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At an HIV Clinic in Queens, N.Y., a Sense of Home Hangs in the Balance

Health care workers at the city hospital hit hardest by the pandemic go beyond their job description in tending to a vulnerable population

Nurses at Elmhurst Hospital's HIV clinic.

Credit:

Maria Ferreira-Ortiz

This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American


When I was younger, like most kids, I’d always look forward to the days when I could go to work with my dad.

He’s an infectious-disease doctor at Elmhurst Hospital, in Queens, so there was always plenty of excitement in the neighborhood that still now remains one of my favorites in all of New York. Jackson Heights was especially alive in the mornings; on the drive in, I would open the car windows and look out wide-eyed for women pouring cups of coffee from colorful thermoses, for Buddhist monks in orange robes walking down 80th Street, and for flashy soccer jerseys hanging in the windows of sports stores on Roosevelt Avenue. There was the hospital gift shop, which had Skittles; the lunch outings to La Fusta, the Argentine restaurant where my dad watched Champions League on Wednesdays and knew all of the waiters by name.

And as we finally made our way to his office, my dad seemed like the coolest guy on the floor: he would scan his ID and we’d walk down these long corridors and suddenly there were all these people popping their heads out their doors to say hello. Whenever they saw my brothers and me, their smiles widened. “Carlos, your boys are so handsome,” a nurse would say to him, adding: “They get it straight from their mother!” And my dad would laugh, and our faces would turn red and then he would parade us to his clinic, the HIV clinic, where Nurse Gil would pinch our cheeks and Nelson the clerk would crack a wide smile from behind his desk.


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Every time my brothers and I came in, his clinic family made us feel welcome. It didn’t take long for me to learn that this was how they make their patients feel, too—and at a far more important level. Elmhurst serves some of the most vulnerable people in the city, many of them immigrants from all over the world, and the HIV patients are some of the most marginalized among them. The clinic staff, from nurses and doctors to social workers and clerks, recognize the many challenges their patients face: they work irregular hours, and many experience financial, housing and food insecurities; on top of it all, being HIV-positive, they often experience a vast array of cultural stigmas and discrimination from people close to them.

So, the staff, many of them immigrants or the children of immigrants themselves, often provide socioemotional support that is an integral component of their care. “We’re like a second family to our patients,” Maria Ferreira-Ortiz, a nurse in the clinic, told me on the phone in Spanish the other day. “Hola, ¿cómo estás, querido?We hug and kiss them when they come in, because many of us have known them for years, sometimes decades.”

But when the coronavirus arrived in New York, suddenly everything changed. The fact that many of Elmhurst’s patients work essential minimum-wage or gig-economy jobs meant that the hospital quickly became the “epicenter of the epicenter” of the outbreak in the city. It caused me a particular kind of pain to see such a familiar place suddenly draped with so many signs of plague and death. There was a time, some weeks ago, when almost every night I watched as the evening news had reporters standing beside the mobile morgues that were parked near La Fusta. The long hallways were now filled with stretchers carrying the sick, and with doctors and nurses gowned up like astronauts. I couldn’t bear to think of the people I knew as being so dangerously exposed.

For now, the very worst of the coronavirus at Elmhurst seems to have slowed. But as the camera crews move on to other hot spots and Elmhurst fades from the headlines, hospital staff must confront a new challenge: how to return to caring for non-COVID patients as normal, maintaining the sense of community and closeness necessary for the people who need it most, all amidst the long-lasting impacts of a devastating virus that threatens to lurk in waves for many more months (or years) to come. For the HIV clinic, considered a safe space for many patients, the need for distancing with COVID-19 could make that significantly more challenging.

“Our warm touch, our human-contact approach is now gone,” Helen Chabla, another nurse, told me on the phone. There’s plexiglass at the front desk, makeshift windows and doors scattered about the long hallway where patients were once able to ask everyday questions and make friendly conversation with the staff. Most appointments are being done by televisit—for some patients, this means the only place where they don’t have to hide their condition, where they can speak freely without fear of discrimination, has vanished. And that matters.

It matters because sometimes, at a place like Elmhurst’s HIV clinic, that hug or friendly handshake from a clerk might turn out to be the only one a patient might receive all day. Because nurses and social workers help translate complicated English paperwork, provide shoulders to cry on, and advise on family matters for patients belonging to communities where their medical conditions might make them unwelcome. Because doctors like my dad don’t mind being woken up by late-night personal calls and e-mails from patients in need of advice (even if the patients have moved far across the world, they don’t forget where their support networks can be found). It matters because the staff have all become accustomed to helping in ways that go far beyond their job descriptions, all without sacrificing their commitment to the medical care itself—the clinic, despite being in a public hospital with resources stretched thin, was recognized in 2017 as one of the top HIV/AIDS care centers in the country.

I’m not surprised that the staff are already trying to figure out ways to keep doing what they do best. While the physical support—the hugs, the wiping away of tears—might be on pause, the verbal and emotional support will hold strong. “The love hasn’t gone away, the love is still there,” said nurse Judith Garcia. “I’ve called quite a few of my patients to see if they’re okay, and they’re so happy. And so many of our patients have also reached out to us to see if we’re okay, too. They know what we’ve gone through.”

The whole world seems to know what they’ve gone through, and to know the name “Elmhurst,” now. It took a disaster like this pandemic for the frontline workers in underserved communities like Jackson Heights to finally be noticed—while day after day, long before this horrible virus plagued them and their patients, they had already been performing some of the most important, unprompted heroics to keep one of the most vulnerable yet vibrant neighborhoods in New York healthy and humming.

I yearn for the virus-free day when it will hum again—for the day when the churro carts are out in full force, when the Agencias de viajes are back open for business, and when the playground across from the hospital will once again be filled with children hailing from all over the world. “Oh my God! This is your son? I remember when he was this tall,” Nurse Gil will say to my dad when I come to visit, putting her hand three feet above the floor.

And I’ll hold out hope for the day, post-pandemic, when they finally get the adequate resources and support that they need not only to fully restore the home they’ve created but to maintain it, continuing to provide top-quality care for those who need it most. Patients will always remember their Elmhurst family, and now that the name has ricocheted across the planet for the saddest of reasons, I hope the world will remember them, too.