Article by Don Cellini (USA)

Published in The Ofi Press issue 48

At the Free Clinic

For the past several months, I have had the opportunity to serve as a volunteer in a local health clinic.  Patients receive free service, but must fall 200% below the US Poverty Level.  Most of them are employed – mostly in low-paying or seasonal jobs – but none has health insurance.  Eighty percent of them do not speak English so I serve as an interpreter between patients and the nurse practitioners who work at the clinic.  Here are some of the patients I have met in my time there.

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He came in for his blood pressure.  Checked out fine.  He asked the nurse practitioner about the swelling in his one ankle.  After many questions, she determined that it was not caused by the blood pressure medication, but seemed to flare up when he was on his feet for long periods of time or when he walked a lot.  She asked if anything helped alleviate the pain.  He said, “Yes, I have this ointment that I got in Mexico and it helps. It’s made of coyote extract and snake venom.”  She replied, “Keep using it.”

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When he first arrived in the US, his friends warned of the difficulty of sending money to his family in Michoacán. Seems that when they had tried to send money, the wire service forwarded it to a bank in Michigan.

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He had his head down and spoke so quietly I had to ask him three times why he was there to see the doctor.  “Premature ejaculation.”   After questions from the nurse practitioner – how often, how soon, how long he had experienced it – she asked him to keep a diary of each time he had sex with his wife and bring the diary with him when he came back in a month.  “My wife would not like that,” he said.  “Why?”  No answer.  “OK then, just keep track in your head and write it down when you get here.”  “No.  My wife won’t have sex with me until I get this fixed. “

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He complained of constant headaches and insomnia.  He had left his wife, two children, mother and siblings in Veracruz.  One brother had been shot recently in gang-related violence, but had recovered.  At the Mexican grocery story they had recommended that he try Nervio Sil but he said it didn’t help.

(From the label on NervioSil: valerian root extract; passion flower extract; celery seed powder; catnip powder; hops powder; dried orange powder.  Two tablets at bedtime followed by 8 oz. of water.  NervioSil is made from herbs and herbal extracts and contains no drug.  Not habit forming. )

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 He came from Guatemala and he works here on a farm.  Small and short, he complained of shortness of breath.  The nurse practitioner could find nothing wrong.

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She had a large mole on her arm. It had begun to itch and to increase in size.  It was recommended that she see a dermatologist but when informed that the specialist would charge $160 for the office visit, she said, “I’ll start to save money and tell you when I have enough.  Then you can make the referral.”

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Imagine my confusion.  The patient told me she was having pains because of the “diapositivo” (slide/transparency) that she had in order to help with family planning.   What she really said was because of the “dispositivo” (An IUD, or coil). 

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He seemed young although I did not see his records.  Testing and lab work showed he had kidney disease.  There was talk of a kidney transplant at some point in the future.  How does someone without insurance consider such surgery?

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She had been injured on the job.  The MRI showed no injury although she was in pain.  She sought out a chiropractor, but he was unable to help.  Finally she found a physical therapist and she was now showing improvement.  When asked how she could afford to pay the therapist, she said, “I have baked a lot of cakes and bread to pay for it.”

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She complained of blood in her mouth.  A quick exam showed a growth on her tongue and it was bleeding.  The nurse practitioner said this was not something she could treat, but that the patient would have to see an ENT specialist.  She said she did not have the money and left the clinic with her head down.

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 I’ve learned a lot about healthcare during my time at the clinic, especially how culture, experience and economics influence care.   Although I have always believed in the abstract ideals of life, liberty and the pursuit of happiness for all people, this experience has also made me very aware of everyone’s desire to live without pain.  Everyone –above or below the poverty level – wants to live a life free of illness and pain.  In fact, most of the patients want the very same things: a place to call home, to be surrounded by family and loved ones, to work at a job which provides the essentials, and to enjoy good physical health.  I want the same for them and for me.