By Leigh Saint-Louis, M.D.
Photos provided by Eugene Weekly: http://www.eugeneweekly.com/20130411/lead-story/occupy-medical
When I arrived downtown, at noon on a hot summer’s day, there was already a long line of patients outside. I hit the ground running. Wash my hands, grab my stethoscope, and we’re ready to roll. I’m one of the Occupy Medical Clinic physicians.
Occupy Medical Clinic started as a first-aid station for protesters in October 2011. It grew organically, adapting to local conditions. Every Sunday, it’s constructed anew, in a bus and two large tents. For four hours a week, it provides medical, nursing, and mental-health care, herbal and nutrition therapy, and assistance in navigating the healthcare maze – all free of charge. Periodic dental, vaccination, and veterinary clinics are held. Patients stop in at Hospitality for a cup of tea or a bite to eat while they wait. Ten to fifteen patients will head to the Gorilla Salon for free “hairapy” (hair therapy), a healing modality that restores self-esteem.
It’s not only free of charge. It’s free of judgment. Nobody asks a patient to prove they’re poor enough to qualify. We’re not worried about “free riders.” Many of our patients are unemployed and struggling, with health problems that can’t wait for better times. Many have insurance, but can’t find a primary doctor. Others have insurance and a primary, but can’t get an appointment when they need it. When you need your asthma inhaler or your birth control pills, you can’t wait six weeks for “the next available.”
When I arrived downtown, some of the nurses and mental-health workers were in a “huddle.” Nurse Bill was saying, “If a chart has a sticker on it — any kind of sticker — that patient needs to be fast-tracked, for their safety. They go to the head of the line.” I was glad to see a Medical Translator arrive; we kept her busy. At one point, we chain-translated, from Haitian Creole to French to Spanish to Medical English, and back again.
The unspoken language of physical medicine, of course, is universal. Touch gently, firmly. Unwrap and look closely. Listen carefully, to the breath in and out, to the heart, softly beating. It’s the same for rich and for poor.
A year ago, we took care of 10-20 patients per Sunday clinic. Six months ago, 20-30. Yesterday, we saw 53 patients – a new patient every five minutes on average.
A Nurse Practitioner came to look around, and stayed to work. I gave her a drive-by orientation, in between seeing a Bipolar patient unable to find a primary doctor, and an 8-year-old with acute vomiting and fever. Pertinent questions included: How do you prescribe medicines, without a scrip pad? How do you order labs, when people can’t pay for them? How do you evaluate dental problems, orthopedic injuries, heart murmurs, skin infections — without x-rays, EKG machines, microscopes, or even running water?
You do the best you can – and surprise yourself with your own ingenuity. Many of us rely on medical cellphone apps, and on our small reference library, and on each other.
Since the bus was now full of practitioners, I saw patients outside, on the park benches. None of them minded. I visited with an older man who was sad because he’d lost his hearing. I irrigated his ears with plain water, sitting in a tent with a cool breeze blowing, until he smiled — he could hear again.
On a bench in the shade, a lady wiped away unexpected tears. “My doctor made me have these expensive tests, but then my insurance wouldn’t pay for them. He won’t see me again, until I pay him the last $400. I’m almost out of my blood pressure medicine. I just don’t know what to do.” She smiled, like sunshine breaking through storm clouds, when I gave her a new prescription, with refills.
A young expectant mother dropped by to let us know that the herbs and vitamins we gave her worked. She’s eating full meals again, and gaining weight normally. Several midwives are on our staff, so she can get questions answered every week, if necessary.
A row of people sat in lawn chairs at the Wound Care station, side by side, pants rolled up, feet in tubs of warm soapy water, joking with each other in the shade. Volunteers sat on the pavement in front of them, carefully washing and dressing their wounds. Nurse Donna rode herd on them, in her cowboy hat, boots, and utility belt. Kids ran around, playing nearby. Summer is the best time for outdoor healthcare.
At the end of the day, I asked our new Nurse Practitioner how it went. Her face fairly glowed. “It’s a lot more fun and exciting than my regular job. Where I work, you can only do what the insurance companies say you can, and it’s cold and sterile. Here, we’re doing the work we’re trained to do – really helping people. Why doesn’t everybody want to do this?”
For more information about Occupy Medical Clinic, visit us any Sunday, 12-4 p.m., 8th and Oak Streets in Eugene, Oregon.