The doors of Hahnemann University Hospital in Philadelphia will be shut in September after 170 years of operation. This sudden closing of a 496-bed academic medical center will be disrupting the patient care, research, cost around 800 nurses, as well as, hundreds of other workers their jobs.
It will be also be flinging the lives of 570 medical residents into chaos. Some might be taken in by residency programs of neighboring hospitals, however, others will have to relocate to different cities & reorganize their lives on short notice at their own expense. Through no fault of their own, these young physicians will be suffering a distracting disruption in their training.
To a few people, the reason behind the closing is just another example of a dysfunctional healthcare system, however, the news struck me more viscerally.
My first exposure to “real patients” occurred during a humid and hot Philadelphia summer at Hahnemann. For an impressionable young medical student, the patients were fascinating. One case, in particular, I’ll never forget, because I’ve never seen anything like it since.
Mr. Green (not his original name) had a long history of excessive alcohol intake. His skin radiated a mustard color. His sclera glowed an even brighter yellow. He spent most of his time in bed. He had severe gingivitis & had lost most of his teeth. Only 2 top incisors jutted from his mouth. Majority of the fingers curled with Dupuytren contractures, and his spindly legs and arms rarely moved.
But the most unusual feature was his belly, which protruded into the air as if it was filled with helium. Also, he had an umbilical hernia, which made it compulsory for him to wear a colostomy bag sealed over his belly button. Whenever he used to sit, foggy fluid drained into the clear plastic bag.