The Clinic

Hey, hey, hey, hey, get us. Latino USA is celebrating thirty years today, Ain't that amos? And we would love to hear from you. Dear listener, Do you want to share with us exactly what Latino USA has meant to you? Do you have a birthday wish for us? Leave us a voicemail at six four six five seven to one one two two four. That's six four six five seven to one one two two four, and we might feature

Nose Bayan.

Hey, Latino USA, listener, here's a show from our archives. For this episode of Latino USA, We're going to do something a little bit different. Normally, when we interview people who speak Spanish. We translate all of those interviews into English, but today we've decided not to translate any of the Spanish. We wanted to preserve the voices and the people in

In a health clinic in Chicago, Marta Flores is receiving.

Some news chom.

Her doctor walks into the exam room and she barely closes the door before she gets right to it.

Squila and toss see.

Martha has clearly taken aback. The doctor tells her her high blood sugar means something else.

And tossnostico de diabetiss see per controla.

This is a new diagnosis from Martha, but she's been coming to this clinic for ten years. She's sixty six years old and originally from Al Salvador.

Yeah.

Well, Martha doesn't say much or ask many questions after she hears that she has diabetes, but after the physical exam, she seems to get less calm.

Comp we know, Whensa, it's a c.

Marta is also worried about what her daughter will say when she hears about her diagnosis.

Okay, I be an rico mia.

Diabetes can be genetic, but it can also be brought on by diet, especially sugary drinks.

A no.

Martha says that when she sits down to eat, she forgets all about what the doctors tell her she should be eating.

Media, because.

Then Martha begins to listen to me all of her favorite foods.

La banana jos.

Include.

She opens her purse and shows me the banana she has stashed there, and I want to hear more about her banana fanaticism, but we're interrupted by her cell phone.

Buzzy Dana Gisa, Hello, ladies.

It's Martha's daughter calling to see when she can pick her up, and Martha gives her.

The Newsma Notitia, the goat.

Is from Fudromedia and pr X It's Latino Usa. I'm Maria nojosa and today off to the doctor's office. Going to see the doctor is almost always a stressful and vulnerable experience. It's a place where your anxieties about your body and your life are super heightened, and where everything can change with just a few words from your doctor. Undocumented people generally can't access insurance and so their healthcare options are very limited, but one of the places they

What's a free clinic.

It's where our growing up children go for help when they can't or won't come home.

The first one was the hate Ashbury Free Clinic, which came to be after a flood of young people ended up in San Francisco for the Summer of Love.

Dentists, doctors, lawyers, and other professionals are here as volunteers. They treat all the embarrassing ailments of the youngsterdents to nereal disease, drug complaints, hepatitis from shooting drugs with dirty needles, pregnancy problems here, for example, was developed that form of teenage group therapy where the kids just talk out their emotion.

Oh yeah, thank god that you don't think I felt that her so she said she couldn't see me.

Oh yeah.

Today there are twenty eight million uninsured people in the United States, and free clinics can often be their only safety inn We're going to spend time in one of those clinics. In fact, it's the largest free health clinic in the United States. It's called Community Health in Chicago, and it only serves people who don't have health insurance. Now, it's almost impossible for journalists to get behind the scenes access to medical centers because there are a lot of laws,

Thanks Dramos.

The clinic is located in Chicago's Ukrainian Village, a quiet residential neighborhood. It takes Gabriel do Mingez half an hour by car to get to the clinic every morning.

That is logo.

Gabriel is the custodian at Community Health and he is in charge of opening the clinics unassuming glass stores every day around eight o'clock.

Aki in directa meenteno.

Gabriel has a kind face transition lenses and a lot of tools hanging off of his belt loop so.

The key.

He leads me inside the building and I thank him for letting me in, But as soon as I start to leave in search of the front desk, he stops me.

He lets me know that he's like me. He documents the world, Yeah, does your participate?

He pulls up Facebook to show me videos he took of his zoomba classes. He even bought a stabilizer which makes the videos look very professional.

He's implemented.

See the pro.

Over the next three days, we meet a lot of characters. Okay, to go do that?

Do you have time?

Yeah, the patient's not here.

Yes, so I leave you.

Yeah, yeah, I know, sorry about and you are.

If you were to take a god's eye view of the clinic while my fellow producer, Sophia and I spent time there, we would look like pac men gliding around a maze of corridors chasing patients, and the patient's path through this maze starts at the front desk. According to the front desk, Monday and Thursday mornings are their busiest times.

Amos Borquet.

This is Altis Mendez and her name could not be more perfect for her position.

