Lixel Barnhill did not cry as she listed all of the loved ones who required her care. Two of her three children have cerebral palsy: 18-year-old Daniel and 10-year-old Duke. Her daughter, an 8-year-old named Destiny, is healthy despite her 13-hour birth was Barnhill’s hardest and longest. Then there were her parents. Her mother had Parkinson’s disease and diabetes. Her father had Alzheimer’s disease. She took this as a sign she belonged in health care, so she went to school to make it official.

Monday through Friday, from 8:30 a.m. to 4:30 p.m., Barnhill works with other workers and volunteers at the Health Care Access Clinic in Lawrence to help provide health care for those in the Douglas County who can’t afford it. These people face the hard realities of the bad economy, and their numbers are growing faster than the resources that assist them. For this reason Barnhill recently volunteered to work two jobs at the center, as a clinical nurse and as the medication coordinator. She also gave up her office so it could be used as another exam room. Her desk now sits in the middle of the medicine supply closet—room as small as it sounds, without windows but with walls lined with shelves full of medicine. This is where Barnhill starts and ends her day.

It is a Thursday. Barnhill agreed to let me shadow her. I went everywhere she went. This is her story.

8:30 a.m. Barnhill finds her purse in the bottom drawer of her desk. It reminds her that she worked 12 hours yesterday. It would have been more if she hadn’t accidentally locked herself out of the clinic last night. On Mondays and Tuesdays, Barnhill works mainly as a clinical nurse. Consequently her work as the medication coordinator piles up. After having dinner with her family, she returned to work. Taking a box full of paperwork to her car, Barnhill accidentally forgot her purse inside. “Yesterday was a long day,” she says. “One of those days I just went home and cried to my husband.”

9 a.m. Barnhill is calling patients to tell them their prescriptions are ready when she is paged. A patient is here to pick up his medicine; this happens about 30 times a day. She finds a brown paper lunch bag and goes to the waiting room. A man in his 50s takes the bag and whispers he doesn’t have the $2 fee. She says no problem, it happens a lot. On the way back she is handed six more medical charts.

* * *

Jeri Safarik, nurse practioner at the clinic, says Barnhill is managing a prescription program with more than 700 enrolled people. “It is a huge task,” the nurse practitioner says. “We keep her busy.”

* * *

9:30 am After filling the prescriptions of five more patients, Barnhill’s husband calls. The school says their 10-year-old son is sick. Barnhill hangs up to call the school. As she dials she says, “Anytime he even sheds a tear the school is all over it, which is great but they call a lot.” The school asks her to come get him. Barnhill firmly explains that she works two jobs and her husband is in Kansas City but will come soon.

* * *

Barnhill inspires her coworkers with her devotion to her job and family. Safarik says Barnhill takes on so much both personally and professionally outside of the clinic. Barnhill’s sister and her sister’s children also live with her family, and Barnhill is a Girl Scout troop leader. Barnhill also taught a night nursing class until she took on the second job at the clinic and had to stop. “She finally gave up something,” Safarik says.

* * *

Without hanging up the phone, Barnhill dials the next patient. This time she speaks Spanish. The patient says she doesn’t have the gas money to drive to the clinic. Barnhill says she will call the prescriptions in to a nearby store so she can walk to get them. The patient then says her diabetic mother needs an eye exam. Barnhill says she’ll schedule it. Meanwhile nurses and workers walk in and out to pick up charts and medications.

9:45 a.m. Only one chart left. A coworker updates Barnhill about a patient who was misidentified at a hospital. A hospital claimed the patient had surgery and sent the clinic the paperwork. During an exam at the clinic, it became clear that the patient could not have had the surgery documented in her chart. When they asked the patient about the surgery, the patient panicked. The hospital was contacted to correct the information.

10 a.m. Barnhill is paged into an exam room to translate. Barnhill is the only staff member who is medically certified as a Spanish translator.

10:10 a.m. A volunteer nurse asks for Barnhill’s help. The nurse doesn’t think her patient, a single mom in high school, can afford a $4 prescription. “I’ve been there,” Barnhill says, relating to the patient’s situation. They look at the wall with the “freebie” medications, mostly donated from pharmaceutical companies. They find an antibiotic. The nurse says, “OK, let’s give her our last bottle.”

* * *

Safarik describes Barnhill as constantly moving. “You can interrupt her and it is not a problem,” she says. “She will still give you a smile.”

* * *

Barnhill is back to the eye exam patient. She looks at an Excel spreadsheet on the computer to find a volunteer doctor who is available.

10:15 a.m. Another page, this time to fill the role of clinical nurse. She looks for her stethoscope. “It must be in my other desk,” she says laughingly. She finds it at her desk in the nurses’ office, throws it around her neck, and escorts the Spanish-speaking patient into an exam room. He is a male in his 40s with bronchitis. The patient’s mother-in-law is in the waiting room, wanting to pick up the family’s prescriptions.

10:30 a.m. On her way back, she is handed packages full of donated medications from pharmaceutical companies. “Back to the meds,” she says with a laugh. She opens and organizes them while calling the doctor to schedule the eye exam. She then calls the patient to let her know. She gets up to fax the patient’s information to the doctor’s office.

11 a.m. Back from the fax, eight more charts are stacked on her desk. “Wow, look at the stacks, I’m so happy,” she says. “Yesterday I had them piling up back on the shelves. At some point, I may eat breakfast.” As she sits down, the nurse practitioner asks her to come translate the medication instructions for the bronchitis patient.

11:30 a.m. The school calls. “They are on a hunt for my husband,” she says with a smile. She calls her husband. He says he is on his way and asks if she has eaten. “I get caught up and don’t get a chance to eat,” she replies.

She goes back to the charts. One patient is getting out of jail and requested refills on her medications, but because it has been so long, her paperwork has expired. Barnhill gets the proper forms and starts filling them out for her.

Another page, this time a patient calling to ask about a doctor’s referral. Barnhill answers the phone as an office worker delivers the patient’s chart.

Noon Barnhill opens the medicine packages and starts organizing them. She explains that the amount of medications coming in isn’t even half the amount that it should be. She looks up at the shelves of medications. “Right now we are really low,” she says, “Believe it or not.” JP