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Certificate of Appreciation from the City Council of Los Angeles for Excellence in Community Journalism
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"Dr. Don Noyes - More's amazing expose' of a medical system out of touch is one of the best articles in this genre
- Live Science Magazine -
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I would like to thank the Los Angeles Board of Supervisors for their support and help, they made a difference. Dr. Don Noyes-More Ph.D.

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LAC-USC MEDICAL CENTER REVEALED!

A First Hand Account 
Inside LA County's (In)Famous Hospital

Exclusive From
 Dr. Don Noyes-More Ph.D.


PART 1
(Parts 2 and 3 Below)

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     It was the depth of our recent Depression - Recession that was the background for this emotionally charged medical drama. One brave man stood up to a medical establishment that was failing the patients it served. Dr. More was determined to make changes at LAC-USC Medical Center. And for the first time in Los Angeles medical history he forced demotions and replacements of the entire executive leadership of LAC-USC Medical Center. Dr. Don More organized agitation and direct action taking to social media, patient, and Doctor interviews, photos, and a short film as a spearhead. This is Dr. More's amazing record of events.
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- About the Author -
     Dr. Don More sits on the Board of Directors of Occupy LAC, a Patient's Union which he founded with a team of medical advocates, public health doctors, nurses, attorneys, social workers and many others. He endures as a moral example for us all and in the beginning was a single voice for medical justice.

     Dr. Don More is a retired Ph.D. Clinical Psychologist and Medical Anthropologist with 30 years of working professionally with dying patient populations including AIDS/HIV patients and their families. (Clinical Speciality Thanatology) Sub-speciality: Cross Cultural Medical Systems

He has served as Editor in Chief of Downtown LA Life Magazine for 15 years winning many awards and citations for his journalism.  

     He sits on the Board of Directors for Gay Downtown: A Civil Rights Community, and is active in LGBTI Equality internationally. In 1970 together with friends he helped organize the first Gay Pride parade in Los Angeles - "Stonewall West".

     Dr. More is Chaplin at Our Lady of the Mystical Rose  Shrine, Chapel, Gardens & Sanctuary in Los Angeles, holding a degree in Theology and Pastoral Counseling.

     Dr. Don More was a founding member of the: "Internazionale Socialista Brigit Gioventů Cattolica" -International Catholic Socialist Youth Organization -<1970>  in Rome, Italy, and was a 3rd Order Dominican for 25 years <Liberation Theology> in Chiapas, and Tepic, Mexico.

     Dr. More was past Director of Medical software development (Marketing-International & Domestic Sales) at GlobalLink and Lernout-Hauspie a Belgium  company in the late '90's.

     Dr. More lives with his partner of 15 years in Los Angeles. He was in a previous relationship for 32 years with now deceased partner Rick, who was a Presidential Appointment to the Justice/INS Dept.
 
   This is a man with a plan!  He has made an outstanding contribution to medical services in the City of Los Angeles especially for the poor and medically marginalized.        

- Paula Frank Steinman Ph.D.
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ABOVE: A PARODY

The Good, The Bad, The Injured & Sick Come Together 
in a Medical  Facility with Many Problems and Extraordinary Strengths and Medical leadership that forgot the patients!
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WE WON!!
A Total Clean Sweep!!

* Dr Stephanie Hall MD  
Chief Medical Officer of LAC + USC Hospital
Has Been Removed! Fired!

* Dr Nicolas Testa MD 
Associate Head of LAC-USC Medical Center: 
Has Been Removed!

* Terri Smith, RN, CPHQ, Assistant Nursing Director, Administration Quality Improvement Manager: Anesthesiology, Surgical Specialties, and Employee Health Services 
Demoted then fired

Questioned by Dr. More: 
Dr. Hall looks mortified, worried, and out-of-control as her leadership, policies, and procedures fall like rotten fruit from a tree after a bruising number of 
Dr. More's "stab-in-the-heart" questions .

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Los Angeles County USC Medical Center is one of the largest public hospitals and medical training centers in the United States, and the largest single provider of healthcare in Los Angeles County. It provides healthcare services for the region's medically underserved, is a Level I trauma center and treats over 28 percent of the region's trauma victims. It provides care for half of all AIDS and sickle-cell anemia patients in Southern California. LAC USC Medical Center is owned and operated by the County of Los Angeles. Although by law the emergency room must evaluate all patients to determine if a life-threatening emergency exists, regardless of ability to pay, hospital care is not free. LAC USC accepts self-pay patients as well as patients covered by private insurance, Medicare, and Medicaid.

