Sunday, January 13, 2008

New Orleans Nurses Turn Home Into Clinic

NEW ORLEANS (AP) -- The sign on the gate in front of the pretty blue house announced the good news to a neighborhood that has had little since Hurricane Katrina: "There's a doctor in the house. Make your appointment NOW!"

Earl Davis paused to take in the words, then headed up the ramp and through the door - destined for his first doctor visit since returning to the city five months earlier. The family practitioner who treated him as a boy, and then saw his own kids, left after the storm and isn't coming back. Hundreds of other doctors have gone the same route.

Medical centers devastated by floodwaters remain closed, with the number of beds available to the sick cut in half.

Charity Hospital, which for generations provided care to the poor and uninsured, sits like a darkened tomb on a downtown street, plywood blocking the main entryway, window shades twisted and broken.

But the blue house at the corner of St. Claude Avenue and Egania Street is open for business, dispensing free health care to anyone in need.

The Lower 9th Ward Health Clinic is its official name now.

"A medical home," Patricia Berryhill calls the facility offering primary care.

Before Katrina, this was Berryhill's own home. The living room where her kids congregated after school serves as a waiting area now, its walls painted a peaceful powder blue. The bedrooms are exam cubicles, the kitchen a file room and office.

Berryhill, a registered nurse, still spends almost every day at 5228 St. Claude, working as medical director of the clinic, lording over it as she once did her household.

Another registered nurse, Alice Craft-Kerney, runs the business side as the clinic's executive director. She grew up in the Ninth Ward, and rode out Katrina in her brother's house a mere three blocks away.

The story of how these neighborhood women and nurses gave a home - and themselves - to help a community they cherish is one of faith and perseverance but, most of all, friendship.

It is also the story of health-care delivery in post-Katrina New Orleans, where clinics have cropped up in corner groceries and old department stores, and Good Samaritans are stepping in to mend broken bodies and souls.


They met on the night shift at Charity Hospital. Berryhill, 57, was a veteran with more than three decades of nursing experience, and Kerney, seven years her junior, often sought her out for guidance. They shared laughs and advice, and came to lean on each other. If one had trouble starting an intravenous line she would call the other for help.

Their professional relationship blossomed into a personal friendship. Even after Berryhill transferred to University Hospital, Charity's sister facility, Kerney would stop by her home in the Ninth Ward just to say hello. When Berryhill remarried, Kerney helped her plan the wedding.

In 2005, when Katrina struck, Berryhill was managing the high-risk obstetrics and gynecology unit at University Hospital while Kerney was a supervisor for trauma, surgery and the prison ward at Charity. Berryhill was assigned to the medical team that stayed behind during the storm; Kerney was delegated to another group that was to relieve the first.

Eventually, both wound up evacuated from the city - and they returned to a health care system in shambles. Charity, its basement flooded, was closed. University was shuttered for more than a year, though doctors temporarily offered care from a tent. In some neighborhoods, medical workers took to bicycles in search of patients.

"Pre-Katrina there was an inadequate number of beds," says Kerney. "Charity Hospital was the safety net that would take all of the medically indigent. With Charity being closed and so many of the private sector hospitals closed, it put a tremendous strain on the health care system."

Berryhill put in for retirement and considered teaching. Meanwhile, she had to look for a new place to live. Her home on St. Claude Avenue, where she'd lived 28 years and raised four children, was structurally sound on the outside but wrecked inside. She rented a townhouse and considered refurbishing and renting her home below the going rate, to try to help another family.

Kerney was furloughed but found work for an agency doing per-diem nursing wherever she could. She reconnected with Berryhill, who offered a room while Kerney's house was repaired. Kerney declined, but would soon turn to her friend with an offer of her own.

At the beginning of 2006, Kerney met some folks working with Common Ground, a volunteer organization established in the aftermath of Katrina that has provided an array of services to people returning home, everything from first aid and legal assistance to shovels, hammers and manpower to help rebuild homes.

Michelle Shin, the coordinator of services in the Lower Ninth Ward, told Kerney about a group that wanted to donate as much as $35,000 to help rebuild a family's home, but Shin and Kerney envisioned some type of project that would instead benefit the entire community. Shin suggested a clinic, immediately asking Kerney: "What do you think about spearheading it?"

