Elisabeth Francis keeps a small glass bottle on her desk.

Inside is a printout of the heartbeat of a man that she knew for more than 10 years after meeting him in the early days of her career as a homeless outreach worker in Denver. John Hull died in July in a hospital.

“I was able to be there in the hospital room — not when he passed, but in the hours before he passed. I was able to say my goodbyes,” she said. “It’s rare that we have that much warning.”

Francis is the director of the street outreach program for the St. Francis Center, one of the city’s leading homeless service providers. She is careful not to reveal the names or too many details about people she has worked with on the streets out of concern for their privacy, but the name of Hull, a beloved client, was read aloud Thursday night in front of the Denver City and County Building.

He was one of 311 people who appeared in the program for this year’s Homeless Person’ Memorial Vigil. That staggering number of names, representing an average of six deaths per week in the course of a year, was a record for the 34th annual event, said Cathy Alderman, a spokeswoman for the Colorado Coalition for the Homeless.

The coalition organizes the mass memorial every Dec. 21 — the shortest day and longest night of the year — to remember those who died while homeless in Denver, a toll that has grown as a drug crisis has ravaged the streets.

Those 311 people were just those whom the coalition and other homeless service providers could confirm had died between Nov. 1, 2022, and Oct. 31, Alderman said. Time is always left at the end of the event for people to speak the names of other people they lost who were not included in the printed program.

Francis doesn’t know exactly how many people she has worked with over the last decade who have died.

She’s not sure she wants to know that number.

But she does know the St. Francis Center contributed 60 names to the vigil’s roster this year.

Street outreach workers strive to maintain professional boundaries, but their work often hinges on building a rapport with people so they are more willing to accept services and housing when they become available, Francis said. That connection is part of what makes the annual ceremony meaningful.

“It’s hard not to care about people that you’ve known that long — that you have experienced some heavy things with,” Francis said. “The people that we get to know, they’re such a joy and such a light, and it’s an honor to get to be part of their life while they’re here.”

“He just affected our space so positively”

David Martin, who went by Michael, was among the people commemorated at the memorial.

Martin in August was provided a room at the coalition’s Stout Street Recuperative Care Center, a facility that gives people who are homeless a place to recover from illnesses or medical procedures if they’re too frail to return to the streets.

His outgoing nature, along with a rare guitar that he played as a busker on Boulder’s Pearl Street Mall, made an immediate impression on staff and fellow clients, said Sara Keith, the facility’s manager of patient activities.

“It’s a very transitory community that we have here. People aren’t here very long,” Keith said. “He just affected our space so positively.”

Duane Marx met Martin at the Stout Street facility. The two bumped into each other a few times around the building before they talked a bit more. They discovered they had a shared interest in music, particularly in musicians and trendsetters from bygone eras, including the 1960s.

“Once that came up, we never stopped talking,” said Marx, who finally found housing in October after a decade of homelessness in Denver.

Along with a third client named Larry, the men became a sort of “crew” around the facility, Marx said.

He was the first among the people staying at Stout Street to find out that the man he came to know as Michael had died.

Martin had traveled to Boulder for a follow-up medical procedure. A short time later, Martin’s son contacted Marx to say he didn’t make it.

“I don’t accumulate friends, but he was one that I had hoped to have a future relationship with,” said Marx, 66. “It was pretty stunning when he went to Boulder and, two nights later, he was gone. He had a single room, and we spent the whole night (before he went to Boulder) playing guitar together.”

At the urging of clients, Keith organized a memorial for Martin. People streamed in, Keith said, and it was a powerful reminder for her of the way that seemingly small acts of kindness — like complimenting someone’s colorful socks, as Martin did — can reverberate in the lives of others.

“We want to keep his memory alive”

At Thursday night’s vigil, tears began to stream down Gloriane Olivas’ cheeks once her family found the luminary lantern memorializing her son Joseph Olivas.

