The oppressive heat that has baked the region recently has found its way inside D.C. General Hospital, forcing doctors to move patients to rooms that don't rely on an aging air conditioning system that hospital officials have vainly tried to replace for years.
For a decade, mayors and the D.C. Council have rejected annual capital budget requests of $400,000 for major improvements to the heating, ventilation and air conditioning system that serves the main buildings on the campus at 300 Massachusetts Ave. SE.
D.C. General, with the help of nearly $50 million in city subsidies, treats more Medicaid and uninsured patients than any other District hospital.
When outdoor temperatures soared to 104 degrees last week, the cooling system experienced a sort of meltdown, inflicting misery on patients, visitors and employees. Officials at the city-owned hospital transferred patients and shut down some rooms because of the sweltering conditions. Isolation rooms for tuberculosis patients got so hot that they were closed and some patients were turned away, officials said.
"For the most part, we managed to make it so the patients in general were--I won't say comfortable, but at least they were not in any way jeopardized," said Robin Newton, the hospital's new chief medical officer. "They were slightly uncomfortable and sticky, but at least we were able to keep them from being in harm's way."
One ailing prison inmate was moved from the 16-bed locked ward to a regular room and guarded around-the-clock by a corrections officer.
Hospital officials try to keep the temperature throughout the hospital in the low 70s to create an environment "conducive to healing." But they report that interior temperatures have hit the mid-80s in recent days.
Employees and patients complained that indoor temperatures in some wings exceeded 90 degrees. And when desperate patients opened windows to catch a breeze, it only made things worse by letting in super-heated and humid air, officials said.
The hospital's chief executive said that he doesn't know how high the temperature climbed, but that whatever it was, it was too hot.
"It's been tough," said John Fairman, chief executive of the Public Benefit Corp., the quasi-independent city agency that runs D.C. General, 12 clinics and the school nurse program. "There were various interpretations about whether it was bearable or not. I've heard all the sides. I have to say we clearly need funds to enhance our air conditioning system."
Because the city's financial situation has improved, Fairman said, the Public Benefit Corp. will have an unprecedented $8.7 million capital budget for 2000, but it does not include money for air conditioning improvements.
To make things more tolerable for visitors and to prevent dehydration and other heat-related problems, hospital officials have set up portable fans and temporary water coolers throughout the building. In some rooms, they replaced faulty medium-sized air conditioners that serve smaller areas of the hospital.
"Things are much cooler than they were, even though I wouldn't say they are optimal," Newton said.
If things remain too hot, hospital officials are planning to stock up on cardboard hand fans like those often used in churches that don't have air conditioning.
Officials throughout the Public Benefit Corp. say their facility has been neglected for years because of budgetary limitations. Without a capital budget, said Angelo Ellison, the agency's facilities maintenance director, he has to take money out of the operating budget to keep the heating and cooling systems going.
"It makes me angry," Ellison said. "There are patients here who come to us for assistance, and it's like Congress and everyone just turns their back on us."
The worst problems are in the so-called core building, which houses patient rooms and the cafeteria. It was constructed in four phases between 1927 and 1965, which by hospital industry standards is ancient.
Ellison said many building systems need rehabilitation on the campus, which includes the D.C. jail, the correctional treatment facility, mental health services, the medical examiner's office, a drug crisis center and a health department facility. One key facility in need is the boiler plant, which provides steam for heating, cooking and laundry.
"It's working, but we've been using wire and bubble gum to keep it going," he said.
The maintenance problems reflect the uncertainty that constantly nags at the people trying to plan D.C. General's future.
Years ago, the city's persistent financial difficulties meant there wasn't enough money to invest in the facility. Some politicians began urging that the hospital be shut down because it was costing too much to operate, but the hospital's forceful group of backers staved them off.
Several years ago, the city created the Public Benefit Corp. with instructions to become a competitive system offering hospital and clinic services. But Fairman has argued that after doing that, top city officials have kept the agency's hands tied with financial limitations.
In May, Greater Southeast Community Hospital, which also serves poor District neighborhoods east of the Anacostia River, filed for bankruptcy. It is functioning now only with the help of a city bailout that has given Mayor Anthony A. Williams (D) a major say in what happens to that facility.
Williams used the opportunity to push for a possible consolidation of services to eliminate duplication among D.C. General, Greater Southeast and Howard University Hospital. Those talks are continuing, and D.C. General's fate remains as uncertain as ever.
"We need some sympathy," Ellison said. "We've done so much for so long with so little that we're now qualified to do much with nothing."