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Fall 2003
City Of Angels
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He has been coming to the clinic for about two years and regularly receives
hygiene kits with vitamins, toothpaste, shampoo, soap and other personal-care
supplies. (The clinic distributes about 50 kits each week.) This evening, Tran
Janco is tending to his injured right foot. "You're going to have to try
to stop running into walls and letting large women step on your toes,”
she teases him. Then she asks, "Are you going to your meetings? No more
falling off the wagon?” No, Paul says, smiling, no more falling off the
wagon. "Now I've got everything going in my life the way I want it to be.
I want to have a girlfriend, just a nice, decent girl — that's not asking
too much — and to be able to give her nice things.” That's good,
Tran Janco responds. "Like we've talked about before, keep working on getting
yourself together.”
The medical care the students dispense is basic. There's only so much that
can be done working with limited supplies and waning light on a desolate city
street corner. After clients talk to an undergraduate caseworker like Tran Janco
or Lozares, they are seen by a medical student to further discuss any health
problems they are having. (The attending physician on site supervises the work
of the medical students, as well as examines clients.) The ailments they most
often confront are colds and the flu, muscle pain, sores, cuts and bruises,
respiratory ills, foot fungus, high blood pressure and diabetes.
The doctors-in-training listen attentively to each person's complaint, ask
probing questions, take careful notes in the record charts kept on each registered
client. They lance fingers to check blood-sugar levels. They dispense what medications
they can — Tylenol for aches and pains, Sudafed or Nyquil for a cold,
beta blockers for hypertension, antibiotics or skin creams for infections, inhalers
for asthma. When a concern is too serious to handle on the street, the students
refer clients to hospitals or more comprehensive health-care clinics, sometimes
giving them bus tokens to get there, and then hope that they'll actually go.
(Often, they don't.) Continuity of care is important, even here, and if the
client is back in the next week or so, the students will be certain to ask whether
he or she followed through to seek help. On occasion if someone is seriously
ill, the students will call a taxi and have him taken directly to an emergency
room for immediate treatment.
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