WBEZ | Cook County Hospital http://www.wbez.org/tags/cook-county-hospital Latest from WBEZ Chicago Public Radio en Will an iconic hospital emerge from life support? http://www.wbez.org/series/curious-city/will-iconic-hospital-emerge-life-support-109086 <p><p>Like many residents of Tri-Taylor, Dorota Gosztyła hopes her Chicago neighborhood will finally figure out what to do with two city blocks of brick and terra cotta rising up from Harrison Street.</p><p>&ldquo;I find the building to be beautiful, and I think it&rsquo;s a shame that it&rsquo;s just standing here vacant,&rdquo; says Gosztyła, 35. She often glimpses the old Cook County Hospital building while driving on the Eisenhower Expressway (I-290). The hospital&rsquo;s fluted columns soar three stories, lining a facade festooned with classical symbols: cupids, lions, warriors&rsquo; shields.</p><p>&ldquo;When you get a closer look it&rsquo;s a little different. It&rsquo;s definitely run-down. &lsquo;Neglected&rsquo; I would say is the perfect word to describe it,&rdquo; Gosztyła says. &ldquo;It&rsquo;s pretty sad.&rdquo;</p><p>It bothered her enough that she sent Curious City a succinct question about the building that could play a future in her neighborhood:</p><p style="text-align: center;"><em>What will become of the old (and now vacant) Cook County Hospital?</em></p><p>The building, 1835 W. Harrison St., is hard to miss. When it opened in 1914, it had space for 650 patients. Subsequent expansions made it the world&rsquo;s largest medical facility from the 1920s until the 1950s. Among the superlatives it racked up during that time: It was home to the world&rsquo;s first blood bank; Chicago&rsquo;s first HIV/AIDS clinic in 1983;<a href="http://www.wbez.org/content/why-trauma-centers-abandoned-south-side" target="_blank"> the site of the country&#39;s first dedicated trauma center</a>; and in 1973 Dr. Boone Chunprapah became the first doctor to successfully reconnect four severed fingers to a patient&rsquo;s hand.</p><p>While its architectural significance has never been in doubt, the aging structure isn&rsquo;t a sure bet for rehabilitation. New construction now surrounds the site, and it wouldn&rsquo;t be the first time Chicago has demolished a historic building in the name of progress. Gosztyła&rsquo;s question got us talking with people who know the building&rsquo;s history and its potential for redevelopment. The bottom line is that preservationists and county officials seem to agree on this: The building can and should be saved. What remains unclear, however, is just how to do that.</p><p><strong>A landmark on life support</strong></p><p>Before it made medical history, Cook County Hospital was an architectural achievement.</p><p>&ldquo;It is a terra cotta marvel. The building is enormous, at the same time as being very elegant,&rdquo; says Bonnie McDonald, president of <a href="http://www.landmarks.org/" target="_blank">Landmarks Illinois.</a> &ldquo;The mix of brick and terra cotta create a really lovely façade.&rdquo;</p><p>Architect Paul Gerhardt, who designed the building in association with Richard E. Schmidt and Hugh Garden, was known nationally for his hospital designs. Gerhardt also designed Christ&rsquo;s Hospital in Topeka, Kan., as well as Chicago&rsquo;s<a href="http://www.wbez.org/tags/michael-reese-hospital" target="_blank"> Michael Reese Hospital</a>. Cook County Hospital is one of the city&rsquo;s best and largest-scale examples of Beaux Arts architecture.</p><p><img alt="" class="image-original_image" src="http://llnw.wbez.org/styles/original_image/llo/insert-images/RS7395_AP03063004261-scr_0.jpg" style="margin: 5px; float: right; height: 184px; width: 275px;" title="The old Cook County hospital's facade earned the beaux-arts structure landmark status. (AP Photo/Brian Kersey)" />Landmarks Illinois&rsquo;<a href="http://landmarks.org/images/COOK_COUNTY%20HOSPITAL.pdf" target="_blank"> reuse plan</a> for the building makes note of its mansard roof, made with green glazed terra cotta, and other ornamental details. But it also calls attention to the steel frame; the widely spaced columns preserve an open floorplan conducive to reuse. The preservation group&rsquo;s analysis called for turning the building into 320 residential units for medical staff, a 95,000 square foot health and wellness center, ground-floor commercial space, and 150 parking spaces.</p><p>&ldquo;Think about a historic building as a space to accommodate whatever need there is in the neighborhood, because they are highly mutable,&rdquo; McDonald said. &ldquo;You&rsquo;re able to oftentimes take a modern use and put it into a historic building.&rdquo;</p><p>Their recommendation changed slightly when the county demolished the building&rsquo;s three southern wings in 2008 (they were not original to the building,<a href="http://achicagosojourn.blogspot.com/2008/01/cook-county-hospital.html" target="_blank"> but still considered a loss</a> by preservationists). Like<a href="http://www.cookcountygov.com/taxonomy/Capital_Planning/CookCountyHospital_ReuseStudy_1109.pdf" target="_blank"> another study commissioned by the county</a>, they recommended repurposing the building primarily as office space. While the studies concluded modern medical equipment would be too heavy for the building&rsquo;s aging floors, they didn&rsquo;t rule out reuse as a hotel, dormitory, rental housing, senior housing, or educational space.