Evening Star Newspaper, September 10, 1929, Page 4

SEEK CALLINGER PROBEBY EXPERTS Committee Asks Government Officials v Name Board of Inquiry. other in the countr ‘A staff of 158 of the pick of the medical and surgical fessions of the city, giving lree, rvice for operations and treatment at | the rate of about 20 visits per day, and | visiting for monthly conferences and | inspections in groups of more than 100, the report stated, “should be an added assurance that there is nothing seriously wrong with Gallinger.” With the exception of the Thomp- son case, the report dismisses briefly the eharges made by Judge Kathryn B. Sellers_of the Juvenile Court, which were directly responsible for the public criticism leading to the inguiry. ‘The board accepted the testimony of the operating surgeon and nurses that Mrs. Thompson gave her consent to the peration which ultimately resulted in her death. Judge Sellers and the pa- tient's mother had charged otherwise. Cannot Disregard Testimony. The report added that the board “does not see how it can disregard the t ony of surgeons that this oper- n was desirable and necessary If 1e patient was to improve.” “While negligence, improper methods and lack of skill in deciding upon, ar- ranging for, or conducting a single operation, if found to cxist, merit the severest condemnation and summary treatment of the guilty parties, the board feels that one such charge un- sustained by evidence does not justify the wholesale condemnation of the hos- pital and all its activities,” the report contin ‘The re “To’the Honorabie missioners of the lum “Recently there” appeared in one or more newspapers of the City of Wash- port follows: the Board of Com- District of Co- ington articles containing certain state- | ments alleged to have been made by the judge of the Juvenile Court of the | District of Columbia, from the bench, severely criticizing Gallinger Municipal Hospiital, particularly with. reference to certain_specified cases, and avowing it | To be the purpose of the judge to send no more wards of that court to-said hospital under any circumstances. “About the same time there appeared apers a series of . in which a reporter of said paper, who had obtained admission to the psychopathic department of the hospital by feigning amnesia, gave a detailed account of what purported to be his experience, ations and treatment while an inmate, which ac- count was likewise severely critical. Probe Is Ordered. “Gallinger Hospital is one of the In- stitutions under the control of Board of Public Welfare, and the board, because of the gravity of the charges, and espectally because of the high source fiom which the first-mentioned criti- cisms emanated at once took up the stion of an investigation of the hospital in all its departments. It was decided to make such investigation, and | the committee on medical service was directed to take up the task for the board. It should be stated here, for in- formation, that the extended character of tie board’s duties makes it impera- tive to operate through committees. Fach member of the board serves on at least two committees. The committee on medical service has for its chairman one of the medical members of the board. One of the regular members of the committee has been absent from the ity during the entire period of the in- vestigation. His place wase filled by ap- pointment of the other medical mem- er of the board. The vice chairman. a regular member, was directed to st the committee. The investigation has thus been conducted by two doctors, chair- of the T spentabout sideration of these matters, during which time they have examined more then 70 ses, whose testimony. covering every phase of the hospital’s equipment and operation, its personnel and organization, is herewith submitted. These witnesses range from the super- intendent of the hospital, down through the paid professional staff. to the lowest grade of employe, besides sundry mem- bers of the volunteer, unpaid, visiting stafl. composed of one hundreds and fifty-eight (158) physicians and sur- eons from the faculties of two medical hools of the city, Georgetown Uni- ity and George Washington Univer- s Medical Schools, nominated by those universities. Besides these, all persons, with one exception, presently o be noted, coming forward to make statements concerning the hospital were given opportunity to be heard, after | public announcement . through the newspapers that all persons desiring to make complaints would be heard at a cesignated time and place. Judge’s Testimony Invited. “The newspaper reporter in question wag invited to testify and promptly re- sponded. The following communica- tion was sent to the judge of the juve- nile court: ugust 28, 1929. r Judge Sellers: ‘“The Board of Public Welfare is engaged in an investigation of Gallinger Municipal Hospital. The attention -of the board has been called to articles in the local press in which certain statements in connection with the hos- pital are attributed to you. “The committee .in charge of the investigation, being desirous of cover- ing thoroughly every fzha.w of the oper- ations of the hospital, has directed me to inquire whether it would be your pleasure to make any statement, either oral or written, for its information in connection with the matters mentioned in said articles or any other matters within your knowledge concerning the hospital. ““If it should bz your pleasure to mak= such a statement orally, the com- would bz pleased to hear u at any place in the' District of bia and at any