HOW I FOUND MY RHYTHM WHEN THE MUSIC STOPPED

At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.

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THE MAN IN A BLUE SARONG

I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.

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PATIENT “OWNERSHIP”

I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.

….FULL ARTICLE

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Faith Pharmacy became part of Mission Lexington in 2015. Medications are donated by physicians and drug companies but recent regulation changes have limited donations and medications have to be purchased at wholesale prices. Controlled substances cannot be dispensed. It is estimated that 35 million dollars worth of prescription medications have been dispensed since 2002. It serves 135 patients each month.


The most recent clinic added is the vision clinic staffed by volunteer opthalmologists and optometrists. Patients are evaluated with acuity exams and prescriptions given. Frames and lenses are available on a limited basis. The waiting list runs to about 75 patients.


Chris Skidmore, Executive Director, states that major accomplishments include care for 3,200 patients (a number growing each year), the growth of the medical and dental services and the recent addition on the vision clinic. These included 771 medical clinic patients, 1,531 dental clinic visits and 887 pharmacy visits. Ongoing needs include volunteers for the optometry clinic as well as more ophthalmologist volunteers. Dentists are in high demand as are Spanish speaking volunteers (50-60% of patients are Hispanic). The major limiting factor as with most voluntary service organizations, remains funding.


Free care programs in Fayette County include not only primary care, dentistry and vision clinics but outpatient surgical care as well. This is available thru the Surgery On Sunday (SOS) which is now in its twelfth year. Dr. Andrew Moore, ll initiated the program in 2005 with seed money from St. Joseph Hospital and with surgical suites and equipment provided by the Lexington Surgical Center. Over the years the program has grown to 400+ volunteers (physicians, nurses, clinical staff and administrative staff) who provide outpatient surgery on the third Sunday of every month. To date five thousand five hundred patients have been served.


Procedures include hernia repair, cyst removal, gall bladder removal, cataract removal, carpal tunnel and other problems not requiring post op hospitalization.  Cataract removal is in particular high demand with a long waiting list. At times diagnostic/treatment procedure are done such as colonoscopy with polyp removal.  Usually each procedure is a three step process with a pre-surgical evaluation, the procedure and a post-op followup.


Listed needs for the organization include more funding. The annual total revenue is about $300,000. Financial support for SOS is entirely thru individual donations, grants and special events.  The Lexington Rotary Club’s “ Dancing With The Stars” has become a significant contributor.  Good Samaritan Foundation grants have also been a major contribution.


Other needs include surgical supplies, office equipment and office supplies.  More volunteer SOS anesthesiologists, orthopedic surgeons and gynecologists are in demand as well.


Amanda Ferguson was appointed Executive Director in May, 2017.  She has lived in Lexington all of  her life and has been involved in many local organizations giving her a well founded knowledge of the community’s needs as well as its resources.  In her role as executor for the local SOS her goal has been to provide services as inexpensively as possible compared to their free market value.  SOS has established a permanent office at St. Joseph Hospital at 533 Waller Avenue and is identified with new signage.  It is also initiating the REDCap system (Research Electronic Data Capture), a program developed at Vanderbilt to collect data for research studies and also for operational purposes.


The success of SOS is reflected in similar programs being developed across the country.   SOS has exported a template for many other communities who have recognized not only the humanitarian value but also the economic value of free outpatient surgical care.  Hospitals have seen the value in treating the patients at earlier stages before major complexities develop and the patient requires a more extensive in hospital procedure and subsequent long hospital stays which may not be reimbursed.


Similar programs are in operation in Omaha, Nebraska, Dallas, Texas, Macon, Georgia and close to home in Louisville.  Thru an endowment fund at SOS they hope to provide seed grants and to “pay forward” with other similar programs.

As Americans most have been secure in our needs for food, housing, safety and health. Health care has become more of a right than a privilege and has become more accessible thru expanded Medicaid, Medicare and the more recent Affordable Care Act. In spite of these, many continue to fall thru the cracks and that number may again increase with proposed changes in public health policy and program coverages. The underprivileged will continue to require care often not covered by government programs or limited insurance coverage and again are likely to fall back on the emergency room or urgent care facilities for primary health care.


In Fayette County we are fortunate to have a number of medical programs for the uninsured, the under insured and the indigent and often homeless. Free clinics include Mission Lexington, Refuge Clinic at Southland, The Salvation Army Clinic and Surgery On Sunday. These clinics are staffed by volunteer unpaid physicians and operation of the program usually funded by donations, church congregations and fund raising events as well as foundations.


The Salvation Army Clinic is staffed by medical students from UK and is supervised by a number of practitioners.  Not only does it provide free care it also provides beginning medical students with early patient care experiences (See other article in this issue)


Mission Lexington is a free clinic providing medical, dental, vision and pharmaceutical services to Fayette County residents whose

BY LOWELL QUENEMOEN MD

William Henry Harrison

incomes are below the federal poverty level.  These are adults over age eighteen and may be self referred or sent by other agencies.  Support comes from a number of churches including Calvary Baptist, Maxwell Street Presbyterian, First Presbyterian, Good Shepherd Episcopal, Immanuel Baptist, Faith Lutheran and South Elkhorn Christian. Other support comes from individual donations as well as annual fundraisers, The Mission Lexington Gala.


The clinic is located downtown at 230 S Martin Luther King and houses a large dental clinic with room for five dentists as well as techs and dental students.  It opened in 2006 and now serves 180 to 190 patients per month and has a waiting list about 6 times as long. First appointments are 10 months out.


The medical clinic opened in 2008 and is staffed by a number of physicians. Dr. Sam McGee is the medical director. The clinic currently sees about 85 patients per month with a slowed growth rate after the Affordable Care Act was put in place and Medicaid expanded. Dr. McGee relates that a number of patients were added with the demise of the Nathaniel Mission which for many of years had served the residents of Davis Bottom southwest of Rupp Arena.  The area was disrupted with the Newtown Pike extension and the residents displaced to other areas of Lexington.

LOWELL QUENEMOEN, MD

Lowell Quenemoen MD is a retired clinical neurologist having practiced in Columbus, Ohio for 20 years before moving to Billings, Montana for a further 15 years of practice. At the time of his retirement he was a Clinical Associate Professor at the University of Washington Medical School Department of Neurology. He is a graduate of the University of Minnesota Medical.