Healthcare in the fringes

Yesterday, for the 1st time I had the opportunity to supervise a group of intrepid 1st year medical students taking care of real patients. Working under the auspices of the North Dallas Shared Ministries, these neophyte doctors took time out of their incredibly busy lives to spend an evening taking care of walk-in patients who have no where else to go. It’s an incredible opportunity for these students to start practicing their craft at a very early point in their careers, providing much needed services to folks who lives in the fringes of society.

Although it’s a great opportunity to learn for them, and  a great opportunity to teach for me, the stories that come through this clinic are a testament to the state of healthcare in our country. Here’s a sampling of the stories we heard.

1: A young talented girl that plays 2 musical instruments, attending community college, working a minimum wage job, struggles to cope with her busy life as she grieves the death of a family member in her native country whom she wasn’t able to visit because of the figurative and literal walls of immigration politics.

2: A middle aged mother gets gets a perfectly good course of donated antibiotics for a simple urinary tract infection. But unbeknownst to the medical students, lies the reality that she may never get properly screened and treated for a myriad of other chronic illnesses and cancers because she has no access to real primary care.

3: A young woman with recent admissions to the county hospital, returns with a recurrence of a recent illness. Without access to outpatient care and the resources to run proper diagnostic tests, we blindly treat her illness, keeping our fingers crossed that she doesn’t end up back in the hospital. 

4: A well spoken, intelligent immigrant from East Africa came to us suspecting a tape worm infection. She was quite knowledgeable about the parasites, how she might have acquired it and the commonly used treatments in her native country. We proceeded to recommend treatment only to find out that without health insurance, the 1 dose of the medication costs $250. We scratched our heads, scrambling to figure out options. Fortunately, she wasn’t acutely sick. We advised that while the organization looks for ways to pay for this medication, she contact family back home to mail her a dose. 

This is healthcare in the fringes. No where to go, no one to see, an endless cycle of repeated illnesses and a hope and a prayer for a few tablets that cost pennies elsewhere but too much in America ; the best and most advanced healthcare in the world.

Thanks again to the incredibly bright energetic students who did a great job!

UTSW Medical School





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