Even though she hasn't seen patients in many years, Novello, 64, holds a medical license and trained as a pediatrician. A specialty was treating children diagnosed with HIV and AIDS.

Novello will be assigned to Koinonia Primary Care at the corner of Clinton and South Lake avenues. The clinic is a block from where 10-year-old Kathina Thomas was killed by a stray bullet just over a year ago.

"These are our must vulnerable citizens and it's important that a person of her authority get a dose of the real world," said Dr. Bob Paeglow, founder and director of the clinic, which sees about 6,000 adult and pediatric patients each year, many of whom are indigent.

Novello is no stranger to adversity. She grew up in the small town of Fajardo, Puerto Rico and her father died when she was eight. Her mother, Anna Flores, worked as a school principal there into her 70s.

"She taught me that education is the way out. My mother made me who I am. I'm a workaholic and very competitive," Novello told the Times Union shortly after she became Gov. George Pataki's surprise Republican appointment as health commissioner, a post she held from 1999 to 2006. Her final salary was $256,000 a year.

Novello's childhood was made more challenging by congenital megacolon, a condition that left her without normal nerve cells that signal the brain to move the intestines. She spent weeks hospitalized as a child and endured numerous procedures and tests. She suffered the humiliation of having to wear diapers to high school, trying to mask a distended belly and making frequent trips to the bathroom.

Instead of the planned corrective surgery at age 8, she had to wait until 18 to receive proper medical care. She learned to cope by using humor.

"I fell through the cracks of the health care system," she said. "When we talk about the underinsured and uninsured, I didn't just study that in a textbook. I had that experience growing up."

Paeglow has been in discussions with Novello's attorney E. Stewart Jones and District Attorney David Soares about Novello's assignment, but no specific start date has been set.

"We're working out the details, but she'll be seeing patients and working with our staff," said Paeglow, who has one other full-time physician, four doctors in supporting roles, two medical students, nurses and clerical workers on staff.

Novello enjoyed a luxurious corner executive suite on the 14th floor of the Corning Tower as health commissioner. At the clinic, she'll be tightly packed in a cramped office shared by two other doctors and filled with secondhand furniture.