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ŠKECK

Preface:

A NEW LAC USC MEDICAL CENTER HAS BEEN ADDED TO THE ALREADY EXISTING MEGASTRUCTURE BUILT MANY YEARS AGO. THERE ARE PROBLEMS...

“LAC USC is one of the busiest public hospitals in the Western United States, with nearly 39,000 inpatients discharged, and one million ambulatory care patient visits each year. The Emergency Department is one of the world's busiest, with more than 150,000 visits per year. LAC USC operates one of only three burn centers in Los Angeles County and one of the few Level III Neonatal Intensive Care Units in Southern California. LAC USC is also the home of the Los Angeles County College of Nursing and Allied Health, which has prepared registered nurses for professional practice since it’s founding in 1895.” Wikipedia

Introduction:

 This article is based on three years of being an outpatient and short-tern in-patient at LAC-USC Medical Center, and through direct observations, and interviews with doctors, nurses and staff. Departments that I have focused on are: Emergency, Triage, LAC-USC Hospital, Orthopedics, Eye Clinic, Hematology (Blood Lab), Pharmacy, and Doctor’s Clinic.

This story has been on my back burner for three years. This is one of the most difficult articles I’ve ever written.

I owe a debt of gratitude and thanks to the medical professionals at LAC-USC Medical Center for their amazing care.

There are more heroes than villains at “County”.

Sadly I also must report there have been some serious flaws in medical building design/environment and in the delivery of medical services. At times I have been cofounded by the seemingly endless rules, regulations, and bad procedures at LAC. The procedures are Byzantine bureaucracy with some rather thoughtless and mean workers. 

In the process of writing this story I have spoken to dozens of patients, nurses, medical techs, and doctors. I was invited and accepted an invitation to speak one-on-one to the LAC-USC Medical Center leadership, Dr. Stephanie Hall, Chief Medical Officer, Dr. Nicholas Testa, Associate Medical Director, and Teri Smith, RN, CPHQ, Asst. Nursing Director, Adm., and Quality Improvement Manager, who listened for almost two and a half hours to my story. It was the first time I actually cried in any meeting. I could see on their faces concern. Had they never known about the problems at LAC? I had kept a lot of my emotions deeply inside me, there was now no holding back. The people that needed to hear my story were hearing it. And they were very concerned, but they were years late in their interest in what LAC patients actually encounter. It was all sort of anti-climatic. What would change?

Background

My mother and grandmother were both Registered Nurses. My grandmother was a non-reservation Cherokee Native American holding an RN specialty in Psychiatric care. She worked for over 40 years as a private duty RN for rich families with mentally ill family members. My mother worked for the French Hospital in what was LA’s "Little Italy” now “New Chinatown”. I have 3 cousins who are physicians.

From time-to-time my mother and grandmother spoke in almost hushed tones of “<LA>County Hospital” as some dank monstrosity of a building filled with patients who were Winos, drug addicts, and the extremely poor. I remember hearing my grandmother say “A poor person worth their salt wouldn’t go there!” She never bothered to say why a poor person should not go there for medical treatment. It’s how most people thought of “County”, it was the LA political line of the day in majority White LA, it was mainly about classist racism. Being poor was almost seen as un-American.

In the upper-class White community, people had private physicians, no HMO’s and no PPO’s. Doctors came to your house when you were sick, not the other way around. And we always knew the families of our doctors because they lived in our community. The relationship with our doctor was seamless and based directly in community and relationship. My childhood friends included the children of my own private doctor.

In California, medicine really changed in the late 1960's and 1970’s. Doctors did not provide “house calls” and you might well have been a member of one of the emerging HMOs, PPO’s or community based local clinics providing urgent care. Blue Cross/Shield took off in medical services delivery. More and more businesses provided employees HMO care. Over the subsequent years people saw private doctors less and less, instead opting for the more affordable PPO’s or HMO’s, like Kaiser Permanente of which I have belonged to for half my lifetime. I actually came to like their “clinic” setting. The doctors were personable and the facilities were good. I was satisfied. I have always thought of Kaiser as the model of what good Socialized Medicine should look like.

