Wilkes-Barre, Pa., Clinic Is Last Resort for Uninsured Poor. - Knight Ridder/Tribune Business News

By Todd Meyers, The Times Leader, Wilkes-Barre, Pa. Knight Ridder/Tribune Business News

Mar. 17--WILKES-BARRE, Pa.--Patrick Ripley visited the Interfaith Health Clinic on a recent Wednesday, worried, unable to stop thinking about a lump on his neck.

The lanky 34-year-old father of six said he had no medical insurance to pay for diagnostic tests.

He injured his shoulder at work pulling a rope several months ago.

The workers' compensation doctor ordered an MRI scan that revealed a swollen lymph node in his neck.

'The doctor had me so freaked out,' Ripley told Shirley Smith, the clinic's coordinator and a registered nurse. 'The doctor wanted me to get a biopsy. It's a lot of money and I just don't have it.'

Downcast, Ripley mentioned how another area clinic turned him away because he didn't live in a homeless shelter.

Speaking in soothing tones, Shirley laid out a plan for Ripley. A doctor would examine him now, and the clinic would schedule blood tests at Mercy Hospital, Wilkes-Barre, for that afternoon to check for lymphoma or other cancer.

A half hour later, Ripley, visibly buoyed beneath his black-and-red Tampa Bay Buccaneer ball cap, returned to the clinic's waiting room, lab orders in hand.

'They're going to rule out the possibility of the bad stuff,' he said. 'At first when I got here, I thought they were going to send me away. I don't cry, but I thought I was going to bawl.

'This was the last resort.'

That's a fair description of the close-knit gang of volunteers who work in the refurbished clinic in the basement of St. Stephen's Episcopal Procathedral in Wilkes-Barre each Wednesday from 9 a.m. ntil noon -- or until the last patient is called in from the blue plastic chairs in the hallway that doubles as a waiting room.

The clinic is open to anyone in the community who is uninsured, underinsured or who lacks access to health care. Clients must sign a consent form that also documents their inability to receive medical care elsewhere.

Since Shirley helped establish the interfaith clinic five years ago, volunteers have provided free exams, medications and limited diagnostic tests to more than 1,000. Many are repeat clients who schedule regular office visits.

The clinic recorded 813 visits last year. Five of the eight patients examined on a recent Wednesday were first-time visitors.

Behind the statistics is a corps of folks who give freely of their time, week after week, month after month -- some, year after year -- to treat sick people who have nowhere else to go.

Brother Jerome Matthews, retired from the King's College library, is the front line, greeting patients, creating their charts and keeping records.

Whenever he hears footsteps on the stairs, the tall, wispy clerk rises from his seat, pokes his head into the hallway, and instructs patients to sign in on the yellow legal pad.

As often as not, Brother Jerome ends up directing people down the hall to the Clothes Closet, which shares the church basement and is open the same hours as the clinic. The Clothes Closet provides free clothing for men, women and children.

On a recent morning, Brother Jerome frets. A man named George has left abruptly after signing in, but promises to return for an exam.

'Has anyone seen George?' he asks a reporter and other patients every 10 minutes.

Nearly an hour passes and still no George.

The doctor du jour, a senior resident physician from the Department of Veteran Affairs Medical Center, must leave 15 minutes early to make it to another clinic on time.

'Any more out there?' Shirley asks.

'We lost George,' the clerk replies.

'Well, doctor, it's past quarter of. You may go to your next duty,' Shirley says.

Dr. Ponnaiah Mohan pulls a coat over his turquoise-colored scrubs and leaves. Moments later, a red-faced George bounds down the steps, mumbles an apology about being detained and announces he's ready to see the doctor.

George has run out of blood pressure pills and he can't reach his physician to refill the prescription. He complains of a severe headache and a skull that feels 'ready to explode.'

Brother Jerome exchanges worried glances with two volunteer nurses.

Shirley averts a potential showdown, steering George into a chair and briefing him on the facts: He left the clinic. The doctor is gone. No doctor means no prescription. No prescription means the locked metal cabinets stocked with medicines will stay locked.

She suggests that George try harder to contact his doctor, or visit an emergency room. George goes quietly.

That's why fellow volunteers refer affectionately to Shirley, 67, as 'the big boss.' They marvel how easily she handles Charlie, a well-known street person in the city and a fixture at the clinic.

Asked why he's at the clinic, Charlie fires back, 'I'm nuts.'

Charlie tells tales that can last for hours and disrupt the clinic.

'I'm not going to cause trouble,' Charlie pledges, reminding Shirley she's a 'nice lady.'

'Next week's my appointment.'

Still, Charlie is clearly in no hurry to leave.

He models his newest prize from the Clothes Closet: a navy blue overcoat, size 42. The perfect new layer to add to the multiple overcoats he wears to ward off the winter chill.

'This is nice. It's London Fog,' he says, revealing the label. 'And look at this, it's 100 percent virgin wool. I look like an undertaker now.'

'No, you look like a classy gentleman now,' Shirley says.

Shirley listens patiently for another minute, but pulls the plug when Charlie veers from coat talk to an overblown yarn that features police, a food court, TGI Friday's and idiots.

'Bye, Charlie,' she says over his booming bass, with an exaggerated wave of her hand. 'See you next week.'

Charlie heads for the stairs.

Shirley retired from the VA Medical Center in March 1997. The Rev. Don Muller, rector of St. Stephen's, immediately recruited her to help form the clinic.

Asked if she wouldn't rather spend her golden years on a tropical island, Shirley replied, 'This is the island.'

A transplant from Morristown, N.J., retired registered nurse Kathy Thrapp agreed to put one a day per month at the clinic. Now she's there nearly every Wednesday.

'If we had the funds, the volunteers and the doctors, I could see where we'd be open five days a week and we'd be busy,' said Kathy, 59.

High blood pressure is the most common malady treated at the clinic.

'I check blood pressures, and if I find one that's normal, I think there's something wrong with my hearing,' Kathy said.

As if on cue, a well-dressed woman in her 50s appears to replenish a month's supply of hypertension pills.

'I think (the clinic) is the best thing that ever happened to the community,' the uninsured woman said. 'I've been coming here for two years. Thank God there's nothing really wrong with me. I come here for my blood pressure medication.'

Shirley Robins, a first-timer at the clinic, likewise suffers from hypertension and has no insurance. Robins hasn't taken medication for more than a year, saying she can't afford the follow-up visits to the doctor.

'I'm on Social Security, I have to wait three years and hope Medicare is still around,' said Robins. 'I'm absolutely relieved.

They're going to handle my blood pressure problems.

'I believe in prayer,' she continued. 'He is with us when we are in trouble.'

In addition to high blood pressure pills, the clinic supplies antibiotics, cholesterol-lowering drugs, medications for diabetics, ointments for skin problems and non-narcotic pain killers.

Clinic doctors wrote 975 scripts in 2002, with 800-plus coming from the clinic's stocks.

The clinic does not stock or supply controlled substances.

The clinic tries to procure low-cost medicines with proven track records whenever possible.

'For us to use donated funds and to get stock meds, we have to find out what works the best for the best cost,' Shirley said.

Cost is always on the minds of those who operate the clinic.

'People who come here for the first time expect us to do whatever a hospital can,' Kathy said. 'In all honesty, if it's anything really expensive, we can't do it. If it's really and truly an emergency, all we can really do is send them to Mercy.'

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(c) 2003, The Times Leader, Wilkes-Barre, Pa. Distributed by Knight Ridder/Tribune Business News.