Sister Mariana Koonce, RSM, reflects on her time establishing St. Mary’s Legacy Clinic for the Diocese of Knoxville
By Emily Booker
Sister Mariana Koonce arrived in Knoxville in the fall of 2012, having recently taken her temporary vows with the Religious Sisters of Mercy of Alma, Mich. As she has grown in her religious life, her mission of establishing a mobile clinic to reach the neediest in East Tennessee has grown, too.
Now the physician who brought free medical care to the Diocese of Knoxville is leaving the diocese to study theology in Washington, D.C., this fall. She has been reflecting on her work starting St. Mary’s Legacy Clinic and serving hundreds of uninsured and underinsured patients in rural areas.
“I was in temporary vows. I had completed one year of temporary vows, so I was very much still young in religious life and here given this task of trying to start up a mobile clinic from scratch,” she said. “I didn’t know how to do that. It’s really just, I think, a story of God’s providence, of having to trust in Him.”
She recalls traveling through Grainger County with Kim Cook of Catholic Charities of East Tennessee and seeing the poverty in which some families live: no running water, no indoor plumbing, no electricity.
“I mean, it’s only 30 miles outside of Knoxville as the crow flies, and yet there’s conditions that would mimic the Third World,” she said.
St. Mary’s Legacy Clinic was established in 2013 and saw its first patients in January 2014. The mobile clinic has carried on the legacy of St. Mary’s Medical Center in Knoxville, one of only two Catholic hospitals in East Tennessee that was acquired by a for-profit company in 2011.
The mobile clinic travels hundreds of miles each week to serve those in need — those who are living be-low the poverty line, unemployed, disabled, or homeless. The clinic is free and helps patients control chronic diseases or get referrals to medical specialists.
“Since we are engaging with treating our patients with chronic diseases, that requires them to come back,” Sister Mariana said. “We’re providing them with medications, with the labs they need. Our average patient comes back three or four times a year.
“So it’s been a bit bittersweet because you’ve been working with them for so long, and they come to see you as their doctor, and some of them will even brag, ‘I have a nun as a doctor.’ So it’s been bittersweet from that standpoint to have to say goodbye.”
Sister Mariana has enjoyed get-ting to know her regular patients over the years.
She noted one woman in particular, who was there the first day the clinic arrived in Crab Orchard. The same woman was there on Sister Mariana’s last day in Crab Orchard.
Before she joined the Religious Sisters of Mercy of Alma, Sister Mariana was a doctor in the Navy. Although operating a mobile clinic in the rural East Tennessee hills is far from a naval ship, she sees similarities in the two. She said her stint in the Navy helped prepare her in making do with the supplies you’ve got, working in tight spaces, and properly stowing all the medical equipment for travel.
Travel is a big component for a mobile clinic. The 40-foot-long van is a fully equipped family medicine office and includes two examination rooms, a nurse station, a laboratory area, and an undercarriage wheelchair lift. It travels to the communities of Washburn and Rutledge in Grainger County, Decatur in Meigs County, Crab Orchard in Cumberland County, Athens in McMinn County, and Gatlinburg in Sevier County to reach patients where they are and give them the best care possible.
Sister Mariana’s guidance and commitment to this ministry have been profound and far-reaching. Not only did she bring much-needed medical care to people in need, but indirectly she exposed rural areas of the region to the compassion and love that Catholics share.
“I was confident Sister Mariana was a good doctor, but she also turned out to be a great driver, mechanic, administrator, and fundraiser. There was nothing she wasn’t willing to do to keep the clinic on the road. She worked hard for some of the most disadvantaged people of this diocese, and I will always be appreciative for that,” said Bishop Richard F. Stika.
It is each individual encounter that makes the clinic so special to Sister Mariana.
“I think what we do best is treat each individual as an individual created in the image and likeness of God,” she said. “So while our numbers, our volume, may not be as high as some of the fixed clinics around the area, I think it’s the individual outreach to individual people who are treated as individuals. They know they are loved. And they know that they have value and that their health-care needs are being met to the best of our abilities.”
It is that compassion for each per-son and ambition to serve that led to Sister Mariana being a finalist for Catholic Extension’s Lumen Christi Award in 2016. The award honors an individual or group working in one of America’s mission dioceses who demonstrates how the power of faith can transform lives and communities.
Sister Mariana and her team of volunteers work to see Christ in each patient and be Christ to each patient.
“I tell the volunteers the most important part of what we do is we love our patients,” she said. “Our Lord promised that whatever we do for the least of our brothers and sisters we do for Him. And so we have the incredible privilege of going out every day that we’re out on our sites and meeting Christ. Because in the eyes of society, our patients are the least.
“The medical care is important, obviously, but it’s also putting a face on the Catholic Church as well in an area that’s not known for being Catholic. Many of our patients had never met a Catholic or knew what a Catholic was.”
The volunteers who help run the clinic are essential, along with executive director Brandy Fuesting and clinical nurse manager Beth Ann Arrigo, who have been added to the administrative staff as the clinic has grown. Sister Mariana trusts that God sends the right people at the right time.
“He put the right people in my life and provided when there were needs, and here we are,” Sister Mariana said. “It’s always been God’s providence as far as the volunteers go. They just show up when they’re needed.”
In August, Sister Mariana moved to Washington, D.C., where she will be studying theology at the Dominican House of Studies. While she expressed a bit of nervousness about being a student again, she said she loves learning and is looking forward to this next step.
As for the clinic, she trusts that God will continue to provide.
“I think we’re in a good state. We’re past the initial start-up phase. We’re in more what I would call a growth and maintenance phase, which is a good time for me to leave and let new people come in with fresh ideas and fresh energy and take the clinic to the next level,” she said.
Sister Mary Lisa Renfer, RSM, DO, has been named the clinic’s new medical director, carrying on the legacy of caring for bodies and souls across East Tennessee. Joining her on the mobile clinic staff from the Religious Sisters of Mercy of Alma is Sister Joan Miriam Nelson, RSM.
As she closes this chapter in her life, Sister Mariana’s advice to her volunteers rings true to anyone no matter what they do: “Be faithful to mission. Remember that you’re going out to be Christ whenever you go out.
“I think for me that’s been the highlight of the time, just the deepening of the witness and the privilege that it is to go out and be able to provide that service,” Sister Mariana said.