Category Archives: Clinic Log

Occupy Medical in the News

This week, the Eugene Register-Guard published an article featuring OM’s temporary Cottage Grove Clinic. The grin on Sue’s face reflects the excitement we all feel at pioneering another clinic to help our neighbors just south of us. We are grateful to both the Register-Guard for helping us spread the news. http://www.registerguard.com/rg/news/local/30315793-75/medical-clinic-health-occupy-care.html.csp

Occupy Medical also enjoyed marching in the Eugene Celebration Parade Saturday, August 24, 2013. The Register-Guard covered this event as well. Look for the photo of our favorite cowgirl driving the famous white and red mobile clinic through downtown Eugene. http://www.registerguard.com/rg/news/local/30360181-75/eugene-parade-celebration-winner-street.html.csp#slideshow

Remembering to Be Human – Guest Blog

acupunctureOn May 12 2013, we had a special Mother’s Day guest. One of our nurses, Barbara, asked if her daughter, a licensed acupuncturist, could offer her services at the clinic for the day. Knowing how many patients are crippled by pain that a professional with this skill set could alleviate, we said YES! The post below is a description of her experience at Occupy Medical. For more on Erin or to read more of her insightful blog posts, go to Radiant Heart Acupuncture.

Remembering How To Be Human*
by Erin Telford, L.Ac

I had a glorious, profound experience this past weekend. I flew to Oregon to surprise my amazing mama for Mother’s Day. Since my visit was unexpected, she was already on schedule to volunteer at Occupy Medical in the center of downtown Eugene. We decided that I would come with her and volunteer my acupuncture services.

This is a fantastic setup to provide free medical care and a myriad of services to the under-served population in Eugene. They have doctors, nurses, fresh food, an herbalist, and even a person to cut your hair! It was a gorgeous warm day and I had a nice little line-up of people to treat.

I have never worked with under-served populations. Under-served by my definition are people who don’t get enough. They don’t get enough food, they don’t get enough medical treatment, they don’t get enough comfort, warmth, nurturing, empathy or love.

My second patient of the day was a prostitute who was afraid to be homeless on the street because of her background. She told me a lot of stories, most of which left me slightly stunned and sad. I usually feel like I have some things to say when I’m working with patients. Some pretty reasonable, helpful, relatable things to say.

I like to have a golden nugget here and there that someone can take away and feel uplifted by. It might be ego-y but I feel good making other people feel good. So when this fellow human says to me, I sell myself for money when I’m depressed, I’m stumped.

I felt kind of like a jerk. I don’t have a pretty bow to put on this one. I can’t say, “Yeah, we’ve all been there” and have a laugh because we haven’t. I had nothing. Nothing. I started and stopped. Silence. Awkward? A teeny bit. But then we just looked at each other.

Okay, I thought. Let’s just be here. Because THIS is what is happening right now. This is her reality. I didn’t need to make it better or make it different. My reality and her reality were crossing over and we were just being humans together. So we just sat for a minute or two looking into each other’s eyes. I’m saying I hear you, I understand you, that sucks and I love you in my mind. I hope she felt that. I think she did.

I treated a young woman who was kicking a speed addiction and was grieving losing her children on Mother’s Day. I treated a woman with a painful bunion who was craving more connection with her family of origin. I treated a very sweet man who wanted to propose to me with a ring made of a pine cone and string. All were in heavy transition with very loose foundations, all were very anxious, all really, really needed to tell their stories.

The Dalai Lama had just been in Eugene the day before and everyone was quoting him. It was a bit surreal. The major theme of his talk seemed to be around compassion, nurturing and the responsibility and power of the feminine. We were putting these teachings into direct action on this day.

My mother is a registered nurse so she was camped out on the bus checking vital signs and taking care of wounds. I’m in my own little section of an outdoor tent with just a few battered folding chairs and a metal table that we pulled off her deck and covered with a pretty cloth to use for a workspace. There was no glamor. No flannel sheets, no table warmer, no aromatherapy, no music.

