Moving a medical landmark

CHICAGO -- Cook County Hospital, the sprawling institution that inspired TV's "ER" and provided first-class care under Third World conditions for much of the last century, is shutting its doors.

At 7 a.m. today, patients will start moving from the old building into a sleek new one nearby. While the distance between the two can be measured in yards, the difference is immeasurable.

"I've been waiting for this since the day I arrived," said Dr. John Barrett, director of trauma services, waving at his pristine new trauma unit. "This is as good as it gets."

Dr. David Soglin pointed at an elevator in the new building and said: "You can actually push a button and go where you want, which is an incredible experience for us at County."

Care for everyone

The public hospital has provided care to everyone, regardless of their ability to pay, since 1914. The centerpiece was a trauma unit -- the nation's first -- with a training program that attracted doctors from around the world.

Ask any Chicago cop where they'd want to be taken if shot and the answer will invariably be "County." In fact, 98 percent of patients who arrive alive at the trauma center survive.

"ER" was set at County General by its Chicago-born creator, Michael Crichton, who was a student at Harvard Medical School. The show debuted in September 1994 opposite another hour-long medical drama, "Chicago Hope," set in a ritzier hospital.

Although County's trauma center helped inspire "ER," the show is not shot at the hospital and takes frequent liberties with Chicago geography. Television doctors often step outside for a break and are shown on the city's lakefront, miles away from the real hospital on the West Side.

Still, the show's producers interviewed the staff about the trauma center, Barrett said. "They get the medicine part right. I actually still watch it."

While many doctors and staff members admit to a sense of nostalgia for the old building, it's the kind of nostalgia World War I veterans might muster for trench warfare.

With its intermittently operating elevators, funky smells, shortage of bathrooms, lack of sunlight, vast distances between wards and other nuisances, the building was declared too decrepit for modern surgery by the American College of Surgeons in the 1930s.

Making advances

Yet its doctors pioneered the trauma center and the blood bank and made internationally recognized advances in prenatal care.

"I think we'll all miss that building at some ridiculous emotional level," said Soglin, the chairman of pediatrics. "There is a perverse pride in working under these conditions."

Not that he'd rather stay.

"The moment we move in, the quality of care is going to improve," he said last week while walking through one of the sunlit hallways in the new pediatrics ward.

John H. Stroger Jr. Hospital of Cook County, as the new building is called, is a half-billion dollar investment in public health care at a time when cities around the country are closing public hospitals or cutting back services. It, too, will offer care to all county residents, regardless of their ability to pay.

Doctors say the new hospital will improve their efficiency, morale and ability to take care of patients. More important, they say, is the effect the surroundings will have on patients.

In the old hospital, patients slept in open wards with little privacy, no telephones, no televisions. They walked to shared bathrooms. Nurses were as far as a block away and there was no quick way to page one. Women gave birth in an open ward, separated from others in labor only by curtains.

In the new hospital, all rooms are private or semiprivate, with bathrooms, televisions and telephones. There are private labor-delivery-recovery rooms with reclining chairs for visitors.

"Something as basic as this chair is saying 'Family, come and share this,"' said Dr. Elwyn Grimes, chairman of obstetrics and gynecology.

Grimes and Soglin are happy that pediatrics and obstetrics now share a floor, along with the neonatal and pediatrics intensive care units.

"Now, every sick newborn has to go up an elevator, across a bridge and down an elevator" to be brought to the ICU, Soglin said. "It's a five- or 10-minute walk. Here, labor and delivery are next to neonatology. If for no other reason than that, care will improve."

Dr. Quentin Young, who fought many battles with the county as the hospital's chairman of medicine from 1972 to 1981, said the new hospital is a marvelous commitment to health care for the poor.

"A brand new, state-of-the-art public hospital -- that just isn't happening in this country," he said. "It's extraordinary."