Patients struggle, doctors worry in aftermath of hospital shutdown
on December 13, 2015
At the El Sitio Restaurant in San Pablo, Shirley Gayer sits beside her son Melvin Willis. Willis pushed his mother in her wheelchair from their home, which is many blocks away. Her wheelchair has cobwebs around the metal bars and shows wear and tear from excessive use. They don’t have a car.
Gayer is a former patient at Doctor’s Medical Center, which closed its doors on April 21. This San Pablo mother and son, like many other residents of western Contra Costa County, acutely feel the closure’s impact. DMC, which provided services to the community for over 60 years, fell victim to fiscal pressures despite efforts to save it.
Now doctors and patients alike are dispersed to other care centers, from LifeLong Immediate/Urgent Care center across the street in San Pablo, to facilities farther away in Pinole, Walnut Creek, Martinez, Concord, Oakland or Berkeley. The distance makes former DMC patients anxious, and worries their former doctors.
“I’m in constant pain to the point where I’m in a wheelchair to travel long distances. Sometimes I suffer in pain just trying to scoot over in my bed. My son has to physically push me on my hips,” said Gayer in an interview. She relies on her son to be her caregiver. “Recently, I fell by the bathroom and was sitting on the floor crying because I was in pain. I couldn’t get up. My son came behind me, put both his arms underneath my armpits, and lifted me up. I’m worried, if something happens, what I’m going to do? You don’t have many options anymore.”
Her son Willis is a member of Alliance of Californians for Community Empowerment. ACCE does community outreach for health care and other issues. Through this organization Willis attended many hospital board meetings to speak about the closure of DMC. “I worry about my mom constantly,” he said in an interview. “When she gets stressed out with her irregular heartbeat, she starts to lose breath. She starts to feel a numbing in her chest.”
“That’s in the back of my mind every day. When she is walking to the store, I am hoping she doesn’t fall down on the way over,” Willis said.
Located 20 miles away in Martinez, Contra Costa Regional Medical Center is now the nearest public hospital. If patients are relying on public transportation, the cost and travel time increase dramatically. An Uber drive would be approximately $30. If a patient seeks medical attention and relies on the bus, the time increases more. If a patient falls ill at 12:30 p.m. on a weekday, it may take an hour and a half on the bus to get from now-closed DMC to the Martinez hospital. This travel time includes three buses and a walk that may strain a body weakened by age or illness.
The nearest basic medical care solution for the displaced patients is an urgent care facility located directly across the street from DMC. LifeLong Medical Care, at 2023 Vale Road, treats limited medical needs. Many doctors and staff formerly employed at DMC now work at LifeLong. Migdalia Callen, a communication coordinator at DMC, worked the night shift in the emergency room for the past five years. Recalling the day DMC closed, her voice cracked.
“It was devastating, tears in my eyes, tears in my co-workers’ eyes, because this is home away from home,” Callen said. “The emergency department crew considered each other family because we worked together for this community to save lives. That was our goal even though we had little resources, were always short-staffed, or didn’t have the equipment we needed. We knew we had to make a difference even if we just saved one person that night.”
Painted in bold red letters, the sign, “DMC Closed,” still remains, a reminder of what was lost. “Every day I work here [at LifeLong], it’s a tug on my heart when I walk and look across. I ask why, why, why? Why did they let it happen? This is years of struggling to keep this hospital open. Years of knowing they needed to retrofit to continue service.”
Doctor’s Medical Center was much more than an emergency department. Along with the ER’s closure, other departments treating chronic and life-threatening conditions were lost, such as its cancer center and stroke program. The stroke program helped patients such as Jim Coates.
Around 8:15 p.m. on a Friday in February of 2014, Coates was sitting on his couch when his vision shifted. “I was seeing double images. I got out my wallet because trying to call an advice nurse from HealthNet, but I couldn’t read the number, so I called 911,” said Coates.
Replaying his phone conversation with the 911 operator, he recalled, “I was asked if I could get to the front door and unlock it. At that point I crawled to the door because I couldn’t walk. I got to the door, unlocked it, and then I collapsed on the floor.”
The MRI of Coates’ brain showed blood clots. He was given tissue plasminogen activator, a drug that dissolves blood clots to limit any further injury to his brain. According to StrokeCenter.org, each year approximately 795,000 people suffer from a stroke. In such situations where swift treatment can save brain tissue, having a stroke program nearby is crucial, doctors say.
