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General Medicine

(Click on title to be directed to posting, most recent listed first)

Tacrolimus-Associated Diabetic Ketoacidosis: A Case Report and Literature 
   Review
Nursing Magnet Hospitals Have Better CMS Hospital Compare Ratings
Publish or Perish: Tools for Survival
Is Quality of Healthcare Improving in the US?
Survey Shows Support for the Hospital Executive Compensation Act
The Disruptive Administrator: Tread with Care
A Qualitative Systematic Review of the Professionalization of the 
   Vice Chair for Education
Nurse Practitioners' Substitution for Physicians
National Health Expenditures: The Past, Present, Future and Solutions
Credibility and (Dis)Use of Feedback to Inform Teaching : A Qualitative
   Case Study of Physician-Faculty Perspectives
Special Article: Physician Burnout-The Experience of Three Physicians
Brief Review: Dangers of the Electronic Medical Record
Finding a Mentor: The Complete Examination of an Online Academic 
   Matchmaking Tool for Physician-Faculty
Make Your Own Mistakes
Professionalism: Capacity, Empathy, Humility and Overall Attitude
Professionalism: Secondary Goals 
Professionalism: Definition and Qualities
Professionalism: Introduction
The Unfulfilled Promise of the Quality Movement
A Comparison Between Hospital Rankings and Outcomes Data
Profiles in Medical Courage: John Snow and the Courage of
   Conviction
Comparisons between Medicare Mortality, Readmission and 
   Complications
In Vitro Versus In Vivo Culture Sensitivities:
   An Unchecked Assumption?
Profiles in Medical Courage: Thomas Kummet and the Courage to
   Fight Bureaucracy
Profiles in Medical Courage: The Courage to Serve
   and Jamie Garcia
Profiles in Medical Courage: Women’s Rights and Sima Samar
Profiles in Medical Courage: Causation and Austin Bradford Hill
Profiles in Medical Courage: Evidence-Based 
   Medicine and Archie Cochrane
Profiles of Medical Courage: The Courage to Experiment and 
   Barry Marshall
Profiles in Medical Courage: Joseph Goldberger,
   the Sharecropper’s Plague, Science and Prejudice
Profiles in Medical Courage: Peter Wilmshurst,
   the Physician Fugitive
Correlation between Patient Outcomes and Clinical Costs
   in the VA Healthcare System
Profiles in Medical Courage: Of Mice, Maggots 
   and Steve Klotz
Profiles in Medical Courage: Michael Wilkins
   and the Willowbrook School
Relationship Between The Veterans Healthcare Administration
   Hospital Performance Measures And Outcomes 

 

Although the Southwest Journal of Pulmonary and Critical Care was started as a pulmonary/critical care/sleep journal, we have received and continue to receive submissions that are of general medical interest. For this reason, a new section entitled General Medicine was created on 3/14/12. Some articles were moved from pulmonary to this new section since it was felt they fit better into this category.

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Entries in Jamie Garcia (1)

Friday
Nov022012

Profiles in Medical Courage: The Courage to Serve and Jamie Garcia

“I've seen and met angels wearing the disguise of ordinary people living ordinary lives.”-Tracy Chapman, American singer-songwriter

Abstract

Some of our Profiles in Medical Courage series have dealt with the famous, and several such as Barry Marshall and Archie Cochrane are household names in medical circles. However, some physicians, just as courageous, are not so renowned. Jamie Lynn Garcia was one of those who died earlier this year at the age of 52.  She was a devoted servant of the poor and founder of the Pomona Community Health Center. Her road to becoming a physician was not straight-forward but her life story was an extraordinary one.

Early Life

Jamie was raised in the Westchester section of Los Angeles, just north of the Los Angeles International Airport. She had a rather ordinary middle class upbringing in a Hispanic family where her father was a gardener and her mother a realtor. Her parents were strict Catholics and she attended the Catholic schools. She was a bright student but also had a beautiful singing voice that she was encouraged to develop. "As a child she had severe asthma," but there was a physician who helped her, "a doctor who was inspiring." (1). However, with adolescence her asthma improved but other issues were hard on Jamie. After reading the Bible at age 12, she rejected religion, and after passing a high school proficiency exam, left high school at 16 to become a professional musician.

Rock and Roll Years

Jamie used her voice and her instrumental talent on guitar, bass and keyboards in many of the bands in the Los Angeles during the1980’s while supplementing her income as a realtor (2). These bands followed her eclectic tastes and included country, jazz and pop but the most successful band was the all girl rock band “On the Air”. They had gigs throughout Los Angeles, aired videos on VH1, and garnered the attention of major record labels. However, the band collapsed when the lead singer decided to pursue an education. Several of Jamie’s friends, encouraged Jamie to do the same. Thinking that they might be right, she decided to go to college with no particular goal in mind.

