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Social services with nowhere else to go end up at D.C. General complex

By Nathan Rott
Washington Post Staff Writer
Tuesday, November 30, 2010; 10:59 PM

Michael Poindexter's first memory of D.C. General Hospital is the waiting. For hours, he and his family sat in the "crazy waiting room," holding out for a doctor to check on his little brother, who had swallowed a tooth. That was in the late 1970s, when Poindexter was in elementary school and the hospital saw thousands of patients a month.

Poindexter and his family relied on the much-maligned but affordable hospital in Southeast Washington for the benign, such as the swallowed tooth, and the traumatic, such as when Poindexter was stabbed and when he was shot.

He'd rather have gone to any other hospital, he said, but for many Washingtonians who lacked money or insurance, D.C. General was not merely the city's hospital of last resort, it was the hospital of only resort. "We had nowhere else to go," Poindexter said.

Nearly a decade after the hospital closed, people with nowhere else to go still end up on the 67-acre campus of what was once the city's only full-service public hospital. Today D.C. General - located near the Anacostia River between Robert F. Kennedy Memorial Stadium and Congressional Cemetery - is "a dumping ground for services that other people don't want," said D.C. Council member Tommy Wells (D-Ward 6).

Within the complex's rusted fences are the city's jail, its correctional treatment facility and a halfway house; the medical examiner's office and the morgue; a warehouse and a boiler plant; methadone, STD, detox and tuberculosis clinics; an emergency psychiatric treatment center; and a 100-bed women's shelter and the District's largest shelter for homeless families, which holds up to 135 families and 100 single men in the coldest months.

Last winter, the city's unwanted snow was hauled to the campus parking lots and dumped in massive mounds.

At D.C. General, Poindexter is still waiting, this time for a permanent home.

Thirty-nine years after he was born in the hospital's obstetrics unit, 21 years after watching his mother die in its intensive-care unit, Poindexter and his three children last summer moved into the Family Emergency Shelter in the decaying old hospital building.

Their bedroom, inpatient Room 509, is packed with four dorm-style beds and three wooden dressers. Their dining room is the old cafeteria. Their entryway is a long, dimly lit tiled hall lined with locked doors labeled "Fracture Room," "Cast Change Room," and "X-Ray."

Every time he walks in, he gets depressed, Poindexter said. "They closed this place down for a reason," he said, waving his hand at the sprawling parking lots, run-down brick buildings and the grassy tracts that have become his front yard. "If they wasn't going to tear it down, leave it closed. Turning it into a shelter is like going backwards."

Bleak history

It's hard to describe the decay of D.C. General as a fall from grace because that would indicate that it once possessed some.

The Washington Infirmary, the first incarnation of D.C. General, was established with a congressional appropriation of $2,000 in 1806. It offered free health care to the city's poor at a downtown location near today's convention center. In 1843, it was renamed Washington Asylum Hospital and moved to its current location, then an isolated section of farmland on the western shore of the Anacostia.

A quarantine station, disinfection plant, crematorium and smallpox hospital - the unwanted social services of the 19th century - soon followed.

For the next 150 years, the complex would suffer from a lousy reputation. The Washington Post in 1920 described the hospital as "totally inadequate facilities for the relief of suffering and proper care of the sick."

Two name changes and 81 years later, in 2001, D.C. General (the name since 1953) was described in the same way. But this time inpatient services were ending, effectively closing the hospital.

"It was definitely in terrible shape," said Robert Malson, president of the D.C. Hospital Association since 1997. Renovations had been delayed and repairs stalled. Entire sections of the hospital were closed off.

Even then, its emergency room saw more than 51,000 people in 1999, making it the city's second-busiest trauma center.

D.C. General, Malson said, was the physical embodiment of a "philosophical belief that we as a society have the moral obligation to give health care to citizens who can't provide it for themselves."

But the hospital gobbled up tens of millions in taxpayer dollars every year. In 2000, with the District facing a projected $250 million budget shortfall, then-Mayor Anthony A. Williams (D) pulled the plug, despite unanimous council disapproval and public outrage.

People asked: What would happen to the city's poor? What would happen to the surrounding land, known as Reservation 13?

They are still waiting for answers.

Unrealized visions

Frank Zampatori, 66, remembers the hospital's closing as the time he started hearing sirens again. Before that, "we had gotten so accustomed to them that we didn't even hear them," he said.

For 23 years, he has lived less than a block from Reservation 13, a parcel of land - now entirely city-owned - that includes the hospital and jail and stretches to the stadium and the riverbank.

As Zampatori saw it, the hospital's closing presented an opportunity. In 2002, as a member of the Stadium Armory Neighborhood Association, he helped develop a master plan that would "reenvision the site, not as a reservation but as a beautiful public place."

The plan, approved by the D.C. Council a year later, called for extending Massachusetts Avenue SE to the river and adding 800 residential units, a 1.2 million-square-foot health-care center, millions of square feet of office space and retail, and a 16-acre waterfront park.

"It was a wonderful and beautiful plan," said Colleen Garibaldi, a Hill East resident.

But the plan only "gathered considerable dust," said council member Phil Mendelson (D-At Large).

Instead of a new hospital, a mixed-use development or a new stadium for the Washington Redskins (something council member Jack Evans (D-Ward 2) has long sought), residents of Hill East have seen temporary shelters become permanent and clinics expand.

In recent months, the methadone clinic, a squat brick building adjacent to one of the family shelters, more than doubled its clientele.

"We now have 500 methadone clients," Zampatori said, frustration in his voice. "When this started in 2001, the Nationals baseball stadium was not on anybody's radar, the development in Ward 1 wasn't on anybody's radar. We've seen things getting shuffled and moved into Ward 6."

As neighbors like to say: If you don't want it in your back yard, it ends up here.

'But we're helping'

In the early '90s, when Darlene Lawrence was a medical student at Georgetown University, she did her clinical rotations at D.C. General, which she remembers as a tough, bustling place, outdated and in disrepair. Jail inmates were treated while chained to gurneys. Victims of drive-by-shootings were dropped at the emergency room door.

Today, Lawrence is medical director of the Unity Health Care clinic, which offers free care to the uninsured and underinsured at the northern end of the old hospital. One floor below, old X-ray machines and radiology equipment collect dust.

When the hospital closed, Lawrence expected the city to raze the buildings and develop the area, to do "what D.C. loves to do," she said. So she was shocked to come back last January and see "a ghost town - all those windows boarded up."

The open windows were even scarier, she said. They meant people were living behind them.

In its first three months, the Unity clinic saw more than 3,600 patients - a reflection of the former hospital's clientele: nearly all African American and overwhelmingly poor.

"We're not filling the gap, but we're helping," said Meri Kolbrener, a doctor at the clinic. "People were waiting for something like this."

At 11 a.m. on a Tuesday, the waiting room is full. Two kids chase each other through the crowd of patients, most of them old and slumped in their seats, watching a cooking show on the overhead television.

Save for the occasional muffled cough, the buzz of the TV, and the muttering of people checking in, the cramped room remains quiet.

The people are patient. They are used to waiting.

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