Just Listen

Every now and again, something happens that renews my belief that there is good in all people.

A few months ago, I received a call from a woman who was desperate. She didn’t need medical care; she had Medicaid. But she needed help. Her apartment was infested with fleas and she had a service dog. The dog and the apartment had to be treated, and that used every last penny she had. As a result, she was unable to pay for her much needed medications. As we were talking, she also told me that she could not afford soap or toilet paper or other personal care items. What she most needed, though, were her medications.

Being a skeptic, I called the local drug store to make sure that none of her medications were narcotics; they weren’t – just the medications she needed to manage her chronic health conditions. So, I authorized payment of the medications. Her co-pay was just a few dollars.

When I went to lunch that day, the question came up about people, and whether they abuse our system here at the clinic. That launched the story about this woman. As I shared with a couple of local businessmen the need this woman was experiencing, one of them said: “Give me a list of what she needs,” and the other one handed me $10 – which I handed to the first man, along with a list. The next morning a big grocery bag filled with the needed personal care items was delivered to my door.

Now this is a businessman who is very busy, is very skeptical of people, and enjoys being perceived as “gruff.” But hearing her story moved him to action. He was able to do something concrete to help one individual and he did it. It didn’t cost him much money – just a little bit of time.

I called to let her know I had some things for her. She came by to pick them up, thrilled not so much that she had received all these much needed items, but that she had been heard. She told me she had called several agencies looking for help, and no one had listened to her. She just needed to be heard.

It’s amazing what we can do if we just listen.

Betty

Betty was one of the very first volunteers at the clinic. She and Carol, her neighbor who is a nurse, would come together to volunteer. Betty wasn’t a “medical” volunteer, though she had lived through a serious chronic health crisis herself, and knew the importance of healthcare. Betty had a heart of gold, and would do anything that needed done around here. And, I mean anything. She sorted through some of the dirtiest items I have ever seen. She took on the task of keeping the supply closet organized.

She had a daughter, Julie, who she always said was going to save Chinese baby girls – one at a time. Julie adopted two girls from China during the time I spent with Betty. When Julie was preparing for a trip to China, Betty and I would scrounge around for the items on the list that Julie needed. Some of them were things that we had in surplus here – clean syringes, alcohol wipes, etc. Betty loved her family and would do anything for them.

In April 2004 we celebrated Betty’s 70^th birthday here with a cake and all her “clinic friends.” Age did not slow Betty down at all. She was at the clinic every single Tuesday, and most weeks at least one other day.

Later that year, my husband was diagnosed with Hepatitis C. He had received blood transfusions in 1983 – before the blood supply was tested for all the horrid viruses that are transmitted by blood. My world spiraled out of control – I may be a nurse, but when it is my family, I am completely worthless. I was devastated, frightened and so sad. On Tuesdays, Betty would come in the afternoon early, grab a dust cloth, and come into my office. I’m not sure she dusted on those days – but she listened, she gave me her time, her attention and her affection. I’m not sure how I would have survived those days without her. Betty gave me the priceless gift of herself.

On Wednesday, October 25, 2006, I was in my office with the radio on in the background. I heard that there had been a fatal accident on one of the rural roads in our county. I remember thinking “that’s a bad corner” but didn’t really think much else about it.

That is not until I received a phone call from Julie. Her parents were on their way to see her, and there had been an accident – Betty was dead.

I cannot even remember how I reacted or what I said. Her death was such a shock, and such a loss.

I still miss her. The clinic receives a check every single month from her husband in her memory. We don’t need the check to remember her, but we so appreciate his commitment to the clinic that she loved so much.

 

 

 

 

Simon - a story of four-legged healthcare!

I was going to call this article “My Dog, the Felon.” He really isn’t a felon, but he does have a police record. It’s a long story.

In August, my beagle, Simon was diagnosed with lymphoma, a cancer that affects the lymph nodes. He isn’t quite ten years old, so young enough we weren’t ready to lose him. We embarked into a journey fraught with peril, but of course we didn’t know that at the time. I love to tell people that I live in “de-Nile” a lovely place where I don’t have to deal with reality. I was clearly living in denial as we made the decision to begin chemotherapy on Simon.

