'I Can't Imagine Having to Go Anywhere Else'
By William Nottingham, Times Staff Writer
Race. Poverty. Disenfranchisement. All were watchwords in last week's public hearing over Martin Luther King Jr./Drew Medical Center, for years buffeted by reports of questionable deaths and lapses in care.
Los Angeles County supervisors voted 3 to 2 to consider "” in a series of hearings this fall "” closing the pediatric, obstetric and neonatology wards.
Dr. Thomas Garthwaite, director of the county Department of Health Services, said that might allow for better management of what's left.
But no one from the public spoke up for the closure.
Two hundred people packed the room; the parade of 65 speakers lasted five hours; the makeup of the Board of Supervisors was noted "” three white men (who voted to consider the closures) and two minority women (who opposed the idea).
And the volatile history of King/Drew's South Los Angeles area community was a common reference point.
Here are excerpts from the remarks:
"¢ Rep. Maxine Waters (D-Los Angeles):
" ... It is absolutely unthinkable that [the community] would be denied the services of pediatrics and OB/GYN. Do you understand ... we have Jordan Downs housing project, Nickerson Gardens, Avalon Gardens, Imperial Courts, Hacienda, concentrations of some of the poorest people in this state, in this county and perhaps in this nation?
"The children may not be seen at King [as a recent study suggests], but if you walk through these public housing projects, you cannot help but understand why they should be seen. The babies with sickle cell anemia, the babies born with HIV/AIDS, the children with asthma.
"No, many of them are not being seen, and I blame the hospital for not doing all of the outreach that it should do....
"Madam chairwoman and members, this is the 40th-year anniversary of the Watts insurrection, the turmoil out of which King/Drew was created. This is no time to plan to undermine the mission of King. King was developed to provide comprehensive medical services, not some wretched down description of a would-be hospital that denies basic services that are needed in this [community].
"King certainly has been mismanaged, undermined, shortchanged, misused and abused. And, yes, some patients have suffered for it. Careers have been destroyed but, more than anything else, the citizens of [the community] have been marginalized and underserved, and the only winner in all of this is the L.A. Times." (The Times won a Pulitzer Prize this year for its reporting on the hospital.)
"¢ Rep. Diane Watson (D-Los Angeles):
"I come here today with a single message, a message that you have been hearing all the way from the halls of the medical center in Willowbrook to this Hall of Administration in downtown. Fix it. Don't close it....
"The calls, mail, electronic messages and face-to-face communications I continue to receive on this issue are unanimous.... Don't close it, don't shrink it, don't hack it up, don't starve it of resources, don't drain it of its professional talent, don't hand it over to strangers, don't pass the buck, don't ignore it and don't abandon the people it serves day in and day out....
"I ask that you remember why King/Drew was founded in the first place.... If it were easy or cheap or profitable to build a hospital to serve this community, it would not have taken an uprising to do it. Don't throw away the dream that built this house of healing where the need was so great. The need is still there....
"King/Drew is a vision made real. Its conception was violent. Its birth was bloody. Its gestation was long and its maturity has been slow in coming. But if you take it away or shrink it into irrelevance, you will be sending a message and starting a sad cycle all over again. The message will be that there are those in our midst who don't deserve to be cared for in an accessible manner. And the cycle will be set in motion by those who don't care, turning their backs once again, to walk away, inviting the same bitter sequence of events we endured 40 years ago....
"¢ Lynwood Councilwoman Leticia Vasquez:
"The city of Lynwood is the home of [private, nonprofit] St. Francis Medical Center, which is the hospital that has basically been forced to pick up the trauma patients that the [King/Drew] hospital can no longer serve.
"Our services to trauma care patients have more than doubled since the closure of the trauma center [at King/Drew], so our hospital has greatly been impacted.
"St. Francis hospital has been forced to scramble to create a different department, which now is called the Fast Track Emergency Care Center, in order to fill the void and the gap that is currently there because of the closure of the trauma center. The recommendation to downsize services at King/Drew Medical Center would have a further strain on the medical services....
