A doctor tells of Cook County Hospital being so short-staffed that several physicians once trained a few homeless men sleeping in the halls to do lab tests.
A nurse describes women in hard labor stumbling into the maternity ward clutching their living room televisions because they know the hospital doesn’t have any TV sets of its own.
A patient who had her first child at the hospital remembers being shocked when she returned with heart trouble nearly three decades later to find the place still had the same 1950s-style wards with no air conditioning, no private rooms, no telephones and just one bathroom–without a shower–to be shared by all patients.
Since 1914, the year the gray, ornately columned hospital that caters to Chicago’s poor and uninsured was built on the city’s West Side, Cook County Hospital has been famous and infamous, educational and unforgettable for the generations of doctors and patients who have passed through its grimy, historic halls. Its notoriously outrageous cases and environs have been the inspiration for the television drama “ER.” And everyone who has spent any time in the place has a story about the ramshackle hospital that has long been dubbed the “Old Lady on Harrison Street.”
But now the storied Chicago institution is on the verge of being demolished, to be replaced by a state-of-the-art $623 million hospital expected to open within weeks. People say they won’t miss much about the actual building–the fact that the maternity ward is a 10-minute walk from neonatal intensive care, the vending machines that are the only places to eat since there isn’t a cafeteria–but they say the legend of the place, the history, is going to be hard to replace.
“Let’s put it this way,” said Dr. David Soglin, interim chairman of pediatrics. “We complain about this place every day. It’s hot; it’s cold; it’s drafty; the elevators don’t work. But this old hospital is a character in and of itself. There’s no place in the world quite like it. And, on the day we’re finally wheeling all our patients across the street to that gleaming new building, we’re going to be more than a little nostalgic to leave it behind.”
The 88-year-old Cook County Hospital is famous for its fair share of things–the nation’s first blood bank, Chicago’s first open-heart surgery, one of the nation’s finest burn centers, and a neonatal intensive-care unit that serves more than half of all premature babies born inside the city. But the old hospital’s real claim to fame is its trauma ward, a place so chock-full of gunshot wounds, stab gashes and blunt head injuries that military physicians who need combat training are sent there for hands-on experience.
Storied trauma ward
Where the rest of the hospital has fallen into disrepair, trauma gleams from recent renovations and constant updating.
“We save between 300 and 400 lives here every year,” said department chairman John Barrett, a physician who is legendary around County.
Barrett, who, like thousands of other doctors, saw it as a badge of honor to be trained at the high-pressure, low-resources hospital, was first lured to County when he was a young resident fresh out of medical school in Ireland.
“I don’t think there’s another hospital anywhere that is comparable with the number of patients we see and the kinds of patients we see,” Barrett said recently, standing in the middle of his trauma ward.
About 5,000 patients come through trauma every year. Because the hospital is near neighborhoods that are heavily gang controlled, it takes in a steady stream of gunshot victims. Trauma attending physician Gary An says it isn’t uncommon to see one gang member come in all shot up and then a couple of hours later to see an opposing gang member come in after being shot in a retaliatory attack. And, amazingly, despite all the bullet-riddled bodies that come through County’s trauma doors, 98.5 percent of people treated in the unit survive.
“Basically let’s put it like this,” Barrett said. “You come through those doors alive and you are more than likely going to eventually walk out of them alive.”
`It ain’t the Ritz’
Thus the running joke around the hospital: If you’ve been injured in some kind of trauma–stabbing, gunshot, head injury, car accident–you want to be taken to County. They’ve seen it all; they’re good at fixing it all. But once you’re stable, you want to get transferred somewhere else, somewhere clean and modern, somewhere with private rooms and television sets and a bathroom with a shower.
“Look around this place,” hospital spokeswoman Rendy Jones said one afternoon. “It ain’t the Ritz. Heck, it’s not even the Motel 6 or the Super 8.”
Stepping into one of the hospital’s inpatient wards is like stepping back in time.
Some nurses still wear those cardboard white hats that stick up like a piece of angel food cake. There are no private rooms. Until about a decade ago, the beds were just lined up in the open, but now plywood partitions and curtains have been installed to allow at least a minimum of privacy. On each ward there is one bathroom for all patients (at the end of the hall), one sink for all nurses (at the end of the hall), one pay telephone for anyone who wants to use it (again, at the end of the hall).