Dr. Desmond Carson, who ran the stroke program at DMC, now provides medical services at Lifelong Medical Care. Carson spoke about the impact of the DMC closure. “Emergency services, heart attack, and strokes are where minutes matter to getting care as for long-term outcomes. People in this community suffer,” said Carson. This winter season, he believes, will bring problems for the community. “For impatient services we will start to see the devastation soon because winter increases respiratory illness rates. Flu, pneumonia, bronchitis, and asthma will all get worse,” he said.
Lifelong has served the community, but there are limits to its medical treatment. “What we can do here (LifeLong) is minor trauma. If you’re in respiratory failure, any organ system failure, we cannot treat you here,” said Carson.
Other doctors who worked at DMC and are now employed at LifeLong speak of the dangers of a lost second, especially when dealing with the heart.
Dr. Laurel Hodgson explained what happens during a heart attack. “The big MI (myocardial infarction) is the one that goes through the full thickness of the heart muscle. So whatever vessel is feeding that part of the heart is completely clogged. That whole part of the muscle is going to die. Tick, tick, tick, tick, tick, tick, tick, every second that goes by more of that muscle dies.”
Lives depend on swift action: getting the patient off the ambulance, getting an electrocardiogram (EKG), getting a chest X-ray, doing a complete physical, and getting all the necessary materials. The next parts of the chronology include Step 1: call the cardiologist that’s on call. Step 2: feeding a line into the groin and up into the heart. Step 3: finding which vessel is clogged. Step 4: pushing the line across the clot, and putting in a stent, a tiny pipe that holds open the vessel to allow blood flow to resume to the heart muscle. The total time to complete should be no more than 90 minutes. Hodgson and her team averaged 60 minutes.
When asked how a longer travel time impacts the heart, Hodgson replied, “That extra 40 minutes you’re talking about, well you just lost half a heart. The closest cardiac center is John Muir Medical Center in Concord or Summit Medical Center.”
As reported by Richmond Confidential and other media, DMC’s decade-long fiscal crisis was the subject of multiple rescue efforts, but in the end, cash infusions from state and local agencies were unable to save the hospital.
“The closure of Doctor’s is really an indictment of a poor medical reimbursement system where federal or state medical reimbursements do not even cover the cost of providing service. For example, $10 million out of the $18 million annual loss of the hospital is due to low medical reimbursement rates,” said Contra Costa County Supervisor John Gioia.
“Despite how hard we all tried to keep Doctor’s open, the closure had negative impacts on all of us who live in west county,” Gioia added. “Lifelong Medical Urgent Care meets some, but clearly not all, the medical needs of west county. It’s a community loss for all of us who live here.”
“Health care follows the dollar. When you have plenty of dollars, you have plenty of health care. Where there are no dollars, there is no health care,” said Carson, DMC’s former stroke program director.
Anthony Brown, formerly an emergency room tech at DMC, added, “I think it was more red tape and political backdoor dealings. When it was all said and done, the community doesn’t have enough money to keep this hospital. So we will shut it down and count our losses,” said Brown.
“I’m always worried about my patients. I wonder how he or she is doing because the last time I saw that person they were going through a lot with their diabetes, or cancer. I wonder where they’re going now since the hospital closed. So where are they getting treatment?” said Brown. “No one knows.”
For Brown, the answer is prayer. “I tell them to go to church and pray. If you think about if you’re trying to get from Richmond or San Pablo, to Martinez to Vallejo, or Oakland, there is a pretty good chance you might not make it.”
The DMC community said goodbye to the hospital with a celebratory service.
“About a month after we closed we had an Irish wake for a dead hospital,” said Hodgson.
During this service people wore black, there was a bagpiper playing “Amazing Grace,” and a cake in the shape of a coffin. The participants then had a eulogy. When it was all said and done, “We said it’s time to eat, drink, be merry, and celebrate each other,” Hodgson said.
Correction: This story was changed on April 13 to correct the identification of Contra Costa County Supervisor John Gioia. In our original version, he was identified incorrectly as a supervisor in Alameda County.
Editor’s Note: Richmond Confidential covered the history of the closure of Doctor’s Medical Center in a series of articles by Gabriel Sanchez.
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