BY: MARGARET M. BARRON, MD
Dr. Barron is director, Emergency Medicine, Providence Hospital, Washington,
DC.
In November 2000, a group of physicians and health care leaders gathered
to explore 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. Barron's talk from the Forum has been adapted
for Health Progress.
Our hospital is located near many group homes for mentally retarded adults.
Very often, when these people fall, are injured, or become ill, staff from these
homes bring them to our emergency department because we have a policy to expedite
their care. Emergency department waits can be long, especially if the problem
is minor. When someone from this population needs to seek treatment, a staff
person from the home has to accompany him or her, which takes that employee
away from the home for extended periods of time.
In response, our hospital instituted a program of examining group home residents
first whenever possible. This is the only time we do not receive complaints
from the other patients and families in the waiting room wondering, "Why
did so-and-so get to go first?"
Working with this patient population is a challenge, but it also has rewards.
They cannot communicate very well, they have difficulty conveying their symptoms,
and clinicians have to do a lot of guessing to provide appropriate treatment.
Often we think they are incapable of speech, yet they will turn around and say
"thank you" when we least expect it.
One particular instance involving a mentally disabled man comes to my mind
as an example of how our institution expresses what is special about Catholic
health care. Two years ago, three days before Christmas, a 35-year-old man was
brought to our emergency department. He had cerebral palsy and was mentally
disabled; his foster parents had cared for him since he was two years old. Now
in their 70s, they simply could not care for him any longer. They dropped him
off in the emergency department and said, "We just can't do it anymore."
Although we could not admit him, we kept him for three days while searching
for a placement. For Christmas, the nurses collected money, went shopping, and
returned with socks, sweatshirts, and little presents for him. They made sure
he had Christmas in the emergency department.
In December 26, we decided to get resourceful. The city government was providing
no assistance. Finally, I allowed one of the staff social workers to accompany
this young man in a cab down to City Services, camp out in their offices, and
say, "You have to find him a place now." Because of our personal determination,
City Services found a placement for him by that afternoon.
We must reach out to the poor and vulnerable. We must take care of these people — this
is why we exist. Our mission statement says that we reach out to them with joy,
care, and respect. The "care" and "respect" are basic to
our jobs — we give them naturally. The "joy" is something that
we have to work on. So often, though, the patients are the ones giving joy to
us.