A Not So Brave New World--Part III

"If you build it, they will come." The new philosophy hatched by the medical schools took hold and spread like wild fire. The great urban centers became hotbeds of change, as first one and then another community fell under the spell of the unified hospital idea. "Join our community and have the benefit of the great _________ hospital center!" was the rallying cry. Larger communities found themselves split, as first one part declared undying devotion to their hospital, and other parts did the same for their hospitals. Maps were gerrymandered into strange configurations. Neighbors on the same block suddenly found themselves belonging to two different communities. Families sometimes found themselves split asunder as members in different geographic locations took up the defense of their own hospitals.

There arose a new power: the hospital Director. Working hand in glove with medical school Deans, they saw the benefit--certainly for themselves--of the new social order.

Walking the streets in the great urban centers became fraught with danger as each hospital, egged on by the Deans of the medical schools and the hospital Directors, sought for dominance. Soon the hospitals fielded groups of guards to patrol the streets of their neighborhoods; all those clearly not belonging there were told to leave--they would not be served by the local hospital. Those who did not publicly adhere to the philosophy of the hospital in any way were also publicly humiliated. Rarely were such humiliations overt; for the most part a whispering campaign was all that was needed to get community members to toe the line.

But what of the practice of medicine? Did the great hospitals that arose provide the best and most innovative of medical care to those in the community? Sometimes. Sometimes not. But medical care was no longer the issue--dominance and conformity was. "Our hospital uber alles!" was the rallying cry.

"So every community was healthy?" one could ask. Not hardly, but this news was suppressed and kept from the general community members. Only the medical school Deans, the hospital Directors and select members of the hospital board needed to know just how ill some users of the hospital were. Paternalism became the order of the day. Individuals were not encouraged to think for themselves; that was the job of medical school Deans and their puppet hospital Directors. And if a case truly confounded the doctors of one hospital, truly resisted any treatment that their philosophy could offer, the sufferers were dispatched under cover of darkness to another hospital, preferably far away. Let it be their problem.