Title: Cabrini Clinic: On the Frontlines Since 1834


Narrator: In the summer of 1834 the Detroit Courier wrote, “We have indeed passed through a melancholy and trying season, the people have sunk into a gloom which cannot easily be dispelled. What was most appalling was to watch people falling around us.”


At the time this was published, Detroit was beleaguered by the great scourge of the 19th century — the cholera epidemic. When a ship with confirmed cases of cholera aboard landed in Quebec, Detroit and New York City were soon overwhelmed with cases in a matter of months. Detroit lost 20% of its population in one summer alone. Businesses closed their doors, grass grew in the streets, and flaming tar barrels were scattered throughout the city because people thought it would disinfect the air. The customary ringing of church bells when someone died was suspended for fear of spreading a panic. Father Gabriel Richard himself, the man renowned for promising Detroit would “rise from the ashes,” died from the disease. And it seemed the city would never rise again. 


1834 was also the year that Detroit was going to open its first English-speaking Catholic church, Holy Trinity. The archdiocese, however, decided to postpone and transform its brand new church into a medical facility for the city’s cholera victims. It was Detroit’s first hospital. 


100 years later it would, again, open its doors to those in need of basic medical care, this time as America’s first free clinic, the St. Frances Cabrini Clinic where Holy Trinity pastor Father Clement Kern pursued a mission to serve his neighborhood’s poorest of the poor. Since then, the doors have stayed open for the uninsured to receive the medical care they need. That includes this last year and a half when COVID made even the possibility of getting routine medical treatment frightening. Cabrini Clinic did what they always have done: they opened their doors, poured themselves out in service, and fought for their patients. 
Welcome to Detroit Stories, a podcast on a mission to boldly share the stories of the people and communities in Southeast Michigan. These are the stories that fascinate and inspire us. This episode is sponsored by Alliance Catholic Credit Union. Learn how “you belong here” at www.AllianceCatholic.com.
Much attention has rightly been paid towards the valiancy of healthcare facilities and providers as they endured the trauma of the last year. But in the chaos of overburdened medical facilities and the burgeoning unemployment rate, there was a huge population of people, many recently uninsured, in great need of care for chronic health needs. And they didn’t know where to go. 
Alisa: The most popular thing that we hear is that we are the best kept secret. A lot of people never heard of Cabrini Clinic. They didn't know that we were here.
Narrator: This is Alisa Smith, a nurse practitioner who has volunteered at the clinic for over 13 years. Today, Cabrini Clinic is located across the street from Holy Trinity in Detroit’s Corktown neighborhood where it’s been serving Detroit’s uninsured since 1950. 
Alisa: We have patients from all over metropolitan Detroit area, as far away as Lansing that comes down. We are in the Southwest part of Detroit. So we have a lot of Hispanic speaking patients and the area now has become, you know, with a lot of young people coming into the area. We get a lot of the young people, especially with people getting unemployed now, losing their insurance. So we're getting a lot of those patients as well.
N: To keep services free for patients, the Cabrini Clinic operates through donations, partnerships with local hospitals and universities, and a large staff of volunteer doctors, nurses, psychologists, and pharmacists. This is Tawana Neetles-Robinson, the executive director of Cabrini Clinic. 
Tawana: So since Cabrini Clinic is, you know, a free clinic, we are very much very volunteer based. And so though we have a clinical staff on, you know, that works with our patient population regularly, we’ll have a lot of volunteers that come into the clinic to provide services at no cost to patients. And a lot of those patients and those volunteers are either working a second job and their primary job and then volunteer, or are retired. And we made the decision to volunteer at Cabrini Clinic to help support, you know, the mission of our work. 
Narrator: The list of services the clinic offers is large and ever-growing. It includes prescription assistance, podiatry, optometry, dermatology, gynecology, pulmonology, infectious disease care, social services, dental care and mental health care. The expansive list of services is the perfect culmination of Father Kern’s oft-repeated mantra, “If it was the right thing, you just had to do it.” The clinic was just one of the many services the New York Times and TIME magazine-celebrated priest was known for.  
Sr. Mary Ellen: He was a great man. He was a saint.
Narrator: This is Sister Mary Ellen Howard, the former executive director of the Cabrini Clinic and resident historian of all things Father Kern. 
Sr. Mary Ellen: There's a lot of people moving into Detroit at this time. Of course, that was probably the peak of people coming up from the South to find jobs in Detroit and Chicago and Pittsburgh. And they didn't have any health insurance and they needed access to healthcare. So Fr. Kern was — his goal was to provide services that were needed by the community. And he started a wide variety of services, including Cabrini Clinic, but many of the things that he started then, you know, they're still around and he was a visionary.
Narrator: Father Kern had a bleeding heart for the community, a community a TIME reporter described as a rundown, ramshackle slum. But for Kern, and the community that lived there, they knew there was a beauty to the area only few could appreciate. His parishioners called him “Saint of the Slums,” or the “Labor Priest” for his dedication to serving the blue-collar workers. He was constantly adapting to the needs of his parishioners and neighbors as it shifted from a largely Irish immigrant settlement to a neighborhood where Mexicans, Puerto Ricans, and Blacks migrating north settled. He learned Spanish, started a Puerto Rican club, a Filipino club. A St. Vincent de Paul Society. A legal clinic. A credit union. "Corktown College" which offered English and citizenship courses. He started self-help programs including Alcoholics Anonymous that had over 1000 members. So when the neighborhood swelled in the 40’s with uninsured settlers looking for work, Kern responded to the need for healthcare the way he did everything – he met their needs. 
Sr. Mary Ellen: He didn't have a lot of resources, but what he had were at the service of the poor.
Narrator: The legacy and spirit of Father Kern proved particularly crucial in the last 15 months when the clinic was, once again, like in its first days, faced with the needs of a city battling a pandemic. While hospitals filled beyond capacity and medical staff and resources were unthinkably strapped, the clinic had to decide how to fill the gap with less. Here is Tawana again. 