tim> that you gnate, as suiting your conven- not later than the fifth of Sep- 1929. Tt it.should be your a statement in writing, they would be « pleased to receive it on or before Sep- t-mber 5th, and if it is not your pleas- ure to make a statement in either form, you are respectively requested to so in- form the committee by the date men- tioned. Such date is named because public interest seems to demand that the investigation be pusl as rapidly and concluded as speedily as may b2 consistent with thoroughness. ““If you should indicate an oral statement, ity is requested that you give one full da: notice of the time and place suggested by you for receiving the committee. Reply may be address- ed to the undersigned care of the Board of Public Welfare, Municipal Bullding, Washington, D. C. ““Very respectfully, (Signed) “‘W. W. MILLAN, . For the Committee on Medical Service of the Board of Public Welfare of the District of Columbia.” “To this communication a reply which is incorporated in the report of testi- mony was received. “No other witness was given a writ- ten invitation to testify except one of the visiting staff who failed to respond to an oral request over telephone. ~The one witness requesting to be heard, who was not heard, is a former member of the board, who desired to inform it concerning - ‘treatment of employees.’ He was informed that this question is not within the scope of the present inquiry, but might properly be the sub- the | three weeks in the con- | “The chn"l.;m Juvenile Court are llgnzd. definitely, to three cases. The first is case a_ patient, apparently a to the hosoif , the influence of an overdose of & cer- addiction _thereto. Unfortunately this investigation, the doctor who treat- ed this patient and the nurse who attended her, both left the - institution before these charges were heard of and we are. therefore, without their testi- mony. The report of the superintend- ert of the hospital, on this case, is in- ccrporated in the record. From this re- port it is impossible to conclude that there was anything irregular, harsh or improper in the treatment of this patient. It seems to be” quite usual hospital practice to relieve psycho- pathic patients of their belongings (for safe-keeping), to require them to chan to hospital clothing, to subject them neecssary restraint and to release them only when responsible persons receive them. So far.as the board has been able to ascertain, no charge of miscon- duct, inefficiency or diseourtesy, in this case, was made until fifteen (15) charged, and then only through the public press. Any complaint of this character, seasonably made to this board, would have been promptly in- vestigated and any offender summarily dealt with. “The board feels that it can confidently give the same assur- ance with reference to any complaint made to the superintendent of the | hospital. Case for Legal Dec'sion. “The next is the case of Regina Burks, a minor, who, in an emergency, donated a certain amount of her blood for transfusion to a patient critically in need thereof. As this case is now the subject of threatened litigation against certain officials of the hospital, personally, the board deems it improper to express any opinfon on the legal question whether the taking of this minor's blood without the consent of her parents, constituted a technical as claimed. The question will be determined by proper legal authority, in due time. In the mean- time, There is no probability of another such occurrence until the question has been so determined. The report of the superintendent on this case is in the record. “From this report, it appears that the action complained of was prompted by the most humane of motives and that it\probably resulted in saving a life, and further that no harm t the minor resulted and thut there existed no reasonable ground for fear that harm would follow. “The next is the case of Mrs. Nettie ‘Thompson, a patient who died at the hospital on July 25, 1929, following a gynecological operation performed the preceding day by a member of the vis- iting staff, also a member of the fac- ulty of one of the schools mentioned. The complaint in this case is, in sub- slance, that the patient did not go to the hospital for an operation, that she was not in a condition to be operated upon, that the operation was unneces- sary and unwise and was performed against the patient’s will, and without notice to her friends. The report of the superintendent of the hospital on thi ase, is also in the record. The testi- mony of the mother of this unfortu- nate woman and of her best friend, who was closely in touch with the case, has been taken and the chief of staff of the hospital, the surgeon who oper- ated, the chief of the gynecological service and the nurse in attendance have been examined at length. It seems clear that there was reluctance on the part of this patient to go to the hos- pital. Naturally so: most people are | reluctant. It is said that she was urged to go by: the judge of the Juve- nile Court—for examination only—but | testimony from her best friend, a pre- | sumably critical witness, shows that the patient, before she went to the hos- pital, was examined by the physician of that friend and at her inistence, and & was desirabie. Believe Party Consented. “The board 1s constrained to believe, from the evidence before it, that this patient’s consent to the operation was given and that her reluctance to submit to it was overcome when the advice of | the physician she had consulted was backed by the advice of the