Living our Catholic and physician values

Health Progress, Jul/Aug 2001 by Carter, Gertrude

In November 2000, a group of physicians and health care leaders explored the foundational values of Catholic health care at the Physician Leaders Forum, held in Amelia Island, FL. Participants agreed that a highlight of the forum occurred when physicians came forward to relate experiences at their institutions that exemplified, in a tangible way, what is special about Catholic health care. Dr. Carter's talk and two others, which will run in subsequent issues, have been adapted for Health Progress.

When looking at how Catholic identity is alive in my health system, I can immediately think of small but vivid examples that portray how we follow three core values of Catholic health care. The first, attending to the whole person, is expressed in an unusual program at our hospitals-an adult literacy program. Many of the young adults who began attending the reading program had the goal of entering or re-entering the job market. But in addition to their limited reading ability, they had another thing standing in their way: many were former gang members and had tattoos that obviously declared their former gang memberships.

We recognized that for these people to achieve their goals, we needed to offer them something else in addition to the literacy program. So we developed a tattoo removal program. This procedure may seem merely cosmetic, but the service is vital if these young people are to become viable, working members of our community.

A second value that is important in our system is promoting and defending human dignity. One of the ways we live this value at one of our hospitals is through our end-of-life protocols. In that emergency department, we allow family members to be present during codes and resuscitation attempts. We have a "code white team," which consists of members who have been trained by our mission department to attend to the family members during a code.

The code white team has been a tremendous service for us. Patients who have survived resuscitation have told us that knowing their family members were there, hearing their voices, feeling their touch, was a countervailing force to the frightening "high tech" experience. Family members have talked about how this opportunity allowed them to be with their loved ones until the end. Family members aren't required to be present; the staff are very sensitive about offering the opportunity to those families who want to be there.

As a physician, the thought of having family members present during a code is a turn-off. Some physicians at our hospital originally stated, "This will never happen on one of my cases." But as they have learned-much as I have learned-- once they have been through a "code white" and seen the positive effects, the experience has a positive effect on them as well.

The third value present in our system is caring for the poor and underserved. One story that particularly exemplifies this value is that of an old man dropped off in our emergency department one night. He was around 70 years old and had Alzheimer's disease. His family was moving back to Mexico, and they brought him to the hospital, left him in a seat in the waiting room, and walked out. The poor man was filthy, with dirt and stool caked on his body. His condition was so bad that when the triage nurse saw him, she could barely stay in the same room because of the smell. We couldn't tell if he even spoke English-he wouldn't utter a word.

Once he was brought to the treatment room, none of the staff was eager to treat him. Our hospital is a trauma center, and we were very busy that night. But finally the lead physician in the emergency department said, "I'll do this; you guys continue with what you are doing." This doctor and one of the nurses spent more than two hours bathing and scrubbing this man so that they could examine him. He still hadn't spoken a word. When he was cleaned up, the nurse left the room to get some warm blankets to wrap around him. The physician was left alone, gently holding the man before examining him. The man then brought the physician's hands to his lips and said, "God bless you."

BY GERTRUDE CARTER, MD

Dr. Carter is senior vice president and chief medical officer, Catholic Healthcare West Southern California, Pasadena.