The governor of Guam Lou Leon Guerrero called me last week while I was busy taking care of Vietnam War military veterans who had been turned away from the overstaffed and frequently criticized VA clinic in Agana Heights.
I politely told my patient, a 72-year-old former infantry soldier, that I needed to be excused to take the governor’s apparently urgent phone call. The governor has never before called me while I was in the clinic, in fact, I don’t recall the governor ever calling me before.
Gov. Lou was gracious and remarkably congenial as we began our phone conversation. I had worried that she would be mad at me because I have been relentlessly outspoken about her administration’s six-year failure to maintain a safe, clean or medically competent public hospital for the people of Guam.
Honestly, I knew that she had personally tried to accomplish good things at Guam Memorial Hospital but the fact remains that GMH continues every day to spectacularly fail to meet national patient safety standards.
Instead of blaming the messenger, the governor expressed genuine concern for my safety. She seemed to worry that my recent comments regarding the ongoing debate about GMH would lead certain people to come and physically hurt me. It was then that I realized the true heroism of our island politicians who must do and say things that they know may cause some people to threaten violence against them or their families.
Politics on Guam and throughout Micronesia can be violent. Arguments can frequently become heated. Voices are often raised in anger and words can become visceral and harsh. Unfortunately, blood occasionally has been shed.
We all have others to whom we must listen and by whom we are held accountable. These are often those whom we serve, such as our parents, our family and our friends. Sometimes, we will be held accountable by those whom we lead, such as colleagues, students or even little children.
Apparently, many of our people have a deep love of GMH and I unintentionally offended that love by my harsh, honest, incisive and biting commentary about decrepit, leaking, foul facilities, protracted patient safety violations and mean-spirited tax increases on food and medicine to fund a stubbornly bloated, local government payroll.
If my words stung anyone, I hereby apologize to the many hard-working, honest, and kind front-line employees at our beleaguered Guam Memorial Hospital.
For the past too many years since losing the Joint Commission accreditation, you have been subjected to savage criticism by members of our frightened community, your disgruntled patients, and even well-meaning medical doctors like me.
The sting of your shame is only magnified by the public recognition of long-standing hospital safety violations. Pseudomonas-stained towels strewn under black moldy ceiling tiles; Legionella bacteria brewing within leaky air-conditioning units; and widespread systemic operational failures surround you daily. But the humiliation of being the only local hospital to lose accreditation is not the fault of the honest, hard-working GMH employee who works rain or shine, 24/7, 365 days a year.
You have been betrayed by our government leaders who have falsely promised monetary relief so that necessary medicines and hospital supplies could be purchased. You have been insulted by your own human resource officials who defend substandard nursing and allied health professional wage structures while hiring overpriced business consultants and attorneys.
As the great Yankee philosopher Casey Stengel once said, there are three kinds of people: those who make things happen, those who watch things happen, and those who ask, “What happened?”
The Joint Commission national certification had meant that Guam’s hospital met the highest standards for safe patient care which is central to GMH’s core identity. Over the past five years, while GMH failed to prioritize patient safety, the Naval Hospital Guam and Guam Regional Medical City actively maintained accreditation.
The protracted and persistent loss of accreditation is damning testimony of GMH’s underlying weakness and failure. Hospital and government leaders continue to value payroll politics more highly than safe patient care.
In other words, GovGuam has thrown the taxpayers of Guam under the bus. As I scrape myself angrily from the road, I would like to join those of you tired, poor, huddled, wretched masses yearning to make good things happen for GMH.
Unlike some pessimistic politicians, I believe GMH has the talent to reattain national accreditation patient safety standards.
I hereby acknowledge that I have the will to do what is needed and I now loudly offer the following solutions to our hospital’s life-threatening problems:
1) Laterally transfer 500 administrative and clerical personnel to the Guam Economic Development Agency and the Department of Revenue and Taxation. Ask not what they will do there, rather ask what are they doing at GMH? With that payroll transfer, GMH will have $17 million to hire the necessary clinical staff to open 45 unused hospital beds that will then allow the Emergency Room to focus on acute, critical care.
2) Immediately give GMH the $60 million generated by the vicious gross receipt tax increases done in its name. Regain accreditation. Fix the electrical panel. Fix the leaky roof. Get rid of the mold and the snakes. Make the hospital safe again.
3) Prioritize medical vendor payments over hospital staff payroll. GMH must never again become delinquent to oxygen and blood suppliers. Better that hospital payroll be late than for GMH to be cut off from life-saving medicines ever again.
4) Require all GovGuam employees, retirees, and their dependents to receive their medical care at GMH to keep the $105 million GovGuam health insurance dollar. If GMH is good enough for Guam then it is good enough for GovGuam employees.
5) Outsource GEDA and GVB and fund those inorganic and non-critical functions with taxes on hotels, banks, insurance companies, and GRMC. De-fund special assistant and deputy director positions and use that money to fund pay increases for GMH nurses.
6) Redirect the $45 million Tourist Attraction Fund to the GMH administration for capital improvement and continuous facilities maintenance expenditures at the hospital. Complete the long-promised OB ward renovations.
After I returned from my phone conference with the Governor, my Vietnam Vet patient asked me about the call. I told him that his Governor was passionate about building a world-class medical complex of which all the people of Guam could be proud.
He said, “Lastima! She can’t even fix GMH now. What good is it to dream about how good things will be 10 years from now when I’m 82 years old and still waiting for my appointment with the VA clinic? Go ahead and build your medical complex but fix GMH now. Quit making excuses!”
I quietly nodded my head while the words of the famous Samoan cultural anthropologist Margaret Mead lingered in my head, “Never doubt that a small group of thoughtful, concerned citizens can change world. Indeed it is the only thing that ever has.”
Vincent Taijeron Akimoto, M.D., is a doctor of family medicine on Guam.
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