As a free clinic, we get a wider diversity of patients and thus, a wider diversity of conditions than a paid clinic. Our supplies were donated from individuals and businesses in the community that understood that good public health helped us all. We are careful with our fiscal donations. Tea tree oil is one of the items that we will pay for from our meager funds. It is too important a resource to do without.

The weather was starting to warm up in Oregon. Spring was on its way. That meant rain – lots of it. Gabe came to us with an immersion foot condition often known as trench foot. Trench foot earned its common name in World War I when soldiers standing is wet, cold trenches every day began to report pain due to loss of circulation and swelling in their feet. The cold and damp resulted in open sores which eventually ate away soft tissue and got infected. Some soldiers lost their toes. Some lost their legs.

In many ways, our little clinic serves as a MASH unit for the victims of the the war against the poor we see waged in our struggling economy. Gabe had been on the streets since losing his job last year due to downsizing. His friend, whom we had also treated for trench foot a few months earlier, brought him in.

trench footWe see trench foot with unhoused younger patients more than any other section of the people we serve. The young people who live on the street are regarded with more fear than pity. Despite the soaring unemployment in our little college town for their age group, members of the community shame them for not having a job. Police and store owners in our area hassle them at every corner. During Oregon’s wet winters, these kids are, like the young soldiers of World War I, on their feet constantly in wet socks.

Gabe was resistant to care despite the pain. Living on the streets had chipped away at what little pride he had left. Asking for help and exposing his injury seemed like just another defeatist act. He cringed as he peeled back his socks. The smell of rotted flesh was overwhelming. He looked away in embarrassment.

The nurse prepared a tub of warm water infused with calendula, usnea, mugwort and birch. The warm water soaked off the debris from life on the street and gently loosened decayed skin. The herbs served to fight infection in a broad spectrum of areas. Our volunteer podiatrist bent down to examine Gabe’s feet carefully. He gingerly moved the toes with his blue, nitrile-gloved hands.

“You came in at the right time. We can treat this. No problem. You have to keep coming back every week though. Can you do this?”
Gabe nodded. “We’ll clean your feet and Sue will give you some dry socks to change into plus anti-fungal oil to rub into your feet every day. Do you have a bottle to send with him?”

I held up a small vial containing tea tree essential oil. I would add it to a small mister bottle so it was easier for him to apply to his tender skin without rubbing.
“Yes, sir. Right here,” I said.

I smiled at Gabe in what I hoped would be a reassuring way. He winced as the nurse helped him lower his feet into the pan of warm water.
His friend had been sitting silently by his side, just watching this familiar routine. Both of the young men were in their 20s but Gabe’s friend had been on the streets since high school. He was a seasoned veteran of conditions of a world without walls. He knew the consequences of untreated trench foot. It was a serious problem. He saw Gabe get nervous and spoke up.
“Tea tree oil is good stuff. My feet were way worse than yours. I thought I was going to lose my toes. No problem. Tea tree oil smells funny, but I like it now. I still got some left.”

Gabe’s friend fished around in the pocket of his leather jacket and pulled out a familiar bottle. Gabe relaxed a bit and looked silently from face to face. We were all smiling in encouragement. He took a deep breath and sat back in his chair. The key would be to keep his confidence up so he returned every week for the herbal foot bath and the tea tree oil treatment he applied himself. Having dry socks was also part of the plan for healing. Our team made sure he was comfortable and safe. All of these factors worked together to combat trench foot. Gabe was going to be okay.

Note: The Clinic Memoirs are based on real experiences from Occupy Medical clinic, a free, integrated health clinic that serves patients primarily, but not exclusively, in Lane County, Oregon since 2011. The names of the patients and a few personal details are changed to protect patient identity.