The Commitment

Florence Jameson rose from poverty to prominence. Now she and her volunteer brigade are determined to bring health care to Las Vegas’ poor.

It was well past 2 on a Sunday afternoon in October 2000, and I was becoming more convinced by the minute that I would soon be delivering my own child. My wife had been in labor since Saturday night; our regular doctor was stuck at an airport in Denver; no one had appeared in his stead. Whispers of a mythical doctor-on-call had strangely faded as the baby made its way down the birth canal. Our nurse, who had gotten us started with the requisite counting and pushing, was called away to attend to something that was, she told us, urgent. Count. Push. The crown of a small, pink person came into view.

That’s when Dr. Florence Jameson arrived—perhaps it was a hallucination, but I think she may have floated in—with singsong words, deep reassurance and an inimitable mix of mastery and warmth. We’d never seen her before; her understanding of us seemed complete. She informed us that our son’s umbilical cord was wrapped around his neck, fixed the problem in the nick of time, and brought the boy into the world.

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It is 8:07 a.m. on a clear, chilly day early this February, and Dr. Jameson—the one person who will never, ever need to apologize to me for anything—is already making apologies. She delivered a baby just past midnight; this morning, she had rounds at the hospital. Only now, seven minutes late, has she made it to her office in a beautifully retrofitted ranch house on Eastern and Hacienda avenues. When was the last time a doctor apologized for being seven minutes late? A decade after our fortuitous first meeting, I’ve come to talk to Jameson about her career, her life and the secret of her preternatural gift for inspiring belief. But what she really wants to discuss is the groundbreaking organization she founded in 2008, Volunteers in Medicine of Southern Nevada (VMSN). She prepares a quick breakfast of oatmeal and bananas, sets it on her desk, leaves it untouched, fixes her dark eyes on me and tells me the story of building something from nothing. One of the old saws of journalism, devised by people who never met Florence Jameson, is that you never let a subject steer an interview. I prefer another old saw—that when someone’s got something worthwhile to say, you listen.

Jameson arrived in Las Vegas in 1985 after completing medical school at UCLA and her OB/GYN residency at Cedars-Sinai. Over the years, she developed a reputation for both clinical expertise and extraordinary empathy. She has cared for thousands of patients and delivered about 5,000 babies. This would seem more than enough to reflect upon as a career well spent and a community well served. But Jameson saw that something was missing in Las Vegas.

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Today, San Diego’s Normal Heights neighborhood has a growing reputation as an artsy, demographically diverse urban enclave, but when Jameson was growing up there in the 1960s, it was a decidedly low-income district. Her father was rarely at home during her childhood; when she was in her early teens, he went to prison, leaving Jameson and her four siblings to be raised and supported by their mother. There was little money, but a local physician provided free medical care. His example has stayed with Jameson for four decades, a constant reminder of the power of her profession.

The venom of hard times, though, worked its way into the family’s future. Jameson’s older brother died of a heroin overdose, a sister became addicted to methamphetamine; another sister became pregnant at 15 and left home. Only Jameson graduated from high school. She worked her way through both college and medical school.

“When my father got out of prison, I asked him for help,” Jameson says. “I was putting myself through medical school, and I asked him for $25 for tennis shoes. He promised it for about a year. After that, I gave up waiting.” The experience left Jameson with a deep appreciation of the value of community; one of her UCLA professors even gave her a bicycle so she could make it to classes. “I’ve been extremely blessed along the way,” she says. “I always had people extending a helping hand, food, clothes, a room when I had none—and, of course, health care.”

When she was studying in Los Angeles in the late 1970s and early ’80s, Jameson paid close attention to the work done at volunteer-staffed clinics such as the Venice Family Clinic and the Los Angeles Free Clinic. “It was an older city, and the infrastructure was well established,” Jameson says. “The concept of free medical clinics was just a given. Students could go to these places and really learn early on how to serve the community, to give back, and how that’s a part of the bigger equation.”

But in 21st-century Las Vegas, where an estimated 350,000 people are without health insurance, there was no such clinic until Jameson decided to create one.

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Last June, the Corporation for National and Community Service released its state-by-state rankings for voluntarism in America. Nevada finished next-to-last. Twenty percent of Nevadans volunteered; the national average was 26.8 percent. What’s more, across the nation voluntarism had increased markedly during the recession; the CNCS study concluded that Americans were responding to the crisis by serving. In Nevada, though, voluntarism decreased.

“Las Vegas grew so rapidly in the past 30 years, and people came here to follow their American dream to this last frontier where they could set up their businesses, get good jobs, make a good salary, buy a home,” Jameson says. “People came with the idea of ‘I can do it by myself’ rather than ‘I’m going to connect with my community.’ That connection hasn’t been a big part of the equation here—not just in medical care, but across the board. But we’re changing that.”

In January 2010, the first VMSN clinic opened alongside the pine trees and picnic benches of Paradise Park, near the corner of Tropicana Avenue and McLeod Drive and a block away from the Gun Store. (The area, which was hit hard by the suburban flight of the 1990s and 2000s, is one of three—along with downtown Las Vegas and old Henderson—that VMSN had designated as high-need neighborhoods.) Jameson had spent the previous two years working feverishly with colleagues in the medical and broader philanthropic community to prepare for the opening, raising money and attracting volunteers to do everything from patient care to janitorial services. National pharmaceutical firms agreed to donate medications. VMSN partnered with local hospitals, labs and radiologists for services that couldn’t be provided on site.

VMSN leases the Paradise Park space at virtually no cost from the county, but it had to make certain compromises with county authorities: Patients must demonstrate that they are legal residents of Clark County; they must show that they are not insured and not eligible for any government-funded programs, such as Medicaid. And the county, responding to concerns about the clinic’s impact on the park, did not permit it to offer mental health services.

Nevertheless, the clinic has been, by any measure, a resounding success, enlisting top physicians from around the Valley and serving—at no cost—more than 2,000 people who had virtually no access to basic health care. (Indigent patients have traditionally turned to the emergency department at University Medical Center, which is expensive for the county and inappropriate for minor problems, chronic illnesses and preventive care.) Lives have been saved; public health has been served.

VMSN now has 564 volunteers, including Jameson herself. There are physicians and housekeepers, accountants and housewives, teachers and architects. From patient care to custodial work, the entire VMSN operation (with the exception of four paid positions) is staffed by these volunteers. And Jameson is actively working to bring their energies to a second site, downtown on Martin Luther King Boulevard. The land was donated, and VMSN will own the building. That means the limitations the county placed on the Paradise Park clinic won’t apply. There will be mental health services, and no residency check. VMSN recently began raising funds toward its goal of $3 million. Jameson hopes the center can be up and running within 18 months.

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Jameson still works 60-hour weeks at her private practice in addition to all the hours—she’s stopped trying to count them—she spends on administration and patient care with VMSN. She loves her practice, and somehow still lavishes the same remarkable attention on her patients that my wife and I experienced the day our son was born. But she hopes to retire in a few years to devote herself full time to the clinic that has clearly become her mission in life.

“Every civilization at some point has to recognize its responsibility to feed the hungry, shelter the homeless, give water to the thirsty and administer to the ill,” she says. “This is right now what our community is recognizing. This is a wonderful opportunity to serve our neighbors. Most of our volunteers say every day that there’s no greater joy in life than working at our clinic.”

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