03/09/17  Portland, Ore.

On the frontlines of care for disadvantaged people; Japanese-born OHSU graduate shares her insights

By Lee Lewis-Husk

Photo: Tomoyo Uemura and daughter

Tomoyo Uemura's desire to be on the frontlines of providing care to disadvantaged populations made the Wallace Medical Concern (WMC) a natural choice after finishing her bachelor's degree in nursing at OHSU in 2015. She started working at the Rockwood primary care clinic in northeast Portland as an RN care coordinator in March of 2016. WMC receives federal funds and donations to provide low-cost medical and dental care in the Portland metro area and the Rockwood neighborhood.

She recounts a story about a homeless man with mental illness and addiction who visited emergency departments 25 times, had 45 encounters with the police and lost 90 pounds –all within a few months. Uemura and others at WMC provided him food and clothes at their initial encounter and then helped him with housing, health insurance and access to other community resources. He returned to WMC often and said things like, "I'm sorry, Tomo, I messed up again. Can I give you a hug? Oh, I am stinky. Thank you for your help." He's a completely different person now, according to Uemura. "I feel very privileged to serve anyone in the community. I came from a humble background and can relate to some of their experience during hardship."

Born in Japan, Uemura was dismayed that some Americans cannot access health care because of money. She explained that Japan has national health care. "It's very hard to believe that people wait and wait until it gets too late and end up going to the emergency room for care," she said. "Even though medical technology in the U.S. is the most advanced in the world, if it is not accessible to everyone, we cannot be completely proud."

Now 43, Uemura first came to the United States at age 22 with a non-profit organization that sent her to Bayou, Louisiana, where she spent two years. In the intervening years she graduated from Mt. Hood Community College and attended Portland State University. She worked as a medical interpreter, a substance abuse counselor and caregiver in a residential care facility for older adults with Alzheimer's and mental and/or physical disabilities. She also volunteered at summer camps for children in the foster care system.

Her love of snow boarding –she's a self-admitted adrenalin junkie who also sky dives, scuba dives and "drives fast on the German autobahn" –propelled her back to Portland to be closer to Mount Hood.

Of her three years at OHSU, Uemura has nothing but praise. "The nursing faculty members were incredible," she said, adding that she was "shocked" to find that student feedback was taken seriously and a program adjusted almost immediately to reflect student input. She also found it inspiring that nurses are their own entity of health care professional, respected as such and not as doctor's helpers.

"Tomo was the kind of hardworking, optimistic student who was easy to want to see succeed in whatever project she set her imaginative mind and kind heart to address," said instructor Ginger Keller. "I am delighted to see that Tomo continues to find the good in those with whom she interacts and to set right the wrongs she encounters in her life journey. Truly, it was a gift for Tomo to share her young family life with us as she made her way through the undergraduate program at OHSU."

Without the strong support of the faculty, Uemura said she would never have made it through the rigorous education. The language proved a barrier. She developed gestational diabetes in her second year. And after her son was born in her third and final year of nursing school, she felt she was "hanging on a cliff with her little pinky," she recalled. "I was basically bleeding to death all the way to the finish line," she said metaphorically, adding that her instructors "kidnapped" the two-week old infant and fed him a bottle so that she could attend a lecture. "I learned that when I'm treated kindly, I can be kind to others because my instructors taught me this," she said.

 "Nurses are the No. 1 trusted professional, and I am at the frontline in a primary care clinic," she said. "I feel responsible for bridging the disadvantaged community and health care system."

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Among Tomo Uemura's insights as an immigrant is the importance of food. "I want sushi-grade rice, miso soup and broiled mackerel fish with soy sauce for breakfast," she said. Not a top choice for most Americans, it's the comfort food for Uemura.

She discovered a similar sentiment among a Chinese patient who almost refused an organ transplant because the hospital food wasn't his comfort food. As a result, she hopes to administer more culturally accommodating nursing home care someday, with a focus on the Japanese community living in the U.S. and needing long-term nursing care. She realizes that she may need further education, perhaps a master's in business administration, to achieve this goal but whatever her future, she'll apply the same passion and insight she's brought to all her endeavors.