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UCSD Free Clinics Project at Pacific Beach United Methodist Church

"Working at the Pacific Beach homeless shelter has been one of the most rewarding clinic shifts of my interning career. My first exposure to the reality of the homeless arose very early on when I asked a patient what made his pain worse - heat or cold. This was a tough question for him because most nights of the week he slept outside on concrete. The showers that are provided for the homeless are usually cold and he really had to think back to what it was like the last time he had a warm shower. So I've had to learn to ask different questions. This extends to treatment as well. Before I use Po Sum On I have to ask, "Do you have someplace warm to sleep tonight?" I've also had to become very practical in the lifestyle advice I offer since the homeless rarely have the resources to make the changes I ask of my other patients - suggestions I've made so often that it has almost become a mindless activity on my part. My experience here has made me much more aware of the importance of really understanding a patient before developing a treatment plan or suggesting any sort of lifestyle change. At the PCOM clinic I tend to see a fairly homogenous patient population and it is dangerously easy to become too comfortable with a standard set of "solutions" which may be completely inappropriate for a patient who doesn't fit the mold.

The homeless patients have been some of the most gentle people I have ever treated. Most of them have a great sense of humor, too. All of them deeply appreciate the care they receive in our clinic. I feel privileged to be able to participate in their treatment. For many of them, the attention we provide is the nicest thing that happens for them all week. Unless we are very busy, we usually get to see some of the same patients each week. This makes it possible to develop rapport and follow a patient's progress in terms of their health as well as their search for work and a stable living situation. Since the treatments are free, patients tend to return, providing us with the opportunity to follow their progress over a longer period of time than many of our paying clients at the PCOM clinic. The fact that money isn't involved in these treatments coupled with how much the patients appreciate our care makes the homeless shelter a truly rewarding experience."

Andrew Crimmel - Intern