Dr. Richard Paat is a clinical professor of medicine at the University of Toledo College of Medicine and the chairman of medical missions at the Special Commission on Relief and Education (SCORE), through which he has completed dozens of medical missions trips to countries like Guatemala and Ukraine. He also hosts free medical clinics in Toledo, Ohio that offer not only medical help, but also information and resources on insurance, follow-ups and further care. He was born in Jacksonville, Florida to Filipino parents, and grew up in the Philippines and Toledo, Ohio, where he currently resides.
Below is a transcript, edited for length and clarity, of a conversation between Dr. Paat and Ruth Chang (creative director at Midstory) on April 13, 2023. The transcript is representative of a subjective and fluid conversation at a specific moment in time and should be read as such. This project also includes many individuals whose first language is not English; these transcripts prioritize the integrity of the interviewees’ expression over grammatical correctness. Midstory assumes no responsibility for any errors, omissions or inaccuracies.
Ruth Chang (RC): When and where were you born?
Dr. Richard Paat (RP): Jacksonville, Florida; April 24, 1960.
RC: So, growing up in Florida in the ’60s. What was it like there? When did you end up moving to Toledo?
RP: Well, actually, my father was a surgical resident at the time, so we were only there for about a year. And then from there, we moved down to Colorado; my brother was born there. So, my father was allowed to train here for four years. He did his surgical residency training for four years and then moved back to the Philippines. Then in the Philippines, he practiced there as a general surgeon, as a family physician, then he came back to the United States. So he was supposed to go to Cleveland and start an OB GYN residency. But at that time, he had already had four kids, and the salary of a resident was probably $50 a month. And we had family here in Toledo, so we stayed here in Toledo. He became a hospitalist at the old St. Luke’s Hospital and stayed here and developed his practice — hardworking just like many, many immigrant families. He had his wife and five kids to support, built his practice, had an excellent reputation. And then in 1989, when I finished my residency, I went to medical school here at University of Toledo, finished my two-year internal medicine residency and came back and joined them.
RC: So what would you say the majority of your growing years, was it in the Midwest?
RP: Yeah, yeah. We’ve been here in Toledo since first grade.
RC: So what was that like growing up as a Filipino American?
RP: So, we were the only Filipinos in our school, in high school. There may have been two or three Asian American Pacific Islanders in the same situation. We were the only ones. And in a way, we felt special. Education was always stressed in the family, and we knew that you could always get ahead by by pushing with education. So, my mom was a nurse. She retired. My father was doing family medicine, and that’s what led us into medicine.
RC: That inspired you?
RP: Yeah.
RC: And did you grow up speaking Tagalog? Do you continue that tradition?
RP: So, my father and mother are from the northern part of the Philippines where they speak Ilocano. The Philippines has about 110 different dialects, but the mode of education is in English. So, when we lived in the Philippines, I could speak some Tagalog even though everybody spoke in English. And when we came back here, everything, obviously, was in English. I started bringing medical teams back to the Philippines in about 1992, 1994, and when we go to whatever part of — the Philippines is 7,100 Islands, and I have to learn that dialect. So, I’ll learn that dialect for that week; I’ll memorize about 200 key phrases so that I can discuss things with patients to understand things. I still might need a translator at the end if they start speaking too fast, but between learning the dialect, them knowing some English because the mode of education is in English, that’s how we communicate. We do the same with any other place that I go on medical missions. So, over the course of the last 100 missions, I’ve learned everything from Haitian Creole to Swahili to Mayan Indian dialects to Spanish to now we’re learning Ukrainian — our team is going on to Ukraine.
RC: So how did your upbringing being in between Filipino culture, American culture, Philippines, Midwest, influence what you now decide to do — community work?
RP: Yeah, we have a Filipino Association in Toledo. It’s a number of expatriate Filipinos, initially very professional physicians, engineers. And when the second or third wave of immigrants came, we were always a tight-knit community. So, having Christmas parties, having parties — we love to eat, love to party — having picnics, and then are helping organizations branch out to more of a philanthropic role. So, we have an organization called Special Commission on Relief and Education. It’s a nonprofit foundation. And it’s designed to assist with education, providing scholarships, medical mission work and improvements in the life of the Filipinos, not only in the Philippines, but also here. So, when that organization started, probably 30-40 years ago, I became a board member. When we started our mission work, then I became chairman of our medical missions. And I bring teams around the world now.
RC: I’m wondering about your observations about the perception of the AAPI community here in the Northwest Ohio region. How has it changed over the years? Where is it going now?
RP: It certainly has changed over the years as there’s more and more people that are coming in. Our Filipino Association, it was a very small group, and now it’s become maybe nearly 100-150 different families — enough to the point that there are two different organizations and in every single ethnicity. We work with the Nepali students at the University of Toledo through our organizations here. I am the faculty advisor for the APAMSA (American-Pacific Asian Medical Student Association), at the University of Toledo. So we help to organize our students to do activities that are beneficial to the AAPI community.
