She's health on wheels

The city of Baltimore did a splendid thing yesterday: It made sure the spirit of Dr. Sebastian Russo lives for another generation, so that how Russo practiced medicine -- with compassion, long office hours and frequent house calls -- might not be remembered as something quaint and gone, but seen as something present, real and possible.

The city named an award after Russo, a selfless general practitioner who treated the poor and uninsured out of his storefront office in Northeast Baltimore.


Yesterday, at City Hall, Mayor Sheila Dixon gave the first-ever Russo award to a woman who does the same out of a van in Southeast Baltimore.

The award recipient is not a doctor.


Perhaps, in seeking nominations for the Dr. Sebastian Russo Memorial Award, the city could not find one who practices medicine in the generous, Old World style his many patients came to expect from Russo in the two decades before his tragic death.

Perhaps such a doctor cannot exist in the modern America that Michael Moore presents in Sicko, his new documentary about the nation's health care system.

Maybe the "five-dollar doc," willing to treat patients who can't afford more than that, is thoroughly anachronistic.

But the awards committee found someone whose work evokes the Russo spirit -- not a doc, but a physician's assistant named Patricia Letke-Alexander.

She's the driving force behind the Johns Hopkins Bayview Community Care-A-Van, a 39-foot mobile clinic that has been making rounds in Southeast Baltimore, bringing treatment, prevention and health education to uninsured families and others on the margins since 1999.

Letke-Alexander's nomination calls her a "hell on wheels" advocate for patients and attributes the success of the Care-A-Van operation to her passion for the work.

"Pat has impacted thousands of lives -- children, women and men living at the edge of the health care system," the nomination says. "To many, the Care-A-Van has become a place of comfort, compassion and understanding -- thanks to the dedication of Pat and her staff."

Letke-Alexander has been a P.A. for 22 years. She has worked in pediatrics and emergency medicine, pulled a stint at a remote hospital in New Guinea, and worked for Health Care for the Homeless on the streets of the nation's capital.


"When Pat Letke-Alexander's name surfaced and I reviewed her curriculum vitae, I knew right away she was the one," writes Dr. Michael Crocetti, clinical director of pediatrics at Bayview, in recalling the development of the Care-A-Van.

"Not only does she provide clinical care, at times she is the mobile van driver as well as the intake coordinator. She has a profound commitment to the care of the underserved population in southeast Baltimore. She understands the barriers these individuals face when seeking health care and she is always devising ways to deliver care in the most optimal, meaningful way."

Sebastian Russo did much the same, not from a van but from his office in the Hamilton section of Northeast Baltimore. He was a multitasker, too.

People started lining up outside his office daily at 7 a.m. He would see as many as 75 patients in a day. He answered his own phone. He worked long hours, seeing patients at his office each morning and night, and making house calls in the afternoons.

"Doing the work of three people, he designed his office for maximum efficiency," the News American reported in February 1981, after Russo was slain in his office by a gunman in a still-unsolved robbery-murder. "He kept his four filing cabinets within arms' reach of his desk so that he wouldn't waste time walking to get patients' medical files. Because his phone rang constantly, he kept one on the desk of his office and another in the adjoining examination room.

"Often he would cradle the phone on his shoulder, talk to the patient over the phone and continue examining the patient in his office."


After Russo's senseless death -- police believe a man, possibly a drug addict, shot him during a robbery in his office on a Friday evening -- there were candlelight vigils on Harford Road. Hundreds of his patients turned out for Russo's funeral. I remember an elderly woman genuflecting by the pew in front of me, blessing herself and whispering the words, "Some man, some man. Where'm I gonna get another doctor like that? He made me walk and talk."

Whenever I drive past St. Dominic Church in Hamilton, I remember Russo's funeral, all the stories his patients told. Even by 1981, the description of his practice seemed almost unbelievable to those already accustomed to specialists, group practices and the complex, increasingly costly health insurance system.

I mentioned Russo in this space last fall, suggesting that the city name a health care crusade after him -- specifically, Baltimore Health Commissioner Dr. Joshua Sharfstein's efforts to get more doctors to prescribe buprenorphine, a new drug full of potential as a treatment for the heroin addiction that fuels the crime that leads to deaths like Dr. Russo's.

After that, Rosann Russo, Dr. Russo's daughter, contacted The Sun, and we put her in touch with Sharfstein.

Eight months later, the city has a new annual award that recognizes medical service in the spirit of the selfless, five-dollar doc from Harford Road. Rosann Russo was in City Hall yesterday to help present the award, and it's all good: remembering Sebastian Russo, taking heart that his spirit lives in people like Pat Letke-Alexander.



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