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Interview with Trish Doyle, January 31, 2008 | UNCW Archives and Special Collections Online Database

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Title:
Interview with Trish Doyle, January 31, 2008
Date:
January 31, 2008
Description:
Trish Doyle is the Executive Director of the Tileston Clinic, a non-profit health care provider funded by grants and private donations. The Clinic's services include primary care, mental health care, pediatric care, and health education, and the rotating physicians consist of both general practitioners and specialists.
Phys. Desc:

Interviewee: Doyle, Trish Interviewer: Jones, Carroll Date of Interview: 1/31/2008 Series: SENC Volunteers Length 58 minutes

Carroll Jones: Today is January 31st, 2008. I'm Carroll Jones and this is Chris Malpass for the Randall Library oral history project. We're talking this morning to Trish Doyle in the special collections. Trish is probably one of -- if not the -- most busiest people and dedicated and filling the needs of some of our most unfortunate citizens. Good morning and thanks for squeezing in time to see us.

Trish Doyle: Good morning and I'm delighted to be part of this.

Carroll Jones: I want to share your mission with Tileston but before we get there, let's go back a little bit and talk about you. You are very obviously not a native. Most of the people around here that we talked to aren't and all doing good stuff. Where are you from originally and bring us up from there to how you got to Wilmington.

Trish Doyle: I was born and raised in Worcester, MA, the commonwealth. I was one of five children. I left Massachusetts at 17 to go to Trinity College in Washington, DC. I was a major in math and physics. I worked in Washington for a couple of years, really about 15 months before I married and moved to California. While in California, I had four sons--

Carroll Jones: Where were you in California?

Trish Doyle: We were in San Clemente, Dana Point, Hacienda Heights.

Carroll Jones: Was he in the navy?

Trish Doyle: He was Marine Corps.

Carroll Jones: Marine corps.

Trish Doyle: Then we moved to the Bay Area. I'll just tell you that in the first 12 years of marriage, we moved 12 times. I've had a lot of experience up and down the coast and some time in Tucson, AZ. While I was raising these little children, I went to graduate school at the University of San Francisco and worked on my master's in business with a specialty in marketing.

Carroll Jones: Good heavens!

Trish Doyle: We relocated to New York. I lived in Westchester County in Rye, New York and started working as an engineer for New York Telephone. I moved up the ranks there and worked a lot of time in marketing, bringing new products to service and ended up bringing new products to the FCC. We were a regulated entity at that time. In 1995, after I took an early retirement, I came to Wilmington.

Carroll Jones: With your husband? Children?

Trish Doyle: No children, no husband, all by myself.

Carroll Jones: How did you pick Wilmington?

Trish Doyle: I have a sister who was at that time living in Fayetteville. She and her husband are both physicians. She invited me to join them on a couple of vacations here in Wilmington and I fell in love with the place. I fell in love with the fact that it was warm and sunny. I love that. I loved the way of life here. I was interested because of the university and all that brings to a relatively small town. It just filled all my needs. I loved being on the water.

Carroll Jones: This is 1995 you did this?

Trish Doyle: Yes. So I came here.

Carroll Jones: I-40 had just opened, right?

Trish Doyle: Yes! Well, it hadn't even opened. It opened a couple years later.

Carroll Jones: That was easier to get back and forth.

Trish Doyle: Exactly, and I have never been disappointed about coming here. I absolutely enjoy this community immensely.

Carroll Jones: That's marvelous, we hear that so much.

Trish Doyle: I really do. So--

Carroll Jones: You came by your lonesome--

Trish Doyle: I came by myself.

Carroll Jones: What a brave lady.

Trish Doyle: I had a son in Detroit, a son in New York, and two sons in Texas. I might add that all my sons now live in the area; two are in Charlotte and one is in Augusta, GA so they're all within striking distance.

Carroll Jones: And have holidays together.

Trish Doyle: And we have holidays together. And the weekends. We spend a lot of time together. In 1996, a friend of mine told me about the Tileston Clinic and I started volunteering there.

Carroll Jones: Were you a member of the church? Or--

Trish Doyle: No. I actually go to St. Mark Church. I think one thing that's really wonderful about the Tileston Clinic, it's really a community effort. It's certainly not just a church effort at this point, but we'll talk more about that. I started volunteering and like so many of our volunteers, I just got real hooked into the mission and I enjoyed volunteering there so much and I did it as much as I had the time. I was working in real estate for a short time when I came here, did property management, and then I migrated to retail where I managed a couple of stores here in Wilmington.

