Friday, March 7, 2014

A SLEEPING GIANT OF CARE DELIVERYwakes again after 100 years

Midnight in South Chicago.  1896. A maternity hospital flying squad rolls through the streets to a tenement where a woman screams in a difficult labor.  The team delivers the child on the kitchen table, protected by the germicide in newsprint ink. When all is well, they roll on the next call.

I read this unforgettable story in high school near the greater Chicago area.  The only rolling healthcare delivery anywhere near us was a local undertaker's funeral car.  Babies were delivered in the hospital or by the neighbor. 

I've searched repeatedly since then, including in the  hero's own book, for proof that I didn't dream it.  Nurses I meet have heard of the germicide in newsprint, but none have heard of the Lying-In flying squad

Then last night, I found some proof. 

"In the USA, as far back as the last decade of the 19th century, Joseph de Lee . . . in his Chicago Maternity Centre was taking competent obstetric help,not only to his 'booked' cases, but to anyone who called
for help. His work was carried on by Beatrice Tucker{}  in a foundation whose finances were so slender during the depression years that the most urgent call had to be answered by a team travelling to the patient in a street car."

From a paper read at the South African Obstetrical and Gynaecological Congress, Durban, July 1956.

A recent Modern Healthcare headline:

U.S. lags behind in healthcare innovation, Sebelius says

had led me to medpage's Feb. 21 stroke flying squad innovation article by Todd Neale: 

 Taking Stroke TX On The Road, referring to Memorial Hermann's new mobile stroke unit soon to roll in Houston, with its founder on board.

Neale wrote:  "The idea of mobile medical imaging isn't new. In fact, Marie Curie equipped ambulances with x-ray equipment and drove them to the front lines during World War I."  

(So that was about a hundred years ago this year!  Since a woman did it, it couldn't be worth emulating? Or maybe nobody in the US heard about this?)  
"But the concept of a mobile stroke unit was introduced more recently in Germany -- about a decade ago by Klaus Fassbender, MD. . . caught the eye of stroke neurologists like Grotta." wrote Neale.  Okay, a decade ago.   And in another country. 

That's still a long time since Madame Curie's rolling imaging center and longer since deLee's flying squad.  
I salute Dr. Grotta's triumph in getting everyone on board, so to speak, for this breakthrough in care delivery. In fact, he was so committed he quit his job to be able to roll with the new center.  

Why did it take a hundred more years for the US to produce such an innovator, such a leader?  In a country so automobile mad, so technology mad, and with so many under-served, Dr. deLee's and Madame Curie's innovations should have inspired many more...
while we were thinking about what?

Apologies for the formatting - this program is uncontrollable today.

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