"¢ Dr. Carlyle Langhorn, first-year emergency room resident at King/Drew:
"I've seen women, pregnant women, children, adults with trauma, who have really been saved and benefited by the services provided. And I believe that the piecemeal cutting of services that has taken place thus far and that is proposed undermines the community, undermines the mission of the hospital and will ultimately undermine my training as a physician at King/Drew."
"¢ Dr. Marcelle Willock, retired dean at the affiliated Charles R. Drew University of Medicine and Science:
"The Department of Health Services continues to provide this Board of Supervisors with half-truths regarding King and mismanages it. What do I mean by half-truths?
"Yes, the number of deliveries has fallen, but have you asked why? Centralized fetal monitoring of the mothers and babies has been standard for 20 years. That was only provided at King in September of 2004. LDRs "” rooms where a patient can labor, deliver and recover "” have been standard. It is such at [Harbor-UCLA] and 'Big County' [County-USC Medical Center], but yet King does not have that.
"Our patients are poor, but they're not stupid. They know where they can go. St. Francis remodeled to make it attractive for their patients, whereas King didn't.
"And lastly, the decisions ... are made by DHS leadership, which are all old white males. And, when I look at this board "” and I don't mean to [be] confrontational, but I think this has to be said "” we're talking about women and children, and we need women to make important decisions with this regard. I'm sorry, gentlemen. You are not as sensitive as you should be.
"¢ Barry Weiss, Interfaith Communities United for Peace and Justice:
"I live in Encino, I'm an attorney with healthcare clients, I practiced law, I've practiced law in Century City for approximately 20 years and, in case you haven't noticed, I am an old, white male. So what do I have to do with the King/Drew hospital in South Los Angeles?
"I'm here today to tell you that my community supports King/Drew as a full-service medical center for our brothers and sisters in South Los Angeles as a matter of what is justice and what is right....
"I want you to know that Westside progressives will stand together with our brothers and sisters in South Los Angeles on this issue. We recently organized to elect a councilperson, to help elect a mayor and to assist hotel workers successfully resist multinational hotel corporations in their struggle. We're staying organized.
"And Dr. Garthwaite, I'm going to take a little bit of the heat and place it elsewhere. We're looking at this Board of Supervisors and particularly you, Supervisor Yaroslavsky. This would not happen in West Los Angeles. Your motion [to formally consider closing the pediatric and other wards] is a disgrace!
"¢ Renee Rachal, area resident:
"I'm here representing the single mothers and the children. I, myself, was a single parent, had two chronic asthmatic children that, from time to time, when my car broke down, I was on the bus with them in the middle of the night, rushing them to the emergency [room] to get treatment.
"I can't imagine having to go anywhere else. I can't imagine going to Harbor [near Torrance] or [County]-USC [Medical Center near downtown Los Angeles]. Please consider keeping the hospital a comprehensive medical center, exactly what the mission was in the beginning after the riots.
"¢ Dewayne Anderson, area resident:
"2000, Fourth of July, I was caught in a gang shootout and I was shot about eight times. I was sent to the trauma unit at King/Drew. They pretty much saved my life. When I was there as a patient inside the hospital, that's when I realized what I wanted to do.
"From that point on, I got myself in school, I work as a TA [teaching assistant] for 96th Street Elementary School, been doing that for the last three years. If it wasn't for that hospital, I don't think I'd have been able to teach kids how to read, how to do math. It had a profound effect in the community.
"Dr. Garthwaite's recommendation to close down the pediatrics, OB/GYN; that will have a ripple effect. Those are people that can be saved, be helped, and those people that [are] saved can help someone else." Former supervisor and longtime King/Drew supporter "Kenneth Hahn, he left a legacy, a legacy of doing good for other people. I'd just ask that the rest of you do the same thing."
Source: Los Angeles County Board of Supervisors. For a full transcript of the remarks, go to http://www.lacounty.info/transcripts.htm <252>
*I wonder if this guy will be called out because he is white by the self-haters..I doubt it..