</p><p>&ldquo;Our first and primary goal is to preserve the building,&rdquo; says John Cooke, the County&rsquo;s director of capital planning and policy. But that wasn&rsquo;t always the case. Under Cook County Board President John Stroger&rsquo;s administration, the building&rsquo;s future seemed in doubt. The building closed in 2002, and Stroger called for its demolition while a new hospital bearing his name went up next door. Preservationists and several board members fought the demolition idea, and in 2006 the building landed on the National Register of Historic Places. Four years later the board voted to preserve the old Cook County Hospital building.</p><p><strong>Diagnosis inconclusive</strong></p><p>Until the building is actually occupied again, its future remains uncertain. Cook County officials are waiting for U.S. Equities Realty to recommend future uses and repairs for a slew of county-owned buildings, including the old hospital. Cooke says once the company&rsquo;s report is in, the county will issue a request for proposals to solicit interest from architects and developers &mdash; likely in the spring of 2014.</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/8681326865_54c377cf65_n.jpg" style="height: 206px; width: 275px; margin: 5px; float: left;" title="The remaining portions of the old Cook County hospital lie in the Illinois Medical District, on Chicago's West Side. (Flickr/Josh Koonce)" />The two-block long building could be subdivided into three 185-foot sections for phased development, making it less risky from a financial standpoint. And while the county isn&rsquo;t going to sell the site, Cooke says, it&rsquo;s investigating lease arrangements to encourage private development. That could mean a ground lease, whereby the county sets out what uses and spaces it wants; and a developer pays for improvements to the building, provides said space, and pays an annual fee to the county.</p><p>A<a href="http://www.cookcountygov.com/taxonomy/Capital_Planning/CookCountyHospital_ReuseStudy_1109.pdf" target="_blank"> Jones Lang LaSalle reuse study</a> puts the cost of reusing the building between $103.9 million and $120 million depending on its use. That could be reduced by as much as $50 million through the use of <a href="http://www.wbez.org/series/curious-city/untangling-tifs-108611" target="_blank">Tax Increment Financing (TIF) funds</a> from the Central West district, the study says. Historical preservation tax credits could also offset 20 percent of the total project cost. By contrast, demolition could cost as much as $13.6 million, in addition to the cost of new construction.</p><p>Is that enough to entice developers? Cooke said the County will find out in 2014. But preservationists are eager to see the mothballed building get another chance at reuse.</p><p>&ldquo;The public cares about what is happening to this important resource,&rdquo; McDonald says. &ldquo;So the sooner that we do something, the more we&rsquo;re going to help the community.&rdquo;</p><p><strong>How daunting can it be?</strong></p><p>Now the question is how (not whether) to resuscitate the building.</p><p>Though its presence can be imposing to passersby (including our question-asker, Dorota Gosztyła), the old hospital building isn&rsquo;t too intimidating to architects who specialize in adaptive reuse.</p><p><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/10144070306_d557b76099_b_0.jpg" style="margin: 5px; float: right; height: 199px; width: 275px;" title="Dorota Gosztyła asked Curious City to look into the future of the old Cook County hospital building. The now-vacant beaux-arts landmark will see its 100th anniversary in 2014. (WBEZ/Chris Bentley)" />Joe Antunovich, president of Antunovich Associates, has tackled many such projects. His firm&rsquo;s own office, 224 W. Huron St., occupies the top two floors of a brick building more than 90 years old. In Pittsburgh, the company transformed the dilapidated Armstrong Cork Factory along the Allegheny River into 385 apartments.</p><p>&ldquo;There used to be trees growing out of the windows there. Now, after an adaptive reuse, bringing that beautiful building back, we have 385 apartments there, and now they&rsquo;re the most sought-after apartments in downtown Pittsburgh&rdquo; Antunovich says. &ldquo;So don&rsquo;t tell me that these buildings can&rsquo;t be brought back.&rdquo;</p><p>As for Cook County&rsquo;s old hospital building, he says office space is a strong possibility.</p><p>&ldquo;The old nurses&rsquo; quarters, this old decrepit building, houses the current administration for the state-of-the-art Cook County Hospital system. So if you just swapped that out and cleaned up the old building,&rdquo; Antunovich says, &ldquo;you could have a marvelous front door of the entire Cook County administration.