Moving from "not me" to the courage and love of solidarity

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Jan 27 2018
Dan Lichtenstein-Boris

I am writing to ask you to join me in building a movment for respect and dignity and the human right to health and sanctity of life.

I moved back to LA on Labor Day weekend, after more than six years (again) in Chicago.  It was my second weekend in LA—Saturday, September 9th.  I had just left a meeting of Democratic Socialists of America's healthcare committee when I encountered a hospital patient half naked in a wheelchair, medical bracelet strapped around his left arm, dying on the sidewalk in the late summer heat wave.

I joined the Healthcare Committee because I support the human right to health.  If we let our neighbors die, if we turn our heads to others suffering, it is only a matter of time before we become callous, hardened, cold, and indifferent.  We roll up our windows; everything is fine, as long as it happens to “not me.”  Instead of shirking from attacks on our sisters and brothers, we must meet cruel and barbaric resource deprivation, the medieval-like siege of urban minority and working-class communities, with the courage and love of solidarity.  If we don’t stop it, "not me" quickly turns into "your next."

I had just returned from Chicago, which for the entire 21st century under Daley and Emanuel, has been demolishing public housing, closing health clinics, and shuttering community schools.  This process is what gubernatorial candidate Chris Kennedy calls a “strategic gentrification plan” to ethnically cleanse African Americans and people of color from the city by tearing neighborhoods apart and shuttering vital public services.

We had been picketing and rallying against health clinic closures for over a decade.  First it was the school based health clinics in the shadows of half demolished boarded up public housing high rises.  Then it was closing county health clinics and laying off skilled nurse practitioners.  After that, it was mental health.  In 2012, a group of patients and activists occupied the Woodlawn Mental Health Clinic before it closed. The city called a SWOT team to restore law and order.  I remember that undercover agents ultimately framed a few Florida activist kids who hung around as terrorists.  The NATO 5.  They showed up on a frigid damp morning in early April to our encampment across from the boarded up mental health clinic wearing shorts and flip flops.  They arrived in Chicago to protest NATO and support the fight against endless war abroad and austerity at home.  Some undercover agents got them high and drunk and later locked them up after goading them into talking like they were tough guy activists.  What a con.

 
In 2012 the city closed six mental health clinics and two non-profit providers shut down as well.  Three years later, I worked with therapists and social workers to save another clinic network from shuttering on Chicago’s north side.  Unlike the south side clinics, we were successful this time. The clinic employed 300 therapists and served 10,000 clients.  

When I got to LA, I noticed homeless camped under every freeway.  There was a Hepatitis outbreak because between 50 and 100,000 homeless in the city had no access to basic sanitation, no running water, no showers, no where to piss or shit.  No one lets you use their restroom around here.  
 
They camp out on the same streets that movie stars and media moguls would drive down in their luxury vehicles, porches, teslas, jaguars, lexuses and convertables.  There are three or four souls I see struggling to survive on the sidewalk everyday walking to my car before and after work.

After the DSA healthcare meeting on September 9th I went to the Ralphs grocery store on 3rd and Vermont.  I noticed a middle aged white man in a wheelchair near the entrance to the parking lot, his shorts around his knees, exposing himself to the general public, with only one left shoe, his right foot swollen with yellow toe nails that seemed as if they were about to fall off.  His hands and arms were also severely swollen, and what appeared to be two hospital wristbands on his left arm seemed to be almost cutting off his circulation. 

After getting groceries, I approached him to give him a banana and a bottle of water—it was a hot day.  The man was semi-lucent, he said he had been discharged from a nursing home on our about the 24th of August, supposedly for fighting other residents, and had been staying on the street ever since.  He had repeatedly sought care at a hospital, but they refused to give him a social worker or care coordinator, and he was sleeping on the street.  He had social security disability, he told me, he was insured, but no one would care for him.  People had robbed him, taken his medicine, and beaten him while he sat helpless in the wheelchair all night, defenseless.  I said I had to go, but I’d be back and asked him his name, which he told me. He told me I had to come back, or he would die.

 I returned 15 minutes later.  The banana was on the ground and he hadn't touched the water.  First, I googled the nursing home.  I called them.  A woman answered timidly, and said he had been discharged to the hospital some 15 days before.  There was nothing she could do.  Call 911.  I called 911.  The operator asked me to ask the patient any health problems he had.  He said he had gout in his left hand, and suffered from seizures at night.  The LA fire department soon arrived, and I waved them down.  They thanked me for my help.  One fireman mentioned that it was the 3rd time that week that they had taken him to the Emergency Room.  He had a pained look on his face.  We’ve got it from here, he said.  Thank you for your help.

I ended up googling patient dumping that night.  I left a message on the city attorney’s patient dumping hotline.  No one called me back.  A few days later I called again in the daytime.  I ended up speaking with a lawyer who had prosecuted several hospitals.  They’ve been doing it for years.  Reimbursement rates are so low, they would rather risk killing a few mentally ill patients by abandoning them on the street than pay the cost of uncompensated care.  I went on a date with a nurse in Santa Monica.  She told me medical center in posh Beverly Hills was notorious for patient dumping.  ER Nurses are told to falsify the medical records and if someone comes, refer them to the hospital's management.

And it turns out the hospitals do get away with it.  The lawyer referred me around, and nothing happened.  I called back several times, and wrote emails to follow up over the next two months.  The LAPD had to open an investigation, they said, but they couldn’t find the victim.  So no investigation, no prosecution, no trial, no discovery.  Nothing.  The attorney was helpful, he gave me a list of regulatory agencies, other places to report the medical center.  Shortly before New Years Eve someone from the California Department of Public Health called me.  She was going to the hospital to ask them questions and to see if they violated the law.  She would call me to let me know if she found anything.

She called me a week later.  She had gotten “their side of the story” and called to tell me no laws had been broken.  I asked if she talked to the LA fire emergency personnel who had transported the patient.  She said they were under no obligation to talk to her.  Obviously, I thought, the employees of the hospital are going to say what the hospital told them to say.

This is the brutality and cruelty of this broken system, a place where we dump mentally ill on the street to die, because our employers don’t want to bear the costs of uncompensated care.  Are we so indifferent to dehumanize and let die complicated difficult patients?  Just like Nuremberg, “just following orders” does not wash away our guilt.  We need to fix this broken system.  And we need Medicare for All.

 Dan Lichtenstein-Boris, MPH, is a former member of Chicgo Single-Payer Action Network. During his time in Chicago he worked with National Nurses United and SEIU Local 73, and participated in the Chciago Jobs with Justice Solidarity Committee, among other activities.

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