Patient Advocate

I've written about the Mendocino Coast Healthcare District so much and for such a long time that some readers might have leaped to the false assumption that I, too, work in some part of the medical world. That is not the case. Frequent readers will have noticed that my critiques of coast hospital goings on have usually been confined to leadership or administrative failings and financial matters. When the writing ventured into clinical areas, usually it was in response to patient surveys. 

With the coming of Adventist Health, the coast hospital appears to be in more capable hands than it has been in recent memory. With this transition, the Mendocino Coast Healthcare District's Board of Directors will have a more limited purview. Nevertheless, given past performance, I can say that this writer has the utmost confidence in the current president of the board.

This is about as close as I care to come to writing about coast hospital matters at present, other than to wish that one of the healthcare district board members would refrain from spouting his opinion in social media on matters pertaining to the corona virus. There are members of the current coast healthcare district board of directors who work in the medical world. John Redding is not one of those people, so when/if you see him pontificate about Covid-19 on Facebook or elsewhere, consider the source.

But I come not simply to throw dirt on “Petulant John” (PJ) Redding, rather to delve in my family's medical history involving coast hospitals. My mother was a psychiatric social worker, but the closest relative I can think of in the realm of bone setting and disease prevention was one great uncle physician among my Macdonald ancestors. He practiced exclusively on the East Coast, making only one trip to California in his lifetime.

On that paternal side of my lineage, my father and all three of his brothers worked in the woods as did their father, their maternal uncles, and many cousins. Mostly they chopped, meaning they fell trees with axes, handsaws and, later, chainsaws. The mortal dangers inherent in such endeavors remain to this day. A century ago undertakers plied their trade in Albion and Mendocino as well as Fort Bragg and almost every hamlet within shouting distance of a mill or logging camp. In the early decades of the twentieth century Albion and Mendocino each had a thriving hospital.

Once in awhile family members performed logging jobs less safe than chopping. According to a June 13, 1908 coastal newspaper: “John Macdonald, Jr. [my oldest uncle, known in the family as Jack], who works on a skidder at Boyle’s camp, met with an accident on Friday of last week which almost cost him a leg. He slipped on the skidway and a log while in motion caught one of his legs. The flesh was crushed to a pulp and the blood vessels badly injured. No bones were broken but it has required great skill to save the leg. He is at the Mendocino Hospital.”

Left out of the newspaper account was the appearance at the hospital of Jack’s eighteen year old brother, Charlie. The doctor told Charlie that the only way to save Jack (then twenty) from infection, gangrene, and death was to amputate. Charlie insisted the doctor do everything possible to preserve the leg. Charlie made that argument with a Winchester rifle in hand. It was not hunting season, but this accident coincided with his employment at the Albion Lumber Company’s slaughterhouse, about a mile downstream from the Macdonald ranch. Most likely, Charlie was in the field about to dispatch a steer to the slaughterhouse when news arrived of his older brother's dire circumstance. One didn't just abandon a valuable Winchester in a grassy field, so he lugged it with him on the rail and horseback journey to Mendocino.

We'll leave Uncle Jack with his dreadful leg injury, and his brother advocating with rifle in hand, as something of a cliff hanger in order to jump forward in time. I’ve had two surgeries at the current configuration of the coast hospital in Fort Bragg. The first was an appendectomy a quarter century ago on a Christmas Eve. The surgery went well, but lying around unable to urinate or evacuate for days should not be wished on anyone. 

The second surgery, a hernia operation, occurred precisely a decade ago, April, 2010. My surgeon and her staff clearly explained every step of the process before hand. The pre- and post-op nurses at the Mendocino Coast District Hospital (newly re-dubbed Adventist Health Mendocino Coast) were exceedingly attentive. My only complaint about that experience was the pain killing drug prescribed. I took one and threw up violently.

The drug free recuperation must have worked. Thirty-five days after the surgery I toted a forty pound backpack across the Lost Coast for several days. I continued to backpack through the ensuing decade, and much like my forefathers and uncles, have been able to operate chainsaws here at the ranch, though not on the professional level that they labored.

The 2010 operation might have been a harbinger of things to come at the coast hospital. The only part of the process in which Uncle Charlie might come in handy was the billing department. All of the bills related to the experience, until I called the hospital chief executive officer (CEO), arrived without any specifics as to what procedure was being billed.

What happened to Uncle Jack? An August 13, 1908, publication reported: “John Macdonald, Jr., who had one of his legs crushed at Boyle’s camp on June 5 by being caught by a log on a skidway, is rapidly getting well. About 48 square inches of skin fell off from the injured portion of his leg and a delicate job of skin-grafting is being done by Dr. Piersol. A small patch of live skin from another portion of his body is taken and placed on the skinless place and in time it is believed he will have a whole hide.”

Jack Macdonald returned to chopping and working in the woods for decades after, with only an occasional ache in his leg. Uncle Charlie worked in the woods, the slaughterhouse, and eventually the railroad. The position of patient advocate had not been formally developed in 1908.

(More tales of then and now than you can shake a leg at found within the pages of malcolmmacdonaldoutlawford.com.)

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