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LOUISVILLE MAGAZINE 8.17 73 do all he can do — listen as she unloads her burdens and nudge her toward a drug-treatment facility that can address mental health. Imburgia senses worry in the patient with the mur- mur, who now sits on an exam table. Imburgia looks to the translator. "A murmur, it's really just an extra sound (in your heart)," he says. "It could be nothing. It may be a leaky valve and sometimes that can cause some funny pains." Imburgia pauses. "How's life at home?" he asks. e man says he works long hours and is the father of four. "at's why you're having chest pains," Imburgia jokes. e man nods and laughs. Imburgia sends him to an exam room across the hall for an ultrasound, which spots a minor leaky heart valve. Imburgia says about 80 percent of his patients are one-time visitors whose evaluations rule out heart trouble. e other 20 percent involve an ongoing issue that requires routine care. For some, that fol- low-up may be minimal, perhaps just medicine and monitoring their heart function every few months. Some will have to go to the hospital to have stents put in to unblock arteries or undergo more invasive, complicated surgeries. "It costs us over $80 billion a year to take care of the uninsured (in this country)," Imburgia says. "And $50-something billion of that is paid for by the government. So we're paying for it anyhow." Imburgia sits facing a white wall near the nurs- es' station, dictating notes on the young Hispanic patient and other people he has visited so far this morning. A homeless man with stringy, gray hair and a pained shuffle walks behind him toward the clinic's exit. "Kidney failure," a fellow doctor who examined the man says, leaning back in his chair so Imburgia can hear him. Some who overhear look confused as to how he wound up here. "No clue," Imburgia says, before mentioning to a nurse who handles referrals that there's a local kidney specialist who "has said" he'd see Have a Heart clients at no charge. is patient may never find a specialist willing to see him. He may tumble out of the healthcare system until popping back up in an ER in critical condition. e mood at Have a Heart doesn't reflect the reality — working without pay on a sunny Saturday in June. If anyone arrives begrudgingly, they bury it well. Between taking medical histories and setting stethoscope to flesh to eavesdrop on the thump-thump, thump-thump within, staffers keep it Dr. Michael Imburgia at the Have a Heart Clinic takes a moment before a busy Saturday seeing patients. Photo TK