Idealism founded the People's Community Health Center in Waverly 25 years ago when anti-war protesters, feminists and Black Panthers wanted to make free health care a right for all.
Today, idealism keeps the modest, struggling health center going in what once were three rowhouses on Greenmount Avenue.
Health care is no longer free there, but it's as cheap as it gets in 1995. For as little as $10, a patient can see a doctor.
At a time when programs for the poor are under fire, the People's Community Health Center is celebrating its 25th anniversary. With grants from private foundations, it is planning a $545,000 expansion of administrative offices across the street in the 3000 block of Greenmount Ave., in the heart of Waverly's decaying business district.
"It's a miracle we're still here," said Patricia S. Cassatt, executive director for 15 years.
The center's staff and supporters will celebrate their anniversary today, with a health fair and walkathon at Lake Montebello. Proceeds from the walk will be used to help finance the clinic's expansion.
Patients today come through the cramped waiting room with health problems far worse than the hippies ever imagined in 1970 when they founded the clinic.
In the early days -- when the center was called the People's Free Medical Clinic -- many patients came for birth control, treatment of venereal disease and for "rap" sessions to talk about their problems.
Today, patients come with hypertension and diabetes. Some are infected with the human immunodeficiency virus, and a few are treated for gunshot wounds. The only rap sessions are for drug addicts.
While "the militancy is gone" from the early days, Ms. Cassatt said, the clinic continues to be "the frontier [the founders] wanted to pioneer -- that health care is a right, not a privilege."
"We have been the provider of last resort for so many years and made [medical] decisions for patients that were not good business decisions," she said. "We have willed ourselves to remain in business."
The clinic began with mimeographed letters seeking donations. Jim Keck, a founder, remembers posting notices of the opening on telephone poles in the neighborhood.
The first night, he recalled recently, "I remember jokingly saying I'm going to bring a deck of cards along because we won't have patients. But we had 17 patients. . . . Within a short time we were seeing as many as 200 patients a week."
In the early days, staff and doctors worked for free when the clinic was open in the evenings. Now, the clinic is open during the day and pays six doctors and three nurses. They saw 5,400 patients last year.
Nearly a third of their patients have no insurance. The rest have Medicaid, Medicare or private insurance.
The clinic has a long-standing relationship with nearby Union Memorial Hospital, which takes its patients for tests and treatment.
"The reason they've been around so long is they've been serving this vulnerable, very underserved population providing cost-effective, quality care for a long time that is not being provided by anybody else," said Dr. Peter Beilenson, the city health commissioner.
The center is one of the few health facilities in Baltimore that will never turn a patient away, Dr. Beilenson said.
"They gave us all the best of care," said Alma Bates, a loyal patient since the clinic opened.