An Invitation Like No Other - A Patient's Story

Bowing slowly, part of my cultural upbringing in showing respect, I pondered the sudden invitation to come in. I believe I may have hesitated for about 10 seconds, although it seemed much longer as I tried to quickly sort through a jumble of thoughts. Should I enter the house? Is this appropriate? What about any possible COVID-19 exposure? Would I be disrespectful if I shook my head and politely declined while continuing to talk across the doorstep? What would be the right thing to do under the circumstance? I was just delivering some supplies to one of our patients and anticipated a quick hand-off or drop-off.

And then it hit me hard – the genuine, immediate welcome and offer to come in, sit down and talk. An invitation from both Esther and her young adult daughter Maria who helps and often translates for her mother. Esther is a front-line worker whom I sometime see at the grocery store where she works. I also know the neighborhood where Esther lives, so it was an easy and timely delivery to make. Just a box of over-the-counter large lidocaine patches to help deal with the pain, in addition to the medication already called in to the pharmacy. Not expensive, but it all adds up when uninsured and facing a number of bills. It started with a phone consultation at the Clinic the evening before. A couple days prior, Esther had been broadsided by another vehicle, and had to spend the evening in the Kaiser emergency room before being released -- bruised and sore.

So I took a breath – I was already masked and gloved – and entered the tiny in-law unit where Esther lives. Believe me, GPS was little help in finding the location based on an address alone, as it was tucked behind a house and high fence. After entering, I first noticed the mattress directly on the floor taking up a majority of the front room area, as there was no bedroom. We sat and talked at a small table and chair on the side of the room while Maria showed me post-accident cell phone pictures. Right then and there, I was able to take some of the images of Esther’s bruises, as well as those of her vehicle showing the impact of the collision, email them to the Clinic, and then later upload directly into Esther’s patient chart in Kareo so our providers could review.

Kareo is the Clinic’s new EHR, a secure cloud-based medical office software platform. With this technology we can treat patients using telehealth (via phone/video), a necessity during the pandemic and an integral part of future patient care, and finally transition from paper charting/recording to electronic. (We thank you Dr. Michael Matly, KM, Clinic board member and Kareo board member, for this “gift” –  one that many independent medical practices rely on and pay for as it is considered best-in-class.)

Anyway, back to Esther. Her story could be that of any of our patients, or any one of us should we lose the benefits and security we often take for granted. We have been treating Esther for about six years now, as her medical history is complicated, exacerbated by rheumatoid arthritis. This type of autoimmune arthritis causes pain and swelling in the joints, especially in the hands and feet. And her hands and feet are the necessary tools of Esther’s trade (she stands for every shift she works)  as a front-line grocery checker. Simply put, if her hands and feet don’t work, she can’t work. We are very fortunate to have Ron Connolly, FNP, one of the Clinic staff providers and nurse supervisors, who has experience with RA and musculoskeletal issues. Ron has been working closely with Esther in monitoring her difficult condition, made even more challenging by not being able to examine her in person at this time. And every conversation and interaction with Esther requires sufficient time and a Spanish interpreter. Thankfully, we are blessed  to have two Clinic staff members and several volunteers who are fluent in Spanish and help with patient appointment conference calls.

Unfortunately, Esther recently had another emergency room visit unrelated to the vehicle accident. The Clinic, and Ron as her primary care provider, have been following up and she has recovered from this most recent incident. But her ongoing need for quality medical care is ever present. Fortunately, such care is provided for free by the Clinic –to Esther and thousands like her. Last week I saw her again, working at the grocery store, and with a big smile she proudly introduced me to her co-workers, saying I was from “La Clinica de Malta.” I reflected on my patient experience with her, remembering when Esther first invited me inside her home. I thought maybe this is how the Magi felt, bearing their gifts, when Our Blessed Mother, with the child Jesus, invited them to come into the house (Gospel of Matthew). It was just a simple gift of lidocaine patches for our Lord and truly an invitation like no other.

By Anne Brussok, DM