We were talking to our patients.

He asked me what my name was, and he said, well, I forgot. Like you know, it's very easy when you have pain, just think of me.

That's my name, Dolores.

Overall, the clinic sees eighty five hundred patients a year. To be able to get care here, an individual patient must have no insurance and have an annual salary of under thirty thousand dollars. The clinic doesn't treat kids, because Illinois provides healthcare to minors regardless of status. Once a patient checks in, they sit in the skylit waiting room. Their names are called out one by one, they take their vitals, and then the patients are led to their appointment.

And I think that's all, thanks guys very quick. Today the morning huddle is led by Amelia Pilch. She's from Poland, moved here thirteen years ago.

Uh, you know, economy in Poland wasn't that great? Isn't that great? I guess, so we just came here with my parents.

And the Chicago metropolitan area has the largest Polish community in the United States. And the clinic reflects that about a third of patients are Polish speakers, and that's part of why we wanted to visit Community Health. Almost all of the patients we spoke to there were immigrants, and sometimes Amelia briefs the doctors, but she also maintains this leaderboard at the center of the clinic.

A provider is like, really really good at it, we give them a shout out during the hudel.

It's a whiteboard with names like the high score ranking screen in an arcade game, but all the names on it are residents, and instead of a point total, the categories are things.

Like diabetics for they want to see less than nine.

Percent things us non doctors wouldn't understand.

That means that their diabetes is well ish controlled, so anything over nine percent.

And the residents are pretty into these rankings.

It's pretty competitive, to be honest, Like it's so tiny. They're like they always look for their names, and some of them have been on there for like, you know, eight ten times the same name, so they're very like, you know, so we kind of here's you're awesome.

Doctor Mattilios interrupts Amelia as she scours the board for her own name.

Yes, you were there some Well, it's for the residents only, so.

You know.

She's the doctor who diagnosed Martha at the beginning of the story.

Oh, she's told me. I've heard about the.

Cats, and she's often the center of attention. I'm told I must hear the story behind the name of her cat. Natcho.

Okay, my gran sound gave me a joke. What do you think cheese that is not yours? Not your cheese, Not your cheese.

Doctor Rios has been a volunteer doctor at the clinic for eight years, and so she has a special connection with many of her patients. Both Antonia and I spent a lot of time with her and in her exam room between appointments. Doctor Rios told Antonia a little bit more about herself.

Doctor Rios, like many of her patients, is an immigrant. She came to the US from Urdu Way in the late seventies. At the time, there was a military dictatorship and power and the administration was targeting civilians. They believed to be part of a guerrilla terrorist group.

But they were also taken to jail because you have a family who was involved. They would take Koto and you were afraid. Yes, yes we were.

We were.

That's what we emigrated.

Her family moved to Chicago in nineteen eighty three, and doctor Rio started her career in private practice. She worked for three decades and then decided to retire. But if you can't tell, doctor Rios has a lot of energy, and so she started to get restless. And one night, while she was googling at two am, something she told me she actually does very frequently. She learned about this clinic Community Health and thought it was exactly the kind

I didn't know anybody. And I saw these professors from Northwestern rush walking talking given classes, and I said, what I'm doing here? Because I didn't know anybody, I was going to quit. I felt bitter, uncomfortably.

But then she got a little encouragement.

Somebody from the front this game and say, oh my god, doctor Rio. Sold the patient like you so much. They all want to come back to you. So I said, okay, so maybe I can do something good here.

Mattilee is retired. She doesn't get paid to see patients. None of the doctors do. It takes over one thousand volunteers to keep Community Health running.

The way Community Health runs is that all of the doctors are volunteers. Some are retired, but many are full time doctors who spend a few hours a month at the clinic. And all of the prescriptions provided that Community Health are free for patients, even really expensive things like insulin. They even have their own pharmacy. Community Health was founded in nineteen ninety three by an Italian immigrant, a kidney doctor.

Into effect, and millions of Americans finally had same chance to buy quality, affordable healthcare and the peace of mind that comes with it as everybody else.

And many of the clinic's patients were able to get coverage for the first time. In fact, so many that Community Health decided to close their second clinic because of a drop in demand.

One knowsias, but at least.

One patient Antonia spoke to who felt that getting insurance actually put him in a worse position.

Vis a Linocent Coseinyez stopped going to Community Health when he began getting insurance through his work, but now he wants to return to the clinic. The front desk tries to explain to him that now that he's insured, he can't. Jose hands the front desk person a letter, in it he formally declines his new health insurance. He tells her he's decided to stay uninsured in order to be able

Oftentimes people will elect to cantle their insurance for the sake of returning here, which is not something that we encourage them to do.

