LOS ANGELES — When a local story here in southern California tickles

the antennae of the exalted ones at the New York Times, you can be

sure things have come to a pretty pass. And indeed they have at Martin

Luther King Jr./Charles R. Drew Medical Center, in the Willowbrook

area of South Los Angeles. The Times reported on Sunday that the

hospital has descended into a state of chaos, marked by infighting,

racial tension, accusations of corruption, and many, many millions of

dollars in malpractice payouts. "King/Drew consistently ranks at the

bottom of American teaching hospitals," the article reads. "A report

in January by federal health officials said that at least five of the

hospital's patients died needlessly last year, and the county

authorities are investigating accusations that hospital officials

ordered nurses to lie about the abysmal state of things."

The decline of King/Drew Hospital should serve as a cautionary tale to

anyone who clings to the notion that health care should be dispensed

by the government. Imagine a hospital that makes even the Department

of Motor Vehicles look like a marvel of efficiency by comparison. It's

one thing to be sent the wrong license plates, it's quite another to

be given the wrong medicine, or no medicine at all, both of which have

occurred at the hospital with alarming regularity, sometimes with

deadly consequences (King/Drew has long been known to cops in the area

as "Killer King") The federal government has told the hospital it will

begin withholding Medicaid and Medicare payments if conditions don't

improve, a move that could cost the facility half its budget, some

$200 million per year. The county of Los Angeles is already strapped

for cash, and it would have little choice but to close the hospital if

these federal dollars are cut off. This would shut down the only

trauma center in an area where, sadly, people seem to inflict trauma

on one another with an almost casual alacrity: The hospital handled 40

percent of the county's gunshot patients last year.

Built on land where once stood a public-housing project, King/Drew

Hospital opened its doors in 1972, seven years after the Watts riot

scorched a wide swath of South Los Angeles. (The hospital's website

euphemizes the riot as a "social disturbance.") The McCone Commission,

impaneled by Governor Pat Brown to investigate the riots, identified

the lack of health-care facilities in the area as having contributed

to the unrest, and from its inception the hospital was intended to be

run by blacks for the benefit of the surrounding black community. This

may have made some sense in 1972, when South Los Angeles was still

predominantly black, but today the area is about 60-percent Hispanic,

yet only 17 percent of the hospital's employees are Latinos. The

hospital's administration is almost exclusively black.

Speaking to the New York Times, Connie Rice, a black civil-rights

attorney here in Los Angeles, described the situation at the hospital

this way: "The hospital is run like a tribal fiefdom, and it's

appalling. You can't ask questions because it's a black institution.

If you ask questions, they scream racism. But it's not a question of

race, it's a question of competence." I'm guessing Rice has never

voted for a Republican in her life, but surely that comment had her

telephone ringing with accusations of selling out to The Man.

Adhering more to the party line is County Supervisor Yvonne Brathwaite

Burke, a black woman whose district includes the hospital. "It's not a

matter that you go there and die," Burke told the New York Times,

"it's that the press picks up on every little mistake."

Here are some of those "little mistakes," as reported by the Los

Angeles Times on March 17:

A woman with respiratory failure and ovarian cancer received the wrong

dosage of an antibiotic on Feb. 28; did not receive an ordered dose of

a blood thinner on March 1; and was given only three of 12 ordered

doses of respiratory drugs from Feb. 28 to March 2.

A stroke patient had to wait nearly five hours for a drug to help

prevent heart attacks and recurrent stroke. At one point, pharmacists

wouldn't fill the order because a doctor had spelled the drug's name

wrong. Later an inspector watched as two pharmacists within half an

hour picked up the pill bag and looked at it but did not approve its

use.

In the case of a tuberculosis patient, an inspector found a missing

dose of intravenous antibiotics on a pharmacy counter more than two

hours after it had been ordered, with a sticker that read "missing

dose." The inspector noted errors in three of six medications given to

the patient.

A paraplegic with a pressure sore and bone infection was not given a

laxative suppository that had been ordered and reordered by a

physician over at least five days.

It's odd that Supervisor Burke should today be defending the

management at King/Drew, for she was once one of the hospital's

harshest critics. A Los Angeles Times article from December 1995

described the comparably sorry state of affairs at the hospital at

that time, and quoted Burke as demanding change. "Due to a series of

highly publicized problems, irregularities, illegalities and tragic

mistakes that have occurred at [King/Drew] in the past few years...the

public's confidence in this major county medical facility has been

shaken," Burke told the paper. "It is unacceptable for anyone who

depends on King Hospital — whether they're ill or injured — to fear

that they won't get the level of care they expect and deserve."

Whatever steps Burke might have taken to fix things at the hospital

since then, conditions have only gotten worse. I know as much about

medicine as I do about fixing cars, which is to say not much. But I

can walk into a garage or an emergency room and tell fairly quickly if

the people working there are competent. Having visited the ER at

King/Drew Hospital many times in my career, I can say it's the last

place in Los Angeles I'd want to be taken if I were hurt on the job.

In fact, I've instructed coworkers that even if I get shot in the

waiting room at King/Drew, they're to call an ambulance and have me

taken somewhere else.

I'll close with an anecdote: When police officers respond to shootings

in Los Angeles, they must advise their watch commanders of the

victim's condition so the appropriate detectives can be notified. I

was once on the phone with my watch commander as I watched paramedics

load a shooting victim into an ambulance. "How's he look?" asked the

lieutenant.

"Not that bad," I said, "but they're taking him to King."

"Okay," he said. "I'll call Homicide."

I thought he was just some kind of Republican delighting in bashing public health. I thought maybe he was using one bad example to bash the whole system. There are good hospitals out there too. But the article was well written and had a lot of good points.

The problem at Drew seems to be the fact that some Black administrators, when they get in power, discriminate against Latinos. That seems to me more a case of Blacks acting like Whites than generic government incompetence. Back in the day, Whites would run hospitals "for Blacks" that were substandard.

Even public institutions rely on people going the extra mile, and when people aren't willing to go the extra mile because they think their clients are "the other", all that extra mileage doesn't happen.

Can private hospitals offering emergency services operate in a poor neighborhood? Probably not. They wouldn't get opened without some kind of county subsidy. People living at a subsistence level, by definition, don't have capital, and probably don't have insurance (which is a kind of community capital).

I've been to private hospitals in rich neighborhoods (Cedars) and in working class neighborhoods (Beverly), and the working class ones are worse. I've been to County too, and, it's worse, but not that much worse than a low-end HMO. Not only that, I notice that people in the system will lie about the quality of the hospitals to the clients, saying they are all the same. (That seems to be the modus operandi of the middle class -- to deny the existence of inequality to those who get the shaft.)

But I digress. More about "Randy Constan." He's weird. Not weird-scary, but weird-odd. I wonder if this is the same person as this poster.

http://www.pixyland.org/