Monday, August 17th, 2009

At the Forum: the Los Angeles Field Hospital

The Dental FloorThe first sound you hear is the high-pitched wheeze of 60 dentists' drills buzzing inside of open mouths. Splayed out on a show floor generally reserved for millionaire athletes and rock bands are: a hundred dental chairs; five RVs filled with X-ray equipment; mammogram machines; a 60-person triage station; rubber gloved paramedics; long picnic tables of surgical equipment; and about 1,000 recipients of free healthcare. Since last Tuesday and until tomorrow, the Forum in Inglewood is the biggest free healthcare clinic in Los Angeles. The bill will be picked up by the Remote Area Medical Expedition, a 1,300-person volunteer effort of medical professionals. RAM got their start treating villagers in the Amazon in 1985. Now they have ventured to the first world-their first time treating patients in Los Angeles.

At 2 a.m. on Friday, people started to line up for treatment. Most patients are local. Some drove in from San Francisco and a few folks came from Nevada. It's not a destitute crowd. Many are working families, though some attendees hail from shelters. Hundreds slept on the sidewalk outside of the Forum to be granted access around 6 a.m.


The patients are mostly black, Latino, and Korean residents of L.A.'s working class suburbs like Compton, Hawthorne and Boyle Heights. They are service workers, seniors, immigrants and children who have not seen a doctor since the day they were born.

* * *

The majority of people came to get their teeth fixed. During the first two days of service, RAM dentists have put in 947 fillings.

Dawna and I sat in the bleachers of the Forum. She is small woman with a nut-colored tan and sun-bleached hair. Dawna was about to be the 425th dental patient seen today. Dawna "was conceived on Venice beach" and currently lives in her van by the Venice boardwalk. She has been diagnosed with bipolar disorder and anxiety. She takes her meals at a shelter. She can no longer chew food because of impacted incisors. Ten years ago, however, Dawna worked as a home health in aide in Texas and Alaska.

"When I eat," Dawna said, her hands clutching her jaw, "my gums bleed. I'm in pain all the time." She tells me that she hopes that the dentist will just pull her front row of teeth out.


They will. Crowns, caps, and fillings are expensive procedures that require follow-up, which patients can't afford. Most the dentists working on the floor are going to yank a bad tooth rather than try to restore it. By Saturday morning, RAM dentists had removed 471 teeth.

* * *

According to the registration volunteers, most RAM patients seeking medical attention suffered from chronic conditions: high blood pressure, heart disease, diabetes. These are all conditions that spur other medical aliments. If patients who suffer from chronic conditions were able to receive care early and often, treatment would be less costly as conditions would be less severe.

20 Comments / Post A Comment

KarenUhOh (#19)

Stellar piece. And refreshing.

A question, though, from the lawyer who inhabits my rotten soul: they had to sign releases against malpractice, I'm assuming?

NatashaVC (#464)

Yep. All the standard releases and paperwork. I think organizers assure themselves that there won't be too many malpractice problems because it ain't a very litigious crowd, you know?

NicFit (#616)

Denying people access to doctors, hospitals and dentists is inhumane and evil. For each of these "lucky" people, there are dozens who will just suffer and die because of our me-first society.

And isn't it interesting how many of these "town brawl" yellers are themselves covered by government health care like Medicare and the VA, but can't find it in their hearts to support the same options for others?

Burn in hell, Republicans.

HiredGoons (#603)

to be fair, that last sentence is their default argument, Nic.

abbyjean (#508)

great point about how ongoing management of chronic diseases like diabetes is both better health care and less expensive than forcing the patient to go into crisis before seeking care through an ER.

also – i fully agree with yanking teeth from a medical perspective. but it can be pretty hard to get a job without any front teeth.

Also the remaining teeth deteriorate faster. Dietary issues may follow as well. Or at least that is what my dentist always said and he was a professor.

NatashaVC (#464)

That was actually a point a lot of people in the "tooth stands" (the de facto waiting room") made. How much their mouths and teeth determined their overall health, psyche, and employment. The problem becomes cyclical, especially in service economy like Los Angeles'.

keisertroll (#1,117)

They pay for all this through T-shirt sales, right?


