Little Havana's "Dr. Joe"
by Paula Andaló
What do Cubans and the Irish have in common? "Our cultures are just alike. We both come from little islands; we're both Catholic. We were the first communities in this country to define ourselves as exiles. We're passionate, we like to tell stories, we love politics, and we both drink whiskey and rum. For both Cubans and the Irish, funerals are parties that last all night," says Pedro José Greer, the Cuban-Irish-American doctor who turned his back on Miami's fashionable Ocean Drive to hunt for "souls" living in the mudflats under highway I-395.
Doing justice to all he's done would require a book-and, indeed, Greer has written an autobiography. But to sum it up, "Dr. Joe," as he's affectionately known, has made two major contributions to his Miami community. The Camillus Health Concern, which he founded in 1984, provides health services to more than 10,000 homeless men, women and children each year. His San Juan Bosco Clinic, in Little Havana, sees some 6,000 patients per year, most of them poor, undocumented immigrants looking for a little health care and human warmth.
Greer has won a string of top honors, including three presidential awards, two papal awards and the coveted MacArthur "genius" fellowship, which carries a hefty no-stringsattached monetary award for individuals who "show exceptional merit and promise for continued and enhanced creative work."
A physician trained in hepatology, Greer today serves as assistant dean for homeless education at the University of Miami School of Medicine (where he received his medical degree in the 1980s) and is chief of gastroenterology at Mercy Hospital. He is also a partner in private clinical practice with his father, who he says instilled in him an acute social conscience.
Greer strives to pass on his father's inspiration. His persistent activism has made him a leader in the fight for better health for all, and especially for Miami-Dade's homeless. Reaching out to broad sectors of Miami society, Greer has created a network of people and organizations that provide food and shelter, health care, work opportunities, counseling and, above all, a little respect to those in need.
"He has made a commitment to making this world a better place and lives each day making sure that he follows through," says Gloria Estefan, the Latina superstar and Greer's close friend, on the jacket of his 1999 autobiography, Waking Up in America, written with The Miami Herald's Liz Balmaseda.
Greer was born in Florida, by accident. His mother, a native of Cuba, traveled to the United States in 1956 for a family birthday party. She was only six months pregnant, but little Joe decided to come out.
Two weeks after the birth, mother and son returned to Cuba. Four years later, in 1960, Joe's U.S. citizenship helped his family leave Cuba following Castro's triumph. The Greers are among those expatriate Cubans who've long since burned their boats.
Greer's great-grandfather, of Irish origin, had emigrated from the U.S. state of Georgia to Cuba in 1896 as a soldier in the Spanish-American War. He fell in love with a girl from the Canary Islands living in Pinar del Río and decided she was sufficient reason to put down roots. His son, "Papa Greer," was the first in the family to finish high school and went on to study medicine in the United States in the 1940s.
This multinational lineage helped shape Pedro's persona, along with formative experiences such as the year he spent in the Bahamas, at age 9. His father was assigned to be the doctor on the island.
"We'd go out with my father in little boats to treat children in remote areas," Greer recalls, smiling. "When Papi would walk into a waiting room with his white coat and his doctor's bag, the children would climb out the windows, and we'd have to run after them so he could give them checkups and vaccines. That's what makes a doctor."
A major milestone in Greer's early life was the loss of his sister Chichi, who died in a car crash when she was about to turn 18.
"It was my first lesson as a doctor. I became aware of what it means to lose someone forever. We're never prepared for death, and that's why the most difficult thing in medicine is talking with the family."
The moment that sealed Greer's future, however, came in 1984, on the day he began his internship at Miami's Jackson Memorial Hospital. Greer came across his first patient with no name or address. It was a homeless man whom firefighters had picked up off the street, and who was suffering from severe tuberculosis. The man's only identification was the number "9" on his hospital bed. The young physician became obsessed with learning his name, discovering his history and finding a family member who might provide him company in his last days. But it was all in vain.
That human being-alone, unable to speak, surrounded by the latest technology in a country where hardly anyone dies of tuberculosis-became an obsession for Greer.
"I tried to communicate with him, but he didn't respond. He died a few days later, all alone. At that moment, I became aware of a Miami I had never known. I finally understood that every patient has a story, a soul and that their clinical history is just a façade that conceals dreams, hopes, successes and failures. And I wanted to find those stories, hidden under the bridges."
Bad policiesThe same year "Dr. Joe" met the nameless patient he laid the cornerstone of his clinic, the Camillus Health Concern, dedicated to providing medical treatment to people without health insurance.
"Back then, street people used to complain that nearly all the shelters were religious and dished out what they called 'soup and salvation,'" Greer recalls. "They had to go to mass before they could get dinner. What they wanted was soup, not to be evangelized."
Life in the shelters was highly regimented; residents were expected to go to bed at 6 in the evening and rise at 5 in the morning.
