Through their volun­teer efforts at a Bal­ti­more cli­nic for the wor­king poor, two Hop­kins phy­si­cians are taking a holis­tic approach to bet­ter health.

Linell Smith
Hop­kins Medi­cine Maga­zine, February 5^th, 2009

AT THE OPENING OF THE JOY WELLNESS CENTER, Annie Umbricht wears the slightly dazed  smile of someone who’s living a moment long ima­gi­ned.  The Hop­kins inter­nist admi­res the large bright stu­dio for yoga, tai chi, and other move­ment the­ra­pies, then peeks into an inti­mate space desig­ned for medi­ta­tion. This is the latest dimen­sion of health care she has hel­ped pro­vide at the Shepherd’s Cli­nic, a pri­mary care cli­nic for the unin­su­red “wor­king poor” in the Homestead-Montebello area of northeast Baltimore.

An addic­tions medi­cine spe­cia­list at Johns Hop­kins Bay­view,  Umbricht has volun­tee­red at  this cli­nic since 2002. Typi­cally, she sees peo­ple with such chro­nic con­di­tions as obe­sity, hyper­ten­sion, and dia­be­tes. “All of these disor­ders cause, and are exa­cer­ba­ted by, stres­sors, such as those rela­ted to socioe­co­no­mic hardship and pre­vious trauma his­to­ries,” she says. “This is why it beco­mes extre­mely impor­tant to pro­vide patients with a place where they can learn tech­ni­ques to reduce stress.”

Last year, Umbricht and fellow volun­teer Linda Lee, a Hop­kins gas­troen­te­ro­lo­gist, sug­ges­ted tur­ning an unu­sed por­tion of the cli­nic buil­ding into a cen­ter where com­mu­nity mem­bers could learn stra­te­gies for balan­cing the phy­si­cal, emo­tio­nal, and spi­ri­tual aspects of their lives. Dona­tions from foun­da­tions and indi­vi­duals, inc­lu­ding Umbricht’s family, made it hap­pen. (The cen­ter is named after Umbricht’s late cou­sin, Joy Jai­llet.)  The inter­nist is now hel­ping to deve­lop the center’s pro­grams. Guests at the Novem­ber ope­ning of the 4,000-square-foot faci­lity visi­ted areas for acu­punc­ture, mas­sage, and coun­se­ling as well as a kitchen desig­ned for healthy coo­king classes.

“Hope­fully we’ll be able to bring some peace to peo­ple so that they can start taking bet­ter care of their own health,” Umbricht says. “Now we need to get volun­teer pro­vi­ders in alter­na­tive medi­cine to help show us the way.”

Com­pas­sion already flou­rishes at the Shepherd’s Cli­nic, where patients typi­cally pay just an hour’s wage per office visit. Last year, the cli­nic hand­led roughly 4,000 patient visits with help from volun­teer phy­si­cians, nurse prac­ti­tio­ners, and phy­si­cian assis­tants. Umbricht and Lee work beside health care volun­teers from Union Memo­rial Hos­pi­tal and Uni­ver­sity of Mary­land Medi­cal Center.

Lee, who directs the Inte­gra­tive Medi­cine & Diges­tive Cen­ter at Hop­kins, says she’s drawn to volun­tee­ring at the cli­nic because she can build rela­tionships without watching the clock. “As doc­tors, we’re often too pres­su­red for time to see all the con­texts in which our patients live,” she says. “It’s impor­tant we unders­tand the barriers that peo­ple have for get­ting health care along with the pro­blems of paying for it.” In the new well­ness cen­ter, Lee will pre­sent pro­grams in diges­tive health, with a nutri­tio­nist on hand to pro­vide food demons­tra­tions. There are also plans to create a com­mu­nity vege­ta­ble garden.

Umbricht works a redu­ced sche­dule at Hop­kins to allow time to volun­teer at Shepherd’s Cli­nic on Tues­day after­noons and Wed­nes­day eve­nings. The coun­se­ling she does on stress reduc­tion is a focus of her own research as well. She recently recei­ved an NIH grant to study the effec­ti­ve­ness of topi­ra­mate in trea­ting cocaine depen­dence in patients on metha­done. In other stu­dies, this anti­con­vul­sant drug has dec­rea­sed par­ti­ci­pants’ alcohol intake as well as hel­ped with smo­king ces­sa­tion. Umbricht belie­ves it may help alle­viate anxiety and post-traumatic stress disor­der, con­di­tions asso­cia­ted with impul­sive, self-destructive behaviors.

Part of the goal for the well­ness cen­ter, Umbricht says, is to help peo­ple reduce the anxiety that colors so much of their lives. Once they rea­lize how a state of men­tal and phy­si­cal repose actually feels, it will be easier for them to cap­ture and hold onto it.  “We are trying to create a place that peo­ple want to come back to,” Umbricht says. “When you have a health care envi­ron­ment of ‘you musts,’ you don’t go very far.”