The first week went well – he tolerated the medication, was able to eat, and felt fine.

Then, the second week hit. First, he began having some nausea and vomiting; so we started him on medication to control those symptoms. By Saturday, he was having diarrhea, which quickly became bloody diarrhea. So, we added two more medications to control that. He didn’t feel good; I was no longer in denial but had moved right into panic and fear. It was not a good combination.

By Saturday night when it was time to now give him five pills – well, it was a perfect storm of not feeling good, fear, panic and… … as I tried to give him his medication, he bit me.

I pulled my hand away and quickly rinsed it off, trying to calmly (yea, right) assess the situation. I decided the most important thing was to give him his medications – so I gave that job to my husband. Once all the pills were down, we then went to the emergency room.

Have you been in an ER on Saturday night at midnight? Oh, my goodness… not the time you really want to be there. But, there I was. And, the first order of business? To call the county Sheriff to report my dog!

Yes, he was my dog, with all his shots up to date, but we still had to file a report. The Sheriff Deputy came to take my statement, see my wound (and almost pass out), and then they were able to treat me.

I had three stitches; had I known that I didn’t need antibiotics, I probably would NOT have gone to the ER. I did need a tetanus shot – which they forgot to give me (I got it at the Health Department later that week!).

We are now several weeks into the chemo for Simon; my hand has healed. He has taught us so many lessons in this journey. He is one tough beagle dog. When he is nauseated, he just lies quietly on a cold floor; when he is short of breath, he stops; when he is hungry, he eats.

Did we make the right decision to put him through this? I have no idea. I know we were not ready to let him go, and we promised him that if he was ready, we would let him go. So far, he hasn’t given us any indication that he is ready to give up the fight.

He goes to the vet every Thursday, the girls out there love him – and he happily goes in to see them.

It seems somewhat ironic that my dog can get the healthcare he needs, and I have such a hard time getting care for my uninsured patients with cancer. But, that is another story.

Clinic Night

On a typical Tuesday evening at St. Peter’s Free Clinic, the following patients may be seen. Sue, who has a cough and fever, is worried about losing her job if she calls in sick, but she has no health insurance. Lynn is a 50 year old widow, who has been having heart problems since before her husband died, and now has no health insurance. And, Jim, who due to multiple health problems, has recently lost his job and along with it his health insurance. He has no idea where to go for help. While he was at the Clinic he not only received health care and medications, but was given a list of community resources to help him access other needed services and a small box of food to feed him that night. As he left he summed up the sentiment that is often heard by the volunteers at the Clinic, “Thank you so much for being here when I needed you. You were an answer to my prayers."

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Death Comes in Threes.

Is that an old wives tale, or reality? It always seems to be true in my life, and it certainly has been true here at the clinic this year. In the span of less than a year, we have lost three of our original volunteers.

Pat: Pat was the very first nurse to call and volunteer once word about the clinic went out. I had never met her, and had no idea the impact she would have on my life over the next ten years. Pat was a single woman, taking care of her elderly mother. She was bigger than life in so many ways – physically, she was tall and broad shouldered; she had a voice that was amazing; and she had one of the biggest hearts ever. Pat worked the Tuesday night clinic and was instrumental in the development of the Diabetic Clinic, which she also worked each month. She was a member of the Sweet Adeline’s and introduced me to their brand of singing. It became our annual gift to my mother-in-law to take her to the Sauk Trail Sweet Adeline concert.  She was very involved in her community, her church, and in life! She would work on Tuesday night, then head to her ceramics class for “therapy.” An amazing woman! Pat was one of those people that get in your body space – when she was excited or frustrated she would get right in my face to tell me about whatever was on her mind. I remember so clearly one night when she had been complaining to me about something, that I looked at her and said to her, “I love you.”