surgeons at the hospital. At any rate, the testi- mony of reputable witnesses, both nurses and doctors, including the operating surgeon, who is not on the paid staff and whose standing is vouched for by would have to be accepted, in any tri- bunal, as outweighing the inference that she could not have consented because she had objected to going to the hos- pital at all. Furthermore, the board testimony of surgeons that this oper- ation was desirable and necessary, if the patient was to improve; that it was not unusual, that neither the character of the operation nor the condition of the patient justified any fear that fatal re- the consideration T‘lven the case by the entire staff as well as the very deliber- ate testimony of the operating surgeon that he still thinks the operation was proper, and accept the opinion, how- even sincere, of a lawyer that this oper- ation should not have taken place, no matter how great the learning, how high the position or how deep the sym- pathy of the lawyer. “One feature of this case brought out in the oral testimony but not mention in either of the communications refef- red to, which presents, from one angle, a more serious question than any of the foregoing, will be dealt with in a subse- quent paragraph of this report. While negligence, improper methods and lack of skill in deciding upon, arranging for or conducting a single operation, if found to exist, merit the severest con- demnation and summary treatment of the guilty partieS, the board feels that one such charge, unsustained by evi- dence; does not justify the wholesale condemnation of the hospital and all its activities. Questions Misteading. “While the judge of the Juvenile Court indicated that there was no n cessity for accepting the board’s invita- tlon to testify, for.the very sound legal reason that any further statement from her wouid be helrl.Jl, the communica. ti acknowledging the committee’s in. vitation to appear, contained numerous guestions, all of ‘which were propounded to witnesses in a position to know, but which did not elicit anything to cause a change of the foregoing conclusions. Two of the questions contained in this communication, as it was given to the press, were so framed, inadvertently of course, as to create in the minds of gemms reading them in’the news- apers an erroneous and very damag- Ing impression. These questions ue.‘k information as to how operations upon poor, persons are decided upon and per- formed, leaving the uninformed very likely to infer that there is one treat- ment for rich and another for poor. The questions are mentioned not for criticism, but because the board feels it.a duty to inform the public that there is no gfll;l:d u{:r such lnll:m:oe‘ Proj ce in e Tact Enat the Thompson was a patient, at nger, at Gallinger, o&e“nad o:nm .m:fn 22, 103'. and con: structed equipped at a cost of a million dollars, is exclusively for poor persons. No rich man can buy his - e was_true of the gener: wl in the old' buildings. Hospital, thE peyehopattic buidings and Sy iy an old bui used detention ward. vlm:! t and all other the commi made three lengthy visits. inspection was begun within t after it was decided upon and with er notice than that period to e connected with the every place most marked and tidiness was found. months after the patient was dis-| the great university in which he teaches, | does not see how it can disregard the | 1 advised by him that an operation | ally believed to be usual in all such { sults would follow, and the report of [ PO | crowding or lack of beds. o’f the judge of the | with difficul friend of the judge, who was admitted | employees ‘hopathic rtment of the |the psychopathic bulldings, b yAcpflim 24, i%?i' while urider [ 1923, or the new general hospl cept an occasional cockroac] e tain drug and with some history of | kitchen, a condition with w] for | housewives are familiar. Reporter Testifies. “The newspaper reporter referred to informed the investigating committee that he had been in Washington six months, four months 28 a “free lance” and six weelks with the p: in which his articles appeared; that is to say, two weeks before his visit to the hospital. He 1s 30 years of age, but was never in a hospital before, either as a patient or as an investigator, but the committee has endeavored, to the best of its abil- ity, to give to his complaints and crit- icisms the same serious consideration that they would have been given if made by the most experienced ifivestigators. His criticisms are directed to what is known as the South Building of the thic group, as that was the nly of the hospital, except the alienist’s consulting room, he had an opportunity to see. This is the receiv- ing building where all mental patients and all alcoholics and narcotic addicts are taken in the firt instance. It is not, and under the most favorable con- ditions could not be, an inviting place, It is not a place where one would go from choice, but the board finds It im- possible to understand how so complete a transformation could have taken place between the date at which the reporter’s visit ended and that at which the board’s inspection began, “It is quite true that the walls were dingy and stained and in some places defaced, but they were not dirty. They had never been painted since the bulld- ings were erected six years ago, but sev- eral months before this reporter's visit, a complete renovation of all the builld- ings was begun and had been pushed as rapidly as was possible with the help available. At the time of the reporter’s