Ex-King/Drew Doctor Admits Misdiagnoses
At an administrative hearing, pathologist Dennis G. Hooper contends that the hospital's deficiencies set him up for failure.
By Charles Ornstein
Times Staff Writer
August 26, 2005
A former pathologist at Martin Luther King Jr./Drew Medical Center acknowledged this week that he misdiagnosed a few patients at the troubled public hospital but said his colleagues and the hospital's faulty systems set him up for failure.
The Medical Board of California had accused Dr. Dennis G. Hooper of negligence in six cases. In some, the board said, he failed to detect cancer in patients who had it. In others, he diagnosed the disease in patients who did not have it, including a woman whose reproductive organs were removed after Hooper wrongly diagnosed her as having uterine cancer.
Hooper's trail of alleged misdiagnoses was detailed in a Times story in December.
At his hearing this week before an administrative law judge, Hooper said he consistently sought help to interpret patient slides at King/Drew in 2000 and 2001 but rarely received it. He lamented the quality of the microscope he was given, called his office a "dungeon," criticized rules imposed by his superiors and faulted the speed at which dictated pathology reports were transcribed.
During the four-day hearing, which concluded Thursday, experts for both the state and Hooper's defense separately testified that his work fell below the acceptable standard of care in at least three patient cases.
Hooper's expert said he should be required to seek additional training and prove that he is competent in surgical pathology.
Deputy Atty. Gen. Ismael Castro asked the court to revoke Hooper's license to practice medicine in the state.
"What this court heard from the very beginning were a variety of explanations, a variety of excuses by Dr. Hooper," Castro said in his closing argument.
"All he sees is the problems that are around him and makes excuses for not complying or not meeting the standards, and I find that appalling."
During his testimony, Hooper said he had tried to work within a hospital that had no quality controls.
"I don't think I'm a bad pathologist," he said. "I don't think I'm a bad M.D. I follow up with patients. I care about patients."
When administrative law judge Samuel D. Reyes issues his opinion, the medical board will make the final decision to accept, reject or change it. Physicians can then appeal in Superior Court.
During the course of the hearing, patients were referred to by first name and last initial. The Times has independently identified them.
Among the cases cited by the board was that of Johnnie Mae Williams, who went to King/Drew in March 2001 for a seemingly minor gynecological exam. Hooper diagnosed her as having cancer of the uterine lining, and surgeons removed her reproductive organs, according to her medical records.
Records later showed that his findings were based on a slide from another patient, who had brain cancer. In his report, Hooper raised the possibility that the slide had been mislabeled, but the medical board said he did not investigate further.
Dr. Lowell Rogers, a Long Beach pathologist and the state's expert witness, said the misdiagnosis should have been "quite obvious for a variety of reasons."
"When there's a slide that's missing or an extra slide, you have to resolve those conflicts," Rogers said. "She was diagnosed with cancer when she didn't have it."
Hooper said he had tried to investigate the problem by showing the case to his department chairwoman and sending the case out to a private laboratory for review. Both also got the diagnosis wrong, he said. And Hooper said he warned Williams' treating doctor about the potential problem, but that doctor proceeded with the surgery anyway.
"He was going to do the surgery whether or not my report came back as malignant or not malignant," Hooper said. "He knew I had sent it out, and the results weren't back yet."
Williams has told The Times that no one from the hospital ever told her that she was cancer-free. She did not learn of the misdiagnosis until more than two years later, when a Times reporter "” unaware that she didn't know "” sought her out for an interview.
Hooper said he had sought permission to tell Williams about the error, but his request was denied by the hospital's risk management department.
The medical board also alleged that Hooper missed prostate cancer in a 58-year-old man, did not catch bladder cancer in a 75-year-old woman and failed to spot leukemia in a 27-year-old man, among other cases.
Hooper generally defended his actions but did acknowledge making mistakes in the case of the 75-year-old woman, Virginia Jackson. In July 2000, he failed to spot malignant cells in her urine. Six weeks later, another pathologist found invasive bladder cancer in a biopsy, records show.