The Great Recession of 2008

The Great Recession started for myself in 2008-9, taking its toll on income, short and long-term “solid” investments, my financial advisor of 20 years was in serious trouble with the "Feds", and I lost my health coverage; Kaiser. The fear and anxiety of what would happen if I got sick became real. The world as I had known it, the self sustaining, self-supporting, and well off life came crashing to an end with no let up in sight. Our savings became depleted and work was cutting back in every possible manner. Survivability became the real question for both myself, and my life-partner who had just been let go from a very long-term private banking job as a Personal banking manager. We were adrift and waiting for the next shoe to drop.

Watching the Shoe Drop

I noticed one afternoon that the bottom of my foot hurt and had a small open sore on it. There was a bump too. It was like that for weeks. I assumed that I had some how bruised my foot or even possibly stepped on a rock or piece of metal while walking or exercising. It was hard to walk. The sore began to ooze and was paralleled with a midgrade fever and deep physical malaise. I took to bed and kept the sore clean and bandaged. We had so little money we had no idea how we could afford even bandages without a major struggle; we now were trading money budgeted for food for bandages. It was horrific and we were getting more desperate by the day. My one sore turned ulgy and "sprouted" through-out the bottom of my foot. I now had a serious infection. I could possibly die. We had no place to turn except the emergency room of LAC-USC Medical Center. 

My infection was spreading on my foot like a crimson puff of oozing reddish slime.

County hospital, the supposed “Horror Hospital” of my youth, was the last resort. We had known that the wait at “County” would be a long one, but that a doctor would see me. Little did we understand that an emergency visit to “County” would turn into an 11.5 hour ordeal of pain, frustration, and being accosted by emergency room guards as if we were sitting in a prison cell.

After registration for the Emergency room, which was an easy, quiet, and friendly process I was told to wait in the large sprawling waiting room. The Waiting Room looked as inviting as an unairconditioned Greyhound bus station in 1957 Tupelo Mississippi on a hot and sticky Summer night. It’s nightmarish, simply an inhumane environment, with interior medical design making the room mockingly and tragically uninviting and physically difficult for the patients. There seems to be little thought into how the patient feels waiting 9-17 hours to see a doctor in "That" environment. One feels abandoned and lost sitting in pain, waiting and waiting. I started reciting the rosary in my head... just in case.

 If you really want to know what it means on the Statute of Liberty regarding “Give us your huddled masses” you have it at LAC-USC emergency room. The human smells of illness and cold sweat hits your nostrils when entering the ER. Spanish is the sole language of most ER patients. The shocking cold of the air conditioning mixes with the noxious human smells of the many unwashed, diseased, sweating, and fevered bodies. 

A thought entered, "Every new doctor should be made to sit in ER for 12 hours, before entering any ER training. (Perhaps Dr Stephanie Hall should do this asap along with LA County's CEO.) 

The ER Police

IT'S A $7 AN HOUR LITTLE DICTATOR ISSUE
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"THOU SHALT NOT SLEEP OR SLOUCH!"

People sit lined up on benches and chairs trying to alleviate their pain and misery with a little sleep. But Oh No there is no sleep to be had! The seating is impossible, but bettter on the bench at the back of the  room as far away from it all as possible! TV's are screaming out at the patients going nonstop 24 hours along with hair-raisingly bright and intrusive overhead lighting from Hell. Was this ER design really conceived and approved by medical design professionals? (Does the head of the hospital know?) Do they ever visit what they have produced and force upon the people of LA County?

In the ER lying down, slouching, or anything else is not allowed by the guards that endlessly walk up and down each row of chairs and benches making corrective comments to patients and hitting chairs with their batons or hands, cell checks at Folsome Prison I suppose. If the patient does not respond the guard uses a baton hitting the chair or bench with a stern loud warning, “No sleeping, sit up!” It’s a $7 an hour little dictator issue, guards totally unfit for a place of care and compassion. The guards look as run down, angry, and "Ghetto" as some of the patients who wait up to 17 hours to be seen. With the exception of the homeless looking, toothless older woman guard, who walked aimlessly around smiling at the floor and making PopEye The Sailor impressions. This was Theater of the Macabre, live!

"White people would riot!"