Carroll Jones: What kind?

Trish Doyle: Alligator Pie and Alligator Baby and it was lots of fun. I'd never done any retail business and I learned that business and it was a great product to sell. It was fun to be with the children and fun to be with the parents and the grandparents. I enjoyed that very much and on a whim one day when I was volunteering at the clinic, I was thinking I really wanted to change my direction. I said to the then-director, "Do you need anyone here to work?" and she said part-time or full-time, and I said "Well, I'd really like full-time." She said "Well I have nothing but I am looking for someone part-time."

Carroll Jones: Who was the director then?

Trish Doyle: Dianne Linkfield.

Carroll Jones: Okay, I know who she is.

Trish Doyle: I called her a couple days later and I said I might just work part-time. I'm fortunate enough to be retired and have a small pension, and I have the ability to do that. So I said I'll try it. I worked for her for about eight or nine months and she resigned from the position. And I-

Carroll Jones: This was in '96?

Trish Doyle: No. This was in 2002 I started working for her. She left at the end of 2002 and I took on as executive director.

Carroll Jones: Okay, and at that time, I'm thinking pretty much struggling to make ends meet, right?

Trish Doyle: Yes. The Tileston Clinic? The Tileston Clinic was then almost 100% reliant on St. Mary's Parish for its funding an although they did a wonderful, generous kindness for us throughout all those years, we were to the point that if we were to grow, we really needed to seek outside funding. That's when we kind of split from the parish only in a fiduciary way. We certainly stayed there as their guests in the building that we had started in, in 1991. But we-that's the basement of the old Tileston School and people who are not familiar with the Tileston School often as "Why are you called the Tileston Clinic," and that's why, because we initially started in the basement of the old Tileston School building. And let me tell you, in 1991, it was a ramshackle old basement.

Carroll Jones: I know about that. You had to rely upon probably people with talents of all over, including doctors and nurses and so forth?

Trish Doyle: Absolutely. When the clinic was established in 1991, it was 100% volunteer driven. There were no paid people and it remained that way until the year 2000 and it was at that time that they started with a paid director. When I started in 2002, I was the only person that was paid at that time and still today, we work with about 300 volunteers. We are still volunteer-driven. We rely on your volunteers for all our doctors and dentists and pharmacists and many, many administrative people.

Carroll Jones: Trish, go back to when you first started there and give us an overview. I don't know first hand, but I do know from talking to people. I ran into my first run-in, it wasn't a run-in, greeting; it was to administer a communion one morning to a patient who had just had a leg amputated. She told me that if it weren't for Tileston, she wouldn't be alive; she was a diabetic and they paid for medication, treatment, and the surgery. I thought "this is unbelievable."

Trish Doyle: It continues exactly like that today. In fact, we just had a patient who was seen by an orthopedist in town and he's going to do a complete knee replacement. We had another orthopedist who did a hip replacement about a year ago. We had a neurosurgeon this year who operated on a cervical spot on one of our patients but it's not just the orthopeds. We have ophthalmologists that do cataract surgery. We have one of the first pediatric ophthalmologists in town who operated on a little three-year-old's crossed eyes. I'm sure there's a more technical term for that but that's what it was. We are just grateful for so many people and I think that's part of Tileston that people don't really know. It really is a community effort and without all of the community backing us, we wouldn't be able to survive. You asked me what it was like when I started there.

Carroll Jones: Let's go back to what you did and what it was like.

Trish Doyle: Because it was very different then.

Carroll Jones: This is what I want people to know.

Trish Doyle: Right it was, when I volunteered in '95 up until I took over, Tileston was open one day a week, Wednesday afternoon. We took the patients in at around three o'clock and we saw probably 18 to 20 patients at the most.

Carroll Jones: Were they waiting for you? Did they have to make appointments?

Trish Doyle: There were no appointments given. They would come sometimes as early as eight o'clock in the morning. They would wait outside in the heat, the cold, the rain. There was no way that we could bring them in because we didn't have use of the building until three. The dental patients were the most desperate and they would come the earliest. It was really awful because sometimes, people would wait for several hours until we opened at three and sometimes they'd get upset because people would cut in front of the line. When I took over, I said this is really inhumane to have these people waiting and we started giving out appointments. That has worked very, very well. But also, we had all these patients coming and were only using our facility for clinic purposes one afternoon a week. So the thought was we can utilize this more hours a week and we opened a Wednesday morning clinic, which still continues. As we were able to open more clinics, we finally opened the next clinic we opened was a Monday afternoon clinic and we specified that as a pediatric clinic. But it was interesting to us that because most children under the age of 18 who are low income can get health insurance through Health Choice Medicare, or Medicaid. We couldn't fill those slots with children so we opened it up to a regular medical clinic and that still survives.

