A regular Source column, Undercurrents explores issues, ideas and events developing beneath the surface in the Virgin Islands community. This is the beginning of a series of stories exploring health care services in the territory.
It was the very end of the year 2000 when my visiting mother-in-law had a stroke and I rushed her to the Roy L. Schneider Medical Center. She received prompt and good care in the Emergency Room. Everyone was kind, competent, professional, and reassuring. She was admitted to the Intensive Care Unit where for several days she received excellent care. My husband and I took turns sitting with her, one or the other there almost continually.
The room gleamed with state of the art equipment. The medical staff was attentive and always responsive to needs and questions. Maintenance workers came into the room several times a day to clean it – always quiet, pleasant, efficient. There were two firmly enclosed metal trash cans, one for medical trash and the other for general trash. Each was carefully emptied several times a day, though neither was ever close to full.
We were excited when she was deemed well enough to be released from ICU to a regular ward of the hospital. Then, as she was being prepared for transport, one of the nurses took me aside. It’s nice when families spend so much time with their loved one, she said, but it’s not really necessary here in ICU …
With that subtle warning ringing in my head, I followed my mother-in-law to her new room on the fourth floor. It held two beds and one rickety chair. The night stand next to her bed had a single, broken drawer. There was no phone or TV, let alone any medical equipment. I couldn’t find a waste can by either bed, or anywhere in the room, but finally located one in the bathroom. The foot pedal didn’t work but that didn’t matter since the lid was broken and dangling off the side of the can, which was so full of refuse that used paper towels were falling out of it.
The second bed clearly had been occupied recently, but there was no other patient in the room. Someone had left a breakfast food tray next to the empty bed.
It was lunchtime. A woman brought in a food tray. She remarked that “she” didn’t eat her breakfast, then put the lunch tray down next to the breakfast tray – next to the empty bed – and left. Eventually the kitchen sent up something for my mother-in-law, but whoever prepared it hadn’t gotten the message that she was a stroke patient with great difficulty swallowing and was on a strict diet of soft foods. There was nothing on the tray that she could eat.
The missing patient had a bedside phone. Someone kept calling and eventually I answered. It was the woman’s son. He was looking for his sister, who he said he was supposed to meet at the hospital. I spied a note on the bed and asked him if he’d like me to read it to him. Indeed, it was from his sister, to him, and it said something to the effect of: Mommy had to go for surgery.
It was an hour or two later, after a shift change I think, when a woman appeared in the doorway, looking nervous. She introduced herself as the head nurse on duty. Then she nodded her head toward the empty bed and asked me a question I’ve never forgotten: “Do you know where she went?”
All this was more than 15 years ago. A lot has changed.
Both territory hospitals, Schneider on St. Thomas and Juan F. Luis on St. Croix, have been renovated. Health care options throughout the territory have grown as the number of health care providers, including specialists, has expanded. There’s a serious attempt to institutionalize regulations ensuring a high standard of health care across the board, in government and quasi-governmental facilities as well as in private practice.
But there are lingering concerns, too. Vast numbers of Virgin Islands residents are uninsured. Some people still have to travel off-island for specialized treatment. There are inconsistencies in the level of care. A lack of transparency about malpractice complaints fosters mistrust. And, most important of all, people keep getting sick in ways that are preventable.
In the coming weeks, with the help of experts in the medical and legal fields, Undercurrents will explore various aspects of health care in the territory.