 For some patients it’s simply the end of their road. For the guards it’s an endless job in monitoring those with whom they have no regard for at all, it’s etched into their frown lines. No one should experience this. Again I sat wondering if those that run the hospital knew what was happening? And I also wondered if this place is like it is because of the mainly Hispanic patient load?  A Latin lady leaned over to me during hour #5 and said "White people would riot!" I followed her eyes over the top of the filled Waiting Room. Anyway...I was too sick and only half White. A moment of potential Revolution passed without a whimper.

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For hours I sat with my partner on a long bench on each other’s shoulders trying to rest, and dare not go to sleep. There is endless waiting: waiting with the exception of being called to take vital signs every few hours. I said to the nurse “I’ve been here 8 hours so far”, she replied, “You’re lucky, there are people here who have been waiting for 16 hours.” I must have turned totally pale, “Are you okay?” She asked. I got up and did not answer; I decided I was in Hell. An angel, my partner, kept saying to me “you’ll get seen.” There was real concern in his eyes; it was scary. It was his love and concern that had kept me safe so far. Ten hours passed and I was a physical and mental wreck. It was morning, 10AM and I felt I could take no more. “Just let me die” passed through my head. My partner would not hear of it, “we waited this long we're not leaving!” After an hour, about 11AM, I was called into pre-triage, the final step to a doctor. I prayed I was closer to help.

I hopped on my good foot, but kept having to balance on my bad one. My feet were getting soaked in my blood. I slowly and painfully moved into the pre-triage evaluating room leaving a trail of my blood on the floor. No one seemed concered.

The Final Step to a doctor! Pre-Triage evaluation Room: It’s a cramped space filled with sick and coughing people, packed way too closely together on chairs. There's a total Detroit assembly line focus here. "Soylent Green" passed through my mind as I sat there bleeding next to strangers close enough to smell their rancid bad breath. I became worried I might contract some tropical disease or something worse! My mind was being burned by being up for over 24 hours with a fever. "Maybe I'll never get out of here, maybe they'll just turn me into human fertilizer and hand it over to my partner."  OMG! My mind just refused to shut down.

AFTER MORE THAN 11 HOURS WAIT!
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PEOPLE TOO SICK TO SIT UP!

PART 2

  I felt claustrophobic and trapped sitting close together with so many seriously ill people. Either a PA (Physician’s Assistant) or NP (Nurse Practitioner) inspected my foot, and in a matter of seconds I’m being wheeled off to the real Emergency Room: Triage.

Triage is a high-powered intense place. You can physically feel the energy. Nurses and doctors are tirelessly in a medical ballet. I sat on a gurney waiting to be put into a treatment room. I felt alone, scared, and after not sleeping for so many hours “dopy” from fatigue.

A gray haired man in a white clinical jacket came up to me with a smile; he looked at my foot and winced. “Ouch!” He said. He leaned over and rubbed my back smiling and said, “You’re going to be okay,” My stress and tiredness seemed to respond to his words. I became oddly relaxed and comfortable.  After the many hours of depressing pain and anxiety, the doctor's presence was like God lifting the sinner from purgatory. I felt redeemed. His reassuring manner and how he looked into my eyes and spoke to me not “at me” made all the difference. Tears filled my eyes; I grabbed his clinic smock and just tugged on it with a “Thanks”. As he left me I was being whisked off to treatment. I was wheeled into a smallish treatment area. A African-American NA or PA came in with an amazingly welcoming smile, “We’re going to take care of you” she said with a smile. She was told to clean out my wound by a doctor who acted as though I were not present. Somehow being busy in ER at times seems to translate into not acknowledging the patient. Doctor error. “You know you’re staying with us today” my NP/PA said to me in a serious tone. I looked at her with a smile.

My wounds were dressed. They took me to a post Triage room where I would be until they could find me a hospital room. I was hooked up to an antibiotic drip. Sadly and irresponsibly LAC Hospital architects’/designers only built half the rooms really required for the LAC patient load. A skinny and nervous male nurse first words to me were: “You don’t look your age, you’re still cute.” I was in no mood for that nonsense.

I saw that others in post triage were being served lunch. I had not eaten in a long time so I asked a person walking by with food if I could get a tray. “I’m diabetic so I’ll need a low carb meal.” She looked at me oddly and walked away. She brought me a meal that consisted of spaghetti and meatballs, a roll and salad. I told her the meal was not for diabetics, she responded, “You provably know more about that than we do” and she walked off. I sat on the bed still bleeding from my foot as I ate the three small meatballs and salad.