&rdquo;</p><p>Antunovich and others hope any development will celebrate the hospital&rsquo;s history. Gosztyła, our Curious City questioner, suggests a museum dedicated to that purpose. McDonald, of Landmarks Illinois, suggested that a mobile app could spout historical facts to interested visitors.</p><p>One candidate for inclusion is a reference to the old Cook County hospital&rsquo;s role as &ldquo;Chicago&rsquo;s Ellis Island.&rdquo; A quote from Louis Pasteur is inscribed on a hospital wall, evidence of its reputation for welcoming immigrants: &ldquo;One doesn&rsquo;t ask of one who suffers: What is your country and what is your religion? One merely says, You suffer. That is enough for me. You belong to me and I shall help you.&rdquo;</p><p>By spring of next year, Gosztyła and others who wonder about the future of the building could have their answer. It might bring new meaning to those words, &ldquo;I shall help you.&rdquo;</p><p><em><a href="http://cabentley.com/">Chris Bentley</a> is a reporter for WBEZ&rsquo;s Curious City. Follow him at<a href="http://twitter.com/cementley"> @cementley</a>.</em></p></p> Tue, 05 Nov 2013 13:49:00 -0600 http://www.wbez.org/series/curious-city/will-iconic-hospital-emerge-life-support-109086 Reporter’s Notebook: New life for an iconic hospital? http://www.wbez.org/series/curious-city/reporter%E2%80%99s-notebook-new-life-iconic-hospital-108937 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/8681326865_54c377cf65_b.jpg" alt="" /><p><p dir="ltr">Dorota Gosztyła passes by the old, now vacant, Cook County Hospital building on Chicago&rsquo;s near West Side almost every day. Sometimes, from afar, she&rsquo;ll admire the building&rsquo;s architectural details or its size.</p><p dir="ltr">&ldquo;I find the building to be beautiful,&rdquo; Gosztyla says. &ldquo;I think it&rsquo;s a shame for it to be standing here vacant. I just don&rsquo;t get it.&quot;</p><p dir="ltr">So, she asked Curious City what would become of the boarded-up building that sits right off I-290 next to the Rush University Medical Center. Reporter Chris Bentley sets out to find an answer. You can keep track of his progress in his reporter&rsquo;s notebook below.</p><p><iframe frameborder="0" height="650" src="http://cdn.knightlab.com/libs/timeline/latest/embed/index.html?source=0Am-AbC8HDbXMdHZHTkh1Vmp2UkswUHFLSm5pTmlkb0E&amp;font=PTSerif-PTSans&amp;maptype=toner&amp;lang=en&amp;height=650" width="100%"></iframe></p></p> Wed, 16 Oct 2013 10:37:00 -0500 http://www.wbez.org/series/curious-city/reporter%E2%80%99s-notebook-new-life-iconic-hospital-108937 Cook County Hospital makes history http://www.wbez.org/blogs/john-r-schmidt/2013-03/cook-county-hospital-makes-history-106011 <p><p>Cook County Hospital (<em>aka</em> Stroger) sometimes gets a bad rap. It&rsquo;s often forgotten that the hospital has a distinguished history. One important event in medical treatment took place there in 1937. The subject was blood.</p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/3-15--Jeff%20Dahl%20photo%2C%20Wikipedia%20Commons.jpg" title="Cook County Hospital (Jeff Dahl photo, Wikipedia Commons)" /></div><p>By the turn of the 20th Century, medical science had learned much about working with blood. Transfusions were becoming common. But blood will go stale after a while. If a patient needed blood, a live donor had to give it, directly and immediately.</p><p>Could blood be stored for longer than a few hours? Researchers worked on that problem for decades. During the early 1930s, Russia was able to set up a network of blood depots, where patients could have access to preserved blood. This interested Dr. Bernard Fantus.</p><div class="image-insert-image "><img alt="" class="image-original_image" src="http://www.wbez.org/system/files/styles/original_image/llo/insert-images/3-15--Dr.%20Fantus%20%28Smithsonian%20Institution%29.jpg" style="width: 255px; height: 382px; float: right;" title="Bernard Fantus. M.D. (Smithsonian Institution)" />Fantus was a Hungarian-born physician who had earned his M.D. at the University of Illinois. He became director of therapeutics at Cook County Hospital in 1934. In his new role he began a series of experiments on how to increase the storage time for blood.</div><div class="image-insert-image ">&nbsp;</div><div class="image-insert-image ">Using refrigeration and various additives, Fantus was able to preserve blood for up to ten days. Early in 1937 he made plans to open the Blood Preservation Laboratory at County.&nbsp;</div><div class="image-insert-image ">&nbsp;</div><div class="image-insert-image ">But he didn&rsquo;t like that name! Sure, it described the work that was going on at the new facility. Trouble was, calling it the &ldquo;Preservation Laboratory&rdquo; made it sound like something out of a Dracula movie.