The sun. [volume] (New York [N.Y.]) 1833-1916, 1906-06-03
NEW WORK FOR HOSPITALS.
IT ~ 70 6UIDE PATIENTS 70 THE
RI0HT amor.

tSDeriment IN aaciat aertire W0rk ~ 4
BOatUr Hospital 1faw ~ Step PeSpit
Meuleines NtOne can't tuss worry
ignorance and mad ttathta treated.
BosroN, June s.-tndst Tina nams oi
social aervice work there In being con-
dIctsd At the Massachusetts General Hos
pital, though having no organic connec-
ton with that institution, an experiment
In practical medicine which has no known
parallel In tho world, and which, started
only laat October. Ia considered already IA
have justified liz exlstence and marked out
besides, a line Of development likely 10 I've
followed In greater or less measure by all
hospitals everywhere.
The undertaking originated with Or.
Richard G.. Cabot. one Of the physicians 10
the out patient department Of the hospital
Its object IL TO devise treatment for a very
largo class Of patients whom the hospital
has been unable adequately to relieve be-
cause their maladies werc produced by
worry, ignorance, bad habits and the like,
which could not be reached by drugs or
the surgeons knife but needed right knowl-
edge and conduct on h part Of the pa
tients themselves to eradicate,
Tho treatment has been simply by ex-
pert common sense and friendly Offices to
relieve helplcssness or dispel ignorance,
30 as to allow the patients to regain their
mental or economic equilibrium, and, in
consequence, their bodily health. The per-
SONS who need this help make UP a consider
able proportion Of the cases in the out pa
tent department of the hospital, but until
this service was organized by DR.. Cabot
they had to be turned away or dealt with
perfunctorily.
These sick people had, to use DR.. Cabot's
phrase, been in the wrong pigeon hole.
There are many physical ailments which do
not yield to standard treatment, because
they are really compliments or results Of
bad mental states; they tell stories Of wrong
h~abits-reveal perhaps a skeleton In the
closet.
II the hospital physician, seeking the Be-
cret springs of the trouble, penetrated, as
he had often to do, the intimate life Of a
patient, he was forced at last to halt his
prescription with a shrug Of the shoulders
or a shake Of the head. What Use to go
further2 The hospital could do nothing
for such difficulties.
The poor and the foolish we have with
us always; their struggles and their Stun
blings cannot be helped by medicine. De-
cidedly these people were In the wrong
pigeon hole. Nor did it seem altogether
their fault; helpless patient stood before
helpless doctor.
I'VE are sorry but we cannot do anything
the doctors said In effect. you've come
to the wrong shop; it is not medicine you
want, it's food, advice, education, vacation,
encouragement"
IT. At. n. TAh@k ~z-Is-I 49, IL n->,lN -
to guide patients to the right shop. Where
medicine stopped. he tried to suggest some
thing else.
The task, after an; was to cure, by what
ever means. Dr. Cabot conceives Of the
hospital as an organism capable Of new
powers, growing new organs.
I To be thorough in diagnosis we must
look past the patient, as he stands at the
door asking for medicine, into bis lifeI
his environments, his interests and worries.
The result is a changed outlook Of the hos
pitfalls duties and its opportunities.
In educational matters the newest
catch phrase is: ASend the whole child
to school,; that is, be thorough, consider
the whole nature of the child. The social
service work similarly says in effect: Treat
the whole man when he brings his troubles
to the hospital Not simply the disordered
stomach or the aching head, but all Of the
actual fears and worries which may cause
them, must be studied for diagnosis and
treatment.
With the consent Of the hospital authori-
ties a corner in one of the new buildings
of the out patient department was curtained
of and furnished and a traine nurse was
engaged to interview the patients as they
We're referred there by the hospital
physicians, Each patient came and told
his or her story to The sympathetic at
tendant.
This laboring man, for instance, staggered
under domestic troubles. These could
not be cured, but some of the evil results
were palliated. This young woman, who
had loved not wisely but too well. was saved
from despair or self-violence and, upheld
by sympathy, found herself at last both
mother and wife.
Another girl, taught the rudiments OF
right living, springs up like a flower re-
vived. A babe made i'll by improper feed
ing or neglect Is protected from it's
mothers ignorance by the work Of the
nurse, who instruots the mother as to the
diet and care Of infants. And, lastly, those
patients for whom recovery must be a
long upward climb with special treatment,
too long and too expensive for the Massa-
chusetts General Hospital to undertake or
continue. are sent to other institutions, con-
valesoent homes, &c, which, unguided,
they would never reach.
This, briefly stated, is the social service
work which has been performed for eight
months, so quietly that it is known to but
few people In the hospital itself and to fewer
still outside.
Like other physicians attached to the
Massachusetts General Hospital, DR.. Cabot
has been dissatisfied with the treatment
given to many Of the out patients. TIE
diagnosis Is good, but the treatment Is Fer
functory. This is largely due to the fact
that many patients come to 1t with all
ments which neither medicine nor surgery
can help. A considerable proportion Of the
applicants have no business there. Their
troubles are not primarily physical.
They come TO the hospital because they
are in trouble" says DR.. Cabot, according
to the old liturgical phrase. afflicted or dis
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