Today's post continues our focus on Elica Health Center's Wellness Outside Walls (WOW) initiative, which includes programs that make it possible for our providers and clinical staff to deliver care outside the walls of our clinics to those in great need. While it can be interesting and informative to learn about the genesis of such activities, how they are organized, and where the funding comes from, they are no substitute for the stories about and by the people, both providers and patients, who participate in these unique and valuable programs.
The exam room is a picnic table under a park canopy. Twenty yards away, a second picnic table is the waiting room.
And the waiting room is already full when the Elica Street Medicine team pulls up.
“How’s it going, Doc!”
Some of the patients wave, some nod acknowledgment … and some rise to come and get their hugs. All are homeless.
One of the regulars, Jerry, greets each member of the Elica team with tears in his eyes and heartfelt thanks. In the course of the next hour, he will greet some of them two or three different times, forgetting interactions from just minutes earlier.
“We encounter mental-health issues, substance abuse - or both - in about 90 percent of our patients out here,” says Physician Assistant Abram Nunn, one of the program's lead providers. “For some that can mean a borderline personality disorder, PTSD … basically, they’ve had trauma in their life with no real support.”
The navigating of these various conditions is a learned skill for the Elica team members. But they have found that familiarity breeds trust, and so they enthusiastically greet their regulars by name and spend a lot of time talking about their lives.
In this particular waiting room, most of the patients have makeshift campsites nearby, somewhere in the trees on the adjacent acreage. The Elica staff talks to them like they were neighbors across the back fence.
“Hey, Mr. Hank?” hollers Anna Darzins, the street medicine program manager. “Would you take a picture with me?”
“Sure,” says Mr. Hank, who sets down his shopping bags and promptly poses his fingers into rabbit ears behind Anna’s head.
“We feel we can do the most good if we are a consistent, positive presence,” Nunn says. “The personal aspect is very important to that.”
It can begin near an underpass, outside a tent, or under a tree. But every time Elica’s Street Medicine teams make a first contact with a homeless patient, they know that it could be a last lifeline to wellness for that individual. Dr. Matthew Gibson, co-founder of the Street Medicine program, remembers one man whose story perfectly illustrates this.
On an autumn evening in Sacramento, a tiny woman named Denise is going to a doctor’s appointment without ever leaving the street curb.
She isn’t alone. Dozens of the community’s homeless citizens are checking in at Elica’s Health on Wheels mobile unit, parked just across the street from the landmark Sutter’s Fort. For people like Denise, the fully-staffed unit is the rolling clinic that meets them where they are.
Regularly. “I’ve been out here (on the street) since my house was foreclosed on 8 months ago,” says Denise, through tears. “I came to one of these events for the homeless and the (Elica) bus was there. I was still healing from a broken leg, so I had them look at it, and I’ve been coming every month ever since.”
In addition to medical care, the Elica staff is able to provide counseling with a social worker and connection to other social services.
“There’s no question that, for a lot of people, this (mobile unit) is now their regular doctor’s office,” says Anna Darzins, program manager for the Wellness Outside Walls initiative. “And that gives us a chance to build relationship with them when we see them again and again.”
For Elica’s Street Medicine teams, the mission is not limited to the patient in the field. Team members know that they’re having a systemic impact across the entire healthcare system, as Physician Assistant Abram Nunn explains.
If there is one intangible trait shared by Elica’s Street Medicine providers, it might be their desire - and ability - to see society’s invisible people. That heart burden draws healthcare professionals like Sachiko Kageyama, a former emergency-room staffer who heard about Elica’s mission and signed on with the Street Medicine teams in the spring of 2016.