Carroll Jones: And this is on Mondays?

Trish Doyle: This is on Monday afternoon. As we went through the months after that, we added several clinics until today, we have clinics every single day and we are now able to take in our patients of record, patients that have already gone through the eligibility requirements. We can see them on an emergent basis the very same day: a sore throat, someone came in with an infected toe yesterday; those kinds of things where in the past, we would have to wait until we'd have a doctor in.

Carroll Jones: How do you screen these patients when they come to you in two ways? Eligibility is primary, I'm sure and then to determine what medical attention they need.

Trish Doyle: Eligibility is very, very important to us because when we go for funding, we tell our funders that we treat patients who are within 150% of the federal poverty guidelines. For those who might not be familiar with that, that means a single individual can only take home about $1000 a month. The eligibility requirements go up in small increments if it's a couple and then a small amount for each child that's in the household; or it could be a parent. But we actually sit down and go through a questionnaire with them and we require documentation of their income. They might be required to bring in their last year's tax filings. Some people are not filing taxes; they don't make enough money. So we would require them to bring in four of their most recent pay stubs. Many of our patients work. By the way, I think it's interesting to note that 85% of our patients work. People think, it's interesting. I think people assume that we're dealing with the homeless which in fact we do, but the stagnant homeless population always stay around 2000 in this area. So we deal with many, many more people where 85% of them work; they work at jobs that are very low paying. They work at jobs that don't offer health benefits. In addition, many of them work under the table; they get paid cash: house cleaners and maintenance work, yard work. For those people, we require that their employer write a letter on letterhead saying they make x number of dollars per hour, y number of hours per week. There are, we are very careful about checking that.

Carroll Jones: This process takes longer than might be needed for somebody who's in an emergency situation. How do you handle that?

Trish Doyle: People in an emergency situation come in and we take demographics and then we catch up with the eligibility after the fact. Again, we ask them when they come in because if people have insurance, we don't see them; we would have to send them to the emergency room. People who make too much money, they have other options. We are really dealing with people that have no other healthcare options. These are people that truly, truly would not have access to healthcare without us. You talk about the lady that ended up with surgery because of diabetes, many, many of our patients, if it were not for the Tileston Clinic, many with these chronic health issues, without treatment would end up certainly in the emergency room and many of them in the hospital stays. So we are really doing a service for the community because we are keeping these people out of the hospital. Of course, we're doing a service for the patients because they have a better quality of health and therefore, better quality of life.

Carroll Jones: Do these people come to you singly or are they brought by family members? Or-You know I'm thinking in the income level you're speaking of they probably don't own automobiles today. They couldn't afford the gas.

Trish Doyle: Many of them do have automobiles because they are working. To work in Wilmington, it's tough if you're limited to a job on a bus route. Many of them do have cars. Friends will bring them and that's one of the problems; sometimes they make appointments and can't keep them because whoever was driving them had something come up and couldn't drive them that particular day. But most of them do drive but when we were located downtown at St. Mary's and now in our new location, we are on the bus route so people without cars can take the bus. But how do they get to us as far as how do they know about us? Word of mouth. We certainly don't advertise. I know at the hospital, they have flyers that talk about our services, the eligibility and the availability. But most of the people who need healthcare will find out from one another. Sometimes, the area physicians, particularly those that volunteer for us, will call us about a particular patient and they will sometimes write a note and say they've been in their office and will take care of them. It's something that people who need our care do find out about I'm happy to say.

Carroll Jones: You probably know Mary Ellen Boncheck [ph?] over at the hospital.

Trish Doyle: I don't.

Carroll Jones: She is wonderful. She practically runs the hospital. She's head of nursing. She has actually a CEO over there with all kinds of degrees. She's established a nursing academy and works a great deal with those less fortunate. One of the questions put to her was: in today's world, particularly during election year, you hear all this about health insurance and coverage. I said do you take anybody? She said if they show they have nowhere else to go, she said "we will never turn anyone away." They may have to wait in an emergency situation or referred somewhere, so that's why I wonder if you got referrals from the hospital from doctor services.

Trish Doyle: We do get referrals from the hospital. The way patients going into the emergency room are handled is that those that do not have a physician on record, they will refer them to, generally rotate between sending them to the hospital clinics. They will send them to the community health center, or they might send them to us. So we get lots of referrals from the hospital.