I asked the nurse for a “bedpan” and he said, “I don’t do that.” I responded, “Can you unhook me (from the IV) so I can walk to the bathroom?" He pretended to ignore me, then got up from his computer came over and disconnected me with little or no interest in me or my serious condition. He was just passing time. Painfully and slowly I got off the bed and dragged my bad foot behind me. Blood stained the floor. When I returned I mentioned that my blood was all over the floor to the nurse. He looked at me then glanced away irritated and got back on his computer. 

I watched as the food delivery lady walked through my blood. It was so weird and terrible; I had visions of being back in Balak Bak jungle clinic in the Philippines where the clinic sewage runs down an uncovered channel on the open-air side of the clinic. The memory came and left me. After many minutes I asked the nurse to re-hook me to the IV. He glanced up and said, “Yeah.” It took him 20 minutes to get to me; he was too busy on his cell phone speaking loudly in Tagalog.

NURSE REALITY @ LAC+USC MEDICAL CENTER HOSPITAL
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OF COURSE THE NURSE WOULD HAVE TO WAIT 11 HOURS IN ER TO BE SEEN!

                A woman nurse walking through the open room must have seen the look on my face, “Hey it’ll get better, the rooms are really nice and we’ll have one ready soon.” Another angel! To anticipate and see the patients’ needs, physical or mental, is real professionalism and compassion, it will be a trait of every subsequent nurse I will come into contact with at LAC Hospital. Granted I am biased regarding nurses, I grew up hearing nursing stories most of my preteen life. My mother stopped her nursing career when I was 13. My grandmother worked as a psychiatric nurse well into her late 70’s.

As promised the room was as nice as any at Kaiser Permanente. I was told by my “ward” nurse because of overcrowding I was put in the Pediatric wing. I asked the food service woman for a cup of coffee, she said, “We don’t serve coffee in Pediatrics.”  Dr. Stephanie Hall was to later tell me that I was not in Pediatrics. She never told me how she came to that conclusion. As head of the hospital it would seem good to know the policies you approve. Again and again I was to hear that Dr. Hall seemed oddly detached from her responsibilities and from the people she served. She seemed lacking in a reality check on what patients experience, or know what’s going on in the facility with patients. Sadly the “patient” policy and procedures neglect at LAC has been multi-year. In our meeting I was stunned at just how “Flat” her affect seemed, oddly unemotional, but she dutifully took copious notes. I will have more regarding Dr. Hall in the 3rd installment of this article. 


"They were going to amputate my foot..."

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A doctor came in my room to inform me I would be transferred to a Diabetic Hospital facility for “Rehabilitation” after “Treatment.” “Treatment at that hospital means amputation. Rehabilitation means post amputation. I double-checked the information with a nurse. My worst fears were real. I would lose a foot. It was a Friday afternoon.

About one hour later an older blonde woman doctor came in to let me know more details. I asked her if I could stay the weekend at LAC, giving me time to consider options. She said “yes, but you will be moved on Monday. You'll be there about a month." An Asian doctor came in and looked gloomy saying almost the same thing as the blonde doctor. I responded to him curtly, “I’m staying here the weekend.” He glanced down at some papers in his hand and walked away. Strange behavior.

A Middle Eastern doctor came in the room. He was one of the orthopedic doctors. “I’m going to check this out" he said with a wonderful smile, "this may hurt.” The doctor opened up my wound and put two of his fingers into the wound, all the way in. His fingers gingerly poked and prodded my foot. Then he depressed my leg against my chest. “You’ve got plenty of good tissue" he mumbled, and shook his head. “You’re going to go home, this will heal.” He then just turned to the nurse, told her how to dress the wound and walked out. My foot had been saved by this one doctors visit, which would not have happened if I went off to that other hospital. Things were looking up. But it was far from over.

I heard a screaming coming from just outside my door; it was a doctor I did not know, yelling at my nurse. He would scream at her turn, walk away, and return again screaming at her. This happened 4 or 5 times. It was as horrible as it was depressing. The doctor was totally out of control and had lost all professional control of his conduct. My nurse, (Vietnamese) just looked at him blankly. She was frozen and kept saying, “I heard you” over and over. The doctors face flushed with red to the degree I was concerned if he could get violent. I felt unsafe and threatened by the doctor's behavior. The place became very quiet. When I saw my nurse again I told her how wrong his behavior was. She grinned and shrugged her shoulders. Perhaps this was usual behavior for the out-of-control doctor. Perhaps he was on drugs.

