Disabled patients losing hospital they call homeCook County budget cuts will break up a close-knit community and place the severely impaired people in area nursing homes
Wednesday, May 30, 2007
by Judith Graham
The long-term care unit at Oak Forest Hospital is where Glenn Wise, a former tough guy and addict, learned to sympathize with others after a street shooting left him largely paralyzed.
It's where Lisa Townsend, crippled by a progressive neurological disease, realized she loved crafting ceramics and harbored artistic inclinations she'd never explored.
And it's where Artemio Garcia, who was shot in Chicago after immigrating from Mexico, relinquished his rage, rediscovered hope and encountered a new dimension of human experience.
Now Cook County plans to close the unit in which they live. All 220 patients–quadriplegics, gunshot wound victims, stroke survivors–are to be sent to nursing homes by Sept. 1.
For the county, it's a cost-cutting move, part of ongoing upheaval in its health-care system, of which Oak Forest is a part. But for the profoundly ill and impoverished residents, it means the dissolution of a close-knit community and the end of a way of life.
"The people here, it's like we've been raised together on the handicapped life," said Garcia, 40.
"We all help each other—physically, mentally, emotionally," echoed Wise, a large, garrulous man who's lived in the hospital for 18 of his 46 years.
Going to nursing homes is a frightening prospect for these men and women, who are used to shooting the breeze with one another, zipping around Oak Forest's sprawling facilities in their electric wheelchairs, spending hours in the crafts room, and watching movies shown twice a week in the auditorium.
"I'm afraid I won't be able to do the things I do here or get the same assistance," said Townsend, 42, her hands clasped in her lap, her face pinched with anxiety.
In nursing homes, most of the residents will be elderly people at the end of their lives, many with memory problems or dementia. But many of Oak Forest's middle-aged patients are mentally sharp and eager for connection, said Gina Alessia, a longtime hospital nurse.
"I never see myself in a place like that," said Garcia, who visited a nursing home recently to see what it was like. "Mostly they are old people who look sad—not like the people here."
Also at Oak Forest, doctors are on site round the clock and emergency help available within minutes. At nursing homes, that kind of medical attention won't be available, warned Dr. Srinivas Jolepalem, a physician at the hospital and a vocal critic of the county's budget cuts.
"I don't know how I'll survive when I have to leave," said Wise, who is prone to seizures, bedsores, bladder spasms and sudden, life-threatening spikes in his blood pressure.
The rationale for closing Oak Forest's long-term care unit is financial.
"We're facing a $130 million budget deficit" and nursing homes are a much cheaper alternative, said Don Rashid, spokesman for the county health system. Officials estimate the county will save $31 million annually by shutting the unit—a move that requires state approval, still pending.
To ease the transition, the county is providing referrals to private medical facilities. Garcia's status is especially perilous; he and about 30 other seriously disabled patients aren't U.S. citizens. Although the county has paid for them until now, officials won't guarantee future financial support.
In a statement, the county said it is seeking proposals from private medical facilities to look after this group. But it also noted that "whether Cook County will pay for the care of non-naturalized immigrants is a decision that will be made by elected officials."
If public support evaporates, nursing homes are unlikely to accept the immigrants as charity cases, and they may be returned to their native countries.
But poor families in Mexico and Poland aren't prepared to handle patients' needs and "they will sit at home, without any treatment," said Horacio Esparza, a director at the Progress Center for Independent Living in Park Forest. "If they send [the patients] back, they will die."
Oak Forest Hospital is the only home Garcia has known for 16 years. After growing up as an only child on a farm, Garcia crossed the border at age 21 with a friend and a dream of starting his own band. A year and half later, gang members shot him in the neck while he walked to a store at night—a case of mistaken identity, Garcia says.
Paralyzed in a new country, without family, he despaired.
"I ask God, 'why did you let me come here for this?' " Garcia said recently, sitting in his electric wheelchair. "No answer."
At Oak Forest, psychologists and social workers worked to convince the young man he still had a long, meaningful life ahead. "They encouraged me and told me I had a lot of things to do, and they were right," he said.
An emotional turning point came when a therapist suggested Garcia learn to paint. Unable to hold the paintbrush in his hand, Garcia tried his mouth. Gradually, with practice, he learned to mix colors carefully and paint fine details.
Working several hours daily, Garcia let his emotion-laden visions spring forth on canvas: An eagle clasping an American flag, black wings spread above a line of soldiers. A man in a wheelchair being pushed by a child toward an arch blazing with light. A shepherd in a brilliant green meadow framed by lavender mountains.
Today, he understands that the trauma that paralyzed him also seeded his art. "We all have a mission on this earth, and sometimes the things that happen are to get to the other level, where you can see things different," he said.
At Oak Forest, Garcia has seen what it means "to be like a child, needing other people for everything." His purpose, he believes, is "to help patients here who are not able to speak the language or speak for themselves"—a role he's played on the hospital's patient advisory council.
Still he struggles to make sense of the new turn his life is taking. "Why do we have to move now and lose everything? Why do we get so hurt?" he finds himself wondering.
His impulse is to turn to his faith and find a reason for hope. "I know that bad things sometimes bring good things and that there is always someone there for us," he said. "God sees everyone the same."
It's an attitude Garcia shares with his best friend at the hospital, Onix Flores, 46, a severely disabled Honduran woman who has multiple sclerosis and Charcot-Marie-Tooth disease, an inherited neurological disorder. Flores, a legal U.S. resident, breathes with a ventilator and is almost completely paralyzed.
The two often talk for hours. One recent day, Flores showed Garcia her first painting, also made with a brush in her mouth. It was an attempt, she said, to appreciate his experiences.
"It is not easy," the cheerful woman said, gasping as a machine forced air into her throat. "But I feel how you can express yourself, how you take things out of your heart and your inside."
Garcia nodded. "When you paint, you forget the real world," he said.
Their conversation turned to the changes afoot at the hospital. Flores said moving will be a good step for Garcia, a chance "to meet other people and open his heart to new things."
Flores will remain at Oak Forest, as the ventilator unit there isn't closing. "I'll be calling him every day to see how he's doing and if he's comfortable and what he's painting," she said, glancing at her friend.
Garcia took a moment to think. "I'll go, because the life we have had here, it's over," he said at last. "But I worry about the other patients. Where will they go? Who will look after them? What will happen if they can't speak for themselves?
"You wonder if the people who make these decisions realize what it means."