What this means is that Jose would lose coverage in case of an emergency, since Community Health only offers preventive care. But Kse tells me that it's worth the risk for him because he feels financially that he isn't getting by month to month again, He's willing to risk a surprise visit to the emergency room because his insurance is costing him so much.

Las Cano's camp.

Under his works insurance, he says, he is now being charged five thousand dollars to cover the cost of his lotions to take care of his exzema. When he was a community health patient, they were free. I want to go check out where all these free meds are and so I find myself in the clinics pharmacy. Doctor Rios is there and she lets me know the lowdown on one of her patients.

So we are here because we have a patient with very high cholesterol called familiar hyper cooleisterolemia, and she's in in medication. She's taking a medication who lowered the colesterole What I think now she may not be taking the medication. That's something many times we find that they prescribe a medication, they get the medication from Fienn, but they don't take.

Patient Irma arrives and it has led to the exam room. I followed closely behind.

Is that medicina.

Doctor Rios cuts.

Her gaze away from Irma and towards me with a sly expression that says, see told yourself, mad. It seems like Irma is starting to give in to doctor Rios. She's saying that there are nights that she skipped the medicine because she feared that it was keeping her.

Up well, not is.

Mando?

Okay?

So when doctor.

Rios seems genuinely shocked that she was able to get to admit she wasn't taking her medicine so quickly, and she tells she's worried about her needing to get up in the middle of the night to use the bathroom, that it might be a sign of another problem, and so she's going to order some.

Tests, per okay. When I sit in an empty exam room.

Your croquet when.

Medico perolas, when I the door so we can talk privately, mises.

Bin.

I learned that there are things in IMA's life that are not so easily fixed just by taking the pills for cholesterol that doctor Rios so desperately.

Wants her to take.

Ima opens up about very personal things, and even though I have her sign a consent form with her full name. All of the patients we spoke to did. Because of the nature of her story, we have decided not to include her last name. When she arrived in the US, she started to work in housekeeping at a hotel in Evanston, Illinois, a wealthy suburb north of Chicago, but she stopped after something happened at her work.

Physic any persona and mana years.

Maybe.

And Ima says that she was frequently raped by her.

Managercopava Centia, Centia forte centia.

Can Ima says that people at her job didn't support her, and that many of her colleagues were facing similar treatment but couldn't speak up because they did not want to lose their jobs.

Yep.

Finally, one day she gathered courage to leave her job and filed a complaint with the local police.

And I'm with forion.

A persona.

No no, nothing machines.

She struggled to find help until learning about this place Community Health.

Neste okay no I spress.

In addition to the doctor, she sees a therapist here and with her help, she's been able to reframe what happened to her.

Garnet gnio.

Espress her calu cha.

She's been here for only a year. She admits there's still a lot of work to be done.

Okay, so yes, a moment to schedules Canada, the po be there, and the Moon says as if his sister.

To super.

People who argue undocumented immigrants shouldn't have access to healthcare pose their position as one about lack of resources. Undocumented migrants are invaders coming to take advantage of our system, to use our benefits and take our jobs. But what this argument leaves out is the altogether common situation in

Coming up on Latino USA, we unpack the unique challenges of caring for the undocumented. Stay with us, not stay by, Yes Hey We're back, and producers Sophia Palissa car and Antonia Serejido have been observing the inner workings of the

The clinic normally has the quiet feeling of a doctor's office, in which sound is trapped in the carpet of the waiting room and doctors speak in soothing toes. But there are certain periods of time when the quiet clinic becomes a classrooms. Okay, good. In the evening, dozens of medical students come from nearby universities. They see patients and write up their charts. And she started out and a few of them hang out in the blood lab.

Some centrafugures are running. We're running a couple of miles that patients have given us to test their blood.

You say that likes you're like blood like in a horror movie.

I know, right, I'm count Dracula basically no, yeah.

In the back room is Itze Lopez Tyler mcxanik and Craig Johnson or us Tyler puts it.

This is the original squad.

On their first rotation at the clinic, they were all assigned together each other. They primarily are responsible for drawing patient's blood in order to test for sdis and blood sugar. So what year are you in med school?

First year?

Well, we're rising in second years.

We're in our summer before the rest of our lives.

All three of them are in the process of considering their next steps after medical school. And it turns out Itzel isn't new to community health.

So I took a gap year in between graduating undergrad and then coming to medical school, and I interpreted here.

It says parents are immigrants.

