Clinical Depression

The funeral was over, so the old hands drifted off to mourn among themselves. One after another, they arrived at the small house in Euclid, with husbands and wives and children in tow -- to remember, to celebrate the woman who'd changed everything for them.

Thirty years before, Jeanne Sonville took a simple idea -- that health care should be available to everyone -- and did something extraordinary. She launched the Free Clinic.

Sonville stayed at the clinic for almost 20 years, finally retiring to Florida in 1989. But last spring, a doctor in Sarasota diagnosed her with acute leukemia. She came back to Cleveland to die.

So on this September night they gathered, a misfit mob of do-gooders Sonville had mothered, inspired, and employed over the years. The doctors, nurses, counselors, and volunteers who somehow made the clinic work. They looked at photos and told stories, like veterans of a war most people had forgotten.

And as the night dragged on, the conversation circled back to where it always did when they got together. Back to the Free Clinic. Not as it was, but what it had become: successful, important, an institution. More than a few couldn't help thinking that it wasn't only Jeanne Sonville who had passed away.

"There's this place that still has its name, and it's still doing some bits of good," says Jane Loisdaughter, who worked at the clinic for 27 years. "But what we knew as the Free Clinic, it's been dead awhile now."

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If you grew up in Parma or Pepper Pike, you may never have heard of the Free Clinic. But if you're a doctor, a nurse, or one of the 165,000 people in Cuyahoga County with inadequate or nonexistent health care, the Free Clinic isn't just an institution; it's indispensable.

Over the last 33 years, the clinic has provided a spectrum of services -- medical, dental, mental health -- to hundreds of thousands of people. Today, with 400 volunteers, a staff of 45, and a $3 million annual budget, it deals with everything from tooth decay to AIDS, hypertension to hernia.

And it has never, not once, asked a patient to pay.

A product of the hippie golden age, the clinic has long since become a pillar of the city's medical establishment. A dozen years ago, it was named one of President Bush's "Thousand Points of Light." Former Surgeon General Jocelyn Elders spoke at its 20th anniversary celebration.

"The Free Clinic has an extraordinary reputation," says Amy Rohling, executive director of the Ohio Association of Free Clinics. "It's seen as a leader in the field."

It is also more important than ever. Since 1997, the clinic has gone from seeing 550 patients a month to more than several thousand. Last year, it logged 40,000 patient visits, a number that isn't expected to decline any time soon.

Amid a dismal economy, the Free Clinic has prospered. Last summer, it moved into a new $4.4 million building on Euclid Avenue. An endowment was recently established, and the clinic's finances are more stable than ever. "I think it's fair for me to say that this is about as good as it gets here," says recently retired Executive Director Martin Hiller.

Unlike its services, however, the clinic's transformation -- from hippie idealism to civic icon -- has come with a price.

Over the last several years, the clinic has overhauled not only its look and locale, but its organizational DNA. Administrators were hired. Veteran staffers were fired. A union drive was quashed. Dozens of workers and volunteers quit. Of the five supervisors who ran the clinic's various departments three years ago, not one is still on the job.

Defenders say the clinic needed to change -- that it needed to drag itself into the 21st century, however reluctantly. Its detractors say it sold its soul. Everyone agrees on one thing: Today, just like in 1970, the Free Clinic is still free. Almost nothing else is the same.

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It's no exaggeration to say that Marty Hiller saved the Free Clinic. Even those who despise him admit it.

A former platoon sergeant in Vietnam, Hiller was hired in 1976 to run Safe Space Station, the Free Clinic's teen runaway shelter. In 1983, he was named executive director. "I don't think anyone else was dumb enough to want the position," he says.

He inherited a disaster. By the late 1970s, the Free Clinic had become more of a vast network of social services than a health care facility. It offered medical care, a mental health hotline, psychological counseling, a legal clinic, and the runaway shelter. But with the ascension of Ronald Reagan, federal money for social programs vanished. Conservatives rejoiced. Nonprofits tanked. Nationwide, two-thirds of the country's free clinics closed by the mid-'80s. Cleveland's was close to being among them.

"We got too big, and then the money for all these programs just evaporated," says longtime board member Gordon Friedman. "We were on the brink of extinction."