For Dr. Patrick Dowling, volunteering at the 2019 Care Harbor free clinic for people who are uninsured or who lack access to health care is a sharp break from his norm of treating people at UCLA Medical Center, Santa Monica.
This atypical setting on the front lines of health care for the most vulnerable, sometimes results in unorthodox treatments.
Dowling and other care givers at the annual clinic held at The Reef in downtown Los Angeles noticed that although the 60-year-old man they were treating said he had given himself insulin prior to his arrival at the clinic, his blood sugar level had fallen too low.
Typically, physicians would have injected the patient with glucose to bring up his blood sugar, said Dowling, chair of family medicine at UCLA.
"We didn't have that available, so what we did do is we started giving him some orange juice," he said, adding that the juice didn't bring the man's blood sugar back to normal."
When the juice didn't raise the man's blood sugar, Dowling gave him a can of Dr. Pepper that he had on hand. That worked.
It was an unusual treatment for an unusual day because, for the first time, the Care Harbor organizers devoted the entire first day of the three-day clinic to caring for the city's homeless. About 1,000 people were transported from homeless shelters to the clinic for physical, dental and vision care.
"L.A. is the capital of homelessness, so we have a lot of people who are sleeping out in the streets with nowhere to go," Dowling said. "And for them to be able to come in and get some medical services … is pretty extraordinary."
UCLA Health has been a major contributor throughout Care Harbor's 11-years in operation. This year a record 350 health professionals from the David Geffen School of Medicine at UCLA, the UCLA School of Dentistry, the UCLA School of Nursing and the UCLA Stein Eye Institute volunteered their services and expertise for the event.
This year's medical director for Care Harbor was UCLA's Dr. Mary Marfisee, a family medicine physician who also serves as program director for the department's Student Run Homeless Clinic for the homeless and underserved.
Care Harbor collaborated with more than 50 agencies and Los Angeles County to provide the services needed for the clinic, Marfisee said.
"In the L.A. community as a whole, it doesn't take any convincing to tell people that there is a lack of affordable health care," she said.
Patients who come to the clinic are frequently medically compromised and don't have good access to medical and dental care, said Dr. Tara Aghaloo, a professor and oral and maxillofacial surgeon at the UCLA School of Dentistry.
The dentistry volunteers performed many tooth extractions, she said. Many patients had high blood pressure, diabetes, osteoporosis, thyroid conditions, infectious diseases, and other health issues.
"So we have a lot of very sick patients coming through here that really don't have access to medical care, and then of course their dental care is also compromised," Aghaloo said. "At UCLA we get to treat a lot of patients, but this is really on a whole other level, these are people who really don't have the access to even to get to us."
UCLA's ophthalmology volunteers see the whole range of eye diseases at Care Harbor, said Dr. Bartly Mondino, director of the UCLA Stein Eye Institute. Among other things, patients get prescriptions for glasses, pick out frames and within one hour walk away with new pairs of glasses, he said.
"It's a natural extension of our mission, which is to preserve and restore sight," Mondino said.
Among the patients who came to the Care Harbor event was Daniel Palacios, a 21-year-old who has been homeless for three years. He came to Care Harbor with his two dogs, Sandy and Polar Bear, who endeared themselves to some of the volunteers.
He was at the clinic to have dental cavity treated. Being homeless, it's difficult to find resources to obtain health care, he said. "I appreciate the help, I feel they're helping out people that really need it," Palacios said.
The spirit of the day was expressed by Dowling.
"UCLA is here because part of our name is L.A.," Dowling said. "This is part of our broader mission to serve all the community."