Maybe they're worn down. Perhaps they're functioning on pure faith. But after two years of perpetual financial crisis and the growing threat of a shutdown, the patients, doctors and employees at Greater Southeast Community Hospital have heard enough about the possible liquidation of their debt-ridden hospital.
Don't bother them with any more discouraging details.
Late last week, they went about their business, coping with long waits for a nurse or scrambling to treat folks backed up in the emergency room. Patients enjoyed turkey lunches, and the clean, well-lit corridors of the hospital remained lively.
Many patients refused to accept the idea that the hospital could be closed, or simply could not imagine that the District government would permit it. After propping up Greater Southeast with $8.5 million in city money since May, Mayor Anthony A. Williams (D) declared last week that taxpayers won't contribute any more to keeping the private hospital alive.
"I don't believe it," said Bernard P. Robinson, 47, who was hospitalized there for a pancreatic disorder last week.
Robinson, who has lived most of his life in Southeast Washington, expects the city to come up with the additional $8 million to $10 million loan that the hospital has requested to launch a financial turnaround plan. The hospital is $70 million in debt and is threatened with liquidation by a federal bankruptcy judge.
"I don't think the government will just let them fold," Robinson said. "I think they'll give them pretty much what they need."
John M. Miles, a 90-year-old retired naval engineer from Temple Hills who was recovering from cancer surgery, said he is "90 percent confident" that the hospital he has used since 1965 will survive.
"I doubt it's going to close," he said. "I suspect it will be taken over by a money-making operation. It would be ridiculous to tear it down. They've got a rather good facility here. A huge amount of money has been poured into it over the years."
Such a takeover scenario is being encouraged by Williams, who has urged reluctant members of Greater Southeast's board to accept a $24 million offer for the hospital from an Arizona firm. The hospital board, which would lose control of the facility under such a move, has balked at that idea, and questioned the Arizona firm's financial muscle.
Although Greater Southeast is the primary health-care provider for D.C. residents east of the Anacostia River, Williams said it is in the city's interests not to put any more money into a mismanaged private facility, and to concentrate instead on developing clinics and providing other basic services.
Several patients questioned that position, given the mayor's support for using nearly $5 million in city funds to pay for construction of a tennis center near the hospital. The tennis center, a pet project of Cora Masters Barry, wife of former mayor Marion Barry, was supposed to have been funded through private donations before Williams endorsed a bailout.
Others who use Greater Southeast said that with the hospital's future uncertain, they worry most about people for whom it would be physically or financially difficult to travel far to get medical treatment.
"I can afford to go where I want to go," said Bernard H. Thomas, a retired government worker from Hillcrest in Southeast Washington. "I feel sorry for the people who depend on it when they're putting a tennis court right next to it."
Liquidation of the hospital could be ordered as soon as tomorrow if a bankruptcy judge and creditors don't see evidence that Arizona-based Doctors Community Healthcare or another investor is willing to immediately invest millions to keep hospital going while streamlining it into a profitable facility.
If the hospital is shuttered, some Greater Southeast patients said they merely will follow their regular physicians somewhere else.
"It wouldn't really be any problem for the two of us," said Edward J. Travers, 72, who lives in Hillcrest with his wife. "We have transportation and sufficient health coverage with Medicare to go where we want."
Because it is not a publicly subsidized hospital and therefore cannot treat many uninsured people who walk through its doors, Greater Southeast does not enjoy the same passionate grass-roots support that has helped the city's public hospital, D.C. General, weather its own financial difficulties.
Residents around Greater Southeast have demonstrated little interest in protecting it, even though the 280-bed facility is Ward 8's largest private employer and is undeniably important to the insured people in the area.
Hospital officials say that about 15 percent of the patient revenue comes from D.C. Medicaid patients and another 8 percent from uninsured people who pledge to pay their own way. About a third of Greater Southeast's patients live in Maryland, further diluting the passion for the hospital in the city.
Last week, as Williams prepared to announce his decision not to direct any more money to Greater Southeast to a community gathering at a church, his aides worried that community anger over his decision could boil over and that the meeting could get ugly.
Instead, the few people in the audience who weren't employed by the health-care industry remained relatively quiet, and most of the comments came from the large contingent of hospital people in the crowd.
The hospital certainly has its loyalists. Thomas A. Dockery, 51, a gardener at the National Park Service's Kenilworth Aquatic Gardens, takes a Metrobus two hours each way to see his doctor for routine visits at his medical office in the hospital. When Dockery was hospitalized for complications from pneumonia last week, he again made his way to the hospital on Southern Avenue.
Few have become more dependent on Greater Southeast than Donna L. Brown and her husband, Terry A. Brown. Last week, she delivered a baby boy, Terrell. He was the couple's 10th child--all born at Greater Southeast.
"This community will be in great danger if the hospital closes down," Terry Brown said just before the couple was ready to head back to their Washington Highlands home with Terrell.
Donna Brown's labor was brief, he said, and he shuddered to think what might have happened if they had needed to go to D.C. General or elsewhere. "She would have had the baby in an ambulance," he said.
Linda Whyten, president of the civic group that represents Washington Highlands's 15,000 residents, believes the 85-bed Hadley Memorial Hospital--which is owned by Doctors Community Healthcare--would be overrun if Greater Southeast were closed. Yet the prevailing apathy about Greater Southeast puzzles her.
"It's an assumption that someone is just going to come and bail out the hospital, and we don't have to worry about it," she said. "It's really hard to explain."
While everyone at Greater Southeast waits for the hospital's future to be resolved, the doctors and nurses there go about their business. The president of the medical staff, Shantha Murthy, said she would happily give up her membership on the hospital board to keep the hospital alive.
There can be only one goal, she said softly. "Stay open. Stay open."
The number of nurses fell from a full-time equivalent of 303 last year to 202 last week. Those who remain are the longtime loyalists, said nursing chief Mattie Lowery.
"Some people are feeling uncomfortable, and they feel like they need job security," she said. "I'm trying to concentrate on the nurses who want to stay. They say, 'I've been here, this is part of my family. I believe in what I'm doing, and I'm here until the door closes.' "