Again in the New Orleans TP editorial, some reader wrote in on why the old Charity hospital building should be saved. And again the "historic" argument surfaced. There have been several write-in's to the TP on the old Charity Hospital building's behalf.

It is obvious that these people never visited Charity, or at least never made it past the ER. Because that building, even in the 90's needed to be condemned. Between the asbestos in the ceilings and tiles and the infections running rampant in the air ducts, the place was a breeding ground for infection and cancer. My skin crawled every time I had to go in that building, and I've been in nearly every corner of it. If you were unfortunate enough to visit the old OB/GYN ward before University took over the newborn load, you'd think you were in Lebanon or Bogata.

I have a true affection for Big Charity. As a building it is imposing, strong, and dominates the medical district skyline with a tough but loving demeanor. It looks like one of the old guard, with strong shoulders, shrugging off the Tulane campus in the darker hours of late afternoon.

Inside the lobby, the entrance facing Tulane Avenue, were 4 pictures, huge portraits of the great founders of the Louisiana Charity System. And one of them was the grandfather of a good friend of mine. Dr. Adriani was the first anesthesiologist for the system, and proudly and strongly fought for the Charity system's integration into the Louisiana medical community. He was a real inspiration to John, and now his portrait is gone, destroyed by the black mold and mildew after Katrina infiltrated a building that was designated a nuclear bomb shelter. Such is the power of water, and of that storm....

But the building has outlived its usefulness as a medical treatment center. It is not fit to house animals, much less people. It hardly was back in the 90's.

The building could be saved, and would make an excellent instructional museum for medicine, research, and an archive of the entire Louisiana Charity medical system, which has served the populace of this state for so many years, and saved countless lives. Some rooms could be saved for medical instruction, and basic nursing for LPN and first-year RN classes could be held there. Embalmers and mortician student candidates would benefit from a visit to the Charity mortuary. The equipment alone would serve as interesting history and an introductory lesson to those professions. EMT/Paramedic classes could be held there as well, if some of the room could be reconstructed and cleaned up in a suitable manner.

But serving as the housing for the health care of ill patients is not an option. If the "historical" fools in New Orleans get their way and Big Charity is used for health care, I would hope any citizen in New Orleans who has the means decides to go somewhere else. Anywhere else.

A new facility needs to be built. New Orleans deserves that. I'm not in agreement of the current proposed location. I would rather see some other downtown buildings knocked down and Charity replace them wth a new, modern facility. The patients and citizens of the state of Louisiana deserve it. Save the "historical" argument for French Quarter roof colors and street car routes. Health care is too important to trust in the hands of preservationists who value appearance over function.

I can remember picking up countless rich, well-off, white kids and young adults during Mardi Gras in the ambulance. They were injured after a drunken night which involved lots of alcohol and some moronic stunt trying to prove their dexterity and balance on a fence bordering a parking lot, or a fight with some other fools, and the next thing you know they were knocked out with a head injury.

The best place to take them was the Charity ER. Not for the "historic" facility, but the staff, which was fine-tuned to diagnose and save countless people with a plethora of diverse health problems. And I remember making this argument time and again to family members and friends before we would depart the scene, only to hear them scream and yell their opposition. They didn't want to go to Charity, which they described as a backwards hellhole only fit for the poor, black, or indigent. They pleaded and begged to go to Tulane, where numerous times I heard patients or family demand they be treated by white doctors and nurses. In the privacy of the ambulance on the way to the hospital many confessions of this nature were muttered.

Fortunately the health care protocols in New Orleans demanded we bring certain types of injuries to Charity, because the staff was capable of dealing with them, and it was a Level 1 Trauma center. It clearly was the best. And since we received a great deal of training from those involved at Charity, our EMS system personnel were the best. And stil are. If you were injured in New Orleans, seriously especially, you were a very fortunate individual to be picked up by NOHD EMS. And even more fortunate to be brought to Charity.

But once you were stabilized, you wanted to go elsewhere. Upstairs was a different story altogehter.

My partners and I would always welcome the opportunity to bring those rich kids to Charity, especially if they had insurance. Because later when the bills came their insurance would pay at least part of the claim, and Charity would recoup more money from that patient than they would the average Medicaid or Medicare patient.

Sure, many times we exaggerated a patients' complaints or injuries to force them to have to go to Charity due to the protocols. Then we could argue the situation was out of our hands. Or when a drunk obnoxious jerk with no one around would beligerently demand to be brought to Tulane or East Jefferson, we could argue they were "combative" and had to be brought to the nearest trauma facility. Or just deliver about 50 mg of clipboard to the back of the head every 2 minutes. Usually all resistance ceased at that point. The truly argumentative ones needed a trauma center by the end of the ride anyway, because sometime emergency medicine uses unconventional methods to keep the peace. An errant oxygen tank accidentally dropped onto the groin, or a sublte 20 joule shock from the defibrillator to the soles of the feet, would generally evoke compliance.

Ah, those were the days. I miss them.

But the point is the truly ill, who are suffering from chronic disease, don't need to be kept in those rooms. They deserve better.

ok-rizzo