Hospital/Taking Care of Our Own

...the shock room), medical intensive care, and the department of quality assurance...

...Many of the problems at a small hospital are the same as at a large one: government regulation...

...And Jewell Jenkins, a college-educated housekeeper on the AIDS ward,begins the workday raising window shades with the words, "Let's see what God is doing out here today...

...Garrett does a phenomenal job of interweaving into her short memoir some of the specific legislation and clinical advances that have made medicine almost ridiculously complex, even at a small hospital...

...Lewis also points out the racial distinctions in occupational categories at County: most attending physicians are white, many M.D.s in training are foreign-born, nurses now tend to be Asian, and the staff members who keep the building up and running are black...

...In Hospital, Sydney Lewis, the daughter and granddaughter of nurses and former assistant to oral historian Studs Terkel, has assembled sixty-plus candid and poignant interviews with a diverse group from County: physicians, patients, nurses, maintenance staff, administrators, social workers, etc...

...TAKING CARE OF OUR OWN A Year in the Life of a Small Hospital Susan Garrett Dutton, $19.95, 177 pp...

...As one might imagine, the turf wars, red tape, and miscommunications in an institution of County's size are legion...

...rising costs...

...There are opportunists dealing drugs in the hospital, patients who will be released only to have their wheelchairs stolen where they live (or who will sell them on the street), and three-year-olds diagnosed with syphilis...

...This author begins her book with a bit of poetry ("Postcards") from her husband, the wonderful writer George Garrett-"I know what happens in my neighborhood/By sounds, by heart...

...And some of the situations here seem unique to Maine: Dr...

...Various unfamiliar parties who show up at a meeting regarding the bonds that will be used to fund the new-wing construction are referred to as "suits from New York...

...With the Protestant ministers-fine men well organized among themselves to cover the hospital-the schedule is the guide: "I'll be there at four forty-five " or 'The Reverend Welch is taking calls today...

...Ethical dilemmas like treating arsonists burned in fires they've set and the cost of intensive care of high-risk neonates and the elderly (compared with the cost of immunizations) are also discussed...

...the real problem is that they don't have coping mechanisms...

...pick up either one (or both) and ponder what kind of health-care reform would realistically address our needs and be affordable...

...The "characters" in this memoir are composites, but the reader will have no trouble recognizing the truth in this narrative of how a small hospital struggles to stay afloat, compete with other medical institutions, and provide quality care to its community...

...Garrett constantly This is a Protestant-town that happens to have a Catholic church, but in the hospital it is Father O 'Malley who at any time of day walks through the halls, breaking up despair like a ship cutting through Arctic ice, who turns the corner of a corridor as naturally as a handrail and enters with ease a conversation or vigil...

...another doctor (a former seminarian) who first worked in County as a community service project required by his Catholic junior and senior high schools in Chicago...

...She characterizes the physicians of the 1980s as "me me, II, car phone, Brie cheese...

...He appears suddenly us if out of the air...

...and "the ancient Chinese had it much better-they said, 'When you're well, you pay the doctor...

...physical plant and equipment obsolescence and breakdown...

...She also shows that hospital administrators are not just number-crunchers, as when she completely loses patience with a pharmaceutical rep complaining about the cost of research and development, saying, "Your firm makes a gross profit over the diseased bodies of my neighbors...

...We hear from workers who think certain directors are divine and others who consider those same directors incompetent or worse...

...Isn't the government us...

...Whenever I see Father O'Malley, he is on his way somewhere, but I never see him going out nor do I see him coming in...

...Those who think such decisions are better made by Washington officials might consider this passage from Taking Care of Our Own: "A grade school question: Isn't the government us...

...Cook County, which serves as the model for the TV series "ER," is Chicago's only public hospital, and is spread out over thirteen buildings...

...one person per chapter...

...It's difficult to single out any one of them because they all are articulate in different ways and with different foci, but here's a sample: Surgeon John Barrett, a native of Cork, Ireland, who thought he would be a family practitioner in his own country, is now director of the trauma unit and president of the medical staff...

...What saves the reader from being overwhelmed is the fact that Lewis has included interviews with people who seem to have a true spiritual calling to health care: a physician who was in the Jesuit novitiate and recognized that jobs as an orderly and ambulance driver were leading him into medicine...

...lavish expectations by laypeople of what medicine can accomplish...

...These two books reveal what is right and what is wrong with the current health-care system...

...Patricia O'Connell We all know what happened to the l994 Clinton plan to re- form U.S...

...when you're sick, the doctor pays you.'" His American-born wife, Kathy, is a nurse who has served in the medical admitting unit, the coronary care unit, the prison unit, the procedure room (a.k.a...

...Art Seiler falls out of his boat and is rescued by lobsterman Big Scotty Milliken, only to have Big Scotty fall off the town dock an hour later, get carried upriver, and be cared for at the hospital by Dr...

...health care...

...squabbles over seniority versus ability and the fear of being "written up" drain the time, energy, and morale of employees...

...In the 1970s, the physicians and nurses went on strike...

...Further, the decision making that goes into building a new wing of the hospital must take into account the inherent frugality and modesty of the local trustees, who for the most part live in small houses despite their incomes and who tend to regard even required change as extravagance and enslavement to novelty...

...And then there's blessed Jewell Jenkins, the aforementioned windowshades-raising housekeeper, who defies categorization...

...These interviews reveal how extramed-ical issues affect patient care...

...Two of his thought-provoking observations are: "The short-term problem is that people have access to guns...

...Susan Garrett Taking Care of Our Own has to make plans for the hospital with a bifurcated view of her "clientele"-the small, year-round population, then the invasion of summer tourists...

...health care, much discussed in the pages of Commonweal...

...Susan Garrett, the former administrator of York (Maine) Hospital, has written Taking Care of Our Own based upon many years of experience in large and small hospitals...

...However, because of the scope of Garrett's position, she has a more comprehensive view of her institution than most of the folks interviewed in Hospital have of Cook County...

...Seiler...

...A political patronage system in which people paid to get their jobs existed for far too long...

...In two new books-both excellent-a big-city medical center in the Midwest and a smalltown hospital in New England illustrate the current state of U.S...

...patients" suspected of coming to the facility for companionship, a meal, and a roof over their heads rather than for treatment of actual medical problems...