Published: Wednesday, November 15, 2006

Medical assistant Diana Sanchez takes a break from the flu-shot clinic at the center in late October. Below, Sanchez gets ready to leave work after another full day.

Compassion and care
For doctors and staff at the Opportunity Center, attending to the needs of homeless patients is not just medical -- it's personal

Photographs by Norbert von der Groeben

Story by Dan Shilstone

As residents and "drop-ins" at the new Opportunity Center mill around the courtyard, talking and drinking their morning coffee, Diana Sanchez walks among them, exchanging lively greetings in Spanish and English. Each morning she makes her rounds to see how everyone's doing.

"I spend a lot of time with them, out in the quad," the medical assistant says. "I get to know them as more than just patients. They're people. What more can you say?"

This morning she is trying to get the word out about free vision testing that will take place in the afternoon at the facility just off of El Camino Real, which provides housing and services for homeless people and those at-risk.

'OPEN COME IN' says the sign outside the physician's office at the Dr. Donald A. Barr Medical Center in the Opportunity Center, where Dr. Lars Osterberg (left) and Dr. Daryn Reicherter confer in early November

"Oh my gosh, I'm blind," laughs resident Ann Galedrige, drawing Sanchez into conversation with a small, friendly group, before accompanying her to an exam room for a flu shot.

"Is that it?" she asks a moment later, after Sanchez deftly gives her the vaccine. "Just a little sting. I'll definitely be back for that eye thing at 2."

"I take a lot of pride in what I do and try to treat people the way I like to be treated," Sanchez says. "And I know I hate being hurt."

"I hear I'm pretty good," she adds.

Guillermo Ramirez, who spends his nights at local church shelters, agreed with her after receiving his flu shot.

"I'm surprised, amazed. I don't feel nothing. First time ever I don't feel nothing," he said.

Sanchez knows the stories of many of her patients and speaks of them with honest affection.

"Guillermo's a very unique person, a deeply religious man from Guatemala. Worked all his life, raised his kids, put them through school. And now he's homeless," she says.

A medical assistant with almost 20 years of experience, Sanchez found herself overqualified for most positions for which she applied. But when she interviewed at the Opportunity Center, she hit it off instantly with Patty Perkins, the executive director of the health center, whom she teases and jokes with as she goes about her work in the office.

"For the first time, I feel like the people I'm working with aren't my bosses, you know?" says Sanchez.

Stanford medical student Kimberly Montez gets ready to give a flu shot at the center in late October.

On Monday and Thursday afternoons, the chief of general medicine at Stanford VA Hospital and president of the nonprofit that runs the center -- Dr. Lars Osterberg -- is excused from the VA Hospital to work at the Opportunity Center. Osterberg speaks well and exudes an earnestness, essential traits for working with a population with whom, he says, trust can be difficult to gain.

"The doctor is great," says D.J. Wells as she waits to hear the results of her diabetic husband's blood tests. "He has an answer for everything, explains everything. He actually takes time with you. We've never gotten that before."

Later, Samuel Vargas, who lives in his RV and takes whatever jobs he can, came to see the doctor about his high blood pressure. Osterberg sat with Vargas and discussed at length his symptoms, history and treatment options before examining him and asking him to return the next day to connect with a social worker who could set him up with insurance.

"Probably the most difficult thing about working with this population," Osterberg said, "is that even though we're seeing them, they often don't have the resources to get testing and medicines that they need. We need to get them access to insurance and medication. But sometimes our hands are tied, and we can't do as much as we would like."

Dr. Daryn Reicherter, a Stanford psychiatrist who skateboards to work at the Opportunity Center, is nonetheless excited about how much the structure of the center allows them to get done.

"You have people who sit on the board, Lars and I, making these kind of broad decisions on one level, and at the same time we are in the clinic literally putting together the furniture. We are involved at every level, and it's really a dream team we've got here."

In between seeing patients, Dr. Lars Osterberg catches up on paperwork at the center.

The end of the day, when Reicherter departs on his skateboard and Patty Perkins walks to the train station with an entourage of Opportunity Center escorts, Diana Sanchez faces the most challenging part of her job.

"What's hardest for me is going home at the end of the day and knowing that my patients can't do that. I go home -- and I don't know what's going to happen to them."

Chief Photographer Norbert von der Groeben can be e-mailed at nvondergroeben@paweekly.com. Editorial Intern Dan Shilstone can be e-mailed at dshilstone@paweekly.com.

Medical assistant Diana Sanchez chats with Floyd Sadler in the courtyard of the Opportunity Center.	Medical assistant Diana Sanchez (right) chats with Michele Waters-Pritchett before taking her blood pressure at the Dr. Donald A. Barr Medical Center. The center provides medical care both for residents of the Opportunity Center and for the unhoused in the Palo Alto area.	Stanford medical student Pearl Chang prepares Carolyn Ann Moore (left) while fellow Stanford medical student Kimberly Montez gives Daniel Hayes a flu shot in late October at the center.
Dr. Lars Osterberg checks Charline Williams' eyes.	Dr. Lars Osterberg interviews Charline Williams in early November at the Dr. Donald A. Barr Medical Center, which serves both residents of the Opportunity Center and the unhoused of the Palo Alto area.	Dr. Lars Osterberg   pauses between seeing patients in early November at the Dr. Donald A. Barr Medical Center, which serves both residents of the Opportunity Center and the unhoused of the Palo Alto area.
Lars Osterberg listens to a patient.		Lars Osterberg listens to Scott Smith's lungs during an early November visit to the center.