Kings County Hospital Or Cemetery?

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[New York: Commentary]


In 1967 when I was an idealistic 19-year-old,  I joined one of the premier battalions of Lyndon Johnson’s War on Poverty—V.I.S.T.A.—Volunteers in Service to America.

Our task was to enable the “economically disadvantaged” through “maximum community participation” to free themselves of the ravages of poorness.

Some five months later, I found myself a victim of the “benign neglect” advocated by one of President Johnson’s advisors, Daniel Patrick Moynihan, who later occupied the New York U.S. Senate seat now held by Hillary Rodham Clinton.

I had contracted bronchial pneumonia in New York City; my first serious illness, and with a youthful cavalier attitude had delayed seeking treatment for it until I had developed a racking cough, which forced me to my knees at times, coupled with bacterial infection that had grown in the phlegm, which had clogged my lungs. 

Seeking help in this medical crisis, I took a taxi to the nearest hospital. I waited in the emergency room for about three hours without anyone seeing me. I decided to use my acting talents to obtain help from a medical establishment I was sure would be more than willing to help me if they only knew my plight.

I threw myself on the floor and coughed weakly. Other patients in the waiting room got help from hospital personnel.  I told myself—“now everything will be alright.”  Naïve me.

The burly orderlies held me up to an x-ray machine, which took pictures of my lungs. I don’t know what the images showed but they decided to put me in an ambulance and send me to another hospital where I was placed in another waiting room. 

My Academy Award winning performance had another staging—I fell on the floor and when some hospital staff asked me if I had been helped. I nodded to indicate that I had not; weakly, of course. A physician gave me a packet of pills and waved me away. I fell to the floor again. When I was picked up again and asked if I had been treated, I held up the packet of pills. The physician apparently knew the first physician’s reputation because he muttered, “that bastard.” The second physician gave me a shot of penicillin in my buttock. I immediately felt the infection fade away. I found my way home and obviously survived.

This encounter with an insensitive health care system soared like a flock of eagles into my consciousness a couple of days ago with the nationally reported case of one Esmin Elizabeth Green, a 49 year-old caretaker for the elderly, who died with some recognition by having her demise and neglect recorded on videotape at Kings County Hospital Center on June 19 after waiting nearly 24 hours in the psychiatric emergency room without attention. 

When she finally slid off her chair in the waiting room the next day, staff members ignored her, their indifference being recorded for posterity by a video camera. An hour after her collapse, staff members rolled in a gurney with an oxygen tank to revive her. It was too late. Ms. Green died without ever having the chance to explain her symptoms. Her collapse was real, mine were feigned.

The signal abuse of Ms. Green may well lie in the fact that she was sent to the hospital for anxiety and agitation. Apparently the feeling in the ward, which was entrusted with her care, is that these symptoms go away in time. Ask Daniel Patrick Moynihan who proposed the strategy called "benign neglect” as appropriate for dealing with populations, which had been clamoring for attention from government from abuses of various types. Moynihan, then an Assistant Secretary of Labor wrote to President Nixon in a 1970 memorandum that the federal government could adopt more of a hands-off policy toward the enforcement of civil rights laws because of the educational gains that African Americans had made.

Obviously, Ms. Green had not taken advantage of the superior educational gains that had been offered to her in these United States or this great city of New York. Why else did she not jump up when a staff member prodded her as she lay dying with his foot in the video?

The need for the continual diligent enforcement of the civil rights laws that Moynihan felt could use “benign neglect” in emphasis is emphasized by the fact the New York Civil Liberties Union had already filed a lawsuit a year ago against the Kings County Hospital before Ms. Green’s fall to the floor.

The suit accused the hospital of keeping the psychiatric patients in filthy conditions, neglected them and most tellingly of drugging them into submission. The historic  use of psychotropic drugs may well hold the answer to the bizarre spectacle of Ms. Green’s twenty-four hour stay at the hospital.

What potency of drug could induce a person to be content to stay in one place for twenty-four hours? Ms. Green may well have not, in the eyes of the hospital staff, been neglected. She may have been controlled by the drugs. The lack of a bed for her could easily be resolved by forcing her into a catatonic state which was nothing if not cost-effective.

The tragedy of the Green case casts a bright light on the rhetorical swamp, which all the presidential candidates have created in the past months’ contentious debates among caucuses and in the media when they all claim to favor universal health care.

Ms. Green had been to the Kings County Hospital Center several times for anxiety attacks since January.

Presumably, a file had been created of her previous “treatments.” One of the goals of centralized medical service is the continuity of care created by good record keeping and continuity of care by staff members who are familiar with the patient’s history.

In mental health, it would seem critical to have familiar faces and voices steering one through emotional turmoil. Where was the compassionate understanding for Ms. Green from staff members in 24 hours?

The current analysis over the best medical insurance plan for all in our country has focused upon the methodology of payment. But Ms. Green’s slip to the floor shows us that guaranteed payment for care can still leave you or your loved ones on the floor. I learned that in 1967.

Hopefully Hillary Clinton will too. She has Moynihan’s seat in the Senate, hopefully not his heart.



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