Hospital Unaccountability Extends to Outbreaks of Infectious Diseases

Contaminated_surfaces_increase_cross-transmissionSan Francisco     The Affordable Care Act has given health consumers, also known frequently as patients, more significant advances in transparency and information about hospitals and doctors. Medical records are being digitized and becoming accessible. Information is being made public on doctors, exposing some have Medicare mills. It appears the public is getting closer to being able rate and rank hospitals on cost and efficacy in handling various procedures. There’s hope we may be able to be better informed on questions that impact our own life prospects and therefore better able to make decisions and evaluate the opinions and prognosis of this powerful priesthood of doctors and the temples or hospitals where they practice.

Despite this glasnost, it was unsettling, perhaps even shocking, to read a story from the Los Angeles Times that showed light on the veil of secrecy practiced by hospitals in shielding information from the public on outbreaks of infections, whether from staph or so-called superbugs, or other seemingly inexplicable epidemics that suddenly take down otherwise healthy patients often passing through the hospital on minimal or routine visits. Worse, what we know is often only years later through tangential revelations in medical journals still disguising the names of the hospital and other critical details that might have saved lives when a stitch in time was still possible.

The Los Angeles Times told about six children having been killed suddenly in an unknown hospital due to a fungal infection that later information indicated had occurred at Children’s Hospital in Los Angeles several years before due to dust picked up from construction of an overhead sidewalk at the facility. Other examples in Florida and California caused what may be countless deaths, once again only puzzled out for the public years later, because of a design flaw in instruments that prevented complete cleaning. In another case, a doctor had inadvertently spread a staph infection into the hearts of five patients and eventually in sixty others before the health department was able to track the problem down and stamp it out. Tell me all of this isn’t scary as heck!

So, we can say that stuff happens, even bad and evil stuff, but that doesn’t excuse not warning the public as you would with other situations of public health outbreaks. The defense offered by the hospitals and some of their governmental minders is that if the hospitals were not promised confidentiality then they might not report any of the incidents to public health authorities at all, even though everyone agrees that the reporting is not comprehensive even with confidentiality. The hospitals argue that they don’t want to panic the public. The rationalizations seem unending. It’s hard to believe that this isn’t really about having to face liability and legal actions for such errors, but maybe that’s a euphemism for “panic.”

Amazingly, there seems to be virtually no legislation at the federal or state level that mandates reporting or assigns penalties for failing to report. Our legislators seem to be wittingly covering for the abuse and neglect of these priests and their sanctuaries just as we have experienced in other institution where inadequate accountability and disclosure are the rule. A law in California passed after an egregious case requiring a hospital report of how many of their patients get infections seemed a positive note, but then the mother of the victim was quoted saying that she was on the supervisory board and that 12 of the 17 members were doctors and hospitals and only wanted to protect “their employers.”

What do we do in a world where to stay healthy we have to stay away from hospitals? Public disclosure would advance public health and consumer health decisions and confidence. Why is this a hard thing to ask from our politicians?

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Jimmie Rodgers- TB Blues

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Activism Humor Close to the Bone

71cXxcL4PHLNew Orleans   In recent years there seems to be a small cottage industry of novelists mining the left, activism, and the sixties, especially the flirtations with violence in their work: Dissident Gardens by Jonathan Lethem, True Believers by Kurt Andersen, and Flamethrowers by Rachel Kushner are among them. And, yes, I read them all with one eye cocked and a weird fascination at their attraction. You never know when you might learn something about the work from the popular culture outside, rather than the sub-culture inside. Unfortunately the search is also rarely rewarded.

An easier swallow was a zany novel called Wallcreeper by Nell Zink that follows a woman stumbling through life from her American roots to various cities in Europe, especially Germany. Her husband of sorts decides, somewhat surprisingly, to take his avocation about bird observation into environmental activism, and she follows somewhat obliquely. Zink’s satirical comments on the efforts to organize the group and its work are often hilarious and cut close to the bone in our modern add-water-and-stir culture of insta-groups and slacktivism.

Her husband of sorts comes to the conclusion that, “If people spent more time being disgusted, the world would be a better place. People might revolt. Like vomit.” He and a young woman activist organize a group as Zink writes, “Global Rivers Alliance was different. It was modeled on Greenpeace and the WWF. You could donate without ever being asked to do anything but donate.”

It’s not easy though because they are not alone in the fragmented mosaic of environmental activism:

“…every single person who toyed with the idea of wiring two dollars to George first felt compelled to debate the merits … with him. Most were themselves running tiny organizations that had arisen by spontaneous generation or mitosis. No one had supporters. Stephen spent hours writing closely argued defenses of himself and his aims. Each one unique, because you can’t copy anything anymore without getting caught.”

Later she writes, “They had goals, partners, approaches, and a campaign – all the things you can have without actually having done anything…” I might add that if that shoe fits, it must be painful to read.

They tire of trying to find a place in the parade and start thinking about direct action rather than fighting the air wars of publicity and the internet. Thinking of themselves that,

“…we must have been a refreshing change from activists who plan sit-ins in parks where it’s legal to sit and schedule vigils for Saturday nights. We didn’t pray for peace or play “imagine” on the autoharp. We were the real deal. Birke could man the tables at the global car wash and bake sale.”

Direct action is going to be her husband’s thing and our heroine observes:

“For Stephen, the idea of direct action was like a cross between chocolate cake and the onset of mania. ‘Frat boys in Patagucci hoisting banners and calling it sabotage,’ he mocked. ‘Calling it direct action because it goes directly to the evening news. You know their big idea for the Elbe? A raft. Like they’re really gonna make it to the North Sea against the wind. These people embarrass me. But Gernot’s tear-down-that-wall thing, that is some serious shit. Respect!”

Our heroine drifts towards the notion of direct action herself to save the Elbe River by tediously moving rocks that secure a levee against any rising water in a solitary act of personal sabotage:

“…apparently it had never crossed his mind that sabotage doesn’t look criminal if you get a young, middle-class housewife to do it. I looked like Jane Birkin in Slogan, if Slogan had been set in a scout camp in Poland. I worked the way Patty Hearst would have robbed banks if she’d never met the SLA. The militant wing of the Global Rivers Alliance radiated innocent industry. If I have one talent in the world, that’s probably it. Looking innocent enough to make whatever it is I’m doing appear legal.”

Her insight and Zink’s is disturbingly close to the narrative of life underground that emerges from Bryan Burrough’s recent book on the Weathermen and others, Days of Rage.

As the snow melts raise the river, the floods come from her action, and Zink slinks out of Wallcreeper ending with a fabricated fairy tale evolution to a different path for the heroine, but no matter, her novel was not really about organizing and activism anyway, but there were zings and stings in her writing that could serve as warnings for all of us still working on the real “real deal.”

A colleague mentioned to me recently that it is too rare that we get to tell “our own story.” True enough, and in the meantime we need to pay close attention to the way others are telling our stories.

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