</div><div class="image-insert-image ">&nbsp;</div><div class="image-insert-image ">America was in the middle of the Depression. Saving was on everyone&rsquo;s mind. After some rough times, banks were starting to rebound. With that idea in mind, Fantus decided to call his facility the Cook County Hospital Blood Bank. It opened on this date 76 years ago&mdash;March 15, 1937.</div><div class="image-insert-image ">&nbsp;</div><div class="image-insert-image ">A few months later Fantus published an article on the blood bank in the <em>Journal of the American Medical Association</em>. Other hospitals adopted the idea, and it spread world-wide.&nbsp;</div><div class="image-insert-image ">&nbsp;</div><div class="image-insert-image ">Bernard Fantus died in 1940. Today the out-patient clinic at his hospital is named the Fantus Health Center.</div><div class="image-insert-image ">&nbsp;</div></p> Fri, 15 Mar 2013 05:00:00 -0500 http://www.wbez.org/blogs/john-r-schmidt/2013-03/cook-county-hospital-makes-history-106011 Cook County begins enrolling 250,000 new Medicaid recipients http://www.wbez.org/news/cook-county-begins-enrolling-250000-new-medicaid-recipients-103902 <img typeof="foaf:Image" src="http://llnw.wbez.org//main-images/Dr Raju Headshot 2012.jpg" alt="" /><p><p>This week Cook County will start sending letters to about 115,000 of its low-income residents inviting them to enroll in the county&rsquo;s new Medicaid program.</p><p>Adults under 65 with an income of up to 133% of the <a href="http://aspe.hhs.gov/poverty/figures-fed-reg.shtml">federal poverty level</a> will be eligible for Medicaid beginning in 2014 in states that choose to participate in the Affordable Care Act Medicaid expansion.</p><p>In Cook County, the expanded eligibility will begin even sooner, in January 2013. Cook County applied for and received a federal waiver to let the law kick in a year early.</p><p>&ldquo;We are excited not only because we got the waiver, we also get an opportunity to transform our healthcare system into the way it should be,&rdquo; said Dr. Ram Raju, CEO of Cook County Health Services.</p><p>The new Medicaid program, called County Care, will operate on a &ldquo;medical home&rdquo; model - which means the county&rsquo;s patients would have a doctor, a nurse, a social worker, and a medical assistant assigned to manage their health care.</p><p>&ldquo;What we do in the old model is, if you come through the door, you are my problem, I&rsquo;ll treat you well, I&rsquo;ll give you prescriptions. Then, you are not my problem until you come back next time six months later,&rdquo; said Dr. Raju. &ldquo;In the medical home model, even when you go home, you are still my responsibility.&rdquo;</p><p>To begin enrollment County Care, the county plans to reach out to every single eligible person currently on its books.</p><p>&ldquo;It&rsquo;s a massive task, because it is a lot of people we need to reach within a short period of time,&rdquo; said Dr. Raju. &ldquo;But one good advantage is that most of the people are already in our system.&rdquo;</p><p>A total of about 250,000 people in Cook County are probably eligible for County Care, but the county first plans to make contact with those who have already come through the Cook County system or one of its community health centers. After Nov. 26, low-income adults who are not already on the books will be able to call to find out whether they are eligible.</p><p><strong>County Care to provide mental health and substance abuse services</strong></p><p>Medicaid is generally administered by states, but the federal waiver offered under Obamacare allowed counties to apply to create Medicaid programs jointly operated by the county and the federal government. The costs of the expanded coverage under County Care bypass the Illinois&rsquo; <a href="http://will.illinois.edu/news/spotstory/ill.-house-votes-to-slash-medicaid-funding/">fiscally rocky Medicaid system</a>&nbsp;&ndash; they&rsquo;re split between the county and the federal government.</p><p>Come 2014, eligible people will be able to leave County Care and enroll in Medicaid through the state of Illinois. County Care patients are required to go to a provider within the county&rsquo;s network of hospitals and affiliated Federally Qualified Health Centers, whereas recipients of state Medicaid can go to any doctor that accepts Medicaid.</p><p>But Dr. Raju said he hopes that by then, they will want to choose County Care. In addition to setting up patients in a &ldquo;medical home&rdquo;, County Care will provide mental health and substance abuse services, which Illinois Medicaid currently does not cover. The lack of mental health services in the region has been a topic of <a href="http://www.wbez.org/news/dart-%E2%80%98we%E2%80%99re-criminalizing-mental-health%E2%80%99-102218">ongoing controversy</a>.</p><p>&ldquo;If there are substance abuse issues, we do not want them to get lost in the system,&rdquo; he said. And he thinks the medical home model should be in use around the country. &ldquo;We believe that is the future of the healthcare delivery model in this country.