Yuba City Medical Mission 2009

Asalamuwailakum!

On Saturday, I went to Yuba City with Bayanihan Clinic for our "Mini Medical Mission". The Mini Medical Mission is quite possibly the largest outreach event of the year; it's essentially a mobile clinic in which we have Bayanihan volunteers, medical students, and preceptors do free health screenings for Iraq and Afghanistan war veterans. Tables were set-up under a tent where intakes would take vital stats such as: blood pressure, heart rate, breathing rate, and blood glucose checks. The intakes also asked patients about their medical history, main concern for a check-up, pain, diet, and medications. After the data was collected and entered into the chart, the patient was sent to the preceptor-medical student team in an adjacent tent for their full check-up. While working as an intake, the high levels of patient interaction I was able to receive made the experience invaluable. I learned so much today, and I'm not sure how I will able to articulate it all into writing!

The morning of the event, I woke up at 5:35 a.m. and prayed my Fajr. It was pretty early to be up on a Saturday, and it took me a while to even realize that I had clinic! All of the volunteers met up at the University Mall in Davis, and we carpooled to Yuba City. I have to give respect to the clinical affairs and outreach student coordinators for organizing all the logistics for this mission; it probably wasn't easy. I was in Fam's car with Lorigail, and we left for Yuba around 7 a.m. The drive there was fun because I really got to know Fam and Lorigail, and in my opinion we all hit it off. The whole time I was insulting Stockton, which really got to Fam because it's her home town. I kept calling Stockton the meth-amphetamine capital of the world, and went on to explain how people did hard drugs there because of how boring the city was...Fam didn't take it well, but that's what made the trip even funnier. We arrived around 8, and started to set up the registration and intake tables.

There were three tables in the volunteer tent: registration, and two intake tables. My first job was to take blood pressure, heart rate, and breathing rate of incoming patients; I became the first person to deliver care to all the patients and it made for a great learning experience due to large amounts of interaction I had. The first two patient's I saw were veterans from either the first Iraq war or vietnam. The veterans were pretty jovial, which was good because it really made the learning process pressure-free. It took some time for me to comfortably feel out pulses as I would tend to press too hard, resulting in occlusion of the artery; luckily, the veterans were really patient while I was poking around their wrists. After taking vitals, I would enter it into the chart and the veteran would move to another table where he was asked about his medical history and had his glucose checked. Thereafter, the veteran would be sent into the adjacent tent to be examined by our onsite preceptors Dr. Guerrero (the Bayanihan Clinic Medical Director) and Dr. Vati. I became relatively proficient with vitals after about 2-3 patients, and it became a bit mundane after the 6th patient. However, it later dawned on me how important it is to measure vitals and the serious repercussions that can occur as a result of inaccuracy and carelessness, but I'll go into this later. I think checking the respiratory rate was the most frustrating vital to take because I had to subtly look at the movement of their chest without the patient knowing (if they were conscious of their breathing rate, they may alter it intentionally or unintentionally). It was hard to see respiration cycles under clothing, and some patients would vary their respirations without realizing it. All in all, taking vitals was pretty easy and being accurate with measurements comes with practice and a whole lot of PATIENCE!

After patients had their vitals taken they were directed to another intake table where they would be asked about their medical history and main health concern during their visit. During the second half of the day I was assigned to this table, and helped out my peers with medical history and glucose checks. I was trained on the glucometer earlier that day and my first patient was an 87 year old man who was thrilled that I was checking his blood sugar. He ended up donating $100 to the clinic because of how impressed he was with the concept of a free clinic that serves veterans like him. It was at this point I started to realize the real impact we had on others, and how much it meant to them to know that there were students who cared about them and their contribution to our country. At around 3 p.m. there were no more veterans so we decided to pack up and leave. It was a really productive day because we saw about 16 patients, most of them who were veterans or family of those who were veterans. Veterans were really happy about free health screenings because either they didn't have adequate insurance or they just haven't followed up with a doctor for a long time. In fact, most veterans came for the blood glucose and pressure testing because they haven't checked it for months or years, which was apparent because most of the veterans had blood pressures in the hypertensive range and elevated glucose levels (although not necessarily to the level of diabetes as opposed to the fact they didn't come fasting).

A really enriching aspect of clinic is the ability to work with peers who share the same commitment of service to the underserved as I do. It's a deeply spiritual experience because we all share the joy of interacting with the same patients, and we can cultivate each other's humanitarianism by sharing the realizations we've obtained through the collective experience. It's easy to see Marc, Fam, Camille, and Lorgail's passion for service when they interact with veterans, and it rubs off because when I interacted with veterans I was able to understand why they were passionate and develop that aspect within my soul as well. It's such a deep experience that words cannot convey the level of connection you are able to develop among your peers through these shared experiences. By midday all the volunteers had their hearts connected and we all understood each other without words. For example, when the 87 year old veterans was so overjoyed and donated to our clinic we all looked at each other and thought the exact same thing, which is was "Wow, this is the impact we have on this person's life?"..." Is this the difference I am making? This is amazing!"

On Saturday, I learned something extremely key about health care delivery and the role of providers. Until this experience, I suppose I never fully realized the impact that health care providers had on their patients. I realized that patients place their whole physical being in the hands of their provider. They trust them to make the best decisions for their health, thus the provider ends up with a HUGE responsibility in his/her hands. If providers make mistakes, patients end up paying with their either their life or quality of life. This invaluable realization dawned upon me while I was checking blood pressure. I realized that if I took inaccurate readings (ex. learning curve or carelessness) it could translate into the doctor missing vital information essential to the formulation of a correct diagnosis. Hypothetically, If I didn't enter correct information in the chart, the doctor would be using incorrect information in treating patients, which could ultimately mean that a serious health condition such as hypertension or diabetes could be missed completely, or misdiagnosing a problem (which is even worse). Who would've known that something so simple as taking blood pressure can have dire repercussions for the patient. These veterans are unlikely to get check-ups long periods of time. Thus, if a veteran has diabates and the doctor misses it because an intake made a mistake, the patient may go undiagnosed for another few months or years where his/her symptoms could intensify and cause severe damage. The mini medical mission was an INVALUABLE experience which contributed to my maturation as a health care provider. It helped me realize the large amount of responsibility that was in my hands (even for something so simple as measuring blood pressure); my mistakes would be paid by the patient with their health. The experience really showed me how important and serious the role of a health care provider is at every step and level of health care.