The sun. [volume] (New York [N.Y.]) 1833-1916, 1900-06-03
HILLS HITS HOSPITALS.
THE PHYSICIAN FINDS GRAVE DE.
PEcTS IN THEIR MANAGEMENT. II
He Object, to the system That Turns Over so
Large q share OF the Work to Young and
inexperienced Men - His Own Thrilling
Adventure with the Ambulance surgeon.

Adventure with the Ambulance surgeon.
Under the title "rhc Governor and His STAFF:
Being a Glance at the Personnel Of a Modern
Hospital and n Plea for a Permanent Resident
STAFF. " DIR, Thomas J. Hills read a paper before
the County Medical Society meeting at the
Academy OF Medicine last Monday night dis
cussing the management ana ADMINISTRATOR OF
a modern hospital. Department by department
he took up the public hospital as II Is run in
this city and found little of good In it. From
his point Of view II is a place where young doc
tors and surgeons are educated at the price OF
tho lives of the unfortunate patients. The paper
has reused wide discussion among local ply
sicians. Little Is known Of the hospital by the
public. DIR. Hills said at the opening OF his paper.
This he attributed 10 the selfish carelessness
Of the people and to the determination OF the
hospital authorities to keep the affairs OF the
hospital to themselves.
From this condition OF things. he said,
the hospital to the average layman is a place
OF mystery. and he approaches its portals very
much in the spirit Moses did the burning bush.
To him IL Is the stronghold In which the sick
are secure refuge sure and constant where
can be found those capable TO understand and
arrest or mitigate human Ills. There Is balm
In that Gilead; there Is a physician there.
There Is. however, q mail minority In our COM
munity and In all communities which does
not take such an optimistic view OF the hospital
situation. To those people gone to the hospi-
tai has an ominous and funereal ring; II means
the concluding chapter in a tragedy. a mu,ilated
and grewsome corpse,
The hospital is to almost all a sealed book
and It's precincts are guarded with a Jealous
care. A rigid censorship Is observed the sphinx
at the desk is as diplomatic as a Chinese man.
DARN and cunning as a Turkish pasta. To the
inquiry Of one who Is solicitous about his friend
he replies. I am sorry you did not have an OPP
portunity to see him last night, but you know
II was against the rules. However. the opera
ton was a very successful one and the patient
rallied well, but %succumbed to q sinking spell
this morning.
To the hospital governor DR.. Hills paid
his respects at some length. The board Of
governors which controls q hospital. he says.
Is made up of from six TO thirty members. who
hold office practically for life. The individual
governor he described at "A God-like person.
age anywhere between IS and 80 years old.
too scarce for mention of any kind. praise
or blame. An ex-hospital governor is "a rare
as q white blackbird and a dead governor
Is rs scarce as a dead eagle or a dead mule.
When death does remove one its victory Is
not complete. for the board Is self perpetuating
and his counterpart takes his place"
To this board the applicant for q stafY ofloe
must apply. and DR.. Hills said that II was mainly
wire-pulllne and social prestige that won recog-
milton. IL was the governor. he said. who
makes the superintendent. an official for whom
DR.. Hills has considerable respect. Though
the superintendent must be artful enough
to stand in" with the governors he still con-
trives to be an efficient official. II is he who
acts as the buffer between the board OF gov
errors and the stat, or the board and the public
which occasionally asks unpleasant questions
about cases that turn out unfavorably. To
the superintendent comes the hard work Of
the hospital management and 10 him should
be paid the credit. On the whole. said DIR.
Hills. he is a reasonably fair man and not
the tyrant and driver that he Is often consid-
cred. Even the fair trainc nurse didn't cs-
cape the speakers criticism. Useful she il,
he admitted. and ornamental. too. or the chances
are that she could not get a place from the
superintendent. but she declines In useful
she considers herself TOO good for her work
and will attend only those whose social posi-
ton sho approves. Her efficiency in the
hospital. however, he conceded, and approved
Tor the male nurse. the speaker described
him as somewhat chnrlsh and often clumsy:
he carries TOO mucn ballast, tneTe are lew things
he can do that cannot be better done bv the
woman nurse and o few things he does that
hnd better be done by the house surgeon"
4 largs, percentage OF the male trained nurses,
DIR. Hills said, fare addicted 10 the use of drugs.
The orderly. The man Of all work, Is usually
dissatisfied and a kicker. DR.. Hills said.
however, that, IN recent years a number OF
ates down on their luck have attained places
on the stan and thence have achieved promi-
hence in outside medical and surgical work.
Most important of all the hospital posts,
because the one that touches the public most
nearly is the ambulance surgeon. He must
diagnose any kind of disease at once and Judge
OF hand whether the patient Is 10 be admitted
lasts about six months. during which time
he has a varied experience. But DR.. Hills
accused the ambulance surgeon OF an unholy
alliance with the police.
The policeman's club" said he, makes
business Tor the young surgeon who Is in heed
OF skulls to trephine and scalps 10 graft, It
increases his opportunities for clinical exIeri-
ence. For this reason the young surgeon al
ways holds himself ready to be Of assistance
TO his friend. the policeman. who occasionally
is in a little trouble because OF the too liberal
Use OF his club. II Is not an occur
renee for the police officer, the victim of the
club and the surgeon TO stand together be
fore the sergeant's desk in the station house,
the ambulance surgeon being there for a double
purpose TO bind up the wounds of the victim
OF the police bludgeon and TO say q word at
the desk in commentator of his friend. the
policeman. by a~ttesting 10 his good Intentions
and kindness of heart. The man dies i'm his
cell in the night from cerebral hemorrhege.
though the blotter at the desk and tho note in
the hospital surgeons report Of the case both
say acute alcoholism and slight scalp wound. ="
The house staff which does the work of the
hospital is made M Of a medical department
and q surgical department. and in some in
situations of special departments besides these,
The men are chosen by the visiting STAFF. who
may never have seen their faces before their
appointment. through competitive examina-
ton. The senior surgeon has about n yenr's
experience outside Of the medical school, his
assistant half a year. and the junior, perhars,
a month. They cant have more, DR.. Hills
said. because OF the system whereby they are
turned out, after n brief service, TO make room
for others. The hospital is like a merry-go-
round" he said. where new faces are seen in
the saddles every time the gong rings"
He described an emergency surgical ease
at night when the junior surgeon was in charge
Of the hospital. the juniors unavai!ing
| effort to get some one Of the eminent surgeons
, whose names are on the visiting staff list 10
come and operate. and Of the juniors being
visiting staff, appointed by the governors,
he suggested that its usefulness would he
augmented were IL more attainahle in time of
need. At present II takes Cognizance of n case
only when the case is brought 10 lis notice by
the house staff.
I'm some hospitals" he continued. the
visiting staff holds meetings 10 consider tho
advisability Of action in certain cases and
MANY patients have saved tSoir lives or nm
slightly DISAGREEMENT by tho ripe Judgment
displayed In these consultations. II Is rather
Unfortunate that they are going ont and mat
tiers of such moment are intrusted TO the de-
ofafaR nf man xItn haE gn.l g. .,,l