It was still perfect and functional. When you strip away all the bells and whistles, there is just the work. You just give everything you have to give. Nothing else is necessary.

Mother Theresa said that the problem of the world was that we have forgotten that we belong to each other. We are humans. We are all doing this together. It makes no difference if I live in a 2 million dollar apartment on Park Avenue or I sleep on cement steps with my dog to protect me.

We will all take hits in this life. You will never know by looking at someone what kind of trauma they have had to endure. It does not matter. We all deserve to give and receive each other’s kindness and utter humanity.

It’s easy to see other humans as annoying, frustrating obstacles. They are in your way. They aren’t giving you what you want. They are frustrating, shady, slow, entitled, etc.

It’s a choice to remember that we are all made of the same stuff. We all need warmth and touch and sweetness. Be in it together-even with “strangers.”

Connect and serve.

*Used by permission by the author

Benjamin Shares His Day at OM Clinic

I was giving a haircut today to a young man from Oklahoma. He told me that he had never seen anything like our clinic in all the cities he has visited. He wished more cities would offer the nonjudgmental care that we at Occupy Medical provide. He commented that he felt that all the volunteers truly cared about him and for all the other homeless folks.

Volunteers work Together to Set Up the Medical Tents Every Sunday Morning

Volunteers work Together to Set Up the Medical Tents Every Sunday Morning

We volunteers at Occupy Medical seldom have the time during clinic to stop and take in what is truly happening. I personally gave 11 haircuts in four hours today…And that doesn’t count detangling Leather Jacket Dude’s long curly locks. So what I’m trying to say is, I seldom have the time to notice the magic that is happening around me….I feel it but do not always witness it.

Today I witnessed a part of what truly makes me proud to be with this company. Jason came into our intake tent and said that the man with him needed immediate help. He sat him down in Donna’s intake chair and Donna immediately began her process. Jason said to the man, “Are you thirsty,” but did not wait for a reply and ran to get him water. Then Nurse Donna appeared and surveyed the situation. She asked him if he had eaten today and then ran, I mean literally ran to the hospitality tent to get him a sandwich. Within no time the man was fast tracked into the bus. I quietly said to the young man in the chair. What you just witnessed is what makes this team so very special. No one is paid or forced to be here, pure love is the glue that holds this place together.

This is only one incident. I do not always see what happens outside the tent or witness the quality, loving care that is given on the bus. But at the end of the day I see The faces, very tired faces, but faces that glow from knowing that we have truly made a difference today. As my friend and fellow volunteer Carla mentioned after I told her what I witnessed, “This is what villages and small towns used to do, they took care of one Another…We are recreating Community.”

The Clinic Gets a Little Sunshine

Last Sunday, March 24th, Joe and Patti popped by to drop off more donations and take a few pictures of Occupy Medical in action. We were enjoying one of the first sunny, warm days that OM has seen for several months.

Sue sports both the classic Occupy bandana and our new staff shirts. We gone Hawaiian!

Sue sports both the classic Occupy bandana and our new staff shirts. We gone Hawaiian!

The herbalists confer about our newest donations.

The herbalists confer about our newest donations.

OM recycles tincture bottles for the cause!

OM recycles tincture bottles for the cause!

Keeping a weather eye on the clinic. Thanks Martin!

Keeping a weather eye on the clinic. Thanks Martin!

There is always something going on at Occupy Medical.

There is always something going on at Occupy Medical.

Big smiles in the sunshine from Patti and Brooke.

Big smiles in the sunshine from Patti and Brooke.

The New Bathroom

A typical shift at Occupy Medical is pretty serious business. We work long hours, without pay, in all kinds of weather with people who are suffering from sadly neglected medical conditions. For the last year, we have done all of this work without access to a bathroom. Imagine our delight, when the city offered us a free porta potty. Obviously, we are grateful.774565_193986244077694_697280682_o

 OM’s sparkly, new alter-able bathroom

The bathroom was huge hit. Our practical volunteer Benjamin’s 1st thought when he saw this big, blue wonder was, ” I could’ve had another cup of coffee.”  The luxury of a clean bathroom was not wasted on our patients either. Now we can give urine based tests such as pregnancy tests. This is the start of even better service at the Sunday OM Clinic.