Carroll Jones: Okay, well I'm glad. That's a network that's working.

Trish Doyle: Right. I should also talk about our partnership with the hospital which plays a major role in how we operate and how we can provide services because at the clinic, on a daily basis, we see patients -- we not only have regular medical clinics now but we have specialty clinics in orthopedics, pulmonary, cardiology, women's health. We have a small surgery clinic that does carpal tunnel, things like that. So we do have several specialists but beyond what gets done at the hospital on a daily basis, we also have a network of about 60 area specialty physicians: ophthalmology, urology, dermatology. Almost all the specialists are covered but the piece that's missing for all this is the diagnostic testing that's required to practice good medicine.

Carroll Jones: Do you have any, your stuff at this time on a continuing basis, or- Let's see. Let me back up again so I can make this clearer for the tape. To determine- You have experts there to determine really what the cause might be. If somebody comes in and says "I don't know what's wrong," etc. Then they're refereed eventually from what you're saying. Do you have people who are working there, either on a full-time basis or volunteers, who have the capability of teaching these patients who come in, in certain areas of just general health and well being? For whether it's women's issue, or whether it's eating habits, or whether it's talking about diabetics. Generally across the board.

Trish Doyle: We have a big teaching arm within the clinic because although it's necessary with all medical patients, many of our medical patients have not a history of going to doctors and they don't have that knowledge that you and I would garner growing up and reading and being exposed to good health and doctors. So we have-our nurses do a tremendous amount of teaching on an ongoing basis. They teach about diet and exercising. They teach about things -- and this is very necessary -- about taking medication as prescribed--a patient taking it, even when you start to feel better. They have to educate on a constant basis about being responsible for coming and getting refills before you run out. They teach about when we give you your last refill, it's your responsibility to call and make an appointment because you have to see the physician again. In addition to that, we have a separate specialty clinic in diabetes and as you may know, diabetes is rampant and 30% of our patients have diabetes. But it's a tough disease to monitor and to control and in order to do a good job at it, it takes a lot of patient compliance and compliance in our patient group is lower than average. Their lifestyles are not geared to it; they're not as concerned about whether they're having good leafy vegetables.

Carroll Jones: They can't afford it. They're buying cheap.

Trish Doyle: They can't afford it and they'll put on the table what is fast and easy. So we are constantly trying to educate them. We have a separate diabetic clinic and at that clinic, we have several nurse educators. We have a dietician. We also have a podiatrist because that's another problem for them to monitor their feet. We go through retinopathy screening for all of our diabetics, which means they're looking at the blood vessels in the back of their eyes. So we really do a lot of education not only in diabetes but in just general health: exercising, diet. We have a lot of overweight patients. They don't exercise like some of us are able to do and they certainly don't even know the proper diet. So education is a big piece and most of that falls to the nurses. But we have wonderful nurses who take great care and compassion in taking the time to do that with our patients.

Carroll Jones: Do you, are you ever put in a position of having people come to you who have a, this is a type of illness, have a form of mental illness or are in a position of being abused? Either with children, men, women, so forth.

Trish Doyle: It's also very high incidence in our patient population and again, when we are doing the initial triage and as we do the nurse triage every time they come in to see the doctor, that's part of the question: Do you feel safe in your relationship? Do you feel safe in your home? A lot of domestic violence is identified; a lot of depression, anxiety. As you may well imagine, their lifestyles are tending to that and about four years ago, we started a mental health clinic, a mental health arm to our medical care because without good mental health, the medical care is always going to be suffering; they run hand and glove with each other. We have a mental health clinic right now. We have six or seven providers that come in on a bi-weekly basis. We are able to do therapy in both Spanish and English. One of the things I think that the community is aware of is that the state funding for mental health has been cut so drastically in the last several years that the fallout from the lack of services offered puts a burden on us. So we have had to step up to the plate and create this mental health arm.

Carroll Jones: Do you ever work hand-in-hand with some of the, well, services in town, more professional serv-I don't want to say more professional, who are all paid workers or even domestic violence shelter and services or the police department, schools, whatever?