"I wouldn't want to do it without my friend Pat," the nurse replied.

Kerney called up her old comrade to get her on board, and when Shin learned that Berryhill's home was sitting empty, the idea was hatched for renovating it to accommodate the clinic.

"I prayed on it," says Berryhill, who then asked her children what they wanted her to do with the house.

"`Do what the Lord calls you to do,'" they told their mom.

The renovations got under way the summer of 2006, with volunteers from Common Ground hoisting crowbars and hammers to tear out walls and erect new ones. Kind souls came out of the woodwork to help: an air conditioning business donated duct work and units and provided free labor, a New Orleans-trained doctor who heard of the project asked for donations to be sent to the clinic in lieu of wedding gifts.

But the project was not without hiccups as the two nurses suddenly had to learn contracting and management on the fly. On the day of the clinic's grand opening - Aug. 30, 2006, a year after Katrina struck - city building inspectors shut down the operation because the home had been renovated using a residential permit rather than commercial.

New paperwork was filed and additional accommodations made for the handicapped, and last March 1, the clinic reopened.

Kerney and Berryhill vividly recall the first patient who came through the doors: A woman so ill that she passed out and lost control of her bodily functions. The nurses suspected the woman was suffering from severe respiratory problems due to the mold and mildew, but her condition was too dire for their small shop. They called 911.

The incident only proved to Kerney, "We were sorely needed here. Every day."


"Fill all this out. Sign it for me. And I'm gonna need a picture ID," the woman at the reception desk tells Earl Davis.

Clipboard in hand, Davis finds a seat while his wife, Jessica, scans the waiting room, admiring the shelves stacked with children's books and a plastic bin filled with Ziploc bags, each one stuffed with notepads, glue and erasers. She reads a sign: "Kids Please Take One."

"That's neat," she says. "This is one of the good things, apparently, that's derived from Katrina. To go ahead and give this piece of property to help put back into the community ..."

A former medical lab employee, Earl Davis was in a car accident years ago and injured his back and hand. After learning that his family doctor would not return to the city, he began searching for a new primary care physician for himself and his family.

The couple live in Arabi, about a mile east of the clinic, and after passing by on several occasions they decided to drop in.

"They should be commended for what they're doing," he says. "It's definitely needed."

Today, the clinic is one of several dozen scattered across the city but one of the few offering free care. Another is the Common Ground Health Clinic in nearby Algiers, where patients begin lining up long before the doors open. Hypertension, uncontrolled diabetes, asthma, depression and anxiety are the biggest problems among patients at both clinics.

Noah Morris, a 24-year-old street medic who helped start the Common Ground clinic in the days after Katrina, still puts in 12 hours a week without pay at the facility, housed in an old grocery store. Dr. Michelle Carley, a family practitioner who lives in Baton Rouge with her six children, commutes one day a week to the clinic to volunteer.

"When you drive past Charity Hospital ... and you see that it's gone, and then you drive to a corner grocery store in Algiers and you see what's left, the enormity of what's been lost in this city, it's just overwhelming," Carley says. "What we've been reduced to is just trying to help people willy-nilly."

There are plans for new hospitals, but no one expects a system as extensive as the one pre-Katrina. Folks like Morris, Carley, Kerney and Berryhill believe neighborhood clinics like theirs will be the future of health care - in New Orleans and, possibly, other American cities.

Kerney and Berryhill are already scouting for a larger site, but staffing has been a problem, as it is for public and private hospitals and the other clinics around town. Their nurse practitioner found a better-paying job. During a recent week, a volunteer doctor from Pennsylvania arrived with his sister, a registered nurse in Maine, to pitch in.

Still Kerney and Berryhill, who share a devout faith in God, believe they will find a way to sustain their endeavor.

"You have to walk by faith," says Berryhill. "It's only faith that's brought us this far, and faith will certainly lead us on."

"It's not perfect," she adds, and then Kerney interjects: "But we're doing the best we can."

The project has, at times, put their friendship to the test, as any venture that brings together strong wills and strong minds can. But a true friend, says Berryhill, "is a lasting thing ... someone that's there in good times and bad times."

"We are two different human beings, but we have the same vision," she says. "We have a heart for people."