Wholly unprepared

Family rifts often make for heartbreaking scenarios at the end of life, which is why Inouye spends as much time praying with patients and counseling them as she does treating their diseases.

It’s why she’s willing to clean feces off a floor or examine someone who hasn’t been able to bathe in two years — in a stiflingly hot attic bedroom.

And it’s why, when she returned to work following her mother’s death, she no longer found corporate medicine fulfilling. It bothered her that she couldn’t ask patients about their spiritual needs unless they initiated the conversation.

“I was seeing people for 15 minutes, maybe 30 if I could push it, and I had seen one person who was suicidal over and over, and I didn’t have the freedom to share my experience or ask about God,” she recalled.

Dr. Inouye sets up appointments from her station wagon, which she calls her office.

Inouye was working three part-time jobs for Carilion at the time — for its hospice and insurance-plan divisions as well as teaching hospital residents. When the insurance group announced it was folding in 2003, Inouye decided to launch the house-call ministry, recruiting Bob Carroll, a friend from her Bible study group who had worked in health-care administration.

Working out of their respective homes, they opened Jubilee Housecalls, a nondenominational medical practice for homebound people who have no way to get to their doctor — short of an $800, not-covered-by-insurance ambulance ride.

The goal was to treat what Inouye calls “the most forgotten of people,” many of whom have multiple chronic illnesses and yet haven’t seen a doctor in years. “We wanted them to do as well as possible till their time of death,” she said, whether it meant changing their medications or helping them work out family differences. “Whatever it took.”

Inouye was amazed, humbled and wholly unprepared for the work that awaited her.