He died of a fentanyl overdose on Oct. 21, a week shy of his 34th birthday. His mother carried spare programs from his funeral and wore a button with a picture of his face on her jacket. Among other family members at the vigil was his younger sister Celina, who hoped to raise awareness of the drug: “It’s terrible and it’s everywhere,” she said.

“We want to keep his memory alive,” Gloriane Olivas said. “Denver needs to try to do better to help the homeless community.”

Denver Mayor Mike Johnston was quietly on hand Thursday night. He did not speak at the event and stood in the back of the crowd, staying for a short time ahead of a community meeting in northeast Denver. The meeting’s focus was one of the hotels that has been converted into a homeless shelter as part of his House 1,000 homelessness initiative — which aimed to move that many people indoors between when he took office in mid-July and the end of this month.

Alderman, from the Coalition for the Homeless, has been critical of how Johnston and his administration have described the initiative at times, noting that transitional shelter, its current focus, is not long-term housing.

But as the vigil commemorating so many deaths approached, she said the city as a whole should be proud of the work this year to bring more people inside and off the streets.

“I mean, there is no doubt in my mind that moving 1,000 people indoors, or whatever number they end up getting to, is going to save lives. People are in safer places,” Alderman said. “But as a city, we can’t stop there. These lives are going to depend on there being safe, affordable and long-term housing options.”

Counting how many die each year on the city’s streets isn’t a simple matter, though the Denver Office of the Medical Examiner publicly tracks information about deaths among people experiencing homelessness.

As of Wednesday, the office had confirmed 286 deaths so far in 2023. That’s 60 more than in all of 2022 — and more than twice as many as the 133 counted in 2018. The surge mirrors the increase in overall homelessness in metro Denver in recent years, amid rising housing costs, the disruption of the pandemic, and an opioid and fentanyl crisis.

The medical examiner’s figures are tracked by calendar year, using a slightly different time frame than the period used for the vigil. But the coalition’s list this year likely has dozens of names that didn’t make the city’s official toll — likely because the vigil also honors people who died while living in supportive housing, Alderman said. Others gave addresses for friends or family when they were checked into hospitals, she said, so they weren’t counted as homeless by the city when they died.

But both counts are likely incomplete, she said, and the city no longer allows the vigil’s organizers to cross-check records.

According to the medical examiner’s findings, overdoses are far and away the leading cause of death among people who are homeless so far in 2023, accounting for two-thirds of the 286 deaths. The city as a whole is experiencing an unprecedented number of overdose deaths this year that are driven by fentanyl, according to city records.

The coalition’s Dr. Sarah Axelrath has been working since 2021 as a primary care and addiction medicine physician for its clients.

Doing that work amid an overdose crisis means operating in a state of “chronic low-level grief,” she said.

“It’s important to remember people who won’t be remembered in any other ways,” Axelrath said about why she attends the vigil. “This is likely the only funeral for most of these people.”

Each unexpected death “creates a vacuum for mourning”

Private memorials like the one for Martin are rare, but they do happen. Network Coffee House has hosted several this year for people who were homeless in a chapel space on the second floor of the old house the nonprofit calls home in Capitol Hill, executive director Ian Stitt said.

One memorial was for a man named Eric, a frequent visitor to the coffee house, whose body was found in the alley behind the building in October, Stitt said.

“The memorials are kind of fed from this idea that when you’re in community with people, and when people pass away unexpectedly, it creates a vacuum for mourning,” he said.

Stitt, who has been doing work on homelessness in Denver for seven years, said the December vigil typically isn’t heavily attended by people who are homeless. They’re in survival mode, he said, focusing on food, safety and shelter.

But the vigil is an opportunity for service providers to come together.

“By the nature of the work and by nature of the need — the extreme need that’s out there — it kind of forces us to just continue on. And we don’t really have the opportunity to mourn, either,” Stitt said. “Inevitably, and this is the heartbreaking thing, I will find people at the memorial … that I didn’t know had passed away.”

Get more Colorado news by signing up for our daily Your Morning Dozen email newsletter.