Thursday, January 08, 2004

By Diana Nelson Jones, Pittsburgh Post-Gazette

A woman walked gingerly into the examining room in the basement clinic at Bethlehem Haven. She winced when she set her coat down. She was grossly overweight, her eyes were at half-mast, and her expression said life is barely tolerable.

	Ministering to the health needs of the homeless is "an important part of being a doctor and part of my own Christian ethic," says Dr. Randall Kolb.(John Beale, Post-Gazette)

Dr. Randall Kolb sized her up as she hefted herself onto the examining table. She was one of three patients he would see that evening at the clinic Uptown.

Kolb is a family physician and residency instructor at the Shadyside Family Health Center, but a couple of Tuesdays a month, after his day job, he takes his turn at the women's shelter clinic. It's a job that doesn't pay, serving people most others don't care about, but he said it is compelling.

"I think it's an important part of being a doctor and part of my own Christian ethic."

One of this year's local Jefferson Awards winners, Kolb has devoted himself to the mission of Health Care for the Homeless since the program's inception 15 years ago. He has treated patients at men's and women's shelters and helped shape the mobile outreach effort for which Dr. Jim Withers won a Jefferson Award in 1993.

"Somebody like Randy deserves recognition for his selfless acts," said Jennifer Williams, director of Health Care for the Homeless.

She nominated Kolb for the Jefferson Awards for Public Service, a program of the American Institute for Public Service. During a ceremony Jan. 29 at the Carnegie Music Hall in Oakland, each of this area's seven winners will receive a medallion and $1,000 to give to a nonprofit group. As a funder of the award, William J. Green and Associates will donate the $1,000 in Kolb's honor to Health Care for the Homeless.

	This is the third of seven profiles of Jefferson Award winners. Previous articles Terri Watson: Hard-working volunteer isn't slowed by disability (1/7/04) Holly McGraw: Her creative ways made Duquesne students achieve (1/6/04) The 2003 Jefferson Awards: Seven winners honored for their public service (1/4/04)

"He is one of the pillars in the community in terms of both service to the poor and in the teaching of service to the poor," said Withers, a member of the faculty at Mercy Hospital and founder of Operation Safety Net, the service that delivers blankets and medical help to the streets.

"In the era he and I were trained in, and I'd say it's still fair to say, it was not part of your training. I was discouraged from doing service," Withers said.

"In fact, it is a tremendous privilege. It gives you a deep connection to what it means to be a healer. I know Randy has a deep spiritual commitment. He was one of the folks that was already doing homeless health care when I first started."

Kolb, a 47-year-old father of four, is a native of Lancaster. He attended medical school at the University of Pittsburgh and has remained here, except for a brief stint in South Carolina in public health service. He joined the Mennonite Church the year before Hurricane Mitch devastated much of Honduras and other parts of Central America in October 1998.

"I got involved in what the church was doing" for the relief effort "and I started looking for ways to apply that to my work."

For the past three years, he has taken medical students twice a year to Honduras to work at a clinic in a mountain village cooperative.

"It's a coffee-growing area with serious hunger issues," he said. "Forty percent of the kids are stunted."

As he's lauded for his work, Kolb cites the importance of his team. He recalls as salad days the years worked at the Centre Avenue YMCA in the Hill District with medical staff who treated men for mental illness and addictions.

"We had a neat team, me, Chris [Lemley] and Ed [Richards]. We would see patients and then go out for late breakfast and solve all the world's problems."

The integration of such services is the model that has made subsequent alliances work well, he said. Williams, who has been in her job since 1995, speaks to this multidisciplinary approach:

"The homeless can't get better just with a doctor. They need social workers, case managers, shelter staff, mental health clinicians, drug and alcohol clinicians, nurses, housing advisers."

Over the years, she said, Kolb is the one she calls "for help navigating through the system."

"A lot of physicians will volunteer for a few years but then they give up those activities," she said. "He has never given them up. He's taught me a lot about working with the homeless, how to take care of a person no one else wants to care for and going to a shelter to do it."

Most homeless people have chronic and multiple health problems, Kolb said, and most are homeless because of mental illness, drug and alcohol abuse or violence. With a rueful smile, he said, "It is rare to find a happy reason."

As with the woman on the examining table, many homeless people must be prompted to take and refill the medications they need. Her back was so sore, she said, she didn't feel like doing anything. She said she didn't know how she might have hurt it. And she didn't have time to fill her prescription.

"Ow!" she said as Kolb pressed on her back. He gently swayed her arm while massaging the muscle along her shoulder blade. He crossed her arm in front of her, still pressing, and said, "Breathe."

She began to breathe, audibly, but made no other sound.

"How's that feel?"

"Feels OK," she whispered.

He wrote a prescription for a muscle relaxant and urged her to get her other medications in the same trip.

"Do you have bus fare?" he asked. She said she could get it.

"Will you do it?" he asked, tilting his head playfully to make her look at him. She managed a slight smile and said, "Yeah."

This is the third of seven profiles of local Jefferson Award winners.

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