Trish Doyle: We definitely work with schools. Also remember that the schools, because they deal with children, those children have health insurance. They can have Medicaid or they can have Smart Start, which is the children's other insurance that's available to them. We certainly deal with a lot of the Latino children who have difficulties in schools and their school nurses will call us and set up appointments for us to evaluate them and we do work with them quite a bit. Most of the domestic violence will be patients that come in for other reasons and then the abuse is identified. We work very closely with domestic violence. We often call them and refer patients and work them in getting patients to accept their health. So we do work with those organizations in the community as well. We try--it's interesting and I think this is an important thing: we try not to overlap services. If something is available in the community for our patients for nothing, then we do not cover that service ourselves because they have that option. Some of the things that I think of are: would we refer STDs, family planning, TB screening and things like that to the health department.

Carroll Jones: Will they go?

Trish Doyle: Oh, yes, they go. They absolutely go. We have become, in the last several as we've opened more clinics and have much more ability to do really good follow up with our patients, we are really primary care providers at this point. We look to do scheduled PAPs. We're doing those in house. We look to do scheduled mammograms. Those are being done at the hospital for us. We look to do PSA tests and other diagnostic testing for better maintenance; not to wait until the crisis comes. So as we've grown in the last four or five years, we have been able to offer a much more complete scope of services for our patients.

Carroll Jones: Is your growth based strictly on population or is it just the lifestyle that has evolved over the last 20/30 years?

Trish Doyle: What are you talking about?

Carroll Jones: I'm talking about the fact that you've grown as far as your services and the number of people you see. And just look at all the things you do. Diabetes, mental health, woman's issues, etc., etc., etc. You started from a small nucleus and I think all these services in town are the same way. It seems like they're overrun with people who are needy of medical attention and, if nothing else, instruction. My question is: what do you attribute this tremendous growth in these issues and the fact that there are so many people out there that require attention? Is it population? Or is it just one of the things to, I'm wondering is part of this due to the fact that we live in a different lifestyle than we did 30 years ago. It's a little more relax in your relationships in life.

Trish Doyle: I think it is in good part the evolution of our lifestyle. I think that's in general. I think that we have a lot more hypertension, high cholesterol; certainly a lot more diabetes than was present across the population 30 years ago. I think what has made our services required by so many more are that we have fewer people who are being given health insurance through work. The job situation -- many of our people work in the service industry which is a huge industry: the McDonalds and the Burger Kings. They will not allow employees to work more than 30 hours a week so that they don't qualify. I think that the access to healthcare has always been poor. I think that we as a responsible community see our responsibility as a greater thing than perhaps people did 20 and 30 years ago. I think that most of these patients that we serve today would've just had a very poor quality of health, would've probably died younger and probably would've ended up in the emergency room for treatment on an emergent basis rather than treating these chronic diseases on an ongoing basis. I think there are many, many things that have happened and I think that as we go forward, I think the need is going to grow even greater; that there is a huge segment of our population that are living in an income level that does not allow for them to pay for their medical coverage. I think the cost of medical care in general has gone up. If you look at what you spend or I spend or what we are charged on an annual basis, the healthcare dollars are just so much greater. You and I and so many others are lucky enough to have insurance that covers that but certainly those costs have increased tenfold in the last 20 or 30 years. So I think it's many things in our society that changed.

Carroll Jones: Is to your knowledge and for the benefit of today. In your knowledge is an attempt to made or accepted as result of the breakdown of the family unit, where there is no father, there's no safety, there's no comfort and these children grow up not knowing any better. Take it as "Oh well." Do you have any people that can talk to these kids and these young women their responsible, on their responsibilities? Or is it so impersonal you can't get involved.

Trish Doyle: It's not that it is so personal that we would not like to get involved. What it really is, and one of the things that I found as the director of a free clinic, is that that's just beyond our scope of ability at this point. That doesn't mean it won't be within our abilities in a couple years. Certainly five years ago, we didn't see the clinic growing to the degree it has thus far. But one of the things that we learn is that we have to really clearly define what we are capable of doing from a volunteer staff ability and we have to know the numbers of people that we can serve in order to do what we do well. Although I think this is a huge issue, I think it's beyond what our scope is right now and what the mission is. But we see the results of what's happening and I certainly see on a daily basis that this just continues. Obviously, I know they address that in programs at the health department and I don't know what other education is being offered to some of these young people.

Carroll Jones: I, well I don't know either, I do know that I've tried, I guess, in some cases to educate young women particularly at the Wilmington Health Access Center but there's only so much you can do.

Trish Doyle: Right. And they have to come to you for this education and some of the people that we're talking about are not going to Wilmington Health to begin with. I know that they do offer programs in the schools and this is probably a good step forward in that endeavor.

Carroll Jones: I guess so. Let's go back to 1996. There was one paid person that was a director.

