Grief

The clinic has lost three volunteers over the past few weeks: Dr. Erv Malcheff, Marilyn Williams-Bayer and Bev Brown.

Dr. Malcheff was a chiropractor - he called a couple of years ago and offered his services. The patients loved him. He came every week when he was in town, and the care he provided was so appreciated.

Marilyn Williams-Bayer was a nurse, a counselor, a friend. I wrote about her last week. She touched so many lives.

Bev Brown was a behind-the-scenes volunteer. She took all the random notes I sent her and put them together into a newsletter. I first met Bev several years ago; we hit it off immediately. I spent hours sitting at her kitchen counter drinking coffee and talking. We had so much in common. She was a very talented artist and an amazing human being.

I am sharing here a poem from the Northumbria Community’s Celtic Daily Prayer.  They are gentle and wise, and perhaps will speak to your heart, as they have to mine.

Do not hurry
as you walk with grief;
it does not help the journey.

Walk slowly,
pausing often:
do not hurry
as you walk with grief.

Be not disturbed
by memories that come unbidden.

 Swiftly forgive:
and let Christ speak for you
unspoken words.
Unfinished conversations
will be resolved in Him.
Be not disturbed.

Be gentle with the one
who walks with grief.
If it is you,
be gentle with yourself.

 Swiftly forgive;
walk slowly,
pausing often.

Take time, be gentle
as you walk with grief.

Face of the Uninsured

Last week, we saw Mark for the first time. He is a 45-year-old male with a new diagnosis of diabetes and hypertension. He was admitted to the local hospital with an elevated blood sugar; he was discharged to the free clinic for follow-up and medications.

He arrived here accompanied by his mother. His blood pressure upon arrival was 225/94; it was checked again by the doctor, and was still elevated at 212/92. These blood pressure readings are crisis readings – and we had no choice but to send him back to the emergency room.

So, he still has no medications. He now has a second emergency room bill, and most likely, another hospitalization.

Until six months ago, he was employed as a truck driver. With the two diagnoses of hypertension and diabetes, it is unlikely that he will drive truck again. Finding a new job path at age 45 will be difficult. He is uninsured and under the current climate in Michigan, he will remain uninsured with huge hospital debt already incurred and the need for expensive medications for the rest of his life.

Explain to me again why we don’t want to provide healthcare to people? He has worked almost all of his adult life – he has paid taxes, contributed to society, but now in his time of need we say, “Sorry.” I do not understand.

Update on James and Diane

I talked to Diane a couple of weeks ago, before I published their story on the blog. We hadn’t seen them at the clinic for about two years, and I wondered what had happened to them.

Jim started receiving his Social Security, and with his part-time job they now make too much to qualify for services here at the clinic. She said they are doing great – they see a doctor once a year to get prescriptions for their blood pressure medication, and so far they have stayed healthy. They are still uninsured, and unable to afford healthcare coverage.

On October 1, 2013, they will be able to apply for insurance through the Marketplace. They will qualify for subsidies that will make insurance affordable for the two of them – for the first time in years.

Marilyn W-B: A Superhero

I have been struggling with writing this entry. This hero is someone near and dear to my heart, who is valiantly fighting cancer.

We call her “Marilyn W-B”, because we have a couple of Marilyn’s here. She is a tiny package of a woman standing less than five feet tall, but she is a giant in our eyes. She has the brightest blue eyes that sparkle when she smiles.

Marilyn W-B first came here to volunteer as ordered by her doctor – an orthopedic surgeon, who was the first Medical Director of the clinic. He told her it was what she needed. More importantly, it was what we needed. Marilyn is a Registered Nurse and a Licensed Counselor. She brought so many gifts to the clinic – we always need nurses, and she is an excellent nurse. As time went on she saw so many needs and did her best to fill the voids. She began by offering a Depression Support Group to any who would participate. Some nights she had several people; more often she did one-on-one counseling with a hurting soul. She touched so many people with her huge heart.

She had been battling metastatic breast cancer for several years when she first came here to volunteer. But it wasn’t until she had cardiac issues that she decided the time had come to stop smoking. It was a difficult journey for her, but she finally succeeded. We all celebrated with her. About a year after she won her battle with smoking, she decided to offer a Smoking Cessation class for the patients here at the clinic. She worked with multiple small groups over the years, and we have many former smokers thanks to her efforts. We also have a legacy of finding ways to help people, and now have another volunteer who has become certified to facilitate a Smoking Cessation class.

Through chemotherapy, radiation therapy, surgeries and medical tests of all sorts, Marilyn continued to volunteer; to volunteer, and to touch people’s lives. She didn’t just touch the lives of the patients she worked with; she touched all of our lives. She was always ready to listen, to celebrate the good times, and to cry with us in the tough times. I have a note from her that I will always cherish – after having shared with her some difficulties I was experiencing, she wrote me a note reaffirming who I am, and the work I am doing. It meant the world to me during that difficult time.

She became a close friend, colleague, mentor, and supporter. And, so I struggle as I see her dying. I have told her how much she means to me; I am not sure I can tell her that often enough. She has touched my life so deeply.

The dictionary defines a hero as:

1. remarkably brave person: somebody who commits an act of remarkable bravery or who has shown an admirable quality such as great courage or strength of character
2. somebody admired: somebody who is admired for outstanding qualities or achievements

I think of Marilyn as a “superhero”, but the dictionary defines that as a fictional character – Marilyn is as real as it is possible to be. But, she is a superhero in my book.

I love you Marilyn! Thanks for all you have been to me in my life. I will never forget you.

May 20, 2013. Marilyn lost her battle with cancer this morning.

