At Jericho Road Community Health Center, every day is hard. There’s no such thing as a light patient load or an “easy day.” But there are moments—quiet, human moments—that remind me why I do this work.
Juliana was living in a local hotel with her husband and three children. They were homeless. As newly arrived asylum seekers, they were still waiting for work authorization. Back home, Juliana and her husband held prestigious jobs and they both speak multiple languages, including English. But fleeing violence meant leaving everything behind. And now, they were stuck in limbo: highly skilled, deeply motivated, completely shut out of the workforce.
Juliana came to me for a check-up shortly after she realized she was pregnant. Coincidentally, I had just found out I was pregnant too. Our due dates were only a few days apart. I followed her throughout her pregnancy, and a week after I delivered my baby, I was in the clinic for my daughter’s newborn appointment. Guess who walked in? Juliana, with her brand new baby girl. Turns out, we had delivered on the same day. We checked in with each other, showed off our babies, and took a photo together. It was one of those moments that stays with you.
I’ve learned so much from my asylum seeker patients. When they arrive, they’re often still in fight-or-flight mode. The trauma they’ve endured doesn’t just vanish at the border. And now, with increased ICE activity and a public narrative that’s increasingly hostile to immigrants, that sense of fear often lingers. However, once they begin to feel safe, their nervous systems start to calm. That is often when we start to see the physical manifestations of trauma.
Unspecified headaches. Chronic body pain. But blood pressure and labs that look normal. When I ask directly about anxiety or depression, many don’t have the vocabulary for those concepts. I’ve seen patients develop diabetes that seems to be triggered by trauma. We know that stress increases glucose levels and insulin resistance. In hospitals, we monitor blood sugar closely during times of acute stress, like when someone is in the ICU or after surgery.
But what about chronic stress? What about the kind that comes from fleeing your home, losing everything, and living in fear? I have a young patient who arrived with perfect health. No high blood pressure, no cholesterol issues, not overweight. A year or two later, he had out-of-control diabetes and needed insulin. His PTSD was severe—unspeakable, really. It is true that our bodies keep the score.
This is the reality at Jericho Road. We are a Federally Qualified Health Center (FQHC), which means we care for the poor, the underserved, and those who have been pushed to the margins. 84% of our patients have Medicaid or Medicare. Because those payors don’t pay enough, this means that we have to see a high volume of patients just to keep the lights on. And the needs are immense. Our patients carry trauma, poverty, and social instability. Their health concerns are rarely straightforward.
What sustains me are the connections—like the one I have with Juliana. We’ve lived such different lives, but when we lay our heads down at night, we care about the same things: our families, our children. We are all going through something. We all have different experiences. But at the end of the day, we are really the same. We need each other.
The recent passage of the HR 1 bill casts a long shadow over stories like Juliana’s. While framed as a government reform package, HR 1 includes provisions that will significantly reduce access to healthcare for asylum seekers and other immigrants. By tightening eligibility for public benefits and increasing barriers to federally funded health programs, the bill threatens to push already vulnerable populations further into the margins.
For clinics like Jericho Road, this means more patients with fewer resources. It means treating trauma without access to mental health services. It means managing chronic conditions without insurance coverage. And it means watching people suffer—not because they’re unwilling to work or contribute, but because policy has made it nearly impossible for them to do so.
Healthcare should be a place of refuge, not another battleground. As we continue to care for those who’ve been displaced, we must also advocate fiercely for their right to heal. Because at the end of the day, we are all the same. And we all deserve care.
-Abigail Grainge, FNP
Abby Grainge has worked at Jericho Road in various capacities for over ten years. First as a front desk receptionist and eventually as a family nurse practitioner, the mission to care for our neighbors is evident to all who meet Abby. She is very loved by her colleagues and her patients. We are lucky to have medical providers like Abby.
