It’s a Thursday evening in early spring, and the sun is setting over the St. Vincent de Paul Village Family Health Center in downtown San Diego. In the clinic waiting room, a half-dozen patients have already checked in, here for medical care to address a variety of health issues and concerns.
Thomas McCarthy, MD, a second-year resident with the Scripps Green Internal Medicine Residency Program, pulls up a chair beside Maida Soghikian, MD, attending physician this evening. They briefly discuss the list of scheduled patients, then check in on the first walk-in of the night.
Nellie Johnston came in this evening to discuss test results from blood and tissue samples taken last week. Dr. McCarthy puts her immediately at ease. “Everything looks normal,” he says, explaining the complex lab numbers in concise, easy-to-understand terms. “Everything came back negative, so that’s great.”
But while they’re in the room together, Nellie brings up a new concern. “I’m really swollen in my legs and my fingers, doctor,” she says, holding up her hands to demonstrate how painfully tight her ring has become. “I know my body. This isn’t normal.” The young resident begins asking a whole new round of questions, trying to get to the root of the problem.
Back in the physician conference room, Dr. Soghikian, who supervises and confers with Dr. McCarthy, says, “I’ve been coming here with residents for eight years now. We see a lot of patients here who, because of life circumstances, have a hard time doing the things other people sometimes take for granted, like eating healthy meals, or buying or taking medications they need.”
The second patient of the evening, Cynthia Chappell, is homeless. Cyndi is here because of a painful skin irritation, but has other health challenges as well. In light of her blood pressure this evening, Drs. McCarthy and Soghikian strongly suggest both she and her husband give up smoking the cigarette butts they collect and re-roll. Dr. McCarthy would also like her to take medication to control hypertension, and leaves the consultation room to check with a clinic nurse about charity prescription options. He returns with good news: Cyndi’s homeless status makes her eligible to receive the medication for free. He tells her to come back in a week for follow-up testing.