One does not sleep much in the hospital. You are whisked at anytime day or night for testing and X-Rays. At 2AM an African-American hospital worker wheeled me to X-Ray. It’s a long journey though the hospital to X-Ray. She was smiling and chatty with me. We laughed. I asked her how she enjoyed working at the hospital. “This is my last night,” she said quietly. “They cut my job due to the budget cuts.” “I wouldn’t be so happy if I was just let go from my job.” I said. “I love to help people it’s what I’m about, I thank God every day.” Her attitude and care touched me deeply. I was angry that such a loving and dedicated worker had been given the boot. When I was wheeled back to the room after the X-Rays she said, “I’ll say a little prayer for you, get better now!” I just cried. Compassion can be a rare gift sometimes. She has been added to my prayers.

TRY AND GET COUNTY HELP!
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NO ONE CAN GIVE YOU CLEAR POLICY & PROCEDURE

Part 3 

 

Accosted By The LAC Hospital 

‘God Squad’


            The smallish young Latino man came into my room without a knock or hello before walking in. Crossing the room to my bed he said, “Hi I’m with (I forgot the name of the church) in San Fernando Valley, we are Bible believing Christians. I’ll be taking you to your doctor visits and other help you may need.” I just looked at him for a moment wondering what this was all about. Coming closer the man said, “Do you have a personal relationship with our Lord Jesus Christ?” Now I was shocked. “I’m Catholic and just don’t discuss religion,” I snapped back at him. He gets a little smirk on his face and asked me, “Do you really know what Catholic is?” I now had had enough. Half yelling at him I told him to “get out of the room before I call a nurse”. He laughed at me. I said it again and he slowly walked out. It seems more than obvious to me that Christian fundamentalists use volunteerism at LAC+USC Hospital to try to convert the patients. What total bullshit. Who allows this? Who approved this? It was upsetting and I felt intimidated by this aggressive person inquiring about my religion. “Would I be treated better if I just let him rant on about his personal ‘salvation’?”  This became especially concerning to me, since when I checked into my room one of the first things I told the nurse was: “I need to take communion tomorrow, I’m Catholic, can you be sure a priest knows?” my nurse wrote something on her pad and smiled at me. Well Sunday came and went no priest, no communion but to my total satisfaction also no evangelical Christian crazy Latino boy bothering me. Thank God for small miracles.

The 5am Visitor

             I was asleep when she walked through my room and sat down on a chair by the window. I turned and opened my eyes, she said “Good morning.” She was a dark haired woman; it was hard to figure her age by her looks. Her face was kindness. She told me she was a medical student and “Would you mind taking a survey?” She asked me everything about my life not just a medical history but a real profile. When we finished it was 7am. The two hours passed quickly, she was warm and friendly, engaging on a personal level. I don’t remember her name but our visit and her manner was so appealing and oddly healing. The last time I saw her was when a ‘gaggle’ of newbie young doctors surrounded my bed like a “White Wall”, (Making their ‘rounds’), and of course speaking about me but not to me. So I just chimed in loudly: “60 year old, Gay male, in long term relationship, mixed race Native American and white, Doctor of Clinical Psychology, presented with complications/abscess due to symptomless diabetes and a fractured foot bone”. They all turned to me with the oddest looks, and then started speaking with the attending physician Dr. Nguyen. It was like a TV show moment, or Dr Kildare. Only Dr. Nguyen had a smile and he winked at me.  There were no “Good-byes” as they walked out like a line of baby ducks. In passing it was good to see at least one African-American doctor towering over a sea of much shorter East Asian and Middle-eastern doctors. I had an urge to give him a “High 5” but the impulse passed as rational thinking set in. I grinned to myself. My early morning visitor walked over to me and said, “I hope everything is ok” she had tears in her eyes. She walked out with Dr. Nguyen. I thought, “Oh my God” , I wonder if she knows something I don’t?

Someone Let Me Out of Here!