Give rest, O Christ, to your servant with your saints,
where sorrow and pain are no more,
neither sighing, but life everlasting.                                                                                                               

Book of Common Prayer

Lynne

Lynne was first a patient here about 10 years ago. She had lost a son in a tragic accident, and came to the clinic with seasonal allergies and depression. We saw her for several months, providing her with the medication that she needed and some simple support.

Soon she was working at a local business, and as I saw her from time to time, she was flourishing. She had a beautiful smile and seemed to be doing well. She had insurance with her job, so we no longer saw her at the clinic.

She came back here several months ago with chronic Irritable Bowel Syndrome. She had lost her job and is now divorced. The sadness is back in her face, the beautiful smile long gone.

Over the past couple of months she has been in incredible pain with kidney and bladder stones. Fortunately, we have been able to get her into see a nephrologist, but without insurance it is difficult to receive the care she needs. She is applying for Charity Care at the local hospital and if she qualifies will then be able to have the stones removed.

Last week I received a note from her, thanking us for all that we had done.  Really – shouldn’t she be able to get the care she needs when she needs it? Why do some people have access to care at any time and others only when someone else decides that they can? For those of us with health insurance, we would have access to the necessary care when the symptoms first appeared.

Update #2 on Cindy

I received word that Cindy had her mastectomy. They found more cancer than they had anticipated, so she will be receiving chemotherapy. I will keep you updated on her.

(Another) Letter to Senator Bruce Caswell and Representative Ken Kurtz

As a free clinic in your district, serving the most vulnerable of your constituents, we urge you to support expanding and reforming Medicaid to help rein in the high cost of health care, support health care providers and give families access to quality affordable treatments and services.

As you know, our clinic serves people with little to no health insurance, many of them working citizens with families. For them, the first time they see a doctor is when they go to an emergency room, when a medical situation that was otherwise preventable and treatable has become a full-blown medical emergency. This puts their health and lives at risk, and sends health care costs for everyone else through the roof.

By expanding and reforming Medicaid, we can help more than 450,000 people in Michigan get frontline quality health care. They can see family physicians. They can get regular check-ups. They can get treatment plans for a wide range of manageable diseases such as diabetes and many others. All of these add up to a healthier Michigan.

Every year, hospitals across Michigan lose nearly $2 billion in uncompensated care treating uninsured and underinsured people. Helping more people get access to care through Medicaid will significantly reduce these cost burdens, allowing hospitals to improve outcomes, add jobs and support the local economy.

Without Medicaid expansion, hospitals will see even further cuts to Medicare and Medicaid reimbursement rates, exacerbating an already difficult health care environment. Without expansion, we risk weakening both the hospitals and their ability to provide medical care, and worsening the health-care crisis in Michigan.

Free clinics are the ones who experience and, to the extent we can with very limited resources, address this crisis every day. We see what lack of access to medical care, treatment and services do to people and our communities.

For all these reasons, Medicaid expansion is the best way forward for Michigan’s future, and that’s why we urge you to support this critical health care policy opportunity.

Amanda

Amanda has been a patient here for the past two and a half years. She is employed full time as a manicurist, but has no health insurance.

She is diabetic with high blood pressure. Since she started coming here, she has taken control of her life and has lost nearly 100 pounds. It has made a huge difference in her life. Her blood pressure runs from 106/70 to 120/80; her fasting blood sugar levels that she checks daily are at or below 120 and her Hemoglobin A1C – a blood test that provides a snapshot of blood sugar control over a six- to 12-week time period – is under 6, which is considered a non-diabetic level.

It is challenging for her to eat properly on her limited income, but she tries. She says without the clinic to help with her medications, diabetic testing supplies and lab work she would be “a dead duck.”

NEHM Conference

I am back from NEHM conference. I always love attending their conference - I have actually been to all of the NEHM conferences since they started having them. The conference is a great way to meet other people doing health ministry. It is a good reminder that not all health ministry looks alike, but that we are all doing the work we are called to do in our communities.

Those attending the conference include nurses, priests, bishops, lay leaders and this year, even a monk. The conference combines educational opportunities with worship opportunities. We seem to always eat very well, and for me it is a time to rest and reflect. I always come home feeling refreshed.

Next year the conference will be in New Orleans May 8-10. Put it on your calendar and come join us!

NEHM

NEHM is National Episcopal Health Ministries. I am at their annual conference in Baltimore this week. What a blessing to be here with people from all across the country who share my passion for health ministry and social justice.

Yesterday I gave my presentation on "Navigating the Healthcare System". Thanks to Sue Hacker Nelson for  technical support, and to NEHM CEO, Matt Ellis and to Maryfran Crist for their support and encouragement.

Free Clinics of Michigan

I am proud to serve on the board of the Free Clinics of Michigan. At our annual meeting last week, we adopted the following position statements:

Position Statements Adopted by FCOM at the Annual Meeting, April 26, 2013

FCOM Position Statement on

Health Care as a Human Right

The Free Clinics Of Michigan (FCOM) affirm that health care is a human right.  To this end free clinics provide a safety net of primary care for uninsured persons, while working for a reformed U.S. healthcare system that is inclusive, available, acceptable, affordable, and of good quality.

 

FCOM Position Statement on the

Patient Protection and Affordable Care Act (ACA)

The Free Clinics of Michigan (FCOM) affirm the Patient Protection and Affordable Care Act of 2010 as a means to extend healthcare coverage to many of our nation’s 50 million uninsured.  Health reform does not end with the ACA, so we will work for a healthcare system that is inclusive, available, acceptable, affordable, and of good quality.  Until that goal is achieved, free clinics continue to serve those who are uninsured and need care, including immigrants and others who fall through the healthcare safety net.

Further, FCOM supports the expansion of Medicaid eligibility in Michigan, in order to improve the health status of our citizens by providing coverage to more than 400,000 uninsured citizens.