I was so glad that I had that moment to remember. On Monday, January 23, I learned that Pat had been taken to the local hospital and then transferred to a major medical center. On Tuesday morning, she was dead. What I was told, was that she had a “tear” in her heart. I am not certain exactly what happened, but it was so sudden, so unexpected.

In addition to taking care of the uninsured, Pat herself had been uninsured, until the previous May, when she turned 65 and became eligible for Medicare. She had put off taking care of herself for many years. According to a report from the Institute of Medicine, uninsured Americans get about half the medical care of those with health insurance. As a result, they tend to be sicker and to die sooner. About 18,000 unnecessary deaths occur each year because of lack of health insurance.

Pat’s death was such a loss to all of us – at the clinic, at her church, in her community. She will always be remembered here.

Ella: I had known Ella almost since I first moved here. She was a member of the church, and very active in everything going on at the church. When we started the work for the clinic, she was always there. Well, almost always. The only things more important than the church were her two great-grandsons. And they were both involved in sports, so that was always her first priority. Ella always told us she was going to live to be 100. She didn’t make it.

Ella was diagnosed with cancer and she vowed she would beat it. She did for a while, but it came back with a vengeance. Ella volunteered every Tuesday at the clinic. We found the perfect job for her – she was our greeter. As the patients came in, she would direct them down the hall and welcome them to the clinic. She couldn’t be here during her treatments, but when the doctor released her, she would come and wear a mask so that she could be here.

Ultimately, she was no longer able to be here, and on February 20, she died.

She touched so many people with her life. Her great-grandsons are now young adults, and hopefully they will always carry with them the fierce love she had for them.

 

Dee: Dee was also a member of the church and an original clinic volunteer. She was the best sorter/cleaner I have ever known. I am not sure I ever saw her without a dust cloth or a dish towel. She could organize any mess – and there are always plenty of those around here! Dee was diagnosed with breast cancer not long after the clinic opened. She responded well to surgery and chemo, and was soon back here working. For many years, she helped in the kitchen on Tuesday evenings. The clinic feeds the volunteers each Tuesday with food provided by various groups. The kitchen is a place for the volunteers to rest, refresh and socialize. There is always something going on out in the kitchen! And Dee was a part of the group providing a haven to our volunteers. This spring, her cancer returned. It seems to always be worse the second time around. Before we could grasp the reality of it, Dee had died.

Dee and I shared more than church and clinic – her granddaughter is married to my nephew, and they have two beautiful daughters. So Dee will live on in those amazing girls.

So, if death does indeed come in threes, maybe we are done for a while. I sure hope so – my heart has so many holes in it that I am afraid it might break in two with another loss.

Diabetic Clinic

Tonight is the monthly Diabetic Clinic. Not long after the clinic opened, the need for more diabetic care became obvious. With the help of some enthusiastic volunteers including a provider, a couple of nurses and a student from Hillsdale College, the planning began. The idea was to hold a “group appointment” where all the patients came together at the same time to receive diabetic education, to be seen by a provider, to receive medications and all the supplies necessary to take control of their disease, and to form a support group for one another. I’m not sure our idealized version is exactly what happens, but today, and once a month, a group of 12 to 15 patients with a diagnosis of diabetes come together. There is a provider who comes to see anyone in the group that needs to be seen; he also oversees the medications and test results of all the patients. A volunteer pharmacist and pharmacist technician come in to dispense the necessary medications.

Under the direction of a diabetic educator, the patients sit around a table using light weights while she teaches various aspects of their care. Most of them have had a one on one session with a licensed dietician; they all receive glucose monitors and test strips, with the requirement that we see their blood sugar log for each month. Most months a healthy snack is provided. All the diabetics, from this group or the larger population of the clinic, have access to a podiatrist and to an ophthalmologist.

There are always laughs, groans, and the opportunity to cheer each other on as goals are met. The goals may be weight loss, a hemoglobin A1C level that meets a goal, or it may be an exercise program goal that was met. They support one another, and us. As a group we have seen the birth of babies and the death of one of the providers and one of the nurses. We have also experienced the unexpected death of one of the group.