So as like the cultural and linguistic broker, I was often in those clinical spaces with them and just realizing how special and vulnerable those conversations can be, and how difficult sometimes and how things get missed.

What she saw made her want to be a doctor, especially a bilingual doctor.

As soon as you speak their language, even if you don't look like them, they're like, oh my gosh, like they bring in their kids, and their kids don't have to interpret anymore, and they don't have to go through this weird, awkward exchange. So it's important to me, and I really hope, whether it's here in Chicago or anywhere else, that I do serve largely Latino preprilation.

Language is a major issue at the clinic. Their patients speak thirty four different languages, though more than half of them prefer to have their exams in Spanish, and while several doctors speak more than one language, like doctor Rios, the clinic does have volunteer interpreters. The interpreters can be found sitting in a row of bright orange chairs at the center of the clinic, like soccer players on a bench. They wait to be called into the fray.

Yes, I am grading papers. I'm teaching summer school, and I grade papers while I wait.

This is Will Hester. He's a Spanish teacher and a certified medical interpreter.

It's a Spanish one oh one class, so they had to write letters to an imaginary pen pal.

I asked him how he got into interpreting.

I was looking for someplace to volunteer, and my husband said, you need to go to this clinic and you need to serve And I said, oh, I can't do it. I don't know the word for elbow, you know. And my husband said, go get a book, learn the word. That's what I did.

Will approaches interpreting a specific way, like he's not just trying to convey the meaning of words. He's trying to create a more equitable world.

My job is to allow our Spanish speaking patients to have the same access to the US healthcare system as do patients who speak English, and to put them on an equal footing, because what's important in that moment is the connection between the physician and the patient. The interpreter is an important part, but we should be an important part in the background.

In other words, his mission is to convey a patient's words and emotions as accurately as possible, and Antonio got to see him put these very principles in action.

I'm sitting in on an exam with a patient named He's trying to explain to his doctor, Nausea Babel, that he's getting blisters under his teeth. He opens his mouth wide. Doctor Babel is proficient in Spanish and can understand that there's something wrong with teeth. But you can't figure out exactly what he's trying to say. So she steps outside momentarily to bring Will in.

So put this explica, Can I can I precession memo? Will so interpretectunic director.

You know.

Will begins translating for and he does it like he's an actor embodying a new role. He talks in the first person.

So I was going to ask if I could get some better because they're having some blisters to come up under the teeth.

Okay, okay, with this information, I'm going to take it back to the clinic coordinator.

Determinar ne.

Or I can't wait a few days. I feel fine. It's that I couldn't eat.

It feels like Will is the human version of clipping that digital paper clip that used to show up on word documents. Will is very helpful, okay, seems very at home at the doctors.

No mean Cristian Okay, nada, No reporter.

We're not using's last name because of his status. As you can tell, he's a pretty easy going guy, but he's had to face a lot of challenges For as long as he's been in the US. He's had diabetes and he's had to manage it. Along with other health problems, mostly due to his work. Ya so is this Russiao Pintihannas were special compression socks that go up to his knees to help the circulation because he stands for so

Young Gradius, he says this is why he brought.

His family to the US. His nephews were only nineteen and twenty when they got involved with cigadios or hitman, and he feared his children would find a similar.

End your fails, Ya Cal s.

His fear was heightened because he already lost his son in Mexico, not to the drug war, but because of a freak accident.

There's a science, tell you, Natina the away no One.

During exam, doctor Babel asked if he'd be interested in seeing other specialists, including a mental health counselor.

K is a black cone persona.

The problem is similar and prefacing see okay okay.

The counselor's room is three doors down from where Elutio and I are sitting. The room has a surreal quality. When a patient is inside the councilor's room, no one can hear what they're saying because for privacy. There's a white noise machine sitting just outside. But if you were able to see inside, you would see something very unusual. Even though there are no windows, there are dozens of living plants, mostly bamboo. The counselor whose office it is

Coming up the last patient we hear from that community Health.

Stay with us.

Yes we're back.

And for the last few days, producers Sophia Prisa car and Antonia Serejido have gotten to watch how community health works, from how they deal with patients who are more comfortable in a different language to patients with mental health issues. But despite the clinic's breadth of services, they've learned that many of the providers actually wish that clinic didn't exist at all, Sofia Palisaka takes it from here.

In total, we spent three days at Community Health, and over the course of that time, we talked to a lot of patients who are happy with their care, and many of them have been coming to this same clinic for years, decades. Even Community Health treats over eight thousand people a year, and the reason why they can do

I think Community Health does a very nice job of using all the different types of providers in a really innovative way, and I think that that type of innovation needs to be part of our national conversation about health policy.

