It was October. Three heads bent to their task at the donation table. Winter was coming, and we had heard rumors in the medical community of aggressive flu outbreaks up and down the coast. The comforting scent of elderberry syrup filled the air.

We serve between 40 and 60 patients during our weekly four-hour clinic. With a 50 percent rate of unhoused visitors, our people are particularly vulnerable. Living on the streets is brutal to their immune systems. They battle cold, wet weather with little chance of relief. Malnutrition is commonplace. Sleeping on the streets means being awoken every few hours by police or irritated business owners. If they can get into a shelter, it’s crowded with people who have struggled with the same immune damaging conditions.

We advocate for flu vaccines but some in the community we serve is suspicious about them. Many of fears about injections themselves. Some host unfounded myths. Others don’t have the funds to pay for a vaccine or take time off work to get one from their approved clinic. Some have argued that since the flu shot aren’t 100% effective, they don’t see any point in getting one. I am quick to remind people that elderberry is also not 100% effective either. There needs to be many tools in your healthcare toolbox to protect yourself from influenza viruses.

One of our favorite tools in the flu prevention tool kit is elderberry. The herb team volunteers are pouring elderberry syrup into small, sterilized bottles. I am busy sorting pre-bottled donations for elderberry tincture. I pull out a few that fit the bill. I am lucky to find a few elder flower tinctures for respiratory conditions that we see in the spring to set aside. It is the berry that we are focusing on for flu prevention and treatment. The most potent use is in a tincture but we get much better compliance in a honey based syrup. The honey also serves to coat the throat to double as a cough soother.
Elderberry is reserved for our patients who are fighting or trying to prevent the flu. Elder flower is reserved for those with sinus infections. If we add another tincture with this (horseradish or yarrow for example), our patient will be breathing freely in short order.  The combination of vitamin C and flavonoids from the fruit helps prevent influenza taking hold as well as shortening the duration of an outbreak by 4 days.
At the end of our work session, one of the volunteers added a larger six-ounce bottle to my basket. She reminds me it’s for the family with the newborn. The bottle won’t last them a full week but that just means that one of us will need to to return to bring another bottle and do a welfare check at the same time. I thanked her and after a hearty round of goodbye hugs, I drive off to make a special delivery.

When I arrive at the housing complex, the sun is out again. The rain sparkles on the grass. The children across the street are giving each other piggy back rides.
syrupGarry answered the door and squints blearily into the sunshine. He had the classic look of some one just coming down with the flu virus. He looked anxious, exhausted and defeated.
We talk for a while, catching up on news in “newborn baby land”. He has been sleeping on the couch to put some distance between between him and his family so they don’t get what he has. He hates leaving the burden and joys of baby care completely in his wife’s hands. I give him the bottle of elderberry syrup along with herbal cough drops, tea and vitamins. He’s had this syrup before. He smiles in gratitude. He knows relief is on the way.

I explained the bottle was intended for the whole house for flu prevention and treatment. I reminded him to give everyone a teaspoon two or three times a day with a reduced dose of 1/2 teaspoon to his older son who is only 10 years-old. Garry had used elderberry syrup to survive flu season the year before. He chastised himself for not taking it earlier so he wasn’t “putting everyone through this now.”

“How do I give some to the baby?” He asks. “I don’t want any one to get sick, especially him. He’s so little. It would kill me.”
“You don’t have to worry about that,” I say. “Your wife takes a dose and when she nurses, it goes to the baby. Your wife’s breast milk with the added protection of the elderberry syrup is all that little guy needs to stay well. Make sure you are eating healthy foods, get lots of sleep and wash those hands. Next year, we can talk again about that flu shot. Give me call if you have any other concerns. Until then, I’m sure you’ll be fine.”
Garry nods. This has met the approval of a protective father. He takes a deep breath and straightens his shoulders. I can see the courage trickling back into face. Courage is yet another important tool in the healthcare toolkit. I am happy to see that Gary has what he needs to heal and protect his family.

Note: The Clinic Memoirs are based on real experiences from Occupy Medical clinic, a free, integrated health clinic that serves patients primarily, but not exclusively, in Lane County, Oregon since 2011. The names of the patients and a few personal details are changed to protect patient identity.