August 11th was the 2nd anniversary of the epic implosion of George Allen’s presidential campaign, the first defeat at the hands of YouTube. Two recent videos of unattended patients dying in ER waiting rooms leave me wondering whether health care has also entered the YouTube era.
Remember the George Allen fiasco? A 20-year-old Indian-American named S.R. Sidarth, working for Allen’s opponent Jim Webb, was filming an Allen campaign stop in Breaks, Virginia. Twice, Allen pointed to him and called him “Macaca,” a racial slur meaning “monkey.” Once the video hit YouTube, it went completely viral (this clip, one of many, has been viewed 350,000 times) and Allen’s promising political career was toast.
What does this have to do with health care? In the past 18 months, two powerful, highly troubling videos have surfaced of patients being left to die in ER waiting rooms. The first, in May 2007, involved a woman named Edith Rodriguez. Rodriguez began vomiting blood while waiting outside the King-Drew ER, and soon collapsed. Rodriguez’s husband called Los Angeles’s 911 system, but got nowhere. Then someone else in the waiting room called:
Caller: “There’s a lady on the ground, here in the emergency room at Martin Luther King and they are overlooking her, claiming that she’s been discharged. And she’s desperately sick and everybody’s ignoring her.”
911 Dispatcher: “What do you want me to do for you, ma’am?”
Caller: “Send an ambulance out here to take her somewhere where she can get medical help.”
911 Dispatcher: “OK, you’re at the hospital, ma’am, you have to contact them.”
Caller: “They’re the problem. They won’t help her.”
It’s not that the ED staff did nothing –- the video clearly shows a janitor coming out to mop up the patient’s bloody vomitus partway through her dying process.
The disgust over the YouTube video was the last straw for hapless King-Drew, leading to the hospital’s closure late last year.
Last month, another videotape surfaced showing a woman collapsed on the floor of the Kings County psychiatric ER waiting room in Brooklyn, NY. After sitting for a day waiting to be seen, the woman fell to the floor, where she lay face-down for about an hour before anyone appeared to notice her now-dead body. A few weeks ago, the family notified the hospital of their intent to file a $25 million wrongful death lawsuit.
In both the King-Drew and Kings County cases, the videos made a splash when they hit the news. But what really kept the stories alive was their viral spread on YouTube – for example, as of last night, the Kings County video had been viewed 470,025 times and had generated 1,845 comments!
Add to this brew the ubiquity of cell phone cameras, the increasing interest in physician and hospital rankings and comments (Yelp, Zagat), and the public’s growing skepticism of the safety – even the motives – of hospitals and doctors (for example, see Tara Parker-Pope’s recent article in the NY Times), and you have a formula for more “Macaca” moments, seen everywhere, by everyone.
So if professional ethics are not enough reason to be respectful of and polite to patients, perhaps the desire to avoid YouTube immortality is.
Bob Wachter is a professor of medicine at UC San Francisco and quality and patient safety expert. He writes the blog "Wachter’s World," where this post first appeared.