Puttin’ In the Fix (Part II)
What annoys me is that Dr. Ghaly now has to type his own notes into the computer. He is sixty-three years old and went to medical school, not business school. For decades he either has been handwriting his notes or dictating them to be transcribed by a typist. Now he’s supposed to learn how to type? What kind of idiocy is this? Do you want your doctor to diagnosis your illness or type your report? Today’s medical students grew up on the computer and reasonably can be expected to type. The senior physicians with the most knowledge and experience should not be spending their time pecking their notes into the computer.
But what really makes me angry is that Dr. Ghaly says there are about two dozen patients being held in the back of CPEP. An eight-bed unit has got patients sleeping on cots or on mattresses on the floor. People suffering from anxiety, aggression, disorientation, depression and dementia are in each other’s faces. Nobody has any safe personal space. Would St. Joe’s triple-book a single-bed room on the cardiac unit? If Crouse put six women together in each double room on the maternity unit, how far would the cry of rage be heard? If Upstate put three people in one trauma room, how fast would administrators move in to clear up the situation?
But this is psychiatry, the hidden sickness, the locked unit, the out-of-sight specialty. The hospital administrators don’t know or care what’s happening and as long as the doors are kept locked, they don’t have to do to anything about it. If the public doesn’t know then the administrators don’t have to act. But I am mad and I will do something about it.
“Don’t worry,” I say grimly to Dr. Ghaly. “I will deal with this. I will take care of it.”
I am an effective activist. In regard to housing, transportation and medical care, I have worked with county officials. When they have failed to redress wrongs, I have worked with state administrators. When they have not improved the situation, I have gone to federal executives. My highest established contact was with the chief of staff at HUD. I have learned how to identify the person with the power to do what I need to have done, and I have learned what words to use to get through to that person.
At home, I start to work the phones. It only takes me two phone calls, a couple transfers and about ten minutes on hold to reach the state Office of Mental Health boss who can do something about this. I identify myself as “a concerned citizen,” which is the only time I’ve ever done anything anonymously. I’m already up to my ears in crap from six other sources and I don’t want to start a new flow from this one. Also, I have no interest in building a working relationship here.
I just want the bureaucrat to do her job, so I repeat what I’ve been telling each person along the line: You’ve got twenty-four people locked in an eight-bed unit. That gets her attention. I identify the location. She tells me that some time previously they were in St. Joe’s CPEP to deal with this same problem. In fact, they considered the situation so severe that they hired helicopters to bring personnel in from across the state to deal with it.
What she is telling me is that she knew. She knew there was a problem here and she never followed up. She put in a fix, then didn’t check back to see if it stuck. Crisis intervention prevailed; no long-term solution was put in place.
I ask her what she’s going to do about the overcrowding. She says that first she will check and see if my allegations are valid.
I crisply reply that my source is a person who works inside CPEP. That shuts her up. Then I tell her that she has twenty-four hours to deal with the problem; after that I’m going to the news media.
I know from experience that no reporter or editor in this market will follow up on such a story. The Syracuse Newspapers—the Post-Standard—does not do investigative reporting; neither does it report stories about unattractive people—people who are poor or sick—but the state bureaucrat doesn’t know that. Never hesitate to run a bluff when the person you’re talking to can’t prove it’s not true.
The bureaucrat says, “Are you threatening me? I won’t be threatened.”
I reply, “I’m not threatening you. You do what you can and must to do. I’m just telling you what I’m going to do, and when I’m going to do it. The clock is running. It’s up to you which one of us acts first. Good day.” Then I hang up.
The next time I see Dr. Ghaly he tells me that within two hours of me leaving his office, personnel from the field office of the state Office of Mental Health were in CPEP—and therein lays the problem: the field office isn’t doing it’s job. It is made up of hacks who get-along and go-along with the locals instead of maintaining effective oversight, which is their job.
So I fixed one problem for one day, knowing it was only temporary but also knowing it was something I could do. You must always do what you can. Always.
You will answer to God for what you have or have not done. Are you ready for that?