Victoria Sweet planned to practice medicine for only two months at San Francisco's Laguna Honda Hospital, but has stayed for more than 20 years at the last almshouse in the country. Once commonplace (Milwaukee County Infirmary closed in 1978), almshouses served the chronically ill who were too poor to afford a roof over their heads and no longer acutely ill to remain in hospitals. Laguna Honda had open wards, an aviary, garden and small farm to help patients recuperate and grow food.
In God's Hotel: A Doctor, A Hospital, and a Pilgrimage to the Heart of Medicine Sweet argues that the economics-driven HMO model dominating our health care system focuses on short-term savings with drive-by appointments and short hospital stays that often boomerang into costly repeat hospitalizations. Writing about individual patients, she learned to spend more time diagnosing their conditions and treatments. Her research on Hildegard of Bingen and pre-modern medicine also encourage her to practice "slow medicine," which means patients stay in the hospital until they fully recover and can save money in the long run.
One of the amazing stories is the dying patient with no pulse, cold and clammy flesh, eyes rolled back and a Do Not Resuscitate (DNR) order, but still breathing. Dr. Mack moved his leg and his eyes rolled forward and became clear. The patient and Sweet looked at each other in the eyes. You can guess, or better yet, read what really happened.
Readers and patients will find the annotated endnotes provide a good source of books, articles and documents on changes in our health care system during the past two generations.
Submitted by Van Lingle Mungo