Dr Fred Richardson Jr administers to his patients at their homes in Chicago’s West Side.
UP wooden steps, past unlit Christmas lights dangling in the window, Dr Fred Richardson Jr walked through the doorway of Louise Cannon’s house on a cold late fall night on Chicago’s West Side.
He passed Cannon’s grandchildren, a photo of the Obamas on the mantel and a statuette of the Virgin Mary, then pulled back curtains to a dining room converted to a makeshift hospital room.
Unable to speak after a series of strokes, Cannon, 79, was in bed. A rerun of Good Times glowed on the TV in a corner.
She saw Dr Richardson, raised her emaciated left arm and beamed.
“How are you, Miss Cannon?” he asked, taking her hand. “All right, sweetheart. Now I’m going to check your breathing, ok?”
A son of the Englewood neighbourhood on Chicago’s South Side, Dr Richardson has been a solo practitioner of family medicine since 1990.
Throughout that time, he has been doing what he did on that Tuesday night – grabbing his scuffed, black, leather bag and making house calls, primarily in the city’s most dangerous neighbourhoods.
Dr Richardson, 54, has also become a legacy builder, rescuing minority students struggling with medical school by bringing those students – many on probation, some dismissed outright – into the small waiting room of his west suburban Oak Park storefront office three days a week.
There, he teaches them the practical applications of what they are trying to grasp in textbooks.
It’s known as problem-based learning, and Dr Richardson does it without financial compensation.
“He’s our brightest light,” said John Bradley, an administrator at Chicago Area Health and Medical Careers Program, which identifies promising minority students for medical careers, advocates for them in medical schools and supports them academically.
By Bradley’s count, Dr Richardson has saved 50 of those students from leaving medical school.
It was more than 30 years ago, but Dr Richardson still recalls the question from an interviewer screening applicants to Rush Medical College, Chicago, in 1982. How did he know he wanted to be a doctor?
He had no black physician role models who would make for a tidy answer.
His mother was a bookkeeper; his father, a construction worker who struggled with alcoholism. The family moved frequently. Dr Richardson remembers spending a night in a shelter.
“I like M.A.S.H.,” he told the interviewer, a reference to the long-running TV show about a mobile military surgical unit. “I love Alan Alda.”
His other medical idol?
Marcus Welby, MD, a 1960s and 1970s TV drama starring the very Caucasian Robert Young as a family physician. He made house calls, which looked heroic to the young Richardson.
Those small screen heroes are part of a somewhat complicated explanation for why Dr Richardson does what he does.
His Christian faith also factors into it. But all of it starts with his mother, Gladys Richardson.
Though the family moved often, they resided around 63rd Street and Wolcott Avenue, an area of low income, and high unemployment and crime.
Gladys carried the financial load for the family, somehow keeping her four kids in Catholic schools.
“Her goal in life was to educate her children because she thought that was the only way out of Englewood,” said Dr Richardson, “and so, she was a strict disciplinarian; stressed academics; stressed excellence.”
Homework was a serious undertaking. Straight A’s were expected. Anything less and Gladys could resort to corporal punishment.
That approach was her way of making sure her four children avoided the destructive path many young people took in Englewood.
Despite her sometimes harsh discipline, Dr Richardson said he felt overwhelming love from his mother.
While his neighbourhood friends “were into all sorts of bad things”, they protected him and his younger brother, Lendell, who also became a physician.
Playing baseball frequently in the neighbourhood gained them wide acceptance, Dr Richardson recalled, and their focus on becoming doctors was respected by those friends.
“They were like, ‘Ok, don’t mess with them because they may have to take care of us,’” he said.
He arrived at St Rita High School in 1974 and had dreams of playing shortstop for the Chicago Cubs.
But he stood at about five feet four inches – even with a conspicious Afro that earned him the nickname Freddie Fro – and was cut from the school teams as a freshman and sophomore.
He knew then, he said, that academics was his path.