"No one likes to be homeless, but when you have nothing, the only thing you have is your freedom," says Greer. Camillus was new and different, and it caught on, growing steadily over two decades into a health care center with 10,000 patients annually and 100 physicians on its rotation roster. The clinic's goal is 100 percent humanitarian: to provide help-if only temporarily-to those who need it most.
How have things changed in those two decades?
"I've seen the hearts and minds of medical professionals change," says Greer, "but the situation on the streets has gotten worse. There are more poor people, more homeless and more people without health insurance. I always say, what I do for a living is manage the consequences of bad policies."
He goes on: "The ones who pay the price of those bad policies-lack of education, lack of prevention-are the patient, the family and the doctor. It's a vicious circle. If you cut the education budget, kids end up on the streets, they get involved in alcohol and drugs, they get sick and end up in the clinic. It's a whole chain of social problems."
Greers recalls that when he started this work, only 5 percent of people living on the streets were women and children. Now they make up nearly 40 percent.
"These are families where the father is in jail or is an addict. They're people with no education and no protection," he says. Contrary to common belief, he adds, not all of them are illegal immigrants.
"Culturally, immigrant families tend to congregate in communities and protect each other. It's not common for them to end up indigent," Greer says.
Still, he believes that indigence is a constant threat for the growing numbers of illegal immigrants and that fear of it plays a very negative role.
"Many women put up with verbal and physical abuse, or they fail to get treatment for medical conditions, because of their fear of deportation. We trap them in a corner when we should be giving medals to those who manage to come to this country and try to start a new life."
"One year we gave out Christmas presents, and we asked street children what they wanted from Santa Claus," he recalls. "They said socks and underwear-that's what it comes down to when you're living on the streets."
For Greer, diagnosing patients and prescribing treatment is the easy part of doctoring. What's hard for most doctors, he believes, is to feel warmth and compassion and to see that a patient's body isn't divided into parts according to medical specialties. If it were, Greer would be focusing on livers-not a very good place to hunt for people's souls.
"I have never had a liver or a colon walk into my office alone. They always came attached to a person," Greer said in his autobiography. "That person had a family, friends, a history, dreams. As physicians . . . we treat people, not organs or diseases."
In Little HavanaThe San Juan Bosco Clinic was built in 1991, behind a church on a lot that in the 1960s housed an auto dealership that catered to Cuban immigrants. The area is the heart of Little Havana, the point of reference for Miami's Cuban-American community.
The clinic has a medium-size waiting room and an office staff made up mostly of puras (Cuban for "mothers"), who never seem to stop talking. Greer fits into the scene perfectly. Garrulous and fond of doctor jokes-most of which parody himself-Greer chats comfortably with waiting patients, with the priest from the church next door, with the nurse who just returned from a working trip to India, and with Mari, his assistant and right hand.
In his spotless white lab coat and with his trusty stethoscope around his neck (he is a doctor, after all), Greer stands out like the former football player he is against a backdrop of posters promoting diabetes prevention and mammograms. His relaxed style permeates the clinic's atmosphere, producing the opposite of the tense calm that pervades large hospitals' waiting rooms.
"A patient who feels comfortable is a patient you can talk to," says Greer. These days, there are 150 doctors and 37 volunteers who follow that same precept as they treat patients in Greer's "people's clinic."
As part of his campaign to raise awareness of the kind of care patients need and deserve, Greer launched an initiative called "Reach Out, Miami," which recruits doctors willing to donate time in their own private offices to treat patients who cannot pay.
"The key is not just human caring but also accessibility," Greer explains as he greets a patient. He recalls trying to get this point across to policymakers in Washington, D.C, while serving as an advisor to the Bush, Sr., and Clinton administrations.
Did he ever consider going into politics himself?
"I came of age during the era of Vietnam and civil rights. Those were very controversial times. Yes, I considered it when I was young, but when Nixon resigned, I decided no. And it was the right decision. Through medicine, I was able to channel that need I always felt to do social work."
Greer sees himself as living in a "piece of Cuba" inside the United States, but says he retains much of the cultures of both islands that were home to his ancestors. Breaking into one of his enormous, resplendent smiles, he says that one of his fondest dreams is that his wife (who's 100 percent Irish) will someday make him a Cuban sandwich without his having to explain what goes in it.
Greer's ethnic roots may explain his strong attachment to family life and why he spends what little free time he has with his wife and two children (whenever they're home from college) and his sailboat. During those brief Sunday voyages on Biscayne Bay, he surveys the Miami skyline and always comes back to the same thought: "This is my community, this is where I live, where my family is. If I can't make the place I live better through what I do, what am I here for?"
Paula Andaló is a journalist working in the Area of Public Information of the Pan American Health Organization in Washington, D.C.