Read Online Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Sheri Fink - Free Book Online Page B

Anna’s father.
    Proud, boisterous, and principled, Baltz liked to reminisce about the days when the community’s “medical giants” strode the halls of SouthernBaptist Hospital. In the course of his career, he had witnessed two significant changes in the practice of medicine. One was the advent of high-technology life support for patients with critical illnesses. Southern Baptist was believed to have been thefirst hospital in the Southeast to purchase a “crash cart”—a piece of equipment wheeled in during a Code Blue to resuscitate patients who had stopped breathing or whose hearts had stopped beating. The cart contained drugs, a respirator to fill the lungs with oxygen, an aspirator to clear the airway, a cardiac monitor to keep tabs on the heart’s electrical rhythm, a pacemaker to stimulate the heartbeat, and a defibrillator to shock a dying heart back into a functional rhythm. It was a momentous purchase, trumpeted by an article in the local newspaper in 1967. At the same time, Baptist expanded its physical plant and added piped-in oxygen and an intensive care unit for heart patients, complete with alarm systems to alert staff to irregular heartbeats and other emergencies. “In the event of a failure in City electrical power, each unit will be on our auxiliary power, so that no interruption can ensue,” Baptist’s administrator wrote in a June 1967 newsletter.
    Intensive care grew to become a major specialty at Memorial and across the country. With it came new ethical challenges and a changing definition of what constituted “extraordinary measures” in medicine. When should life support be instituted? Critical care, transplant surgery, and other new practices were expensive. On the heels of their invention came the second big change: cost consciousness and the rise of for-profit medicine. By the early 1980s, health care was a medical marketplace.“Many of us have trouble accepting the business motive in medicine rather than the professional ethic,” Baltz told a Baptist Hospital newsletter writer in the mid-1980s. Baptist was still nonprofit and faith-based, but it had to compete in an increasingly commercialized environment. Its doctors, and many across the country, feared being told by accountants and other nonclinicians what tests and treatments they could give to which patients.
    As doctors began to rely more on machines and focus more on business,Baltz worked to remind his Baptist Hospital colleagues of the ethical tenets of their profession. As medical staff president, he urged them to stay compassionate and be selective about adopting new technologies. Baltz encouraged the establishment of an ethics group at the hospital and participated in a discussion of groundbreaking cases, including that of fifty-eight-year-oldClarence Herbert, a comatose patient whose doctors were tried for murder in Los Angeles after they withdrew his life support and IV fluids. The investigation followed from a nurse’s complaints, an indication that difficult end-of-life decisions could create fissures between doctors and nurses. Family members also alleged that doctors had misrepresented Herbert’s chances of recovery so they would agree to withdraw life support. The charges against the doctors were ultimately dismissed.“The ways and means of dying must be carefully considered,” Baltz commented in the newsletter.
    Over the years, Baltz continued the dialogue with colleagues. LifeCare leased the seventh floor of the main building in 1997, establishing the long-term acute care hospital within the main hospital. A Medicare payment change created incentives for these types of business arrangements, and they proliferated at hospitals around the country. Baltz engaged in spirited debates over coffee with colleagues who believed excessive resources were being poured into LifeCare’s typically elderly, infirm patient population. “We spend too much on these turkeys,” one of them said. “We ought to let them