When the fainting spells started, Ella Thomas got worried.
"I'd be walking around and I'd fall," says the 54-year-old south-side resident. "On the street, taking care of business, at work--I'd just fall down. I was afraid I was going to break something."
That was in 2001. The blackouts got so frequent she quit her job as a private nurse's aide, losing her insurance in the process. She finally went to John H. Stroger Jr. Hospital (formerly known as Cook County) for blood work, and was told she had type II diabetes. She was given pills and told to come back for a checkup in four months. That, she says, was it: "They didn't explain things to me, they didn't educate me on how to eat or prepare my food, they didn't let me see a nutritionist." Her symptoms got worse, but she didn't feel comfortable going back to the county hospital. "They don't listen. They know everything, because they're the doctors."
In May 2002 she moved to a new apartment, in the New City neighborhood. Several times a week she'd drive by Saint Basil's Health Service Free People's Clinic, located in the basement of a convent at 1850 W. Garfield, virtually around the corner from her house. "I kept seeing that sign, 'free clinic,'" she says. "One day I just walked in to see if they'd see me." After a short wait she met with Dr. Roberto Ramirez, one of the ten or so doctors who volunteer their time at the clinic.
"My blood sugar was 530, and it's only supposed to be 200," says Thomas. "I could have gone into a coma. Dr. Ramirez kept me there two hours, pushing me to drink fluids, asking all these questions, and talking to me about my diet and my lifestyle. Then he kept me coming back every week until my blood sugar was stabilized. I felt really comfortable with him. He didn't treat me like I was stupid."
And, just like the sign said, it was free.
Since it was founded by Eric Kast in 1982, the clinic has been providing medical service and medication to uninsured people in the surrounding community and beyond. Since 1987 it has offered dental care too. But at press time, it appeared that Saint Basil's would have no choice but to close its doors at the end of April. The clinic's approximately $650,000 yearly budget comes mainly from grants from hospitals, state medical and dental associations, and a few private corporations, but the funding landscape has gotten rockier and several major grants haven't come through this year. For the past few months executive director Laura MiSweet, one of two paid staff members, has been working for free, and funds for medical supplies and rent are tight. "We've sent letters to our volunteers and to our previous donors, asking for money," says Ramirez, who also serves as the clinic's medical director. "We're trying to get donations from other groups. But even that is a drop in the bucket compared with what we usually get from grants. That might hold us over for another month."
Ramirez says they aren't sure what else can be done. "It would be great if we had a mysterious benefactor, some philanthropist, come through with a large sum," he says, laughing. "I'm an optimist. I'm hoping against hope."
Saint Basil's serves only uninsured people, of which there are more than half a million in Chicago, 1.7 million in Illinois, and almost 44 million in the nation. It doesn't serve public aid patients, who have access to Medicaid, but rather the working poor who fall between the cracks in the health care system. The national health care awareness initiative Cover the Uninsured Week reports that eight out of ten uninsured Americans are employed.
"One of the misconceptions is that all you get at clinics like this are delinquents and alcoholics and people scamming off the system," says Ramirez. "That's the furthest thing from the truth."
As health care costs rise and more employers cut benefits or raise premiums, the numbers of uninsured people are expected to keep growing. The most recent U.S. Census Bureau information available shows that the number of people without health coverage increased by 2.4 million in 2002, the largest one-year increase in a decade.
Uninsured people are much less likely to visit a doctor than people with insurance. Cover the Uninsured Week reports that uninsured women with breast cancer are 50 percent more likely to die from the disease than insured breast cancer patients, and uninsured children are seven times more likely than insured children to go without medical care.
Saint Basil's is open Monday, Tuesday, and Wednesday evenings and has served about 30,000 people for a total of 82,000 visits during its existence. Ramirez says it's one of only two of its kind in the city--there are several other clinics offering free care, but the only other facility reserved for the uninsured is Community Health Clinic, on the northwest side.
Though the county hospital is an option for uninsured people, patients at Saint Basil's say they probably won't go there unless they are in an emergency situation--the waits are too long, the care too impersonal and not anywhere near as thorough as they've come to expect at the clinic. "County has thousands of patients; they forget what's wrong with you," says Rosemary Green, 49, who continues to make the hour-long drive here for diabetes treatment even though she moved to the suburbs a couple years ago. "I need personal attention."
If Saint Basil's closes, the six patients waiting to be seen on one warm April evening all say, they don't know what they'll do. Most of them come here on a regular basis because of chronic health problems including diabetes, hypertension, thyroid disease, and asthma. They have worked with their specific doctors for months or even years to find the best treatment regimens, experimenting with different drugs and diets.
Most of the 20 to 40 patients who come to the clinic each evening it's open live nearby, in New City, West Engle-wood, and Englewood. About three quarters of them are African-American, and about 10 percent are Latinos from the Back of the Yards neighborhood. There are 170,000 uninsured African-Americans under the age of 65 in Chicago, according to the Gilead Outreach and Referral Center, and 230,000 uninsured Hispanics. Diabetes and hypertension, which are especially prevalent in African-Americans, are the main chronic problems the doctors treat at the clinic. They also do job and school vaccinations and general care, and the dental clinic offers fillings, root canals, dentures, crowns, and the like.
"We get calls all the way from Indiana and Wisconsin for the dental clinic," says Jan, the "clinic coordinator, dental assistant, janitor, and triage nurse," who asked that her last name not be used. "There's a real lack of free dental care. Most of these people have been going without the care they need. Especially with diabetes, which causes the teeth to come out."
Providing quality, dignified medical care to poor people was the mission of Kast, a Catholic Marxist Jew who immigrated to Chicago from Austria to escape Nazi-era anti-Semitism. He ended up working as a doctor at Michael Reese Hospital and founding a free clinic with Black Panther Party leader Fred Hampton. A faded portrait of the gentle-looking, bearded doctor, who died in 1988, hangs on the clinic wall near photocopied fliers about hyperglycemia and posters extolling the value of volunteerism.
"Dr. Kast believed that all medicine should be free and that it shouldn't be rushed," said Ramirez. "This is the way I want to practice medicine, not the way we usually have to practice it to make money."
Cynthia Simone, a 43-year-old home child-care worker who lives near Midway airport, says medication for her high blood pressure and thyroid problems would cost her hundreds of dollars a month if it weren't for the free clinic. "Many of us work with no benefits, and buying insurance is just too costly," she says. Simone became a patient at Saint Basil's three years ago after hearing about it from a friend, and now she has brought her friend Patty Mackie, a bartender without insurance. "A lot of my friends are working and don't have benefits," says Mackie. "Something's got to be done about the national health care situation."
Eugene Tyree, 67, nods in agreement. He has been coming to the clinic for four years for his diabetes. He retired several years ago from a job as a mechanic building X-ray tables, though he didn't have health coverage there either. "Before, I would go to Cook County, but I didn't have a steady doctor who knew me," he says.
Because of the clinic's funding situation, in the past few months it's had to close several days when it normally would have been open. Already, the doctors have noticed changes in their patients' health. Nurse Linda Schaaf noted that one recent patient's blood pressure was dangerously high because she had had to wait an extra week to get her medication.
"I'm scared to death about what will happen to these patients if we're not here," says Ramirez.
If that happens, Ella Thomas says she'll visit Ramirez at his private practice in Hyde Park. "But that clinic needs to be there for the other people in the area," she adds. "Especially the older people, and the young people who are having kids. They need this clinic. The free clinic saved my life. I hope it doesn't close."
Art accompanying story in printed newspaper (not available in this archive): photos/Robert Drea.