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Saving soles

Carter, Michael

Journal of the American Academy of PAs: October 2015 - Volume 28 - Issue 10 - p 1
doi: 10.1097/01.JAA.0000471480.34253.56
Becoming a PA

Michael Carter was a second-year student in the MEDEX Northwest PA Program at the University of Washington School of Medicine when this essay was written. In 2014, the inaugural class of MEDEX students at the Tacoma campus, in partnership with Urban Grace Church of Tacoma, began a foot care clinic providing basic foot care services to the underserved populations of their city. The essay describes a typical Sunday at the clinic.

Tanya Gregory, PhD, department editor

Reviewers for Becoming a PA: Alexandra Godfrey, MS, PA-C; Jill P. Grant, MMS, PA-C, MS; Laura A. Katers, PA-C, MS; Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE; K. Patrick Ober, MD; Harrison Reed, MMSc, PA-C

The clatter of dishes rings through the air as people begin funneling into the room. Clothed in old coats and worn pants, occasionally wearing mismatched shoes, they line up for what may be the only warm meal they will have that day. Silence fills the hall as the director takes up a microphone to offer a prayer and an appeal for a calm, respectful breakfast. As the people seat themselves in groups of both friends and strangers, the hum of conversation fills the room. The student group wanders among the tables, offering a kind ear and words of hope to those who are used to being ignored.

As the breakfast begins to wind to a close, we rush back to a small room off to the side to prepare ourselves. Washtubs are filled with hot water and oatmeal bath; supplies are set out; chairs and stools are readied as the people begin to appear in our clinic. Patients settle into the seats, sometimes with a weary sigh or a nervous smile, and remove their shoes. “You'd better watch out for this guy!” says an older man with a huge grin as he gestures to the man seated next to him. “I can't remember the last time he took those shoes off!” Sounds of relief fill the air as feet are slipped into baths and the students get to work.

Bars of soap are pulled from premade kits and feet are washed. Students hunch over on their stools as they look for signs of infection, ulceration, or venous stasis. Nails are cleaned, trimmed, and filed as callouses are smoothed out. Laughter bursts out as a young man flirts with the woman examining his shoes for signs of improper fit. Lotion is applied, and new socks are given to the patients, as are the remnants of the kits to allow them a way to provide their own foot care. Referrals are made for those with problems beyond what the clinic can address. As soon as a seat is emptied it is filled again by someone seeking advice and care for tired feet. Even more, these people are seeking that which makes us all human—the simple connection to another being.

As time passes, tubs are filled and emptied and filled yet again. The crowd outside dwindles slowly, as does the pile of socks and care kits in the corner. The frenzy slowly dies until the last patient stands and, with a dignified smile and handshake, walks out the door. The students quietly clean the remnants of supplies, repack their bins, and begin planning for the next month. Hugs are exchanged along with smiles as they recount their favorite patients. Students slowly disperse, returning to their studies and preparation for clinicals, secure in the knowledge that this is the reason they have sought this path, their faith in the profession reaffirmed yet again.

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