&rdquo;</p></p> Mon, 19 Nov 2012 00:00:00 -0600 http://www.wbez.org/news/cook-county-begins-enrolling-250000-new-medicaid-recipients-103902 Why trauma centers abandoned the South Side http://www.wbez.org/content/why-trauma-centers-abandoned-south-side <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-October/2011-10-12/Ambulance_Getty_Kevork Dejansezian.jpg" alt="" /><p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/11Countyward35.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 320px; height: 187px;" title="Before the advent of trauma centers, injured patients would be admitted to open wards like this one. (David Goldberg and Gordy Schoff, courtesy of David Ansell)">Trauma centers take care of the most critically injured people. Car crashes, stabbings and gunshots are the most common wounds that require trauma care. Chicago is served by six trauma centers sprinkled around the city and nearby suburbs – but none is on the city’s South Side. Community members, activist groups and politicians have long suspected that the dearth of trauma centers in that part of town means the area is under-served.</p><p>A <a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012">WBEZ analysis</a> suggests that when it comes to ambulance run times from the scene to trauma centers, there are disparities. Put simply, patients living on the Southeast Side face longer ambulance run times than other residents in the city. Specifically, they have to travel an average of <a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#MAP">50 percent longer </a>to get from the scene of an emergency to a trauma center. More than half of the trauma-related ambulance runs that originate in that part of town exceed 20 minutes, which is considered a professional standard within the city. Those neighborhoods include Hyde Park, Woodlawn, Pullman, South Shore and the Southeast Side.</p><p>In this, WBEZ’s second part in a series on trauma care in Chicago, we look at why such a large swath of Chicago is without a dedicated adult trauma center.</p><p><a href="http://www.wbez.org/tags/chicago-trauma-series" target="_blank"><img alt="" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-12/trauma-in-chicago-promo.jpg" style="margin-right: 10px; margin-top: 10px; margin-bottom: 10px; float: left; width: 280px; height: 63px; " title=""></a></p><p><strong>A new approach at Cook County Hospital</strong></p><p>Health experts say to understand the layout and makeup of the city’s current regional trauma center network, one should start with a short history lesson. Trauma care has deep roots in Chicago; in fact, the city is considered the home of the country’s first dedicated trauma center, which opened at Cook County Hospital in the mid-1960s.</p><p>David Boyd came to the hospital to run the trauma center in 1968. He said before 1966, trauma service at County was a mess; people waited hours for surgery and were sometimes sent to the wrong surgical specialist.</p><p>“We were treating it on Ward 61 tonight then Ward 62 the next night, and where’s Dr. Jones? We can’t find somebody, and it was just this mini-catastrophe organizationally, and we just didn’t have the people to do it,” Boyd said.</p><p><a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#MAP"><img alt="" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/map-promo.jpg" style="margin-right: 15px; margin-top: 15px; margin-bottom: 15px; float: left; width: 300px; height: 190px;" title=""></a>Then a couple of the hospital’s surgeons devised a new model for treating the critically injured. It meant consolidating services in one area – the third floor of Cook County Hospital. Surgical staff was ready, equipment was on the spot and specialists were on call. This was a nascent trauma center.</p><p>Boyd said it was an immediate success.</p><p>“It was a conceptual paradigm change,” Boyd said. “It’s not something you had to explain to somebody it just was– everybody got the gestalt right off the bat. You had to be pretty thick-headed, blind or something not to see that this was different. And not only different, but a heck of a lot better.”</p><p>Boyd eventually used Cook County Hospital’s concept to establish trauma centers around Illinois and, later, he built the first-ever trauma network. This model was replicated across the country, and Boyd went to Washington, D.C., to implement it for the federal government.</p><p><strong>Beyond County Hospital: Chicago establishes trauma network</strong></p><p>Chicagoans are currently served at six trauma centers: four lie in the city and two are in nearby suburbs. Ambulances sometimes deliver Chicagoans to other suburban trauma centers outside the network, but only under certain circumstances. That figure – six – is revealing because there was a time when many hospitals clamored to build trauma centers of their own.</p><p>Creation of Chicago’s own <a href="http://www.wbez.org/story/trauma-patients-southeast-side-take-more-time-reach-trauma-centers-93012#CENTERS" target="_blank">trauma network</a> got underway in the mid-1980s. A city ordinance mandated trauma patients be treated at trauma centers. About 20 hospitals applied.