"I can try to think of every excuse in the book," he said. "I didn't have a good microscope. I was busy.... The problem is that I missed it, and I admit to that, and that is something that is a problem."
Still, Hooper faulted King/Drew for not having staff members to assist with the review of urine cells.
Hooper stopped reviewing slides at King/Drew in June 2001, when he went on disability leave. He remained an employee for another year.
He subsequently moved to Texas, working in east Texas and then San Antonio.
A week after the Times' article on Hooper was published in December, he resigned as a pathologist at Baptist Medical Center in San Antonio.
Hooper's lawyer, J. Grant Kennedy, said his client has suffered enough because of publicity. Kennedy said Hooper, at most, deserved a reprimand.
"Dr. Hooper is a good man. He did what he should do," Kennedy said in his closing argument. "He just got in with the wrong company.
"That's what happened."
Drew Students' Goal: Help the Poor
The medical school's trainees plan to treat patients in underserved areas, a study says.
By Lisa Richardson
Times Staff Writer
August 26, 2005
A new study finds that the overwhelming majority of Charles R. Drew University students plan to practice medicine in underserved areas upon graduation.
The study, to be published in the September issue of Academic Medicine, was touted by university officials as proof that the oft-criticized institution was succeeding in its mission to bring doctors to the neighborhoods that need them most.
"The thing I find impressive is that in spite of all the turmoil and uncertainty, the bad press and the difficulties, these students are able to look beyond that and say we've gotten a fantastic experience," said Dr. Cornelius Hopper, chairman of the steering committee on the future of Martin Luther King Jr./Drew Medical Center.
When asked if they planned to practice in a socioeconomically underserved area, 86% of Drew students said yes, compared with 20% of UCLA medical students, the study shows.
That commitment by Drew students increased from 68.5% upon matriculation to 86%. The trend at UCLA was the opposite, the study found: beginning at 28.1% and after four years, ending at 20%.
"We already know a minority student who goes to medical school is much more likely to work with minority patients, and students from rural areas go to rural areas," said Dr. Kevin Grumbach, chairman of the department of family and community medicine at UC San Francisco and one of the study's authors.
"What's less clear is, can you take somebody who may or may not be interested in working in South L.A. or East L.A. or the Mission district in San Francisco and give them the type of education and skills that inspires them to work with disadvantaged populations.
"This study says the Drew program works," he said.
Drew and UCLA established a joint program in 1981 to train students "to provide care with excellence and compassion, especially to underserved populations."
Twenty-five students spend their first two years at UCLA and their last two at Drew, where they begin their clinical rotations. It enables them to marry the clinical curriculum of UCLA with the social agenda of Drew. For example, each must write a thesis on economic and racial health disparities.
Drew's medical program is distinct from its residency programs for doctors aspiring to be specialists, which has come under fire by regulators.
As part of the Drew program, students spend a year working in a clinic where they see the same patients and establish relationships.
"You put them with role models and on teams where they can see that taking care of underserved patients, the sickest of the sick and the poorest of the poor," has rewards, said Dr. Ronald Edelstein, who is acting dean at Charles R. Drew University of Medicine and Science, as well as senior associate dean for academic affairs and a professor of family medicine.
"They feel at the end of their education, that their idealism can continue," he said.
Michelle Ko, lead author of the study, is a former Drew student and resident in the internal medicine department at David Geffen School of Medicine at UCLA. Her experience at Drew mirrors the findings of the report, she said. Though Ko as an undergraduate leaned toward working in an underserved area, her clinical years at Drew convinced her to do so.
Ko worked for a year at the Imperial Heights Family Health Center, where she came to understand the challenges of serving low-income African Americans and Latinos.
"African American and Latino communities are much more adversely affected by diabetes and hypertension, but also the patients we had tend to be poor and there are issues of safety and violence," Ko said.
"How do you tell someone to go on a regular exercise program if they don't feel comfortable walking in their own neighborhood?" Ko said.
The next part of the study, which is in its preliminary stage, will measure whether students follow through on their expressed interest in practicing in underserved areas, Ko said.