visit, this work had been completed in all the buildings except the South Build- ing. It had actually begun in that bullding some weeks before and was then in progress. It has since been completed, or nearly so, giving all the buildings 'a much betfer appearance. The committee .saw no evidence of It saw the beds and the patients. The testimony of nurses and attendants was that there has been no overcrowding. Evidence of Filth Lacking. “No evidence of dirty floors were found, no lack of chairs, no stench from disinfectants, no evidence of patients being compelled to drink from a com- mon_ @rinking cup, but much to_the contrary, and no evidence of patients being required to work against their will or their being mistreated. The sur- prising charge that dogs were locked in a room with a patient was denied by all the employes and officers who testi- fled on the subject. No dogs were on | hand when the committee made/ its visits. If such a thing should evet oceur, the board has no doubt that the superintendent would promptly remove the dog and dismiss the offender re- | sponsible for its presence. i “Food for all the departments is dis- | pensed from a central kitchen in the | new hospital, under control of a trained superintendent from one of the most famous clinics of the world—the Mayo Clinic at Rochester, Minn. A trained dietitian has charge of special trays for special cases of patients. It is believed that the food is ample and well pre: pared and fully up to the standard of | similar institutions throughout the country. “The manner of serving the food— without knives or forks—seems usual and necessary in a psychopathic hos- | pital. This manner of serving and the character of the food itself would prob- ably be unattractive to any such per- son as the investigator making these charges. Patients do frequently shrick in the South Building. This is gener- places. The physicians at Gallinger do not believe in quieting mental patients, alcoholics or drug addicts with nar- cotics, except in extreme cases. There is no other public place in the District of Columbia where mental patients, al- coholics and_drug addicts are received. The South Building is the place into which the entire intake Naturally it gets them at their They are kept there unmtil they improve to the extent of being fit to fer to the quiet wards. These three classes are! together. This is not & good lmnh~ ment, but for the grtfll?- is unavoid- able because offlack of facilities. The board hopes to see this condition reme- died in the not distant future, and the mental cases, strictly such, separated from the alcoholics and narcotic ad- dicts, Patients suffering only from dis- eases not mental are not kept in the nsychopathic wards. “The water treatment, with 50-pound pressure on a piece of equipment in the hydro-therapy department referred to as a hose, has a pressure of about 20 unds. The committee saw this treat- ment administered. Some might object to it, but it does not apj harsh o cruel as a part of hospital treatment. In some cases it might almost be a! necessity. The various forms of baths, together with the so-called Scotch douche, which is the form of treatment Just referred to, are considered the most efficient means of quieting acute and violent forms of mania. They act not only as sedatives, but also as tonics tc the nervous systems of mental patients. | The equipment referred to is usual in all modern hospitals treating psycho- pathic patients. “But one note of critictsm of the new general hospital was heard. That was from the X-ray specialist formerly con- nected with the hospital as a part-time man on pay, but replaced, properly he concedes, by a full-time man, and | transferred to the unpaid visiting staff, when that was organized. The report on this may well rest on the testimony of this witness alone. The sum of his testimony is that the X-ray equipment hu'.nll?? lll in llceordnlac': with ’t‘hnt generally in use in hospitals throughout the country, but that it is not as good as a system that he has devised but which 1s not in use anywhere in the world and never has been except in the old hospital under his direction. He complains that he was treated with dis- courtesy by the s.perintendent in mak- ng the change from his system to the one installed. The installation was made after consultation with more than 30 experts in manufacture, installation and operation of such apparatus. Razor Blade Incident. “An incident which has been given m:npubwty was brought out in the ony of this witness. It is said that an insane patient, though this wit- ness does not say that he was insane or a patient, about to be fed razor blades and glass. There is disagree- ment between this witness and the pres- ent X-ray specialist as to whiat did oc- cur. The present X-ray that he ever had any mungg ing the witness to swallow glass or razor blades. e most important fact in this connection is that man was not insane and never has been a patient at the hospital. He was at the Indlmlllhlpfllmerl$flujlflln apears to a who makes it & to tend to . 