</p><p>Gary Merlotti, a trauma director at Mt. Sinai Hospital, helped set up the city’s network. He said at the time, health professionals considered trauma centers “good business” and thought trauma centers would attract prestige, patients and dollars. The phenomenon was called “trauma creep.”</p><p>Merlotti said it only took six months for hospitals to realize that “trauma creep” doesn’t really happen.</p><p>“We’re gonna get a fair number of severely injured people with a fair number of uninsured patients,” Merlotti said. “They began to lose money and they began to lose interest in providing trauma care.”</p><p>Hospitals quickly started to drop out of the network.</p><p>A prominent example — and one raised by activists through the present day — is the University of Chicago. It opened its trauma center in 1986, but closed it in 1988 after hemorrhaging $2 million a year. At the time doctors said a majority of patients had no health insurance.</p><p>Stephen Weber, the hospital’s current chief medical officer, wasn’t around to see the closure in 1988, but cites other benefits the U of C hospital system provides.</p><p>“I think that the pride we feel around our pediatric surgery and trauma program is all encompassing,” Weber said.</p><p>The hospital said it’s made tough choices about where to spend money on specialty health care. The upshot is that the University of Chicago has maintained a trauma center for children, but not adults.</p><p><strong>Support for trauma care evaporates</strong></p><p>The U of C’s departure was part of a cascade of hospitals pulling out: Weiss on the North Side; Loyola on the West Side (although it’s still a trauma center, it’s not part of Chicago’s trauma network); and Michael Reese Hospital on the South Side. That meant the only center left to serve Chicago’s South Side was at Advocate Christ Hospital in southwest suburban Oak Lawn.</p><p><img alt="" class="caption" src="http://llnw.wbez.org/story/insert-image/2011-October/2011-10-11/RS4387_P1090014-scr.JPG" style="margin: 10px; float: right; width: 310px; height: 233px;" title="Advocate Christ Medical Center in suburban Oak Lawn accepts trauma patients from Chicago's South Side. (WBEZ/Gabriel Spitzer)">Merlotti said doctors needed to rejigger things to share the burden. People were afraid the whole trauma center system would unravel and Advocate Christ would be the next domino to fall.</p><p>“It would have put Christ in a position where it was not able to provide any services besides a trauma,” he said. “The volume they were seeing was already straining the emergency department and the capacity in the intensive care unit. This would have represented at least a two-fold increase and would have put them underwater.”</p><p>So they regionalized the network in such a way that Advocate Christ and the centrally-located centers (Mt. Sinai, Stroger and Northwestern Memorial Hospitals) agreed to divvy up the stream of South Side trauma patients. Merlotti said the current system works well, but he still wishes the University of Chicago would reenter the trauma center fold. He said it’s the South Side hospital that’s best equipped to take on the financial burden of trauma care.</p><p>The university has clearly stated that’s not going to happen. Instead, it’s focusing on other care specialties such as its burn unit.</p><p>WBEZ summarized findings on trauma-related ambulance run times and discussed them with university staff. They said the school ran its own numbers and concluded the South Side doesn’t need another trauma center.</p><p>“We’re blessed with some great trauma centers,” said Steven Weber. “As it exists right now, there’s not one of those that’s physically located on the South Side. In terms of whether that creates a disparity in outcome, there’s really not evidence. But happily for the patients that are affected —&nbsp;whether it’s a penetrating injury or blunt injury —&nbsp;it’s comforting and reassuring to know that they do have access to expert care within a short period of time.”</p><p>In the final installment of WBEZ’s series on trauma care in Chicago, we’ll take a closer look at whether disparities in ambulance run times affect patient health or survival.</p></p> Wed, 12 Oct 2011 10:00:00 -0500 http://www.wbez.org/content/why-trauma-centers-abandoned-south-side Poet Garin Cycholl traces Chicago’s western boundaries http://www.wbez.org/story/poet-garin-cycholl-traces-chicago%E2%80%99s-western-boundaries-91489 <img typeof="foaf:Image" src="http://llnw.wbez.org//story/photo/2011-September/2011-09-02/old Cook County Hospital_Flickr_John Iwanski.jpg" alt="" /><p><p>Poet Garin Cycholl is fascinated by America’s western edge. In his work he often finds himself asking: Where does one draw the line, and mark down the western-most border of the United States?</p><p>“Is it California? Hawaii or Alaska?” Cycholl remarked in <a href="http://www.chicagoflame.com/features/english-professor-garin-cycholl-and-the-boundaries-between-professor-and-person-1.1294408">a 2009 interview</a>. “The most western U.S. aircraft carrier in the Indian Ocean? The most remote Wal-Mart in western China?”