Soul of the Healer

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By Oliver Goldsmith, MD

In the mid-70s, I was a young physician in the Southern California Permanente Medical Group (SCPMG). As an assertive member of our Board of Directors from the Los Angeles Medical Center, I thought we newer physicians (under 40) could "straighten the problems out" and "get health care delivery right." I set out, as an elected representative, to represent our partners and make sure that our Medical Director and Area Medical Directors understood the views of "those of us in the trenches."

One evening, my wife and I were invited to a reception at the beautiful Beverly Wilshire Hotel, in Beverly Hills, to welcome the Kaiser Foundation Hospital Board members and Edgar Kaiser, a warm and involved businessman who carried the passion and commitment of his father, Henry Kaiser, for Kaiser Permanente. He was visiting the Southern California Kaiser Permanente Region. Our leadership on both the Kaiser and Permanente side were excited to welcome him in a festive way.

That Wednesday night, the entire Board of Directors of SCPMG were invited to join with the Kaiser Health Plan executives to extend a warm welcome. Despite the "weeknight" and young kids at home, my wife and I dressed up in our finest. We left the children with a babysitter and went out to enjoy ourselves as if it were a weekend and meet the senior leadership of Kaiser Permanente. I found myself swept up in the excitement of the evening, meeting experienced leaders who had played such fundamental roles in developing the Kaiser Permanente I loved. I have to confess I overate and imbibed a bit too much, but being part of the evening was just so exciting.

We returned home late in the evening exhausted and fell into a deep sleep. At 2:00 am I was awakened by a phone call from my respected Medical Director, Hart Baker, who said, "Oliver, am I bothering you?"

I, of course, said, "No, what is the problem?"

"Oliver, this is serious. Mr. Kaiser is ill and you need to make a house call."

Waking quickly, I said, "Hart, I thought we got rid of the house call benefit. (I knew we were losing money on it.) And how do I know that Mr. Kaiser has Kaiser Health Plan coverage?"

"Oliver, stop kidding around. Come over to the hotel right away."

I had a cup of black coffee and asked my wife, Sharon, "Where's my black bag?"

She responded, "The kids have played with it; you never use it."

"Don't be foolish. Please get my sphygmomanometer, my stethoscope, and throw some medicine in the black bag."

"What medicine?" she said.

"I don't care!" I said impatiently. "Put some Tylenol, Maalox, or birth control pills in there and let's get on with it."

In a somewhat agitated state, I got in my old Chevy Nova and drove directly to the hotel and entered one of the nicer hotel rooms in all of Los Angeles. There, I encountered the entire leadership of Kaiser Permanente--including Dr. Baker, and some of the founding fathers of Health Plan (their names escape me as I look back). Finally, I was brought in to see the patient. Concerned that this could be serious, I said, "Mr. Kaiser, I think that you need to go to the hospital right now."

"Whatever you say."

"I'll need your medical records."

"My pilot will go get them."

I never forgot accompanying him to the hospital and waking one of our Kaiser Foundation Hospital Administrators at 3:00 am and saying, "I need to talk to you." I doubt he was accustomed to being called at that hour for a hospital admission, but I shared with him the name of my patient. There was silence on the phone, but soon after, Security staff and a confidential secretary arrived to take my dictated history at 4:00 am. Like a good physician, I made sure that all was well, x-rays reviewed, laboratory tests noted, consultations obtained, treatment initiated, and that the patient could be safely observed.

I returned home falling into a deep slumber and overslept beyond 9:00 am. (I swear this was the only time in my SCPMG career!) I raced in, knowing that patients were piling up in my office, that I hadn't made rounds yet, and it was already 11:00 am.

Rushing to my new patient's room, I entered and saw him relaxed and reading a magazine, and I felt the relief that any physician feels seeing their patient doing so well.

To my consternation, he turned and said, "Young man, I need a phone." (In those days, physicians ordered a phone and television for their patients.)

"Mr. Kaiser, I apologize. I overslept. I will get you a phone and TV right away."

"Thank you, I need a phone now. Do you know what is going on in Jamaica?"

"No, I do not sir."

"Bauxite," he said.

Dumbfounded, I looked at him and said, "Bauxite, I'm afraid I don't know bauxite. Perhaps it is a rare vitamin."

"That's what Kaiser Industries uses to make aluminum."

Well, my patient recovered. I was so fortunate getting to know and admire this kind and principled man who cared so much for Kaiser Permanente and whose father founded our Program.

Twenty-five years later, I share the responsibility of leadership and often ask myself, "What would our founding fathers do with the problems we now confront?"

 

 

 

 

 

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