             Sunday Morning: Finally the words I was praying to hear, “You will be released today” about 2pm”, nurse Ho said.  I sat up in bed with a big smile on my face. “We’ll need to get your prescriptions filled and find someone to take you downstairs, that might be difficult to do today.” I began to worry. Ah indeed there was neither Orderly, nor meds for the longest time, no wheelchair, no medical instructions, nothing. After some time nurse Ho came in and said, “I’ll take you out myself”. She seemed angry and frustrated at there being no staff to do this. She had to leave her patients to take me. It seemed to take forever for her to find a wheelchair but she got it! She instructed my partner on how to dress my wound and gave us some much-needed bandages, gauze and tape; without that help we would not have been able to afford it. Nurse Ho came in with the wheelchair and took me downstairs. Before I got in the car she gave me a big hug. I said to her, “I’ll never forget you, honest,” She smiled and said nothing. As we pulled away she waved. For me and I am sure for many LAC+USC patients nurse Ho is a hero, as only dedicated nurses can be.

Home Again

             I arrived home to meowing cats that knew me but were frightened of the distinct hospital smells I carried. It had been a truly emotional and physical adventure, where so many medical professionals came together in one place to help me. I left the hospital with the foot I almost lost, I felt lucky indeed! I sat in our den crying hard, thanking God for being alive and intact. I gave thanks for all the people that helped me. My partner’s dedication to my well-being was an amazing act of love and compassion. He’s like that, it’s one of the reasons I so deeply respect and love him.

Epilogue

              My foot healed rather fast, about 2.5 weeks. My partner changed my bandages daily with no complaints and a smile regardless of the fact my foot looked like chopped liver. I was dependent on another person for pretty much the first time in my adult life. I was humbled. I had always been the caregiver, even at the end of my last partner’s life, a relationship of over 30 years.

Needed Assistance  

            I would now have to apply for county help “ORSA” to continue my visits to the LAC+USC clinics and for my medicine. It was at times an unbelievable hardship: county procedures are just clearly insane and inane, with endless red tape, application redoes, faults, problems, and exceptions. Information was never easy to come by. County workers would say one thing, then another something else, no one seemed to know policy; never a clear policy to follow.

             We were now without a car so here we are getting off a bus in pouring rain, my partner wheeling me down a hill to the small LA County bungalow in back of the old LAC Medical building to get my ORSA/County help finally approved. Pushing me back up that hill took everything out  of him; exhausted, wet and cold.


If the Three Stooges created a medical center’s policies and procedures, The LAC+USC Medical Center would have been the outcome.

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           Once approved I was allowed to see my doctor and go to clinic visits which turned out to be all day events of exhausting waits of up to 9 hours, languishing in a sea of sick, depressed, and angry people. These clinic policy and procedure nightmares have been under the leadership and guidance of Dr Stephanie Hall MD, Chief Medical Officer; a medical system amazingly lacking in compassion or humanity for the people they say they serve. LAC+USC Medical Center’s system is one that confounds people’s health issues by the amount of stress it creates. The waits promote people walking away from appointments after hours of waiting, and what do the medical planners do? They overbook by 40%; this is so stupid as to make me wonder if management is on dope. Endless policies and procedures that make no sense what so ever are always in your face. A pharmacy system that is simply antiquated and extraordinarily slow and cumbersome to navigate, with 5-hour long waits. To renew your prescriptions you have to wait in the Doctors Clinic for a few hours to have them renew it. Then you take it to the Pharmacy and wait 4-5 hours! Any  prescription mistake? You take it back to the Doctor’s clinic and start over. Yes you wait the full time again! They do not have a computer system that addresses these issues at all. It’s all rather primitive. It seems a new updated computer system was not in the plans for the much-touted brand new LAC+USC Medical Center which we all paid for. Someone dropped the ball along with the fact there are only half as many hospital beds as required for the patient population, or that half of the surgeries are not being used. The wait to give a blood sample for testing could take 4 hours or more. There was never enough seating for all the overbooking of appointments, so people sit on floors and in hallways. It’s all nightmarish and poorly planned by people that should have known better. The LAC medical planners did not think about the impact the facilities they created were to have on the people they were to serve. There was no real planning gestalt nor an adequate reality check on the impact of such shortsightedness. They seem not to care what impact their poor judgement and bad skill set had on patients lives, time, families and medical conditions. And who approved it all? Dr. Stephanie Hall, Chief Medical Officer. 

           Because of my vocal and constant social media postings regarding the LAC+USC problems my partner and I were invited to address the (sort of) leadership of LAC+USC Medical Center. It was a day after a 9-hour ordeal in the clinics. No food. I’m diabetic. But we were prepared to present.