In Ward 24, head nurse Divinia Tinazon shows a visitor how hopelessly out of date her 29-patient unit is:
Unlike modern units, where the rooms are clustered around a central nurses’ station, the ward stretches down a hallway the length of a football field, and the nurses’ station is stuck at one far end. With little more than plywood and curtains separating the cubicle-like patient quarters–two people to each–everyone can overhear everyone else’s conversation with doctors, nurses and visitors. When the temperatures soar in the summer, the wards, which are not air conditioned, can easily top 100 degrees.
Everything in the ward feels haphazard: the floors are dirty; garbage bags are tossed on the floor until a janitor comes to get them; a hand-written sign taped to one patient’s bed says, “No blood draws in left arm,” but the word “left” is crossed out with black marker and “right” is inked in above it.
Tinazon, who spent most of her nursing career working at private suburban hospitals, is asked why she would spend her final years before retirement working at County Hospital.
“It’s like working in a different era,” she says, walking past a room where a full bedpan sits at the edge of a bed. “I thought it would be a challenge.”
The new hospital–with its 464 inpatient beds, all in air-conditioned private or semi-private rooms with televisions, telephones and bathrooms–will not just be a luxury for its staff. On a recent autumn afternoon, Betty Hudson, 46, and Diane Velesquez, 49, shared a cramped cubicle in Ward 24.
“The new place is going to seem like the Hilton,” said Hudson, who gave birth at County almost 30 years ago and sees no marked difference in the place today. Well, except one, she says cheerfully.
“The waits to see a doctor aren’t quite as long,” she says of the up to 5 1/2 hour waits at the hospital’s first-come, first-served medical clinics. “We used to have to pack a bag with breakfast, lunch and dinner when we headed in here.”
Tinazon shakes her head when she hears comments like this. These kinds of patients make everything worthwhile, she says.
“People are so patient with the way this old place works,” she says. “The sad part is that so many of them don’t know hospitals can even be different because they’ve spent their whole lives coming here and nothing has changed in decades.”
As if to illustrate the nurse’s point, a gentleman in his 70s who has come to County since he was a boy leans out of his cubicle and asks what she is talking about. She tells him the new hospital across the street.
“Oh, is that what that is?” he asks gloomily. “So once this place is torn down and that place is opened, then where will I go?”
Tinazon tells him he’ll use the new hospital.
“No,” he says in disbelief. “They’ll say that place is too nice for someone like me.”
Poignant personal stories
The stories of County Hospital’s real-life patients could rival any made-for-television moments.
Up in the burn unit, a family from Kentucky recovers from burns sustained in a car accident on the Eisenhower Expressway. Mother Mei Zhu, 33, has burns on her face and neck. Father Xuming Zhang, 35, has burns over the bulk of his left leg. Little Eric Zhang, 4, has burns on 12 percent of his body, and he is using crayons to draw pictures of the previous day’s fiery crash.
In neonatal intensive care, Ethiopia Jackson and Freddie Joiner huddle over their first little boy, Terrell, born three months too soon and fighting to get off a ventilator.
And down in trauma, the cases come in, one after another, on what seasoned doctors call a “quiet night.”
Two gunshot wounds.
Motorcycle crash.
Gang member stabbed in the neck.
During a lull in the action, Marie O’Connor, a young physician just beginning her residency, decides to take advantage of the quiet to steal a quick nap in the middle of her overnight shift.
“OK, there’s a bum passed out in my bed and he’s urinated all over the place,” O’Connor announces as she rushes back into the trauma ward a minute later. “And I mean all over the place. It’s disgusting.”
The other trauma physicians laugh so hard they double over. A janitor takes one glance at the mess before declaring, “It’ll dry eventually.” Dr. David Greenberg shakes his head and pronounces the whole situation “a quintessential County moment.”
An, the attending physician, uses the opportunity to tell of his own quintessential County moments: kids who come in dead from a gunshot wound to the chest even as the previous week’s gunshot wound to the leg is healing; gangbangers who come in stabbed through the chest but who tell the nurse they are too afraid of needles to let her draw blood; young men who come in having shot themselves in the groins because they tried to shove their guns into their waistbands like guys do in the movies.
An, 37, worked at County Hospital from 1988 through 1993 and then went to work in a private hospital. But he came back in 1997.
“When I first came to County I was aghast at how primitive it seemed,” he said. “But I found I couldn’t walk away either. This place has the most extraordinary mix of cynicism and idealism. You can’t work here and not be cynical about the human condition. But you have to be idealistic to believe you can fix something by coming to work every day.”
Another gunshot victim is on the way, and An gets up from his perch on a gurney.
“Even when the bricks and mortar of this place are gone, the stories will remain,” the doctor says. “The legend will stand.”