The girls in the nurse’s station organized a grand opening. Susan suggested a toilet paper cutting ceremony instead of a ribbon cutting ceremony.  As you can see by the photos below, we loved it. Good call, Susan, good call.774462_193986324077686_987077852_o

Deep January clinic. (by Dr. Leigh)

Dude. Winter is here. Winter is here, and we’re making it – most of us.

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One patient said, “Remember, you told me to quit smoking a few months ago? Well, I did it.”

Another said, “The blood pressure medicine you gave me last time? It’s working.”

Another said, “I ran out of refills last week. I thought I was just S.O.L.” ["Seriously out of luck."] (I changed their dosage by a few milligrams, and saved them $40 a month. In other words, I made it possible for them to have any medicine at all, since they didn’t have $40.)

One patient needed, in my estimation, a “simple” skin surgery – simple under normal circumstances, but here? They came back after 2 hours, as I’d asked them, to get a second opinion. In the meantime, they got a tetanus shot. The second-opinion doctor examined them carefully, and finally said, “You should just come into my office, and I’ll do it for free.” Like I said, simple.

The Public Health Department nurses were there, giving free tetanus/pertussis vaccinations, and hanging out with us. We had new nurses. We had a full Triage team, like a well oiled machine. We had new volunteers helping keep track of patients and their medical records. (We take health-record privacy very seriously.)

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Over in the tent, we had a big crock pot full of hot vegetable bean stew; hot tea; home baked bread. Donna said, “I’m still trying to give away these boots,” indicating a large pair of insulated leather-and-rubber winter boots. I got my hair cut in the tent, chatting with a friendly social worker while Benjamin made me look stylish. Food Not Bombs came and set up next door, with more hot soup and bread for everybody.

We have pretty earnest, good-hearted fun at the Occupy Medical clinic. I had a student with me, and I was telling her, This clinic is for everyone, for free, every Sunday. We see a fair number of people who are unemployed and unhoused, and don’t have many resources other than their wits and good looks, but it’s mainly because of where we park the bus, downtown.

If we parked the bus in the Wal-Mart parking lot, we’d still be super busy all afternoon, with people who might have houses to go home to, but they mostly would still lack proper health resources, such as insurance that pays for doctor and dentist visits, lab tests, x-rays, and medicine.

And If we parked the bus at the health-food supermarket, where people go to get their fancy French cheeses, organic blueberries, and herbal toothpaste – we’d still be busy all day. Just because you have $10 to buy a gluten-free frozen pizza, doesn’t mean you have $250 for a single doctor or dentist visit – or $600 a month for health insurance.

No matter where we go, there we are! No matter where we park the Occupy Medical clinic bus, we’ll always be busy, because injury and illness happen in every social class, and people are falling through the cracks in our broken social system at faster and faster rates, as service budgets are cut and insurance premiums rise. This is why, at Occupy Medical clinic, we don’t ask people to prove they’re poor enough to deserve our services (or rich enough to “make it worth our while”). Health care is a human right, not a scarce commodity.

Meanwhile, since we are parked downtown on a Sunday afternoon, we see a lot of folks who’ve been getting really cold. And we get cold, too. It’s cold! When I got out of my nice warm bed this morning, the online newspaper said it was 28 degrees with “freezing fog.”

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We’ve had freezing fog for a week now. I’m seeing more people with bad asthma attacks from it. One guy called it “cold smog.” Today I saw one person with pneumonia. She called it “Occuplague,” after the terrible bronchitis people got last winter in the Occupy camps, nationwide, from living outside. I told her, your lungs sound like a teakettle that’s boiling – they’re gurgling. My little pulse oximeter showed she wasn’t getting a normal amount of oxygen into her blood.

