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Workin’ for a livin’

Hi, everybody! It has been a long time since my last post.

I hope this finds you well.  I have heard from a couple of you who are curious about what it is that I do, now that I have a real job again.  So I’ll start by saying that my job is actually two jobs in one, with the occasional odd job thrown in for good measure.  All in all I am considered a faculty member at Baylor College of Medicine, a private medical school in Houston.  As a part of the Department of Family and Community Medicine I am an Assistant Professor.  I work 50% of the time for the CHP, or Community Health Program, through which I work at the Martin Luther King, Jr. Community Health Center.  I am there on Mondays, Tuesdays, and Friday afternoons, and while there I am responsible for seeing patients who need primary care.  At this facility we tend to get some folk who are really sick in some cases, far sicker than one would expect routinely in a suburban family practice.  The people I see are often those who have been amongst the poorest in the city for most of their lives.  Some are aliens who have been here a while, and some are a part of the working poor.  Lower socio-economic class clientele to say the least.

I find my work there to be difficult and yet rewarding.  I feel rewarded in the interaction with the folks one at a time, though overall the workload sometimes is aggrevating.  And love that I see something new or unique all the time.  I can’t remember when I have had so many patients who have been ex-cons.
The difficult part about this job is that it is often hard to make things happen for a patient in a timely fashion.  One of the beauties of the free-market model is that consultants really do want referrals and work hard to please those who make them.  In our system on the other hand the consultants have far more work than they want anyway, so they really aren’t in much of a hurry to clear the waiting lists, especially because they don’t tend to be paid for services rendered but by salary with little incentives.  This leads to patients getting problems solved with such delay in some cases that a similar patient in the private system would be fully recovered before one of ours has even been seen by a specialist.  But, I digress.  I don’t work in policy but patient care.  And I do enjoy helping the individual, especially one who knows that I am all he has keeping him from the unknown fate of no medicine.  Ah, medicine.

In my other 2.5 days of working I am in a Public Health clinic that sees people who have immigrated into the US either via refugee camps, asylum seekers, parole hearings, or on immigrant visas.  The latter usually worked for the US in some capacity overseas.  The Parolees usually showed up one day at the border and begged to get in- most of them are Cuban.  Asylum seekers tend to be from places like Iran.
In this job we do health screening examinations for the government.  They are usually sponsored by an agency (YMCA, Interfaith, Catholic Charities, etc.) in part, but the State Department arranges to pay for housing, Medicaid, and some other support for a few months.  We try to make sure that any medical needs are identified and then referred to appropriate care.  It is nice in a lot of ways.  I like meeting people who are from all sorts of countries.  Several come from Burma, Iraq, Somalia, Bhutan, Congo, and Cuba, but there are others.  It is nice to hear some of the small stories of their lives; all are glad to have the opportunity to come here, even though for many it is a daunting task to learn enough English to survive and get a job sufficient to provide for their families.  I like it though.  I feel like I am getting to use some of the tropical medicine training that I hoped I would be using sooner rather than later.

All in all that’s about all I do.  As a faculty member I may have opportunity to do some writing sometime, but I need to seek that stuff out.  I also may get to go to Honduras in October- we shall see.

That’s all I know to tell you at the moment.

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