Trish Doyle: No, there was not any paid. That was in the diabetic clinic and we added the pharmacy in 2000. There was not a paid position until 2000 and Dianne Linkfield was the first paid director.

Carroll Jones: How many people did you have one day a week, one afternoon a week when you started?

Trish Doyle: We had about 20 patients and would probably have about 15 volunteers. That would include two doctors, probably four nurses, intake people, people that deal with just running back and forth with the patients. Also, when I began, we also had the dental clinic running on Wednesday nights and that would involve a couple of dentists and a couple of hygienists and so forth. But it takes a lot of people to run the clinic, more than you probably would imagine.

Carroll Jones: I want to come from 2000 then up to now. How many people do you have now?

Trish Doyle: How many do we have on staff or how many volunteers?

Carroll Jones: Both.

Trish Doyle: Within the past six months, we're granted to have a family nurse practitioner full time and an RN full time. That is the first time we've had any medical or clinical paid staff.

Carroll Jones: Then how do these others, who are volunteers, where do they get their knowledge and how?

Trish Doyle: They're registered nurses that work. Many of them we recruit through the hospital. The volunteers bring in volunteers. That's our best source. We also are lucky in this community that we have many young retirees that come, that are nurses. We have a couple physicians; we'd like to capture some more of the retired physicians because all of our physicians at this point are volunteers.

Carroll Jones: How many physicians do you have?

Trish Doyle: We have about 25 that come to the clinic on a rotating basis and we have another 60 of these specialists that we refer to. They see our patients in their offices and they do whatever follow up is required. I mean the several of the doctors do surgery like we've already talked about. The allergy doctor has given a series of shots to several of our people that require them for diagnosis of their allergies. I just cannot emphasize enough the generosity of people because this clinic could not exist without that. It's really--for me, the most rewarding part of my job is working with these people who are so dedicated and so compassionate and I will tell you rarely do I make a call to someone and say could you do this for us. Would you be able to do a special clinic for us? Would you come in on a-- They almost always say yes. It is unbelievable how dedicated these people are to this clinic and to the people that we serve.

Carroll Jones: That's absolutely marvelous.

Trish Doyle: It really is and that's why I say I work very, very hard at my job and--

Carroll Jones: How many days a week do you work there?

Trish Doyle: I work five, sometimes six and I work a lot of hours. But what I wanted to say is that my efforts would be of no value without the efforts of the volunteers. It's not only the doctors, it's not only the dentists and the pharmacists which are wonderful. But it's also a huge group of people who are the support personnel and if the doctors left and wrote their orders and so forth and we didn't have anyone there to do the record work and the appointments and the follow up, that wouldn't be valuable, either. So each of our volunteers is very, very valued on the same level as far as I'm concerned.

Carroll Jones: How are you funded?

Trish Doyle: We are funded primarily at this point by grants and foundations. We do have private donors. One of the things that we have been lacking in or slow to get going is we have not taken the time to really reach out to the community at large and tell people what we're doing. There are a lot of people who have not heard about the Tileston Clinic so our effort in the last couple of years and as we go forward is to really let the people in our community know what the Tileston does for the whole community and that hopefully, more of our funding will come from private donors and from corporate sources and also from some of the other churches.

Carroll Jones: Do you have any corporate sources now that have help fund?

Trish Doyle: We do. PPD has funded us somewhat but the others really have not. It's only because we haven't really gone to them asked them and so that's what we're working on at this point.

Carroll Jones: I think some of them would probably be very willing to. And of course you're probably aware that we have three new, large high tech companies coming into Wilmington. These high-tech companies can afford to do these as you know, or any corporation, because it's a tax write off.

Trish Doyle: I think for most corporations, it's part of their agenda, that they want to be--

Carroll Jones: This is part of their community.

Trish Doyle: Right and they want to reach out. As I worked for a big telecommunications company, we did a lot of community support. And I think because we didn't have the staff, because we had too many other things going on in our growth process, we have not done that as we should have. So we are looking to do that.

Carroll Jones: Do you have professional grant writers?

Trish Doyle: I write all the grants.

Carroll Jones: Oh well, that's pretty professional with your background. (laughs)

Trish Doyle: Again, I'm lucky enough that it's a wonderful cause so we've had good success with that. As a community foundation, the Cape Fear Memorial Foundation has been ongoingly generous with us. We also have received funding from the Cape Fear United Way. We have been funded by the Landfall Foundation.

Carroll Jones: They're good, and this is right up their alley, but they don't have large grants.