This is Margaret Bavis, a nurse practitioner at Community Health and an assistant professor at Rush University, and while she's very proud of the work the clinic does, she tells me that she and other providers sometimes feel conflicted about their work.

The founder of Community Health, doctor Gerrillo, when he was here last year for the twenty fifth anniversary, and he has since passed away, but he in his speech at our celebration, made a statement about how he wished we didn't need to exist. And I always think about that and kind of take that to heart.

And she echoed a thought we had heard from several of the doctors here that community health is just a stop gap.

To that end.

Can we replicate this everywhere and should we have to? I mean, can we get the discussion to include everybody, regardless of status.

Doctor Bavis believes health care should be a human right, but she points out to me that even if you don't believe that, there's a public health argument to be made, when diseases spread, they don't discriminate.

If we don't give everybody the opportunity for measles vaccination, then we're putting ourselves at risk. If we don't give everybody an opportunity to have access to health care, we're putting everybody at risk around us.

But undocumented communities aren't just dealing with infectious diseases. There's an inherent stress in trying to navigate our country's immigration system. The final patient we're going to meet is Maria. My godness, Doctor Emily Handel swivels around her computer screen to show Maria her blood tests.

Dierecis for Movianna.

Maria has a vibe of someone who grew up getting gold stars for perfect attendance polester.

And total for ciento viniquatro normal est menosquelo cientos perfecto.

And she takes that optimistic energy into an interview with me. How long have you been coming here?

Wow? I'm be here since nineteen ninety six.

Maria has been living in Chicago for twenty eight years, though she's originally from Mexico City, but she didn't get her legal residency until a few years ago. Having her papers now should mean that she can sign up for health care.

I could apply for that, but for a while, I can.

I can.

I have to weigh five years and I only have a three years.

Maria wants to apply for Medicaid, and as a permanent resident, she can do that, but instead of doing that, she wants to wait five years until she can become a naturalized citizen first, before she tries to get health care. She switches to Spanish to better explain her concern.

Podria is.

No aorda this scene the kuala kuipida, Are you da public tanto medici for the stamps? Eotro keadimento the medicina. It is tarta publica in no Podria's kalivikar para las yoda dani.

What she's talking about here are changes that the Trump administration has proposed to make it more difficult for migrants to seek green cards. The idea was that if migrants applied for benefits like medicaid or food stamps, they could be seen as a public charge, meaning dependent on the government, and therefore ineligible for residency. The rule was supposed to go into effect in October of this year, but it

The Obama gonna be an imer for us.

Maria has considered getting covered through the Affordable Care Act instead of Medicaid, but she tells me she can't afford it.

It was so expensive and say, okay, I paid the insurance or I pay my rent. The migration situation for our communities gray completely.

Grace you, Mual.

And Samchanci there, and that anxiety is what many of the patients we talk to face in their everyday lives. From the beginning of our time here, we wanted to know what it would look like if undocumented people weren't excluded from our healthcare system, and we observed what a difference it makes to have interpreters who care, free medicine and access to mental health treatment. But this is just one clinic, and even though it's the biggest free clinic,

Solo qui.

Lojemos la semos pert in America too. It is zino so Manila. Yes, Loki Mattafurustrella's personas.

He says, in America were worth nothing and that's what kills and frustrates people.

He is almost inferos.

At six pm, the clinic closes down for the day, even though we won't be around to chase patients down the corridors with our microphones. Tomorrow, Community Health will reopen the doors and start the cycle again.

Looks legit all right, our thanks to the many patients, staff and volunteers at Community Health who spoke with us, especially those who allowed us into very intimate moments in their lives. This story was produced by Antonio Serejido and Sophia Palissa car and edited by Fernando Camarina. Additional reporting contributed by Maggie Freeley. The Latino USA team includes Andrea Lopez Crusado, Marta Martinez, Mike Sargent, Daisy Contredras, Victoria Estrada,

The rush.

Funding for Latino USA is coverage of a culture of Health is made possible in part by a grant from the Robert Wood Johnson Foundation, the John D. And Catherine T. MacArthur Foundation, and the Ford Foundation, working with visionaries on the front lines of social change worldwide.

You're also a member of a book club.

It's no book club. We call it anti book club. I was in a book club and this a group of old ladies. What a little, a little grampy old ladies, I say, And the books were more like weapons. So I say that's enough. I left the group and the well, this will be the anti book club. And we get together once a month. We make dinner, and we watch a movie. And the most important is to treat each other really nice.