Tawana: And so, you know, the biggest change we had was the cancellation of staff. So we didn't have the staff support that we needed because they were volunteer-based. They might've been older and there was fear around the pandemic. And so that's one of the biggest factors that affected us, just understanding that, you know, we have volunteers that were susceptible to the virus, or we had individuals that were in fear of actually, you know, being in contact with the virus. And so we didn't have the support that we usually have. And then, you know, a factor of course, is that our actual on-staff support, you know, a couple of them caught COVID-19 and they were out. So we were tremendously short-staffed and so that was a huge factor. 
Narrator: This is detrimental to a clinic like Cabrini that sustains completely on their 150 volunteers. 
Tawana: So we have to make a decision to commute a lot of our visits to tele-health visits. You know, we had to make that decision very early on because we knew that we still needed to serve patients and needs were critically ill patients. And we still needed to make sure that they have some quality care available to them. And so we switched to tele-health where we could, and that was for primary care visits and for behavioral health visits. And we would make appointments for them to come up and pick up their medications when they needed to and things like that. So we just altered what we did to find ways to make sure that we were still available to serve patients. You know, of note for us is that even, you know, during the height of pandemic, we never canceled not one clinical session. We always made sure that somebody was available to serve patients. And, you know, we thought that, that — we think that that's remarkable. We never closed or canceled one clinical session over this year and a half, and we just found a way to do it. And so we've had a handful of volunteers that continued to come in. And even though, you know, despite their fears, they still came in and then our clinical staff handled the rest. And so, you know, we adapted it to what we needed to do to make sure that we had an opportunity to serve.
Narrator: What was most alarming to Tawana, was the fear patients had about coming in at all. In a typical month they would see 250-300 patients, but during the last year, numbers were down to 100. This scared her. A large majority of the clinic’s patients go there to monitor chronic diseases like diabetes and hypertension and receive medication, without which could result in heart attacks, strokes, kidney failure, and other serious complications. The fact that they weren’t coming in meant they were neglecting serious health conditions that needed constant maintenance.  
Tawana: There was a lot of fear around not being able to come into the clinic and not being able to manage, you know, their much needed, you know, support for chronic diseases. So, you know, people that were diabetic or had hypertension or even behavioral health issues, they weren't coming into the clinic for the support just because of what we were seeing around COVID-19. The major concern is that people with — that needed disease management actually had the opportunity to have that kind of support so that they still had medications, that they can still call us with concerns, they could still be seen when they needed to be seen. And so we were really worried about our patients that needed consistent care.
Narrator: Cabrini developed a screening process for COVID, rearranged their clinic to allow for proper social-distancing, and started delivering patients’ medications to them in their cars. They also personally reached out to their patients who they knew needed consistent care. They called them to let them know Cabrini was still open and inform them about the precautions they were taking. They even sent letters. 
Tawana: So we were very cognitive and very thoughtful about our outreach so they knew that we were available to be seeing, you know, to see them if they needed to be, but they were very much apprehensive. So, you know, in-person outreach is really the best opportunity for that.
Narrator: Their outreach proved particularly fruitful. As the COVID threat has been minimized through vaccinations, word of Detroit’s “best kept secret” has been spreading to a newly underinsured population and Cabrini has surged with new patients. Here’s Alisa. 
Alisa: We have gotten a lot of new patients. During the pandemic, it started with people losing their jobs and losing their insurance. But in that case, they didn't necessarily lose their job and their insurance, they may have gotten their hours decreased and so their insurance did not follow with them. So that's where we stand now, where we have a lot of people that are not necessarily working poor, as we had before, but they're working and still uninsured. 
Tawana: We're seeing our patient numbers start to rise again, as people attempt to kind of come on the other side of this. And so, you know, we think that the safety net supports that have been put in place by the state and the federal government have helped sustain people. And so we, you know, in regards to the insured numbers, even though they might have not had an end point, you know, insurance through the employer, they were able to get some kind of supplemental support. But you know, we, you see people regardless of, you know, it's not unusual for people to fall on and off insurance. And so we fill in the gaps when we can, and we've been doing that over this past year. So whether you lost your insurance because you’re know, recently unemployed or you're in between jobs, you know, we still see — we'll still see you. 
Narrator: As everyone adjusts to the differences in their post-pandemic world, Cabrini has been a newfound haven for many whose “new normal” is a new kind of poverty. 
Alisa: A lot of people never heard of Cabrini Clinic. They didn't know that we were here. And so they are very excited. We have a lot of patients that come and even though they give their insurance, they ask, they want to come back because they do enjoy the help and the assistance that they get here, the compassion that they get here. And so, I think a lot of people are looking for that, especially during this pandemic. You want to be somewhere safe. You want to be somewhere where you know that someone cares and you're going to be taken care of.
N: As they face a burgeoning population of uninsured people lining up at their doors, the Cabrini Clinic will do what they’ve always done. They’ll adapt. They’ll open their doors. In the words of Father Clement Kern, they’ll “do the right thing.” 
Detroit Stories is a production of Detroit Catholic and the communications department of the Archdiocese of Detroit. Find us on Apple Podcasts, Spotify, Amazon Music, or wherever you get your podcasts. This episode is sponsored by Alliance Catholic Credit Union. Learn how “you belong here” at www.AllianceCatholic.com.