Trish Doyle: Exactly. At this point--

Carroll Jones: Every little bit helps.

Trish Doyle: And the other thing too is it gets us known in the community. We recommend- the most they gave last year was $6,000--and

Carroll Jones: That's pretty good for them.

Trish Doyle: Right. That was the most they gave and we will use that to buy medications because that's one of our expenses. It would be wonderful if the community at large could support us to a greater degree. Any non-profit in a perfect world should get 80% of their basic funding from private sources. We get probably 80% to 85% of our funding from grants and foundations, so we really need to turn that around as we go forward.

Carroll Jones: I agree that you have to blow your horn a little louder.

Trish Doyle: Yeah, it takes time. (Laugh)

Carroll Jones: It does take time and I agree too. I married a homeboy.

Trish Doyle: You did?

Carroll Jones: Yes, but I didn't meet him here and he, what I'm saying. Since I've been here and worked at the university, always here in Special Collections, I've had an absolute master's course in the history of Wilmington. When you start reading documents going back to 1729 -- originals -- and papers and the histories of all these churches, and one thing and another, then working on having St. Mary become a shrine, that was like writing a grant to the diocese.

Trish Doyle: And you worked on that.

Carroll Jones: I did. I wrote it with John Gillespie. Anyway, my point is, you become aware of a lot of the history of these buildings. My mother in law attended 8th grade at the Tileston School.

Trish Doyle: Oh really! That's so neat.

Carroll Jones: It needs to be preserved and you calling it the Tileston Center, where it began, I think is a keeper; you should keep that if you can and see if it does anything. Although one population now is naturally aware. But they need to be made aware.

Trish Doyle: I think it's a rich history.

Carroll Jones: It is a rich history. It's a fascinating history. It's kind of a strange history in a way in how they started it. But the way people stayed here, they evidently just got lazy and liked it.

Trish Doyle: I think they understand that.

Carroll Jones: You know that, but at any rate, you really do need to have more publicity. I hate that word but it's exposure.

Trish Doyle: Community awareness. That's why I welcome going to the Rotary. Those are small organizations but word gets out.

Carroll Jones: I don't know who asked you to Rotary but you probably know that the downtown Rotary is probably the best place in town to go and make your plea and talk. Those are movers and shakers down there. Many of then have been here for generations, many of them have come here and dived right in. They're controlling all the business and the fundraisers. They're a lot of big operators -- quietly. They've got deep pockets.

Trish Doyle: I'll be perfectly honest that what we don't have on our board is someone that knows how to get to those movers and shakers. We don't because one of the things is that when we started out as an arm of the church, the board was all church members. We have evolved from that. We have a separate board now that's just for the clinic and the outreach is not involved in it and the church is not involved in it. But we don't have that old boy-- we just don't have that connection yet.

Carroll Jones: We can talk about that off camera.

Trish Doyle: I hope this isn't on camera.

Carroll Jones: It is but that is perfectly alright. It's happening and we all know it, you see. There is nothing wrong with that. Is there, Chris?

Chris Malpass: Mmm-mmm.

Carroll Jones: Alright. I guess this is one of the things I want to bring up. In fact some just up on it. I do want to talk about this because it is an issue here. I'm not asking for personal opinions; I'm simply asking in numbers I guess. The Hispanic community is growing like crazy and it's become a volatile situation because of the citizenship matter. I think that we'll just work around the value of citizenship when it comes to children. How do you deal with this?

Trish Doyle: I'm glad you asked that because when I do speak about the clinic, I know that's always in the minds of people so I usually address it. We need to address it and I will tell you that I think all of us involved in the clinic are equally concerned about the illegal population that comes here and what that brings with it. But I also think that the clinic was opened to help people in need and we have not discriminated against anybody. So when they come to us as patients, they are people in need and I think that we as a one-time faith-based organization that still likes to stick to those guidelines, we treat anyone who comes to us without question. We do not ask people when they come in if they're documented or not documented. We require that they show us proof of residence when we go for the eligibility piece of that. For many of the medications that we see, we require that they have an ITIN number or a social security number. We have been moved to get more into that as we go along.

Carroll Jones: E-ITIN?

Trish Doyle: ITIN number; that's an international tax identification number. It's a number that they're given in place of a social security so they can pay taxes when they work. We really feel that all people deserve to be dealt with with care and compassion so we do see a large number of Hispanics.

Carroll Jones: Is it growing?

