Thursday, April 16, 2009

My Eye on the BI #4

As I have mentioned, I follow Paul Levy's blog "Running a Hospital" I have specifically linked to his comments about MRSA, and I hope that after the recent publicity you will read them with attention. I ask you to consider this principle, the paradox, that those who are honest and sincere about a problem; honest in confronting it publicly; sincere in actually addressing it proactively; are the very ones most likely to be vilified by a superficial public. Please read the NPR article linked above carefully, and you will find this statement

The infection control failures at Beth Israel are not believed to have caused the maternity ward infections. But the problems were discovered during that investigation.

The situation is suddenly far less sensational when you notice this statement. What did the investigation find? a range that includes possibly poor hand washing, or an infected worker. Possibly?

As some of you may know, my home and all my possessions were destroyed because my painting and furniture refinishing materials might possibly have been used to manufacture drugs. Possibly? I am very sensitive to public accusations that have been made with no reference to fact, and are completely speculative. Even NPR is not immune to this tendency. They need listeners, the papers need buyers and advertisers, and for some reason reportage of honest and sincere efforts to combat serious problems seems not to be very good at accomplishing that end. This was discovered and institutionalized by William Randolph Hurst, I recommend "Citizen Hurst" by W.A.Swanberg for an interesting history of the way he fabricated the Spanish American War in order stir up society and sell newspapers. I wont continue with my thoughts on the way the standard of public education facilitates this because I want to return to Beth Israel.

"The B.I." is different from other hospitals not because it has had some infection control problems and the others have not; it is different precisely because Paul Levy and the board of directors are committed to complete openness in public disclosure about the issues that all hospitals deal with. I will bring a personal perspective once again. I have spent seven years with a very compromised immune system, and have received all of my very extensive care at the BI yet have never experienced any sort of infection problem there. Amongst people with HIV MERSA is a rampant threat, yet I have remained completely clear of it.

I am reminded of a tale we were told in Ancient History class in grammar school. In order to illustrate the difference between the Athenians (which we identify with) and the Spartans ("Other" fascist types) the story was related about a boy who had lined up for inspection by his superiors. He had stolen a fox- it was never explained what he wanted a fox for. this story must have originated with English fox hunting types, maybe Trollope! In order to avoid discovery he stood still and motionless while the fox clawed into his chest; this monument of self control and deceit was the behavior that the Spartans admired, while the Athenians, like us, aspired to truth and social responsibility.

In what way like us? Aren't we more like the Spartans of the story, who will forgive any nefarious action as long as it is successfully hidden? Who are we in the face of the Beth Israel's policy of openness, and who in the face of other institutions who will be clawed to death under their cloaks by problems hidden by their public relations departments.

I will now link to another post from Paul's blog which rings very true for me. As you all will guess that I am more than a month old I won't have to explain that this Michael is not me!

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