The shelters generally kick everybody out, every morning, no matter what the weather, so people have to basically walk around all day, if they don’t have a job or school to go to. Last week I took a photo of the view out the window, where I work on the bus. The ornamental pond across the street, with the metal fish sculpture in it, was covered with little icebergs. It’s so cold, and folks are obliged to just kind of walk around all day. So they get sick.

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Did you know that the other local do-gooder low-income clinics are now over-full, and can’t take new patients? One administrator came and visited us a couple weeks ago, to ask, hopefully and apologetically, if we will be able to handle the patients they can’t.

But it’s not all bad news. There’s a lot of good news. I get patients coming back in to show me that they got better, with care. Also, after months of wrangling, protests, and peer pressure, the City has provided the Clinic with a porta-potty. This makes a huge difference! For example, it makes life much easier for our volunteers, who stay on the site for 4-6 hours at a time, often coffee-fueled and unable to stop their work to hike down the street and buy something in a coffeeshop, for the privilege of using a bathroom. It’s also a service to our patients – can you imagine what it’s like to try to get to the doctor for a severe gastrointestinal ailment, or to take small children downtown to be seen, and there’s no bathroom? We can also do pregnancy tests and simple urinalysis now. It’s just incredible. It’s practically “first-world.”

The City has also allowed us to plug into the park’s power supply – after we took out an extra-large insurance policy protecting the City from any lawsuits – the kind of insurance policy that would be appropriate for a giant rock-and-roll show. Oh, well. At least we have lights – and a wee space heater, at the chilly doctor’s elbow.

We’re feeling pretty fat and sassy, now, in fact, with our fancy electric lights, and our porta-potty, and our hot drinks and pot of soup. Benjamin, the guerrilla hairstylist, can even run clippers and a blow-dryer, as I found out myself today. Stay tuned for the Friday clinic, staffed by a heroic team of nurses – a dedicated Wound Care Clinic. By golly, if elected officials can’t figure out how to provide health care as a human right, we’ll just have to do it ourselves! We could be heroes, just for one day.

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Occupy Medical clinic is tremendously excited to welcome any new volunteers who can offer any skill. Particularly needed are additional primary-care doctors, nurses, pharmacists, caring-profession students and trainees, dentists, dental hygenists, certified herbalists, veterinarians, pet groomers, licensed bodyworkers, counselors, social workers, mechanics, engineers, bus drivers, roadies, bouncers, organizers, fundraisers, statisticians, publicists, printers, artists, photographers, seamstresses, group facilitators, workshop teachers, friends, neighbors, cheerleaders, and people to help set up and tear down.

About the Public Health Department vaccine programs: http://www.lanecounty.org/Departments/HHS/PubHlth/Pages/lcph_immunizations.aspx#adults

About Food Not Bombs: http://www.youtube.com/watch?feature=player_embedded&v=_jZKjBVXGJI#!

Chaos

Chaos* is the science of surprises, of the nonlinear and the unpredictable. It teaches us to expect the unexpected.

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My daughter came back to town after finishing midwifery school. She needed a ride downtown to meet a friend for coffee. She came with me first to the five-and-dime, where we bought an electric teakettle to heat up water for the Wound Care nurses, at the Occupy Medical bus. The teakettle was really very pretty: dark red chrome. She helped me carry stuff: my doctor bag, and the teakettle, etc. I introduced her around. We were early: it wasn’t time for me to start seeing patients yet; Dr Peter was on board.
 
The Butterfly Effect: Small changes in the initial conditions lead to drastic changes in the results.
So we filled up the red teakettle, first asking about the status of the water (potable) and figuring out how the faucet works on the bus (you have to pull a knob). We plugged it in and turned it on, and all the lights went out.
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Everybody went, “Woahhh!” and looked at each other. My daughter and I whispered to each other, “Did we do that?” Dr Peter opened the blinds where he was working with his patient, and after a minute, he called out, “Can we get the lights back on?”