He graduated in the top three of his class, earned an academic scholarship to Loyola University in Chicago, and met Julie Ann Llorens, a pre-med student at Loyola, on a Chicago Transit Authority elevated train. The two were married on June 15, 1985.
The volume of material overwhelmed him, forcing him to study 12 hours a day. To get through it, Dr Richardson said, he leaned on the example his mother set.
Gladys encouraged her son at an early age to be an orthopaedic surgeon, which would enable him to treat his father’s bone disease.
But at Rush, he soon discovered that orthopaedics was not for him, and was intrigued by family medicine.
During his residency, Dr Richardson worked with Dr Stephen Humowiecki, who made house calls.
Now retired, Dr Humowiecki recalled a “very outgoing” resident, who was kind to patients and collegial to residents.
“He was someone who was very interested in learning and naturally attuned to helping the whole person,” said Dr Humowiecki. “Everyone liked working with him.”
In 24 years of house calls, Dr Richardson says, he’s never been hassled in the neighbourhoods.
“Part of it is having grown up in an area like this,” he said after leaving Cannon’s home.
“I’m not intimidated by this at all. None of this bothers me.”
Ten minutes after finishing his work with Cannon, Dr Richardson and his wife, who manages the practice and accompanies him to all house visits, arrived at the home of 95-year-old Alberta Bowles, who lives alone in a two-bedroom brick house a few blocks from Cannon.
He asked about her shortness of breath, whether she’s had more belly problems. He gently massaged her hands, asked if they hurt.
“One of the things I enjoy the most about having a doctor like Dr Fred is that he’s a good listener,” Bowles said. “You can talk to him. He does not rush you to do anything and he never dismisses anything you say.”
Dr Richardson works six days a week and is on call 24 hours a day, seven days a week.
He says he sleeps four hours a night, doesn’t drink alcohol or coffee, and avoids carbohydrates to deal with his diabetes. He sips diet cola all day.
“I think what makes you tick is the impact you have on lives,” he said.
He will continue making house calls because it allows him to connect with people in ways he cannot do in an office or hospital.
He’ll hang on to his solo practice, too, which he said makes no money. He views it in part as a haven for helping “under-represented” medical students.
He navigates a healthcare landscape that quakes with change. Flat reimbursements to physicians, rising costs and competition from retail clinics are pushing doctors to consolidate practices and affiliate with hospitals.
House calls, which reached a high of 40% of patient encounters in 1930, nearly disappeared by 1980, research shows. Since then the number of house visits has climbed.
An analysis of Medicare shows that 4.5 million house calls per year are billed to the federal healthcare provider, up from 1.1 million in 1984.
Part of that rise stems from evidence that treating an individual at home avoids the high cost of hospitalisations, experts say.
Dr Richardson handles the challenges by working as an employee physician of Little Company of Mary Hospital in suburban Evergreen Park, where he sees patients through the afternoon before going to his family practice and treating patients through the evening. That’s also when he makes house calls.
When he returns to the office shortly after 8pm, a cluster of medical school students is often seated in his waiting room.
Two decades ago, Clyde Whiting was one of those students.
He described Dr Richardson “teasing out” textbook lessons, helping students assemble the puzzle pieces.
“I think that without that at that particular time,” he said, “I could have been lost. I could have fallen through the cracks for sure.”
Today, he is an emergency room physician.
Gladys, now in her late 70s, suffered a stroke about a year ago and struggles to speak. Dr Richardson cited that complication in declining to allow her to comment for this story. His father died about a decade ago.
At the November wedding reception of his oldest daughter, serving a residency in family medicine, Gladys danced a little, while Dr Richardson used his father-of-the-bride speech to remind people where celebrations like this start.
“This started at 63rd and Wolcott in Englewood,” he recalled saying, “and it started with my mom making sure that I did my homework. And now my daughter’s a physician. I wanted my mom to take a bow for that.” – Chicago Tribune/Tribune News Service