Medical student back to roots at M-F clinic Brenda Simpson, a third-year student at OHSU, is in the midst of a five-week, rural-health rotation in the city.
By SHEILA HAGAR of the Walla Walla Union-Bulletin
MILTON-FREEWATER -- The teen's hand, bearing grubby traces of a day's labor, flutters rapidly over his chest.
Medical student Brenda Simpson carries youthful enthusiasm and hope wth her as she makes her blood pressure checks in the laundry room at Orchard Homes in Milton-Freewater. U-B photo by Jeff Horner
The problem is here, in his heart, Juan says in Spanish to Brenda Simpson. When he runs, his heart feels like it could jump out of his chest.
His face, looking too weathered for the 17 years he claims to be, is creased with concern. Seated in a folding chair in the laundromat at Orchard Homes, he came to Simpson because others told him to see the "doctor" at the labor camp.
He's been to a clinic for the problem, Juan tells the young woman in the white lab coat who shares the small folding table with him - it seems important to him that she understand his efforts.
Doctors in Mexico shrugged off his worry, told him he was fine, the young man continued. But the heavy palpitations haven't gone away.
Adding to his fear is the memory that his grandmother died from "something with her heart," Juan said to Simpson, his flat palm making a half-circle atop his white T-shirt.
Juan, and others in similar situations, is the reason Simpson has chosen medicine in general and Milton-Freewater in particular.
On this night in late July, Simpson is almost done with her five-week, rural-health rotation as a third-year medical student from Oregon Health & Science University. At 25, she's two years away from officially putting "Dr." in front of her name and five years away from going into practice, despite the confidence of Juan and others.
Program a perfect fit
Since 1991, the medical school has required every student to complete a stint in a rural community as a rotation.
This is the first year the Milton-Freewater office of Walla Walla Clinic has participated in the OHSU medical student program, a fact Simpson found irresistible. Not only could she be the first student to come to the community, the small farming town was ripe for research materials.
As part of her rural training, Simpson is required to do a project that benefits her host community. In honor of her own heritage, she chose to look at how Latino workers access medical care, she explained.
Or if they can access it at all, even the most basic services, she added.
A child of a Mexico-born mother and Anglo father, Simpson was raised in El Paso, Texas, just across the border from Juarez. She grew up realizing her stable American life was not to be taken for granted, she said.
Milton-Freewater seemed ideal for her student project. "When I saw it was 30 percent Hispanic, and a large number were migrant workers, I thought I could make a difference," Simpson said, smiling.
She chose to run free blood-pressure clinics for migrant workers on several evenings, allowing her to hand out health advice and ask questions about how people take care of themselves.
Simpson speaks fluent Spanish and she's glad of that now, she said with a laugh. "My mom taught me Spanish first. Not a day goes by I don't use it."
What she found upon arrival, however, was that few Spanish-speaking patients come into the Milton-Freewater medical office ran by Dr. Scott Fry.
There are good reasons for that, Simpson speculated as she waited for more health-screening participants in the clean, well-lit laundry room at Orchard Homes on Elizabeth Street.
In mid-summer, many don't have the luxury of time to come in for medical care. As well, "most don't have insurance and most I've come across are illegal. Undocumented."
Too, many migrant workers lack the education and means to focus on preventative health care, Simpson believes.
A slow start
Despite heavy advertising, including hooking into an informal Latino-centric network, Simpson's first free blood-pressure screenings at Fry's office garnered few participants, she said. "I got two or three."
One man did seek help for painful legs with bad circulation. Simpson advised the 50-year-old to lose weight and wear support stockings. He returned a week later -- five pounds lighter, wearing the stockings and already walking better, Simpson said.
The undocumented worker also had some advice for the doctor-to-be. "He told me people wouldn't come because that meant leaving the labor camp and the safety it represents," she said. "Many are afraid to leave migrant housing, even to walk across the street to Safeway. That was shocking to me. I thought, 'How bad must their situation be in Mexico that they are willing to stay here in that atmosphere of fear?'"
Her own future is only possible because of fate, she feels." My mom grew up (in Juarez), my dad is a dermatologist in El Paso. He treated my mom's dad for a severe skin disease," Simpson explained, "My mom was the interpreter. That's how they met ... I think about how lucky I am. If my mom hadn't met my dad, I could have been an undocumented worker myself."
Two of her siblings have followed their father's footsteps into dermatology and Simpson hasn't ruled it out for her own path, she said. "I love dermatology, but perhaps I could make more of a difference if I was a family doctor."
Reasons for hope
She may be already changing things for some folks. With the simple screenings, which include a caliper measurement to determine the percentage of body fat, Simpson is able to detect potential problems and pass along information in a subtle way. "Taking their blood pressure gives them a chance to talk to them about the health care they get."
Near the table she's set up at one end of the room, three little boys argue loudly over the coloring pages Simpson brought along. One by one, they clamor for her to look at their art as she squeezes the bulb on the blood pressure cuff on a woman who could finally break away from loading washers.
She appreciates she's asking for a sacrifice of extra time, Simpson said. "People are so nice here. They are so happy to talk to me about their problems."
Many of those she examines have higher-than-normal blood pressure readings. While one high reading is not proof of a problem, it catches their attention...the consequences of untreated high blood pressure is new information to most, the student said.
