Whither the Community?
Six months ago, the rallying cry was raised by thousands, printed on T-shirts and bumper stickers that spread the message across L.A. in black and blue apt-enough colors for a battle of this magnitude and considered on talk radio from Pacifica to The Beat: Save King/Drew. As the county Board of Supervisors prepared to close King hospitals trauma center, its most exemplary department, as a way to stabilize the troubled hospital, hordes of people politicians, residents, activists, ministers, union reps, former patients, medical students, public-health advocates showed up at a final public hearing at King/Drew Medical Magnet High School to just say no. Behind the impressive show of force was the Save King/Drew Coalition, based in Watts and blessed by Representative Maxine Waters. With her famously uncompromising voice and political muscle leading the way, the hospital and medical school looked like they might have a fighting chance of not only pulling through, but of evolving into the first-rate, full-service institutions they were supposed to be.
Now, as Los Angeles Times accounts of more medical mishaps at King in the last month have suddenly renewed county supervisors call to downsize or scuttle the hospital and medical school altogether, things on the pro-King/Drew side feel eerily quiet. The supervisors have been anything but. Incidents like another cardiac monitor fatally ignored, a surgical sponge sewn up in a patient, and another patient who suffered neck burns when a cauterizing instrument caught fire in the operating room have the board up in arms and calling for sanctions of Drew University, which oversees medical training at King; the supervisors most dramatic move was ordering county health department chief Thomas Garthwaite to relocate his office to the hospital so that he could keep an eye on the place himself. But the coalition has not countered with any drama of its own. Waters has made no public statements. Except for Jim Hahn, whos still campaigning like hell to win back some of the black vote in the upcoming mayoral runoff, no elected officials have offered a word in support of King/Drew. Supervisor Yvonne Burke is an exception, but she took such a drubbing for ignoring problems at King for so long, she almost has no choice, and besides, shes far outnumbered at this point by her colleagues on the board who are much more inclined to rein in King before it can cause any more trouble. What gives?
Like everything else about the King/Drew situation, the answer is complicated. First, theres the coverage of the situation itself. Many King/Drew supporters say they are not so much silent as they are victims of an almost pathological unwillingness of the media, specifically the L.A. Times, to cover the communitys side of the issue that is, to report any discussions of the hospital that dont put it in a negative light or argue for shutting it down. Supporters say this has gone on for a long time but has reached an apogee thats been fueled by the Times garnering the Pulitzer Prize for its exposé of King/Drew that ran late last year. In a statement to the Board of Supervisors last week barely reported by the Times Tim Watkins, director of the Watts Labor Community Action Committee and a key member of the Save King/Drew Coalition, accused the paper of running an undercover operation that searches the inner workings of the hospital and releases only the failures in the form of front-page news reports without proper investigations.
But Watkins also acknowledged the myriad troubles at the hospital and the coalitions desire to address them indeed, he says, that was the point of forming it in the first place. We strongly support the elimination of mistakes, errors, poor-quality care and deaths resulting from incompetence and/or lack of oversight of personnel, including interns and residents, Watkins said last week. We agree that there are many problems that must be addressed.
Paradoxically, another reason why the coalition is not complaining as loudly is because some things have actually gotten better. Despite the current furor among the county supervisors, Watkins and others have been peacefully coexisting with Navigant, the consulting and management firm the county hired last year to right the ship at King. Although the board was peeved with Navigants recent request for another $3.4 million it was originally contracted for $13.2 million over the course of a year many in the community say Navigant is actually doing a decent job of identifying problems, better than the county itself has ever done. The Rev. Stan Bosch, a Catholic priest from neighboring Compton and a member of the coalition who frequently visits the hospital, says he sees a marked improvement in morale at King, especially among doctors and staff. Navigant seems to care, I can tell, says Bosch. People die, as they do everywhere, but theyre also being better cared for. I would come to King if I had an emergency. Life is not as bad as it seems here.
But life at Drew University is another matter. The most complex piece of the community puzzle involves the board at the medical school, which runs the residency programs at King and, despite being a private institution, is largely funded by the county. In a sweeping reorganization earlier this year, virtually all community representatives were voted off the board, including Watkins and Lillian Mobley, a locally revered activist who pushed for the construction of King in the 1960s and the de facto elder stateswoman of Watts/Willowbrook. The move was almost certainly a response to criticisms raised by the Times that the community was obstructing progress by protecting jobs and maintaining a black presence at the expense of improving the university and thereby improving care at King. But without any locals on the board at all, some supporters have cooled noticeably on Drew, to the point where it appears they agree with the county supervisors who have called for severing ties with Drew. Ernie Smith, a former professor at Drew known for his pro-community stance, said as much at the county supervisors meeting last week. But Watkins stresses that its more nuanced than that. The coalition supports a more balanced board at Drew, he says, but not the county pulling its support. But he adds, Theres always been this battle between the MDs on the board and the no Ds, as Lillian puts it. We think there needs to be a mix. Drew abandoned the community, so are we supposed to stand by and say nothing? Further increasing community antipathy toward Drew is the fact that the school, long considered the only historically black medical school in the West, is getting steadily less so out of the current graduating class of 24, only one student is black. Thats partly because of the passage of Proposition 209 in 1996, an anti-affirmative-action law targeted at the University of California; Drew gets its students from UCLA.
But whatever the demographics of the school, or of the hospital, the bottom line is that they are both still charged with serving a woefully underserved community, the poorest and least health-insured in the county. David Martin, an attorney for a group of concerned citizens and professionals called Friends of King/Drew not affiliated with Save King/Drew has been working through the courts for months to try to get the county to make good on that obligation. Martin has filed a civil rights lawsuit to stop more closures or service reductions at King/Drew; he has also been fighting to get the county to release audiotapes and notes of the closed-door meeting the supervisors held last year in which they made the fateful decision to close the trauma center. Martin is optimistic that the information will be released as soon as May, information that might reset the whole dynamic of the King/Drew debate.
Weve been making progress, but in small, incremental bits that dont make the news, he says. Were winning some arguments. The wheels of justice are turning. Theyre just turning slowly.