At this point, we’re going to be doing a Hepatitis B awareness program with free testing for Hepatitis B. Because of the increased risk of hepatitis B in the AAPI community, we will be able to bring anybody that wants to get tested here for free as part of a foundation and as part of the grant that we’re working with. During the COVID pandemic, with the increased incidences of Asian hate, we thought that it would be important to become a center where AAPIs can come in and get vaccinated. So we made it a point to go out into the AAPI communities — to churches, restaurants, nail salons — and advertise the services that we have, and then make sure that they knew that this was a safe place to go if they wanted to get COVID vaccines.
RC: Are there specific challenges that Asians and Asian Americans face, that you’ve had experiences where your office intersected with?
RP: Yeah always. Language. To be considered AAPI, you stretch from East Asia to the Mideast. And that’s a huge, huge swath. So, language barriers, especially if we’re trying to do health screenings, hepatitis screenings — even in the Chinese population with so many different dialects. And so language is always a large [issue]. There are also problems with undocumented [individuals] that come in. We deal with a lot of the undocumented in our Latino and Hispanic communities; there’s also undocumented in our community. And the people that are living in the shadows, they don’t want people to know that they are undocumented for fear of repercussions. They’re like any of the other families. They’re here to earn a living, too, for a better situation and to help support their family members back in their home country.
RC: What led you to be doing this kind of work? I think you’re in a specific position as an AAPI representative to be drawing attention to [those who have] been marginalized? What led you to do this work?
RP: I’m not sure if there was a gene or something else that kicked in, but in the healthcare profession, that’s what we’re drawn towards — to help others. And what better way to help the people that need the most help? Yeah, it’s easier to take care of somebody that’s rich, that has insurance, that has everything else, but it’s more meaningful to take care of people with limited resources.
RC: I grew up in this area. I think I feel like I’m the product of the American dream. We went through a lot. So, I think when I see this sort of work that’s happening here, I think, “Wow, what, if I had known about this?” So, what are some ways that you’re continuing to expand or to get more awareness out there in this community, especially now when we are at the end of a pandemic, hopefully — we’re still fighting through this Asian hate thing?
RP: Well, the interesting thing is, with our medical school, probably a third of our students are AAPI ethnicity, and that’s huge. That’s huge. And now to be able to help to train those students to understand what it means to be an AAPI health physician working in this country… We’re a hodgepodge — our medical school, the community we are in, in Toledo, is really a huge melting pot. African American, there’s Latino, there’s Asian American, Middle East, various cultures. It’s really a huge melting pot. Even though I was the only Asian American Pacific Islander in my school, that’s certainly changed. The languages that you’re learning in high school — my kids are learning Chinese!
RC: I think culturally that the atmosphere has changed.
RP: Yes.
RC: And the access to other countries, it has also changed. Partly due to technology.
RP: Yes.
RC: I’m wondering about the students that are here, how aware are they? You know, where they come in, and they say, “Dr. Paat, I didn’t realize this part of the community really needed help. And now I have the opportunity to do this.”
RP: Nobody wants to come to a free clinic. But our motto here is “health care with dignity.” Make everybody aware. We talk about the social determinants of health — every single night, you know, that’s one of our main structures: Okay. Was there anybody that you saw that had food insecurity or language barriers that they had overcome or financial barriers to overcome? And how can we help overcome that? So it’s a huge learning opportunity for our students.
RC: And so at this clinic, how did it start?
RP: I started this after the Haiti earthquake. I brought our team into Haiti — we did 200 amputations and surgery, saw a couple of thousand patients and we came back, and we just said, “Let’s do something in our backyard.” So, we gathered nurses, pharmacists, medical students and said, “Let’s start it.” We started here, and over the next 12 years has morphed into the largest student-run free medical clinic. Medical students have become the organizers, have become the fundraisers for the clinic, and they come up with ideas: How can we expand? How can we provide better service to the community? And it’s just really morphed into this outstanding organization of multiculturalism, of multiple disciplines working together to help provide free care to anybody that needs it.
RC: This is the largest in the country?
RP: This is the largest student-run free medical clinic in the nation. Also, during the pandemic, we never stopped. A lot of the free clinics stopped, but we doubled our dollar capacity. So, last year alone, we saw 4,000 patients during the pandemic, and we provided 7,000 immunizations to the Black, Latino, migrant and homeless populations.
RC: You mentioned the undocumented immigrants. Are there a lot in our region?
RP: Yeah, [we] don’t talk about it a lot. But they are definitely there, in the Mexican restaurants, there are undocumented immigrants, a lot of them are working in the back and in Asian restaurants. So, it’s just not something you talk about, but they’re definitely there in the community. They’re all earning money to put numerous family members through school in their home country. That’s what we do. right, to support others?
RC: One of the last questions, what do you hope to see for your children and younger generations as they venture into a new world?
RP: Well, my daughter just moved to California. So obviously, a huge Asian American Pacific Islander population there, a huge Filipino population there. My son just moved to Georgia, so a minimal amount out there, and my other son is in Chicago, which has a large AAPI community. So, two oceans apart and I’m right smack in the middle in the Midwest. And yeah, their opportunities are endless. Are there barriers that they have to fight? Yes, yes, definitely. But they’re meeting those challenges. I see bright things for all of them.
RC: And you’re continuing to do things here — right here in Ohio.
RP: Yeah, this is my hometown. I’ll be here for — we’re here for the long run. And any way that we can help our own community is wonderful.