</p><p>The Decatur, Ill. native has been known to apply a similar set of queries to his home state.</p><p>His first book, <em>Blue Mound to 161</em>, (Pavement Saw Press 2005) was a book-length poem on “geological and historical displacements in Southern Illinois.”</p><p>Now on the creative writing faculty at the University of Chicago, Cycholl has turned his focus to the city - and to some of its most problematic landmarks.</p><p>In his book-length poem <em><a href="http://www.moriapoetry.com/bonegathebook.pdf">The Bonegatherer</a></em>, (Moria Poetry 2011) Cycholl examines the geographic and social borders of Chicago’s West Side through the history of Cook County Hospital:</p><p>&nbsp;</p><p style="margin-left: 40px;">where does “West Side” begin?</p><p style="margin-left: 40px;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; at the Circle</p><p style="margin-left: 40px;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; at Racine</p><p style="margin-left: 40px;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; at Western</p><p style="margin-left: 40px;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; at Central</p><p style="margin-left: 40px;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;in County’s waiting room</p><p>&nbsp;</p><p>The hospital is known for providing coverage to some of Chicago’s poorest residents, and Cycholl’s father worked as a medical student there in the mid-1960's.</p><p>Cycholl writes about the hospital and its spaces – its waiting rooms and examination rooms – in terms of the people who pass through its doors, but also in terms of its place in Chicago’s literal and historical landscape:</p><p>&nbsp;</p><p style="margin-left: 28pt;">terminus of dis-</p><p style="margin-left: 28pt;">placement, suburb</p><p style="margin-left: 28pt;">of Mississippi</p><p style="margin-left: 28pt;">&nbsp;</p><p style="margin-left: 28pt;">historically, the</p><p style="margin-left: 28pt;">spaces defining “West</p><p style="margin-left: 28pt;">Side”</p><p style="margin-left: 28pt;">&nbsp;</p><p style="margin-left: 28pt;">&nbsp;County Hospital and</p><p style="margin-left: 28pt;">&nbsp;“the riots”</p><p style="margin-left: 28pt;">&nbsp;</p><p style="margin-left: 40px;"><em>but why not prairie</em>?</p><p style="margin-left: 40px;">&nbsp;</p><p><em>The Bonegatherer</em> is available <a href="http://www.moriapoetry.com/bonegathebook.pdf">here</a> in its entirety, but I recommend listening to Cycholl’s reading of the first section of the poem. You can hear his rendition in the audio above.</p><p><em><a href="../../series/dynamic-range">Dynamic Range</a> showcases hidden gems unearthed from Chicago Amplified’s vast archive of public events and appears on weekends. Garin Cycholl read at an event presented by <a href="http://www.universeofpoetry.org/">UniVerse of Poetry</a> in April of 2010. Click <a href="../../episode-segments/chicago-poetry-cram-chicago-public-library-poetry-fest">here</a> to hear the event in its entirety.</em></p></p> Fri, 02 Sep 2011 20:35:00 -0500 http://www.wbez.org/story/poet-garin-cycholl-traces-chicago%E2%80%99s-western-boundaries-91489 'Life, Death and Politics' treating Chicago's uninsured http://www.wbez.org/story/2011-06-16/life-death-and-politics-treating-chicagos-uninsured-87930 <img typeof="foaf:Image" src="http://llnw.wbez.org//npr_story/photo/2011-June/2011-06-16/county_frontcover-123kb_custom.jpg" alt="" /><p><p>The first time Dr. David Ansell went into the men's room at Cook County Hospital in Chicago, he immediately ran out. "It was so bad, I couldn't use it," he says. "I ran across the street and had to use the bathroom there. It was quite an introduction to my first day at County."</p><p>Ansell is now the vice president for clinical affairs and chief medical officer at Rush University Medical Center. But he began his medical career in 1978 at County, Chicago's public hospital, where he worked as an attending physician for almost two decades. His social history of the hospital, <em>County: Life, Death and Politics at Chicago's Public Hospital</em>, details his own time on the wards — and examines health care in America from the perspective of the uninsured.</p><p>Working at County, Ansell says, made him realize just how much the current payment system drives health care inequalities. "There's a misunderstanding that if you just go to the [emergency room], that's health care," he says. "It's not. ... And I don't think the public or politicians really understand that. I think the last health reform attempt which is being bandied about — we don't know what's going to happen — is likely to fall short with regards to equity."</p><p><strong>Doctors Within Borders</strong></p><p>Cook County Hospital, where Ansell worked, was a public hospital, a place that treated people with nowhere else to go. Physicians and residents who worked at County, meanwhile, were entering an environment with underfunding, mismanagement, high patient demand, safety concerns and antiquated equipment.