This post is by Katherine Jenson, a Dell Medical Student who worked in the Brownsville, Texas, clinic during Operation Lone Star 2019.
At Operation Lone Star 2019 in July, I was honored to work with one of the rarest patient cases I may see in my entire life. A man with multibacillary leprosy visited the free clinic — the same one at which he was diagnosed by family physician and Dell Medical School professor Jonathan MacClements, M.D., a year prior. He had been connected with his first three-month supply of antibiotics but had been lost to follow-up after an adverse reaction and a disagreement with his health providers. This year, he returned to Operation Lone Star to the same doctor who successfully diagnosed him in the first place. All due credit to the nurse who recognized him waiting in line at 5 a.m. and brought him straight back to the clinic rooms!
Operation Lone Star, now in its 21st year, is an annual large-scale emergency preparedness exercise that the Texas Department of State Health Services leads and organizes. The event brings together local, state and federal medical and disaster response agencies and gives back to the community by providing necessary medical care to Texas residents who are underserved. Partners included the Texas State Guard Medical Brigade, the Texas Military Department, Texas Division of Emergency Management, Remote Area Medical, local health departments and the U.S. Public Health Service Commissioned Corps.
Sites in 2019 included Brownsville, Harlingen, San Juan, Mission, Rio Grande City and Laredo. On the first day of the clinic in Brownsville, we saw 365 children and adults. Leprosy is rare, but we saw many more common ailments, from routine sports physicals to undiagnosed diabetes. By the end of the week, providers saw 1,727 patients at the Brownsville clinic. Other sites ranged from 429 patients in Rio Grande to 2,505 patients in Laredo. Across all sites, 8,642 patients received integrated health care free of charge.
At each location, providers impacted the health of underserved Texans while practicing clinical skills in an interprofessional setting. Patients were seen by co-located physicians, nurses, physician assistants, medical assistants, paramedics and emergency medical technicians, as well as providers in many other disciplines, such as pharmacists, social workers, nutritionists, optometrists, audiologists, dentists and health professions students.
The Brownsville site was set up at a local high school and staffed in large part by the Texas State Guard Medical Brigade along with the U.S. Public Health Service Commissioned Corps, medical students from Texas A&M College of Medicine and nursing students from Texas Southmost College. Remote Area Medical Volunteer Corps provided equipment for lens crafting for eyeglasses as well as dental equipment. Immunizations were also provided, and representatives from community-based social programs raised awareness of local resources.
The day after seeing the man with leprosy, I saw a woman who came to us for her checkup because she didn’t have health insurance. This was the first time I’ve ever made a patient cry, and I won’t forget it.
Her blood glucose was elevated. With a prior elevated blood glucose measurement and clinical exam, we diagnosed her with diabetes. Her brother had gone blind from diabetes, and I had just told her she had diabetic retinopathy, which affects the eyes. We were able to counsel her on diet, give her a prescription and refer her to services we had for free on-site, including a dietician and a social worker who could link her up with a primary care provider. We thanked her for coming to us, so she could treat her diabetes and prevent worse complications.
Interprofessional exercises like Operation Lone Star help us get to know who we, as medical providers, would be working with to care for our communities in the event of a natural or human-made disaster. The University of Texas at Austin and Texas A&M may be rivals on the football field, but at these clinics we are all on the same team. Operation Lone Star was an invaluable educational opportunity for me as a medical student. At Dell Med, we’ve all heard the phrase, “See one, do one, teach one,” and that is exactly what happened that July week in Brownsville.