The morning call., 1893-03-08
JEALOUS DOCTORS.
Animus of the Attack OH
the Hospital.
Police Surgeon Somers Thinks 1t Is
ImpracticabIe-Capi Operations
in Cases of Emergency.


at the bottom of the scheme fathered by
Supervisor Forman to prohibit the sur
geons on duty at the Receiving Hospital
from performing capital operations unless
in the presence of one or more physicians
called in from the outside.
A capital operation in surgery, it should
be explained at tile outset, is one for which
the scheduled fee charged by members of
the San Francisco Medical Society is $500.
They are those operations of unusual diff
Guilty or gravity, such as amputation of
large limbs, compound fractures and dislo-
cation of larger bones eXsection and TeSec-
ton of large joints and bones legation
of large arteries, reno val of large tumOrs,
TRANSMISSION of blood, trephlning of The
Uranium, cleft palate, operations for cat
aract, artificial pupil and enucleatIOn of the
eye, tracheotomy, operation for stone in
the bladder, strangnlated hernia, difficult
plastic operations and all operations invOlY-
ing lapaT0IOmy.
As the Receiving Hospital is public in
sutution. established for the benefit of all
classes, rich and poor alike receiving treat
ment IN cases OF emergency the surgeons
on duty have no right TO inquire in regard
to the material condition of people taken
there. The man or woman with empty
packets Is on the same footing as he or she
with good fat book account upon which TO
draw to pay for medical services.
But 1t happens that well-to-do people
sometimes meet with serious accidents on
the streets. They are Knocked down by
cable-cars or are run over, fall down eleva-
tor shafts and are the victims of The unex-
pected in many other ways that result in
their finding themselves in the Receiving
Hospital long before their friends know of
their mishaps.
If there was no such public charity people
OF this class would, sooner or later, find
themselves upon private operating tables,
upon rising from which they would fad
themselves in debt for the scheduled sum.
Their blood may be called the milk In
the cocoanut which the outside doctors
would Ike TO open outside the San Fran
cisco Receiving Hospital.
The majority of the patients who find
their way TO this institution are, however
either OF the penniless or impoverished
class, or are workingmen engaged Ia hazard
GUS occupations, aud, therefore, not likely
10 have the means to pay heavy doctors
bills. 1t can. therefore, be easily imagined
that the existence OF an emerge ncy hospital
which treats at the public ex snSe five or six
thousand cases of every description an
nually. is not viewed with entire unconcern
by many gentlemen who call themselves
surgeons.
In conversation with CALL reporter on
the subject, DR.. G. B. Somers, the police
surgeon, who has charge Of the Receiving
Hospital, said he was at less TO understand
the motives of the assault on the Institution,
or " no had inspired Supervisor Fnrman to
propose calling in outside physicians when
ever capital operation had to be per-
formed. That gentleman, TO his knowledge
had never called at the Receiving Hospital
nor had Investigated the practice adopted
by him in such cases. Had he done SO. it
is very doubtful whether lie would ever
have proposed the measure.
THE fact is, said Dr.. Somers, 1.-THE rules
for the management of the Receiving Hos
pital prescribed by the Board of Health
forbid any capital operations being per-
formed unless two surgeons are present
and as matter of fact this rule is scrupu-
lousy observed. Night and day there is
always one assistant surgeon on duty, and
l am here a great deal OF the time. Ny
office is within three minutes walk of the
hospital and is connected with it by tee-
phone. My esdence also has telephone
connection. The instructions are that In
every important case | am to be called.
Another thing is that we only perform a
lew OF what are known as capital opera
tons, and only such IS are so critical that
delay would be necessarily fatal. This
place, you understand, is an urgency hospi-
tai and only urgency cases are treated. If
patient upon whom it NAV be necessary
at some future time to perform a capital
operation, which operation is not urgent
when the patient is brought here, can be
temporarily relieved and fixed up so that he
can stand transportation, we make him
tdDitt anu db SOOU as possible tran S.
fer him to the City and County Hospital, to
his home or to any other place where he
desires to be sent"
DR.. Somers added that fractures and dis
locations OF the larger bones, legation of
large arteries and trephining OF the skull
were casualties belonging to a class which
had 10 be promptly attended 10 and the risk
to the patient would be very great il the
surgeons on duty were required to hold their
hands until an outside physician could be
Suunp1pnad f0r consolidation In
to amputate large limbs or TO deal with cases
OF strangulated hernia delay, he said would
work no harm.
81 regard" said the doctor, "Mr Forman's
scheme, as applied to an emergency hospi-
tai. to be simply impracticable. The vOlun-
teer physicians would not always be found
when most wanted. Their private practice
engrosses their time. If we were allowed
to keep our wards filed the situation might
be different We could bolster up our pa-
over at given hours. But you must
bear in mind all the time that 1t is
our duty to keep as many unoccupied beds
as possible on hand. Nobody can tell what
may happen at any moment in large city.
boiler explosion. collision. a serious FIRE
at which walls collapse, In fact number of
catastrophes with which you newspaper
men are famili lar. might at any hour of the
day or night preclpitate score of manned
people upon u.s. In such an event the folly
would be demon strated of making this in
stitution anything else but an emergency
hospital.
IF there is any defect IN the management
of the hospital the proper way to 90 about
remedyiUg it is 10 remove or reorganiZe the
staff. Only competent surgeons should be
employed here. My staff | believe is made
up of competent surgeons. They have both
skill and confidence, aud more than that
have had abundant experience. They have
all the facilities within immediate reach to
meet any case of emergency. Like army
surgeons in war time they are practically
on the battlefield all the time, and they ac-
quire such dexterity, skill and experience
that their work ought to entitIe them to the
respect and confidence of the public"
Fire on the Ocean Shore