Education

She enrolled at Santa Monica Community College and later transferred to UCLA where she majored in philosophy. During her later years in college she recalled her childhood doctor who treated her asthma. She thought, “I could do that”, and applied to medical school. She attended the University of Washington. There she meant her partner for the next 15 years, Dr. Sue Verrault, a child psychologist. After graduation, Jamie returned to the Los Angeles area for a family practice residency at Pomona Valley Hospital.

As a resident she was moved by what she saw as an enormous need for healthcare of low-income patients, especially those with chronic conditions such as heart disease, diabetes, and asthma. Dr. Jamie, as her patients came to call her, was a compassionate physician, but her faculty noted she spent too much time with patients, especially psychiatric patients. Fearless and confident, she occasionally liberated hospital supplies and took them to the streets to treat the homeless. During her last year in residency, she heard of a homeless man living under a nearby freeway bridge who was in dire need of medical care (2). She crawled under the bridge to find him, and convinced him to come with her back to the hospital. She enrolled him in a treatment program for alcoholics, after which he remained sober.

Pomona Community Health Center

At the time many of the ER’s and clinics were closing in East Los Angeles and she recognized that the inadequacy of the healthcare system to serve the healthcare needs of the poor. While still a resident Jamie partnered with the LA County Department of Public Health to operate the original Pomona Community Health Center, a two-room free clinic serving the homeless, uninsured, and underinsured in east LA County. After completing residency, she continued the clinic with the help of Federal grants (Figure 1).

Figure 1. Dr. Jamie Lynn Garcia (right) with patient at the Pomona Community Health Center.

The next 8 years were difficult. Money was tight but Jamie dreamed of a larger clinic and began the long process of planning the clinic’s expansion. She had no formal training or experience with such a large project, but assembled a board and staff, sketched out each exam room and calculated the cost of materials, planned budgets for doctors, created partnerships to secure a location, and raised over $1.4 million from Federal and other sources.  In 2010 she secured the crucial seed money to build the new clinic and proudly exclaimed on her Facebook page, "We're buildin' a free clinic! We have liftoff!"

Declining Health

Jamie had the fault of many physicians; she often ignored her own health. She had abdominal pain off and on beginning in 2005. When she finally had time to get an abdominal ultrasound in 2008, an ovarian mass was found but it appeared benign and Jamie was too busy to have it investigated. When she got around to a follow-up ultrasound 2 years later, the mass had doubled in size and she was diagnosed with an aggressive form of ovarian cancer. On May 16, 2011, while undergoing chemotherapy she oversaw the groundbreaking ceremony for the new clinic's building on Holt Avenue, in The Village, a "mall" of social services for low income LA residents. She was determined to beat the cancer and complete the new, expanded clinic and live to see it open. "I can't wait to meet the first patient," she told the Inland Valley Daily Bulletin at the groundbreaking (1).

She continued to run the clinic and oversee the construction of the new clinic despite her ongoing chemotherapy. The new clinic opened its doors on July 9, 2012 but three days earlier, Dr. Jamie was admitted to the hospital where she learned she had a large inoperable tumor.  She was advised to prepare for hospice care. On July 27 she died peacefully in her home but had lived to see the clinic open. She was 52.

Legacy

Dr. Garcia received numerous awards (2). She was named Woman of the Year in 2010 by the California State Assembly, a Hospital Hero in 2010 by the National Health Foundation, and her clinic has been recognized by the California State Assembly, National Project Homeless Connect, and the House of Ruth Domestic Violence Shelter. The evening before she died, several doctors from her clinic gathered at Jamie's home and agreed to hang her numerous recognitions on an otherwise-blank wall in the new clinic. "But I don't know, honestly, if there's room for all of them," noted one doctor.

The new 12-room clinic opened its doors on July 9, 2012, and is expected to serve 24,000 uninsured, homeless, and underinsured residents in the Pomona area this year (2). However, her most enduring legacy may be her example in serving the poor. She should be remembered for her enthusiasm, courage and perseverance in making her dream happen. She is representative of the many physicians and other healthcare providers who forgo larger financial awards to serve the poor in relative obscurity. Her life is testimony that "anything is possible" (2).

References

  1. Rodriquez M. Garcia helped those who struggled. Inland Valley Daily Bulletin. August 10, 2012. Available at: http://www.dailybulletin.com/news/ci_21288514/garcia-helped-those-who-struggled (accessed 9-10-12).
  2. Marks R. RIP Jamie Garcia, a health hero in Pomona, 2010 California Woman of the Year. Off Ramp. August 10, 2012. Available at: http://www.scpr.org/blogs/offramp/2012/08/10/9379/rip-jamie-garcia-health-hero-pomona-2010-californi/ (accessed 9-10-12).

Donations in Dr. Garcia's memory can be made to the Pomona Community Health Center: 1450 E Holt Avenue, Pomona, CA 91767.

Reference as: Robbins RA. Profiles in medical courage: the courage to serve and Jamie Garcia. Southwest J Pulm Crit Care 2012;5:231-4. PDF