Abe Sauer (#148)

Jesus. The last time I heard about "teeth day" was when talking to some friends who do mountain clinic work in Haiti. People walk dozens of miles and wait all day to have their teeth yanked with the help of novocain. To see this same "teeth day" recreated in the richest nation in the world… well…

abbyjean (#508)

and keep in mind that the latest round of cuts from the legislature and the governor will further erode the existing primary care options for the uninsured and further cut back insurance options for the low-income. so if this is 3rd world, LA should be in 4th world status this time next year.

Abe Sauer (#148)

I think that may be true in a comparative sense. But, having been there, and knowing a lot of first-person stories from clinic workers living there, NOTHING I have ever seen has anything on Haiti. For this hemisphere anyway. In fact, calling it "3rd world" implies that it is of this world. And it is not.

And in one of the richest cities in the richest country.

Maevemealone (#968)

I do wish the insurance/medical community would stop treating teeth and eyes as if they are luxuries. They are firmly attached to my body and they came with the whole package I was born with. It's maddening to me that dental and vision care have the crappiest coverage and highest copays yet when you need that care, it can be as urgent as appendicitis…

NicFit (#616)

Yes and tooth infections can quickly evolve into a life threatening condition. We are so far from getting what the rest of the developed world takes for granted…it's disheartening.

HiredGoons (#603)

I bet the lollipops are terrible.

Ha, a similar roadshow came to my town for two whole days. I got a free x-ray AND a free filling! But the line of people desperate for dental care was so long that by the second day they had to restrict everyone to only one procedure, and some of the services that had been advertised were no longer offered.

What I love most about the treatment of dental care as a "luxury" is the vicious-circle aspect: how are you going to get a job with a dental plan if you're missing your front teeth? That interview is NOT GOING TO GO WELL.

Obamanation (#1,377)

Nic – I can find it in my heart to allow the same care for others. I just don't want to be the one paying for their care and mine.

People are talking about how we have to be “fair and just”, and that we have moral obligation blah blah blah. What about people being responsible for themselves? In school, did you have someone else do your work, attend your classes, and then you get the diploma? How about work? Do you go to work and just sit there while someone else does your job, and you collect a paycheck?

Why should the govt have to burden any of us with heavy and excessive taxes to pay for people who are too ignorant or stupid to take care of themselves? I know, I know, "what a mean and arrogant thing to say". Bite me! I graduated high school, joined the marines, served in Panama and the 1st Gulf War. Got out of the military, got a job, worked my up the corporate ladder. I could have stayed in corporate America as a worker-bee (manager or above) but realized I could do better on my own. I've never asked anyone for a hand-out, but I've asked plenty for a hand-up.

If the govt programs were offering people a hand-up, sure…I'd be more than happy to help. But they aren't. Do some govt programs help people who truly need it? Sure, but do those same programs allow people to abuse the system…hell yes! We need checks and balances with all these programs. They need to be audited and adjusted. A perfect example of how the left is yelling at the right is the Fair Housing Act. People think the republicans are all upset about who gets to buy a house and where people can live. If that’s what you think then you need a history lesson. The Housing Act was introduced by Carter in the 70’s. He wanted to allow fair housing for everyone, saying there is no reason for someone to not be a homeowner. Reagan and Bush Sr both made some adjustments, and then Clinton slammed it with a policy not requiring anyone to show proof of income or immigration status. Now you tell me how the republicans are to blame for that!

This healthcare reform is just another govt run program which is going to fail miserably because the govt has not business being in this business, and business directing or ordering businesses how to run in this industry.

tfey_hawbz (#36)

Can't you just be a wrong asshole in fewer words? Thx.

This is too funny.

Citizens of the richest country in the world need medical aid orginally designed not even for the third world, but for the Amazon jungle. This story hasn't gotten the coverage it deserves. This should be the top news on every network and cable channel, because it so dramatically shows the US is in dire need of health care reform.

RAM's health care expeheditions were first brought to my attention by Wendell Potter.

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