MY INTERNSHIP and pediatric residency was in a poor section of Chicago, noted for its high rate of drug abuse, illegitimacy, and violence. Knifings and sexual assaults were nightly fare in our emergency room. The corpses we pronounced dead were seldom reported in the daily newspaper. We assumed that if other area hospitals received a like number, they were just too common to be newsworthy.
In back of our well-lighted, well-policed hospital area was
a ring of condemned buildings, black shells with cracked
walls.
Hungry rats and stray dogs poked through the piles of
rubble. Still farther away, there rose a series of stark angular
high-rise apartment buildings.
Each was spaced an equal
distance from the other, and each looked exactly like its
neighbor. They were dark gray, constructed of cement and
steel, and designed for low-income families.
The children of the high-rise buildings received care
through our pediatric emergency room. A mother might wait
for six hours to have her feverish infant seen by a harried
resident.
A different child was examined every five to ten
minutes until the resident was so exhausted that one face
became indistinguishable from the next.
Children were seldom
returned for a recheck and we rarely saw an infant who
was well enough to be given his long-overdue routine immunizations.
Head lice and the crusted sores of impetigo were
common.
After several months of this assignment, physicians
became callous and worked much as if they were checking
parts in an assembly line. Instructions to parents were
curt and little opportunity was given for discussion. We were
unable to stem the rising tide of human misery.
Our department of pediatrics recognized the dehumanization
of this experience. In an effort to reinvest us with charity,
they assigned each resident the care of the children in
one of the high-rise dwellings.
We were to make house calls,
vaccinate, recheck ears, and give well-baby follow-up examinations-
providing the families permitted.
On the first day of my assignment, I approached my tall
gray monolith with misgivings. It was a muggy summer, and
wet sheets hung from open windows.
No nurse backed me up
and no one had requested my services. Placing a few instruments
in the pocket of my white coat, I entered the building
only to find that the elevator was out of order.
Breathless
after climbing six flights of stairs, I paused on the landing to
find myself scrutinized by five small bright pairs of eyes,
none of which were higher than my knee. Here were my
patients, partly clothed, alone and untended on the filthy
floor.
There were no toys and no furniture. A soggy diaper,
several empty cans, and old potato chip bags littered the
floor.