On the road

By bus, train, and car this summer, I visited medical clinics in a dozen cities, then walked the neighborhoods around the clinics.

The first stop was small - Zarephath, N.J., 43 miles from New York City, with a downtown home to half a dozen Mexican and Honduran restaurants. Pawn shops, public notaries, and money transfer stores pepper the street.

Like its city, Zarephath Health Clinic (ZHC) isn't physically impressive. Inside, Christian music streams from speakers on the front desk. Pale green walls display pieces of paper with Colossians 3:15 handwritten in black and red sharpie: "And let the peace of Christ rule in your hearts. …"

Dr. John Eck, a tall man with a booming voice and vintage bifocals, tries to foster that peace. His worn lab coat swings behind him as he strides from patient to patient, listening and writing prescriptions quickly since he's familiar with their histories and needs. With one highly traumatized patient, he provides medicine but also conversation, biblical advice, and prayer, spending well over half an hour with him.

Next stop: Baltimore, where doctors at Shepherd's Clinic tell me their patients live with a survival mentality. They must make rent. They must keep the lights on. They must not die young like many of their peers have. Preventative healthcare easily falls to the bottom rung.

I saw the evidence while walking around the neighborhood. Most of the houses are boarded up. Eviction notices hang on windows. The streets are empty except for lone teens walking and an occasional speeding car. But doctors and nurses at Shepherd's don't give up. They work patiently to change behavior: Their healthy cooking classes and stress-lowering yoga classes are often full.

In Washington, D.C., I stopped at a clinic, but it was empty, so I wandered outside and talked to a group of vets. One man said the clinic was all right, but another complained of long waits and bad care.

Many who lack insurance go to hospital emergency rooms when they fall ill. This tendency strains hospital staff and translates into poor service and frustrated patients. I walked to a local E.R. where one woman told me of waiting in pain there for more than 24 hours.

A few blocks later, I met Gregory Sims, a 56-year-old man waiting at a bus stop. He told his own story: incarceration, homelessness, and substance abuse. He said that bad choices and his own pride wrecked his health. A stranger discovered him in pain on the street and called the E.R. From there, he went to Christ House, a holistic rehabilitation program that restored him physically and spiritually. He looks well and now spends his time mentoring guys at Christ House. Sims summed it up well: "This is a stressful city to be poor." He says the best places for care in the city for people with stories like his are the ones run by churches.

In Birmingham, I visited M-POWER, a Christian clinic that provides medical care and help for people struggling to get out of poverty. Inside, the walls are covered with photographs of clients and thank-you notes pinned to a cork board. In the back a community garden produces fruits and vegetables for the clinic to give away. Upstairs M-POWER offers GED prep classes and job preparation workshops.

Everything is volunteer-run, which is why the clinic closes at noon on a Friday. In the afternoon I walked over to a men's shelter with a few people waiting outside. They were eager to talk to a reporter. After interrogating me with half smiles about whether I was mixed-race, they told me where they get care: the hospital mostly, but only on an episodic basis. Sadly, lots of these guys haven't been to a doctor in years.

M-POWER staffer Bethany Rushing put it this way: "We try to teach patients that they can do more than survive, that God does not hate them, and that they can take charge of their lives and succeed."

In New Orleans I met Jack Hunter over steaming plates of barbecue. He told me his plan to open a charitable clinic in New Orleans' Ninth Ward, hardly touching his food because he was so excited: He wants to offer holistic healthcare and spiritual counseling as well as a wellness center.

Hunter is a lawyer, so running a clinic will be a stretch - but he started to stretch when Hurricane Katrina hit seven years ago. He and his wife passed out sandwiches and hosted children's' basketball games several hours a week, but he wanted to do more. His daughter in medical school recommended he look at Christ Community Health Center in Memphis, so he went to visit and came back inspired to go and do likewise in New Orleans. They've secured the land and the first doctor. If everything goes to plan, they'll open at the end of this year.

Wandering the Ninth Ward isn't the safest plan for a solo female journalist, so Hunter put me in touch with Steven Euler - a tall, athletic man who will be the clinic's first full-time doctor. He lives in the Ninth Ward and was willing to take me around the neighborhood. The streets bounce with a Caribbean energy: They're potholed and threatened by weeds, but the houses are painted bright colors.

Euler says he's discovered a deep joy among the locals despite poverty. He introduced me to his neighbors, Joseph and Charles. Later we met Caroline, an expressive woman and double amputee, with a short afro that is dyed reddish-orange. She handed me a glass of water and slowly lowered herself into a chair. For the next hour, she told me one sad story after another of poor medical care at the hands of seemingly uncaring doctors. She's excited about the new clinic and before we left, grabbed my hand and insisted on singing a spiritual together.

How do we get more Hunters and Eulers?