Infected teeth, uncontrolled diabetes: A 13-hour wait for free surgery at Fort Worth clinic

Gaby Gonzalez was hoping to get a dentist to alleviate the pain in her mouth when she showed up at Southwestern Baptist Theological Seminary in Fort Worth, where hundreds of volunteers were offering free medical, vision and dental care.

It was her first visit to a dentist, or a medical provider of any kind, for that matter, in years.

But Gonzalez got a little more than she expected, the doctors told her: She had two infected teeth that needed to be extracted, plus two chronic conditions — diabetes and high blood pressure — that she’d never been diagnosed with before.

Gonzalez is one of hundreds of patients who flocked to the seminary on Saturday for the Remote Area Medical clinic, hosted with UNT Health Science Center. Founded in 1985, RAM’s initial goal was to bring medical care to remote parts of the U.S. and the rest of the world. But eventually, groups in big cities asked RAM to make stops there as well, because even with more providers than rural communities, there were still thousands of patients who were going without care because they couldn’t afford it.

This is the third year that RAM and HSC have brought the clinic to the Dallas-Fort Worth area. The roaming clinic is staffed by a few core volunteers from RAM, as well as local doctors, nurses, dentists, and students who volunteer their time to care for patients. RAM’s services are unusual among the country’s network of low and discounted health care because patients get care for free without any restrictions. They don’t need to provide proof of income, citizenship, or residence.

In Tarrant County, about one in five residents under 65 does not have health insurance, according to Census Bureau data. That number will increase this year, as thousands of county residents lose their Medicaid health insurance coverage because of the end of the federal public health emergency.

The simplicity of RAM’s approach was a “godsend” to Chris Evans. Evans and his mom got in line for the RAM clinic at about 8 p.m. Friday. Evans had driven from his home in Royse City, to his job in McKinney, to his mom’s house in Denison, back to Fort Worth. After hearing about the clinic on Facebook, Evans talked his mom into coming to get her teeth looked at for the first time in years.

His mom, Sherri Hellige, had health insurance through Medicare, the federal program that provides health coverage to adults 65 and older and people with long-term disabilities. But Medicare does not pay for most dental or vision services, leaving Hellige and millions like her without affordable options to care for their eyes and teeth.

On Saturday, Hellige got one infected tooth pulled and also got two new pairs of glasses: One pair of prescription lenses for regular use, and a second pair for reading.

After her morning of medical appointments, Hellige beamed while wearing her new frames, which were silver aviators with a blue trim. Her previous pair of glasses had scratched lens and were held together with tape.

“I have new glasses and a new smile,” she said. Her eyes shone with tears behind the clear glass of her new lens. “I’m just so grateful.”

Like Hellige and Evans, Gonzalez arrived at the seminary grounds hours before the clinic opened. Gonzalez and her niece, Samanntha Avarello, didn’t know what to expect. Avarello, who lives about 90 minutes outside of Fort Worth, doesn’t have health insurance, and hasn’t been to the doctor in years.

After a quick exam and a follow-up X-ray, the dental students treating Gonzalez confirmed that two of her teeth had so much decay that extraction was the best option.

But the surgery had to wait: Gonzalez’s blood pressure and blood sugar were both too high for the surgery to be safe.

So Gonzalez and Avarello walked upstairs to the medical wing of the clinic, where her vital signs were taken yet again. When the medical students looked at her vital signs, the diagnoses were clear: Avarello had both high blood pressure and diabetes. She had never been diagnosed with either before, although Avarello had suspected that her aunt had diabetes.

Dr. Curtis Galke has seen numerous patients like Gonzalez during his time volunteering for RAM. Galke, the chair of family medicine at the Texas College of Osteopathic Medicine, who get new diagnoses at free clinics like RAM because they’ve gone so long without medical care.

“It’s a clear indication our medical system is completely broken,” Galke said, pointing to the country’s status of having some of the worst health outcomes compared to other rich nations despite paying more for medical care than comparable nations.

Long term, Galke and the medical student he was supervising told Gonzalez she’d need to exercise more and make changes to her diet, and begin taking medication for her high blood pressure and possibly for her diabetes. After going years without medical care, she would need to find a way to the doctor’s regularly.

“She’s about to get a personal trainer she didn’t want,” Avarello joked.

As for Gonzalez’s teeth, Galke recommended she walk, drink water, and wait to try and get blood pressure and blood glucose levels low enough for the dental surgery to be safe.

By 1 p.m., 13 hours after Gonzalez had first started waiting for the clinic to open, the dental surgeon gave her the all clear: She could get both teeth extracted. Both of the incisors neighboring her two front teeth would get pulled out, and hopefully lessen the pain that had made it hard for her to eat.