The Frozen Chosen:

A Meeting with The LAC+USC Medical Center Leadership

 

Attending: my partner and myself,

Dr Stephanie Hall MD, Chief Medical Officer, LAC+USC Medical Center

Dr Nickolas Testsa MD, Associate Medical Director, LAC+USC Medical Center

Terri Smith, RN, CPHQ, Assistant Nursing Director, Administration

Quality Improvement Manager: Anesthesiology, Surgical Specialties, 

and Employee Health Services

***

           The administrative assistant to Dr Hall escorted us through the eerily quiet and totally empty halls of the Administrative wing of the medical center to a conference room. It was so quiet compared to the painfully loud chaos driven clinic we just came from as to give sort of a tinnitus in our ears. The room was cold, as it is everywhere in the medical center. One by one they came in. No smiles just polite greetings. I started with a “thank you for saving my life and foot”. My statement caught them totally off guard and with nothing to say in response from them I continued, “seriously, Thank you!” No response, so I launched into my experiences at LAC+USC Medical Center. Dr Hall asked if they could take notes and I said, “of course”. At one point I could not hold back the tears, and for the first time in my life I cried in a meeting. It just all came to a head. The only emotional response of the group came from Terri Smith who had tears in her eyes. She was to prove the only part of that team that has shown any real humanity and compassion for the plight of LAC+USC Medical Center patients. Of course there was the chorus of excuses amid their own embarrassment. And there was the illogical weird response to my complaint about the aggressive overbooking of clinics (that a clinic worker told me about): Cat’s out of the bag! All the workers talk to me. The Doctors and nurses talk to me. The medical Techs talk to me. And guess what? They all let that cat out of the LAC+USC Medical Center bag. The very demeanor of Drs. Testa and Hall was scary enough, like children sitting in the principle’s office being given a long list of their moral shortcomings and misdeeds. But I also mentioned the heroes and hard workers, those that really do toil under at times awful and difficult circumstances. Dr Testa piped up about how they reward good workers with coffee cards. Well guess what? That program as of this writing isn’t even funded. When you see the big picture of “their”  medical operation it’s one sad and sick joke. No letters of acknowledgement for workers, nothing! I was to hear  from workers over and over through two years how management could care less. Even Beatrice the Pharmacy Supervisor was to tell my partner and myself, “They don’t have time for us, Dr Hall does not work that way…<they don’t care>.”

            I kept them sitting and listening for 2.5 hours regardless of getting dizzy from no food. Finally Dr. Testa, or as I call him Dr Freeze, looked at his watch and just popped up on his feet and gave me his card then left, the meeting was over. Dismissed.

           I had directed and set policies and procedures for large companies in my past, with thousands of employees, trans-national too, but I have never seen such poor quality planning, policymaking, and procedures in my life as LAC+USC Medical Center.  It has lowered the dignity of those creating good medicine for Los Angeles County. It demeans the work of the doctor’s and nurses. There is a climate of fear and loathing among employees. And then there’s the ever-present work related exhaustion and compassion fatigue by medical personnel.  I see it in their overwhelmed vacant stares through the clinic crowds. They are lost in a sea of indecision, management neglect, and a lack of direction. In frightened anticipation of losing their jobs many employees hide their ID badges, a complaint might lead to loss of a job?

           To me the “least among us” are the most important because they are the most vulnerable to abuse and neglect. And that is why I have confronted LA County and LAC+USC Medical Center with the truth of what they built, promote, and support. That is why Occupy LAC was organized. And that is why the patients are organizing for the very first time, and to that end this article has been dedicated.

"Our real work in making good medicine available to all is still a goal" - Dr. Don More Ph.D.

  

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BELOW: A PHARMACY WAIT CAN TURN INTO HOURS
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ABOVE: NOTICE THE NEW CHAIRS ARE ALL CUT UP

1 HOUR WAIT JUST TO REGISTER 4 APPT! 5 HOUR WAIT
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ABOVE: NO MORE CHAIRS AVAILABLE. OVERBOOKED BY 40% DIABETICS CAN WAIT UP TO 6 HOURS!

A night in the ER: Adrenaline, chaos and very long waits. At Los Angeles County/USC Medical Center. “It’s like a battlefield in here.… It just doesn’t stop,” says a nurse supervisor. - ŠLOS ANGELES Times

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