Another young man approaches the table. Freshly showered, he wears pressed slacks and a dress shirt on his lean frame. Despite apparent physical health, Simpson finds his blood pressure high.
"Do you drink alcohol?" she asked in rapid Spanish.
With a rueful laugh, the 22-year-old conceded he does, then listens to Simpson's lecture -- delivered with friendly humor -- about drinking and smoking while nodding his head. Neither blink an eye as the little boys careen around the table and continue to shout.
Her prescriptions are necessarily simple: asking people to reduce alcohol use, smoking and the amount of fried food they ingest is paired with suggesting they continue to monitor blood pressure at free machines in drug stores. She talks about Family Medical Center in Walla Walla, with its sliding-fee scale and Spanish-speaking staff.
Yet Simpson knows no answer is simple enough for most of what she sees. A diagnosis does not equal affordable prescriptions. A recommendation for changes in diet will buck cultural traditions. Fear of deportation will sometimes be greater than fear of death.
When she's done for the day Simpson will ask advice from her family about Juan, who declined to give his last name.
His heart condition is likely caused by panic over his living situation -- hiding from the government, no parents in the picture and toiling long hours in American fields, she said.
"He has these issues, he has no money and no insurance. It makes me sad, a 17-year-old with all these problems and he's here by himself ... I feel helpless."
The answer may come someday, perhaps by opening a clinic for undocumented workers, she added.
When asked how she would find funding, her smile was wide and serene. "Anything is possible."
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BERTIE wrote on Aug 23, 2008 12:54 PM:
" WHAT A GREAT JOB THIS GIRL IS DOING, IF WE COULD ONLY BE MORE LOVING AND GIVING TO EVERYBODY INSTEAD OF JUDGING AND CHECKING SKIN COLOR. WHERE DOES IT SAY THAT ONLY WHITE PEOPLE CAN LIVE IN THE UNITED STATES? THIS COUNTRY WAS FORMED OF IMMIGRANTS FROM ALL OVER THE WORLD. GOOD JOB BRENDA, YOU ARE AN EXAMPLE OF WHAT A DOCTOR AND HUMANITY SHOULD BE ALL ABOUT. TREAT AND HELP ALL PEOPLE, NO MATTER WHERE THEY ARE FROM, YOU ARE ON THE RIGHT PATH. "
educated wrote on Aug 14, 2008 6:02 PM:
" Sad, the white people of M-F and Walla Walla are so uneducated themselves of challenges in this world that YES-you as "white" people do cause. "
tap out wrote on Aug 8, 2008 10:20 AM:
" Frank, You are right on!!! "
frank wrote on Aug 8, 2008 10:18 AM:
" all these creeps that sneek in and are too lazy to be admitted in this country are basically criminals. Hate to bring it up, but it's against the law. But you don't care.You're a bunch of stinking freeloaders. You should all be rounded up in cattle cars and sent back with all your Tacos, and take all your deseases with you "
bp wrote on Aug 7, 2008 2:26 AM:
" Listen I am white but was rised to work for my money- at the age of 14 i worked at blue mt growers in the cherrys and i worked at Smith's, & American Fine Foods in the corn I also babysit and I picked rasberrys and cherry's with my Husband and loved it it was fun. I also had to go on welfare until my husband and I got on our feet & were able to support our 2 childern and haven't been on welfare for over 15 years now and it is great there might be a time in someone life that they need a little help that is good but they should be on it for a life time and don't by anymeans think that all white people or all mexicans, or black people are trash because they are on welfare. This is one white lady who enjoys working in the fields. "
mlee wrote on Aug 6, 2008 7:49 AM:
" Maybe we need to all go back to Euroipe where we came from. There is a lot of white trash in the welfare line and at the city parks. Smoking their cigarettes, screaming at their kids and eating fast food. Why does no one tells the freeloading white trash to go back to England. I worked for public welfare for several years and I it is all white people sucking the food stamps and the cash grants from the taxpayers. Those "mexican" actually will WORK, even if it is undocumented. While the poor white trash sits around collecting benefits. Admit it, you all hate people with brown skin, you are racists. "
frank wrote on Aug 6, 2008 3:04 AM:
" Have you all noticed that we are getting back our old cases of TB,,,whopping cough...and the rest that these free loaders are bringing into the country? Next it will be Small Pox and whatever !!!!!!!!! "
panic attacks wrote on Aug 5, 2008 7:29 PM:
" The panic attacks are probably caused by a lack of magnesium. She should have given him some magnesium capsules? Do a google search on panic attacks and a deficiency of magnesium. "
immigrant - but legal wrote on Aug 5, 2008 5:25 PM:
" Mexico has socialized healthcare. Why should US taxpayers pony up the money? Another question - how come mexicans send 27 BILLION of USDollars across the board and yet can't pay $80 once a year for primary care visit? baloney. "
Quick Thought wrote on Aug 5, 2008 4:24 PM:
" Undocumented workers usually pay taxes, they just never receive any of the benefits. "
Moved away wrote on Aug 5, 2008 3:48 PM:
" I find this story to be a wonderful story, but at the end ... that is what bothers me. Why would we want to start a clinic for undocumented workers. They are illegal and should go back where they came from. If a clinic were built for undocumented workers, we would have more illegals in our country and who would be footing the bill.....those of us that pay taxes. GO BACK TO MEXICO "
BERTIE wrote on Aug 23, 2008 12:54 PM: