BY: GERTRUDE CARTER, MD
Dr. Carter is senior vice president and chief medical officer, Catholic Healthcare West Sourthern California, Pasadena.
In November 2000, a group of physicians and health care
leaders explored the foundational values of Catholic health care at the Physician
Leaders Forum, held in Amelia Island, FL. Participants agreed that a highlight
of the forum occurred when physicians came forward to relate experiences at
their institutions that exemplified, in a tangible way, what is special about
Catholic health care. Dr. Carter's talk and two others, which will run in subsequent
issues, have been adapted for Health Progress.
When looking at how Catholic identity is alive in my health system, I can
immediately think of small but vivid examples that portray how we follow three
core values of Catholic health care. The first, attending to the whole person,
is expressed in an unusual program at our hospitals — an adult literacy program.
Many of the young adults who began attending the reading program had the goal
of entering or re-entering the job market. But in addition to their limited
reading ability, they had another thing standing in their way: many were former
gang members and had tattoos that obviously declared their former gang memberships.
We recognized that for these people to achieve their goals, we needed to offer
them something else in addition to the literacy program. So we developed a tattoo
removal program. This procedure may seem merely cosmetic, but the service is
vital if these young people are to become viable, working members of our community.
A second value that is important in our system is promoting and defending
human dignity. One of the ways we live this value at one of our hospitals
is through our end-of-life protocols. In that emergency department, we allow
family members to be present during codes and resuscitation attempts. We have
a "code white team," which consists of members who have been trained by our
mission department to attend to the family members during a code.
The code white team has been a tremendous service for us. Patients who have
survived resuscitation have told us that knowing their family members were there,
hearing their voices, feeling their touch, was a countervailing force to the
frightening "high tech" experience. Family members have talked about how this
opportunity allowed them to be with their loved ones until the end. Family members
aren't required to be present; the staff are very sensitive about offering the
opportunity to those families who want to be there.
As a physician, the thought of having family members present during a code
is a turn-off. Some physicians at our hospital originally stated, "This will
never happen on one of my cases." But as they have learned — much as I have learned — once
they have been through a "code white" and seen the positive effects, the experience
has a positive effect on them as well.
The third value present in our system is caring for the poor and underserved.
One story that particularly exemplifies this value is that of an old man dropped
off in our emergency department one night. He was around 70 years old and had
Alzheimer's disease. His family was moving back to Mexico, and they brought
him to the hospital, left him in a seat in the waiting room, and walked out.
The poor man was filthy, with dirt and stool caked on his body. His condition
was so bad that when the triage nurse saw him, she could barely stay in the
same room because of the smell. We couldn't tell if he even spoke English — he
wouldn't utter a word.
Once he was brought to the treatment room, none of the staff was eager to
treat him. Our hospital is a trauma center, and we were very busy that night.
But finally the lead physician in the emergency department said, "I'll do this;
you guys continue with what you are doing." This doctor and one of the nurses
spent more than two hours bathing and scrubbing this man so that they could
examine him. He still hadn't spoken a word. When he was cleaned up, the nurse
left the room to get some warm blankets to wrap around him. The physician was
left alone, gently holding the man before examining him. The man then brought
the physician's hands to his lips and said, "God bless you."