</p><p>"I went into medicine because I wanted to help people, and when I went to medical school, I found it very disillusioning," Ansell says. "County was a place that many of us went because we believed that disease had social etiologies — the idea that disease just emanated from the individual and wasn't somehow constrained or influenced by societal factors. Going to a place like Cook County Hospital was a place where we could live those beliefs out."</p><p>Health care at County was very different from care at private or university hospitals. When Ansell first started treating patients, County had no air conditioning, poor sanitation and limited patient privacy. "The beds were lined up one after another, separated by curtains, but there was really no privacy," he says. "Patients would roll in and they'd be lined up around the walls of this one room, and the middle was lined with stretchers and wheelchairs. You were forced to take histories and examine patients under these conditions."</p><p>In 2002, a new hospital called the John H. Stroger Jr. Hospital opened in Chicago, replacing Cook County. The facility provides more dignified conditions for patients. But the new facility, Ansell says, cannot compensate for social inequalities and limited access to preventive health care.</p><p>"Just yesterday I had a conversation with a physician [who] says there's a many-months wait to see the eye doctor," he says. "There are 4,000 patients waiting to get a colonoscopy. This is not a screening colonoscopy — they've got blood in their stool. ... The new hospital and the doctors and the nurses and the clinics are spectacular, [but] if you look at the whole system and you look at the outcomes we're getting ... people are going blind waiting to see the eye doctor, in a country where it doesn't have to be."</p><p><strong>Health Inequalities</strong></p><p>On the South Side of Chicago, the life expectancy of an African-American male is eight years lower than that of a Caucasian man, Ansell explains.</p><p>"When you look at the reasons for it, at least half of this is [because of] heart disease and cancer and things that could be treated," he says. "One of the problems with our current system is segregating people by insurance status, which ends up limiting the options of care — especially when you get down to the specialty care that people need."</p><p>During his 17 years at Cook County, few if any of Ansell's patients could get their hips replaced — or other medically necessary but not trauma-related treatments.</p><p>"The only fair way to do this is where people have a card that gets them in, where that card is accepted widely and broadly by everyone, and [giving people] choice," he says. "So you could go anywhere you want, you get the care you want, and choose your own doctors — and that would be some sort of universal plan — Medicare for all, single-payer. We need a system that really gives patients — poor or rich — adequate care." <div class="fullattribution">Copyright 2011 National Public Radio. <img src="http://metrics.npr.org/b/ss/nprapidev/5/1308234722?&gn=%27Life%2C+Death+And+Politics%27+Treating+Chicago%27s+Uninsured&ev=event2&ch=1033&h1=Fresh+Air+Interviews,Nonfiction,Author+Interviews,Books,Health+Care,Interviews,Arts+%26+Life&c3=D%3Dgn&v3=D%3Dgn&c4=137109975&c7=1033&v7=D%3Dc7&c18=1033&v18=D%3Dc18&c19=20110615&v19=D%3Dc19&c20=1&v20=D%3Dc20&c21=13&v21=D%3Dc2&c31=125637934&v31=D%3Dc31&c45=MDA0OTc2MjAwMDEyNjk0NDE4OTI2NmUwNQ001"/></div></p></p> Thu, 16 Jun 2011 11:01:00 -0500 http://www.wbez.org/story/2011-06-16/life-death-and-politics-treating-chicagos-uninsured-87930 New book covers 30 years of history at Cook County Hospital http://www.wbez.org/episode-segments/2011-05-31/new-book-covers-30-years-history-cook-county-hospital-87220 <img typeof="foaf:Image" src="http://llnw.wbez.org//segment/photo/2011-May/2011-05-31/Cook County Hospital_Academy Chicago Press.jpg" alt="" /><p><p><a href="http://countythebook.com/author-bio" target="_blank">David Ansell</a> is Chief Medical Officer at Rush University Medical Center and he also sits on the board that oversees the <a href="http://www.ccbhs.org/" target="_blank">Cook County Health and Hospitals System</a>. But in the late 1970s, he was a young doctor looking for a place to make a difference.<br> <br> Cook County Hospital then had a reputation for being dirty, dangerous and understaffed. So, that’s where he went to work.<br> <br> <em>County: Life, Death and Politics at Chicago’s Public Hospital</em> covers 30 years of hospital history beginning with Ansell's internship. In it he explores how America’s big fights over health and equality have played out in the gritty halls of Cook County Hospital. Ansell recently sat down and spoke with WBEZ's Gabriel Spitzer.<br> <br> Ansell will also be appearing at the <a href="http://www.chicagotribune.com/entertainment/books/printersrowlitfest/" target="_blank">Printer’s Row Lit Fest</a> on Sunday, June 5.</p></p> Tue, 31 May 2011 14:01:00 -0500 http://www.wbez.org/episode-segments/2011-05-31/new-book-covers-30-years-history-cook-county-hospital-87220