in Crowe’s life.

Crowe helped pioneer health care for the homeless and has decades of experience as a nurse. She also holds multiple honorary doctorate degrees and in 2018 was appointed as a member of the Order of Canada. But from 2009 to 2013, Crowe couldn’t find a job and was forced onto Employment Insurance. She sent résumés to every nursing and teaching position she could find, but no one would hire her. “I was blacklisted,” Crowe says. Her reputation as an outspoken activist had come to precede her and no organization wanted to risk Crowe biting the hand that was feeding it. Eventually, she was hired for a part-time position at Ryerson University. But for those four years, it looked like activism had cost Crowe her career and life’s passion. That was when she decided it was time to collect her experiences as an activist and put them into a book.

“I’ve got to put this down to paper so that there’s something left behind,” she says she thought. “It could teach people things.”