I went outside to look for one of the engineers, and Nurse Bill said to me, “You start from the back, I’ll start from the front, and we’ll try to find a fusebox.” When I went back inside, James was already flipping breakers, trying to find one that would work. We unplugged our pretty red teakettle.

Unpredictability: Because we can never know all the initial conditions of a complex system in perfect detail, we cannot hope to predict the ultimate fate of a complex system.
After a while, some of the overhead lights came on, but flickering. Dr. Peter’s lights still weren’t on. People kept calling back and forth, “Is it working now? Now is it working?” “Naw, still out!” “…How about now?”

Chaos explores the transitions between order and disorder, which often occur in surprising ways.
Dr. Peter’s shift was over, and my daughter helped me to quickly wipe down the entire doctor’s area with bleach wipes, like we always do at shift change. Our new Triage EMT, Elliott, asked, “Do you need a medical interpreter for Spanish?” I looked at my daughter, and we both grinned. She’s an activist who just spent the past year and a half learning how to be a midwife, entirely in Spanish. How convenient!

Together we saw a patient with a bad tooth, using a flashlight and the scant daylight through the window blinds half-closed for privacy.

The patient had a friend once who died from an abscessed tooth – most likely septic shock. We were able to discuss this concern in detail, because we happened to have the right interpreter, and happened to ask the right questions, at the right time, on the right day – even though we blew the lights.
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Turbulence ensures that two adjacent points in a complex system will eventually end up in very different positions. Mixing is thorough because turbulence occurs at all scales.
My daughter went back outside with the patient, and the antibiotic prescription, and got them signed up for our upcoming Dental Clinic, where hopefully that bad tooth can be permanently fixed.

The lights came on. My daughter went to the coffeeshop. I started seeing patients with complicated issues – a few with simple issues, thank heavens, but as usual, I got behind. More and more behind. There were others with infected teeth, one diagnosed with a skin condition at an urgent-care site but not treated, one with pertussis who’d been prescribed an over-the-counter antihistamine, at another urgent-care site…

Systems often become chaotic when there is feedback present.
…People with digestive or urinary problems, needing a good explanation of what might be going on, to properly manage and treat them. People prescribed $150 brand-name medications they can’t afford, when $4 equivalents are available. People with medical complexities that are like Russian nesting dolls, one ailment enfolding another, with yet another at the root. A medical system so difficult to navigate, that many patients come to us simply to ask directions for it, or to get a translation from ‘Medicalese’ to ‘Plainspeak’.
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Running late, just at the time we’d normally close, I got down to my last three charts. But a radio journalist had been waiting for a long time to have a quick word with me. Sometimes, all the work in front of you is time-sensitive! We sat together and spoke for a few minutes. I gave my pitch for volunteers. Doctors! Nurses! Veterinarians! Dentists! Two hours ain’t bad! If you have just two hours a month to give to your community… well, that would be fantastic.

Fractals: Infinitely complex patterns, that are that are self-similar across different scales, are created by repeating a simple process over and over in an ongoing feedback loop. Driven by recursion, fractals are images of dynamic systems.
Everybody’s phone pinged. “Blizzard Warning until 6 pm Monday night.”

Huh?! …It wasn’t just me. Nobody else had had their phone suddenly alert them to an approaching blizzard before, either.

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Outside, the wind picked up, and the Intake tent became a very heavy box kite. Volunteers, including the radio interviewer, leaped over to rescue it. I could hear tent poles clanging as I finished seeing patients, long after everyone was ready to hurry home in the dark, through the 50-mph gusts.

It’s a good feeling to tuck everything away at the end of the day, restoring a temporary illusion of order from the day’s chaos – boxes of gloves back in the drawer; dermatology atlas, wilderness-medicine and other textbooks back in the cupboard, sharps box and ear-scope tips put away, homemade public-health flyers and bottles of hand sanitizer stowed – and, of course, the fatal teakettle.

It really is very pretty.

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*from http://fractalfoundation.org/resources/what-is-chaos-theory/

by Dr. Leigh (Leigh Saint-Louis, MD)