I am often accused of “spoiling” this group of patients, and that is true to a certain extent. But we have been through a lot together, and every one of them KNOW that I will discharge them from the Diabetic Clinic if they are not compliant. I want them to take charge of their healthcare, and I will do everything I can to support them. If they are not willing to do the work, there is always someone waiting for a spot to open in the Diabetic Clinic.

Article

This link will take you to an article by the Episcopal News Service about clinics providing healthcare to underserved populations: http://bit.ly/w23HPW

Friends of the Free Clinic

One of the many blessings in my life over the past 10 years has been Kristin Lucas. When the clinic opened, I didn’t know her. A fellow church member introduced us, and told me, “You need to know Kristin.” She was SO right about that! Kristin had served as the founder and executive director of the local domestic violence shelter for 19 years prior to her retirement. She had traveled some, and was ready for a new challenge. I don’t think she had any idea how big of a challenge I would be, but we were brought together for a reason.

Kristin knew all the things that I didn’t even know that I didn’t know. I am a nurse. Being an executive director was not in any of the curriculum I took! I had no idea where to begin with so much of the legal/accounting/etc. side of things. But Kristin was there to guide and teach me. She served as chair of the board until she was term-limited out.

Luckily, she had seen a need, and moved to fill that need: the clinic needed fundraisers. She started a group named Friends of the Free Clinic. The group is mostly women who believe in the work of the clinic and have connections in the community. Their mission is to raise money for the clinic. They are amazing!!

Eight years ago, this group decided to host a yearly event to raise money for the clinic – we are now preparing for the 8^th Annual Taste of Autumn. The event is a food and wine tasting, held at the local college. Money is raised by getting sponsorships from local businesses and having the local restaurants provide enough food for a “taste” to the 250 guests that purchase tickets to the event. It is so much fun and an event our community looks forward to every year. The event brings in about one-third of our annual income.

The Taste of Autumn is this Saturday evening – nearly all the tickets are sold and we are really looking forward to another amazing evening. The Friends of the Free Clinic have been hard at work, and as always, I am awed at their dedication and enthusiasm for this event.

The Friends of the Free Clinic also send out fundraising letters each year, asking their family, friends and neighbors to help support the clinic. The response to this is amazing.

The Friends of the Free Clinic are my heroes. The work is not always fun, it certainly isn’t always easy, and yet they do it year after year because they believe in the work we do here. To say “thank you” seems so inadequate, but from the bottom of my heart, I thank them for the work they do!

 

Todd

Todd was standing outside the clinic door when I came back from lunch one Tuesday. The clinic door opens at 5 p.m., but most Tuesdays there is a line by 3 or 4 p.m. But, it was only 2 p.m. when I returned that day. It was a nice day, but I still stopped to ask why he was there that early. He told me he was homeless, and really didn’t have any place else to be.

I asked him point blank – why are you homeless? This is his story, and I know that there are at least two sides to every story – and often more than that. But, this is his story and the only one I know. He and his wife were having issues. He went to the bedroom to be alone and she came in and poured coffee on his laptop computer. He called the police, but she said she was frightened, so he was arrested. He spent a night in jail and was taken from there to the ER because he had pneumonia. He had spent the last two nights sleeping in the smoking hut in the hospital parking lot. He had the clothes on his back, and nothing else.

I told him to come see me when he came in the clinic. I found a blanket, a sweatshirt, some pants and a little food to give him. And I learned a huge lesson. When someone is homeless, possessions are a burden. A blanket was appreciated because of the cool night air, but what was he to do with it during the day, when he was trying to get food or contact friends?

Fortunately for Todd, one of the volunteers here at the clinic works for DHS – Department of Human Services – and she knew of a shelter in a community about 30 miles from here. She gave him her number, and said to call the next day. They were able to get him to the shelter the next day.

I don’t know where he is now. We will probably never see him again. He said he had a friend with a job in a community about an hour from here. Hopefully, that came through for him.

We were able to give him the antibiotics and the inhaler he needed. Maybe we were able to give him hope. Maybe.