Charity Hospital Care

Last Updated on March 5, 2019 by Laura Turner

When I was an intern at Grady Memorial Hospital, Atlanta, Georgia, the charity patients needed only two things to see a doctor: a medical complaint and one dollar in cash.
In the emergency clinic, after the patients were signed in they were given a plastic card with a large red number that indicated their place in the queue. This number was written on their paperwork and placed in an inbox so that a doctor or nurse could locate them by calling out their number, like a butcher in a deli. Then, they waited for hours on a wooden bench against the outer wall of a cavernous room.
We interns were instructed to take the case at the top of the inbox—we were told to resist the temptation to dig down into the box looking for something more interesting. One evening, I came on duty after being up all the previous night, and I was exhausted before I even started my shift. I looked around and none of the supervising staff was watching, so I ignored the patients waiting with complaints of “backache,” “headache,” and more “backache,” and I searched for something more stimulating. About fourteen layers down in the inbox, I found what I was looking for: a complaint, “chitlins in hand.”
The bench around the room was completely filled with slump-shouldered citizens of Atlanta. I called out, “Number fourteen.” Far down at the end of the room, a gray-headed, elderly black man held up his little plastic card. As I approached him, I noticed that he was holding his other hand firmly against his stomach. I asked him, “This paper says, ‘Chitlins in hand.’ What does that mean?” He looked down and said, “Well, tonight I got stobbed and my chitlins is in my hand.” This said, he slowly let his hand move away from his belly. As he did this, a considerable length of his small bowel spilled out of a wound in his abdomen and came to rest in his open palm. He was now holding a large handful of his intestines—glistening white under the fluorescent lights of the emergency room—to show me what he meant by “chitlins in hand.” There was no bleeding, but his intestines were no longer inside his abdomen where they belonged; they were outside his belly, in his hand.
Imagine the downtrodden mentality of that old black man in 1966. He had been holding them in as he traveled across town to the charity hospital, holding them in while he dealt with the admissions clerk. What he had been told about himself that would make him think it was reasonable to conceal his injury and just wait for his number to be called.
Of course, he was immediately taken to surgery where he was treated successfully by the teaching staff and later received several days of competent and caring hospitalization, all for one dollar. After this he was physically fine.
But after he was released, I’m sure he returned to the dark streets of Atlanta with the same broken spirit…..and that was clearly not fine.
This anecdote is an excerpt from a newly released book, Good Times in The Hospital: A Medical Memoir, by James G. McCully, MD.