Thank the Lord, after 16.5 months of tiny steps toward employment, I did work my first day on my own in a tiny local rural clinic. I had hoped to be employed right here in Fabens, but that process seemed to have stalled, and I’m so thankful that I have this other situation instead. The clinic is essentially a short single wide trailer with 4 exam rooms, a small lab, pharmacy and several other trailers for an employee break room, medical records and space for community educators to work with patients. It is simple but appears to be effective. It is a lovely blend of third world medicine and reasonable access to….well, MOST basics you might need. This clinic is one of three which never turns anyone away, regardless of ability to pay, and they never ask questions about legal status. Medicines aren’t free, but at $3.00 a prescription on average, most patients seem to be able to hold themselves together. A small percentage of the patients speak English.
My first day on my own was Tuesday. I arrived early with various things organized that I thought would help me work more efficiently. I was concerned that the language challenge would slow me down so I organized my understanding of labs, charts and available meds (talk about a restricted formulary!). The medical assistant who knows all was slightly late (which she never is, the staff assured me). I noticed that the waiting room was absolutely jam packed (that would be about 25 people) at 8:00AM and tried not to think about how I was the only provider around. I knew some of them were there to refill meds and some for the lab, and hopefully just a few of them for me. Once the charts started coming, they came steadily. I marveled at how many “WIs” there were (walk-ins) and reflected on the fact that people wrestling with poverty have unpredictable lives, and the scheduled visits were often “no-shows”, so the staff were filling the slots with walk-ins. I soon figured out that my printed schedule had nothing to do with what I was actually seeing, so disregarded it and had no idea if I was way behind or keeping up OK. I decided not to ask, as I couldn’t move any faster. Kindly the staff informed me that the stack of refill requests should also be tended to promptly; as poor people don’t have rides very often, and they would just wait in the waiting room until the refill was tended to. At the end of the day they apologized profusely for how many patients I had seen (16 including 2 physicals) and explained that the computer and scheduling were all fouled up and I normally would not see so many in a half day. Wow! That was music to my ears, and gave me hope for keeping up in the future.
God is gracious, and somehow the language barrier was almost a non-issue. There were a very few patients whom I realized I wasn’t understanding half the time, but I could get direct answers to my questions and they weren’t very ill, so I didn’t call for translator help. A lot of language acquisition seems to be a matter of squelching anxiety. By the end of the morning I was having a conversation with a lady about her almost 90 year old father having a stomach infection underlying his ulcer history and probably prostate cancer as well. We discussed various options they might pursue and I felt like we were understanding each other just fine. I thought that was pretty good! However, I can’t discuss theology, politics or recipes very well, just medicine.
By far most of the people were extremely polite, gracious and thankful for the little clinic and the good care there. Most of the people were there for hours due to the nature of simple clinics and many walk-ins, but they were as pleasant as could be. I met several people with good awareness of their chronic health issues which were either well-controlled or the people seemed to know what to be concerned about. A few of them were quite frustrated with the fact that the last doctor quit rather suddenly (for a higher-paying job, I understand). I tried very hard to remember to greet each patient appropriately and close every visit formally. Hispanic people almost always have impeccable manners in these matters, and I do not. I’m sure I slipped up a few times.
We’re surely thankful for a job situation which seems perfectly suited to the needs of our family and the ministry here. My boss didn’t even blink an eye when I mentioned what schedule I would prefer, and I have the freedom to work more if I want to. My boss, an intense, passionate activist for the poor, is always saying dramatic and encouraging things about my presence in the tiny clinic. I think he is being supportive and genuinely enthusiastic also. Since I work only AMs, we hope that when Thaine is co-leading a team he will still be able to slide over the border and join them for their afternoon activities, which is the bulk of the day, usually. Meanwhile, it’s good for the kids to have Dad as supervising parent sometimes, too. The morning school is getting done fine, and I think they get better lunches when Dad is in charge!
--Erika