HomeCARES.org - Dr Kate Scannell Article

By Dr. Kate Scannell
Contributing columnist: Oakland Tribune

      Years ago, a patient was slowly wheeled into my examination room by her two laboring adult daughters. The patient's wheelchair creaked and thumped as it rolled through the doorway — clearly an antique, and clearly an aerobic workout for her panting daughters. "The wheel's broken," one daughter explained. "We can't find anyone who knows how to replace it, and we can't afford a new chair."

      Later, during a private moment with the patient, she told me how guilty she felt for "burdening" her daughters with her post-stroke paralysis and inability to walk. How her fear of imposing on them worsened after her wheelchair's tire blew out. How she had confined herself to home most of the time to minimize interference with her daughters' lives. Considering the threesome's plight, I realized that the usual medical offerings I might provide — things like optimizing the patient's blood pressure or diabetes control — would pale by comparison to the greater good that could come from fixing the wheelchair. No pill could compete in terms of restoring this woman's agency and morale, enhancing her dignity and socialization, alleviating her caregivers' stress.

      It's hard to appreciate the potential physical, social and emotional tolls of immobility and dependency. Our health insurance intermediaries, including Medicare, do not routinely provide basic mobility aides to people who can't walk — a human disability that would seem as worthy of insurance coverage as erectile dysfunction.

      To improve awareness about this issue, every legislator working on President Obama's new health plan should be required to spend a minimum of one week in a wheelchair while being tasked with negotiating mass transportation, public rest rooms, department store entryways, traffic intersections, and — most challenging of all — mounting an examination table in a doctor's office.

      But I digress.

      Fortunately, a social worker in the clinic knew about "Home Cares" — a local non-profit organization that collected donated medical equipment which it freely recycled to people in need. She laughed while trying to describe the group's wildly diverse collection of equipment and old replacement parts. She finally managed, "It's a Fibber McGee's closet run by a passionate, die-hard social worker with red hair. You have to see for yourself."

      Last week, I finally visited Home Cares in Oakland — a small office located off a parking lot behind the First Presbyterian Church at Broadway and 27th streets. I wanted to thank its director, Susan Murphy, for having helped this patient and the many others I had referred.

      I discovered that my colleague was right about the chock-a-block medical equipment "closet" and its earnest red-haired director. But nothing in her description prepared me for the most extraordinary features of Home Cares: its vibrant expression of community, its spirited volunteerism, and its deep embrace of the shared vulnerabilities of our humanity. Inside Home Cares, dozens of used canes hang from the wall — profoundly human relics from many unique lives that will pass into the hands of strangers in need. Donated crutches gather in one corner of the storage room, alongside wheelchairs and walkers.

      Shower stools, transfer benches, bedside commodes and bags of wound dressings spill out of the office and onto the adjacent parking lot where volunteers sort through donated equipment.

      A man has come to pick up a cane and commode for his disabled wife. He knows there is no charge for the items, but he pledges to make a future donation as he walks away, as soon as he can, when "things get better some day." A woman arrives and hopes to find a walker for a friend who "can't stand on her own two feet anymore."

      Meanwhile, an elderly woman approaches with a large floor mat balanced on the handlebars of her own walker. Susan runs up to greet her — she is a friend and regular visitor who routinely searches the neighborhood for items that Home Cares might use. A volunteer named Wayne offers to assist me, and I discover through conversation that he's an expert mechanic available to help with wheelchair problems. A young man in a baseball cap arrives — there, weekly as usual, with his pick-up truck brimming with donated medical equipment and supplies.

      In these days of fractious and tedious debates about health care reform, it's refreshing to see what can be joyfully accomplished by community visionaries trying to tackle some piece of the enormous American health care debacle. It is reinvigorating to witness the efficiency with which medical problems can be solved, lives are made better, health care costs are conserved, and the environment is protected. Sometimes a small closet contains an entire and amazing world.