Trish Doyle: No. It stays pretty much the same actually. If anything, it's probably dwindling a little bit in percentage because there are more and more others -- African Americans, Caucasians, and others -- that need our services that might not have needed them 10 years ago when health insurance was more readily available.

Carroll Jones: Do you have men and women coming in readily to volunteer or do you have to ask? Do you have to ask people?

Trish Doyle: For the most part, people come to us. One of the most difficult volunteers to get and what we're always looking for is interpreters because we cannot provide healthcare services unless we have truly bilingual interpreters. People will call up to interpret who have taken Spanish in college or high school and although that's good enough for conversational Spanish, we really need people that really are native speakers and can really understand the nuances of medical terms. That's our hardest volunteer to find. We are always looking for good volunteers both professional and non-professional, but we're very, very lucky that people call me on a weekly basis because they want to volunteer.

Carroll Jones: That's wonderful! That's good!

Trish Doyle: Also, the volunteers themselves are our best recruiters because if you are passionate about something that you're doing, you're going to talk to your friends about it and that draws them in, too. I would never say we have enough volunteers but we're very, very fortunate that many, many times our volunteers come to us.

Carroll Jones: Are these mostly retired people?

Trish Doyle: No, they're both. It's both. Most of the doctors are not retired. I would say about 40% of our nurses are retired but it's a mixed bag, it really is. We have young and old alike. I have a 14 year old girl who's in a special program at Cape Fear Community College who's volunteering. And we have people well into their 80s that are volunteering.

Carroll Jones: Can you utilize, for example, juniors and seniors in high school who have got to do a certain amount of community service as part of being in high school and not for punishment?

Trish Doyle: Not court injected or whatever you want to say. This 14 year old girl is an exception. She is in that accelerated program and she is doing it as part of her school. I have found in the past unfortunately that those young people don't often have the commitment and it's difficult for us to train a volunteer and not have them consistent. Unless it's a special case, that hasn't really worked out very well for us. We also have a lot of students from the university that call and have projects. The nursing students call. The School of Social Work, those students have requirements and with them, I will often use them for special projects that I know will utilize the 15 or 20 hours that they need. We always have special things.

Carroll Jones: Do you know Virginia Adams, dean of the School of Nursing?

Trish Doyle: Yes. She used to be on our board actually.

Carroll Jones: She is one of the most fantastic people in the world. And I can vouch first hand. Some of those nursing students are an absolute joy, much more so than the hardened nurses are in some cases.

Trish Doyle: Virginia is a very dynamic and very interested in the clinic. Several of her faculty volunteer for us, which is a wonderful thing. There's this small group of nursing honor's program and they have done some education for us. They came in on an ongoing basis and took modules and talked to our patients on the importance of taking your meds consistently. They did one on weight control so those kinds of projects that the students can do is really a benefit to everybody. I had a young student from the university who did a module for us for dental care. Some of our patients don't know how to brush their teeth so we did modules for the children with little games top lay and like little puzzles to do. That was very successful, too. We gave them toothbrushes and toothpaste if they stayed through the class.

Carroll Jones: Do you seek toiletry donations from individuals who may not be able to give monetary contributions? Things-donations from individuals from those who can't give you a thousand dollars or two thousand dollars, but donate toiletries or things like that for the clinic.

Trish Doyle: Absolutely.

Carroll Jones: These are projects the young people can get involved in.

Trish Doyle: We don't need toiletries but there are other things that we do need. We are grateful when people come in, a family member has passed away and may bring some unused syringes or some unopened meds or some medical equipment that they're not using. We can often use that and we're grateful for it. We also take donations of a dollar and five dollars. Every little bit helps.

Carroll Jones: Well I tell you, you are doing. I have one last question. I am a born nurturer and mother and could not volunteer in the cancer ward for children because I would fall apart. However, I can guarantee hospice and to all those people because it is a joyful place. My question to you having been there so long, what you've described is a gamut of needs and illnesses. How do you put up with it and keep from falling apart?

Trish Doyle: Well, you know, I see that every day. I not only see the poor health that people have but the terrible lives many of them lead. But there's a certain joy. There's truly a joy in my work because I know in some small way, we can make things better. I talk to people every day not from the clinic who are dealing with illness and I think that's tough to deal with but how much tougher is it to deal with when you don't have the ability to go and seek out the best medical care and so forth and so on. So the fact that the clinic can provide that for our patients really keeps me going on a daily basis. I see lots of success stories, too.

Carroll Jones: You're a joy. We're going to end on that note.

Trish Doyle: Great, okay, great.

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