'The demonstral Belent 5 soon a8 T was prowght o bis attention. five testimony with' a nece mmumwmxpeflnmm patient -every minute except cases. But the board are of the opinion that more than one nurse should be were always under the eye of a nurse or attendant, while it might not Ixe- vent a patlent getting out of bed, it ‘would ly prevent escape from the floor. The stan: committee on medical service will deal with this situ- ation id see that proper steps are g‘k:nihm 'aaumonyl shows, hl:wevzrl, 8 practice now in in similar hospitals. m h nurse was engaged as indics hard’ to understand why operator, with intelligence enough for even that lowly task, could have carried a patient in night clothes and a sheet to the first floor on his car. The board learned that this employe is no longer with the hospital, though one witness mistakenly testified to the contrary. “The standing committe¢ on medical service will take up for special con sideration: 2 “(1) The question of adding a fe- male psychiatrist to the staff. 2) The question of the use of strong rooms for amnesia patients con- serning which there seems not to be complete accord. /Strong Room to Expose Sham. “It was: the practice of the chief resident psychiatrist in office, when the newspaper man was with him, to place patients shamming amnesia, in strong rdoms to expose the sham. At his first examination of the newspaper reporter he discovered that he was | shamming and ordered him into a strong room. The charges that patients are placed in strong rooms as a matter of routinc is, however, completely dis- approved. No patient is ever so ‘con- fined except upon order of a doctor, unless in an emergency with a violent patient. Such emergency cases are at once reported ta the doctor in charge and a written order made. “(3) The question of patients in the medical and surgical wards who are able to walk about being allowed to assist in carrying meals to other pa- tients. “There is no evidence that any pa- tient ever did this except voluntarily, but one of the complaints in the Thompson case is that the patient, before being operated upon, was com- pelled to carry heavy meal trays. The board knows from iis own observation that the trays are not heavy and does not believe that Mrs. Thompson was compelled to carry any*of them. How- ever, a patient volunteering to do such work, might afterward change his mind and imagine that he was compelled to do that which was voluntary. patient coming ||;l .txl':ld ‘:'Ir:{llnfi “l;(;lr)::r so engaged, might n| was ces- sary for him to do likewise in order to win favor or receive attention. “(4) The treatment of patients at the Court House, awaiting Court hearings. “Towards the conclusion of the hear- | ings, a newspaper article charged that atients brought to Court suffer for jack of attention, water and food while waiting for their cases to come up. It seemed unnecessary to take public testimony on this matter. If the Stand- ing Committee finds that the condi- tion alleged exists to any degree, ill be remedied so far as the hos- pital authorities are responsible there- for. Complainants Small. “In spite of the great publicity that has been given to this investigation and the occurrences leading up to it, the number of persons who have re- sponded to the open invitation to ap- pear and make complaints was most astonishingly small. Outside of the Thompson case, there were really only two. One of these, a lady of intelli- gence and refinement, gave an exceed- ingly detalled and convincing story of One | tment of her daughter in the | height could not exceed 1, e e r‘d‘e‘d. but con- |the requirements of omud’? sieas ‘The record 'Mn:t' lebar were out to break building, now_disca. Ve her y i volun- she had found courteous it to him laps of her bellef A&‘Bfifl!! y such | Schnéider it t-hle"}_' l.ng rmd was allowed to stand by the New Bullding Adequate. “The new medical and surgical build- ing, with a capacity of 304 beds, with new and modern equipment and appa- ratus in every detall, is believed to be the equal of any hospital in the country. “The psychopathic buildings, though only 6 years old, are not all that might be desired, so rapid is the advance of improvement in hospital construction, Imr the board finds no ground for any general complaint as to the way in which these buildings are being used and maintained or the manner in “The more vital question is the treat- ment accorded to patients. The golrd finds no substantial ground for com- plaint in this connection. It is im- possible for the board to s.and at the elbow of every official or for the superintendent to stand. at the elbow of every employe, but we belicve tiat | his first care is the welfare of pa- tlents and that this is the apirit of the hospital staff generally, including the efficlent superintendent of nurses. We believe that he is constantly on the alert to strengthen his personnel and will be quick to recommend the removal of the careless or the in- efficient if any such should be 1jund. A staff of 158 of the pick of the medical and surgical professions n the city, giving free service for operations and treatments at the rate of about 20 visits per day, and visiting for monihly conferences and inspections in groups of more than 100, should pe an added assurance that there is nothing serfous- | ly wrong with Gallinger. he investigating committee 1as addressed letters to the surgeon general of the Army, the surgeon general of the Navy, the surgeon general or the Public Health Service and the auper-, intendent of St. Elizabeth's Hospital, | requesting each of these officials to designate an officer of high renk to form a committee for the purpose -of making an examination fnd inspection | of the equipment and conduct of the | hospital with a view to having a re- port from competent experts not in any way connected with the adminis- tration of, the hospital or with the District goVernment. (Signed) | “JOHN JOY EDSON. “Chairman | “GEORGE B. 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