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‘Twas a dark and stormy night…

Yo Amti By Vincent Akimoto

Once upon a midnight dreary, while I pondered, weak and weary,

Over many a quaint and curious volume of hospital safety manuals—

While I nodded, nearly napping, suddenly there came a tapping,

As of someone gently rapping, rapping at my chamber door.

“’Tis the Joint Commission,” I muttered, “tapping at my chamber door—

Only this and nothing more.”

Ah, distinctly I remember it was in the bleak November;

And each separate dying ember wrought its ghost upon the floor.

Eagerly I wished the morrow—vainly I had sought to borrow

From my fiscal books of sorrow—sorrow for lost National Accreditation—

For the rare and radiant maiden whom the angels name National Accreditation—

Nameless here forevermore.

Open here I flung the shutter, when, with many a squirt and a flutter,

In there stepped a Raven water soaked from head to toe;

Not the least greeting gave he; not a minute stopped or stayed he;

But, with a look of disgust, perched he above my chamber door—

Perched, and sat, and nothing more.

Then, methought, the air grew denser, perfumed by toilets too late cleansed from the urine tinkled on these hospital floors.

“Wretch,” I cried, “the dead people of Guam hath sent thee.”

Regret—regret and disgust from thy memories of GMH;

Quaff, oh quaff this cruel disgust and forget this lost GMH!”

Quoth the Raven, “Nevermore.”

On any dark and stormy night, toxic black moldy walls, noxious porcelain toilets and slippery, filthy floors await the sick and dying at Guam Memorial Hospital. Like a Devil’s Night house of horrors, GMH again this year provides the good people of Guam an unsanctified place to be scared to death.

This Halloween, the Raven finds crowded, cacophonous hallways in the GMH emergency room moaning with groaning patients. Medications are in short supply for the sick. GMH does not have enough nurses, nor enough doctors to treat the dying.

According to GMH’s curiously essential information officer/ marketing director, everyone at GMH knows they have a problem. Supposedly, no one in the GMH leadership is blind to the myriad of dizzying patient safety violations throughout the hospital.


To be clear, GMH is woke. There is no secret that GMH is broken and the roof is leaking. The malfunctioning air conditioning system is an acknowledged potential breeding ground for multidrug-resistant nosocomial infections. The electrical panel has been loudly declared a danger to human life and male fertility.

The GMH head honchos don’t seem to be in much of a rush to fix anything, though. Throughout this 36-month-long Public Health State of Emergency, GMH procurement of critical supplies and staff has been thwarted by inertia and government holidays, most likely.

For example, the perky GMH information office announced that they were going to finally fix the leaking roof at least five times since 2018.

Unfortunately, it rained again recently and GMH had to admit that they are still having procurement issues. So, the roof continues to leak while a flood of press releases announcing the imminent repair of the roof, the moldy walls, the broken elevators, and the dysfunctional air conditioners inundates the already dirty hospital hallways.

We are apparently to be saved by media alerts. Makes me think of the nursery rhyme: “If wishes were fishes, we’d all swim in riches.” GMH should try to contact the guy at Adelup who got those cool golf carts procured during the middle of Covid-19.

Despite such wishful thinking, Gov. Lou Leon Guerrero has failed to provide effective leadership to fix GMH. For the past four years, Gov. Lou has perpetrated the same selfish patronage politics that resulted in GMH losing national accreditation in the first place. Like a methamphetamine-addicted mother forsaking her own children, Gov. Lou put the comfort and loyalty of nonessential GovGuam workers ahead of the safety of pregnant women and newborn children at GMH.

The only upside to Gov. Lou’s spectacular leadership failure is the unambiguous demonstration that men don’t have a monopoly on bad politics. The Leon Guerrero administration has broken the glass ceiling on bubble-headed thinking. Just like the guys with the Y-chromosomes, Lou’s leadership is out of touch, bereft of compassion, and misreads the hearts and minds of its own people. By allowing her Department of Public Health to declare the people of Guam “vectors, not victims” of Covid-19, Lou definitively revealed that she knew nothing about so many things.

In 2018, the U.S. Centers for Medicare and Medicaid Services (CMS) told GMH it had multiple safety violations which were likely to cause, or to have already caused, serious injury, harm, impairment or death to a GMH patient. In that same year and for the same reasons, GMH was stripped of its Joint Commission accreditation. Four years and one pandemic later, GMH continues to fail Guam by failing to meet national hospital standards for patient safety.

Meanwhile, empowered by local healthcare experts who live and pay taxes in this community, Guam Regional Medical Center and the Guam Navy Hospital proudly maintain their Joint Commission Accreditation. Those hospitals are cleaner than GMH. Those hospitals are safer than GMH. Those hospitals together have 200 less employees than GMH.

This Halloween, GovGuam leadership has decided to perpetrate another mean trick on you, dear citizens. For the first time in forever, GovGuam has the money to fix GMH. Despite having more than enough Covid-19 federal relief funds to rejuvenate Guam’s only public hospital, your elected leaders have chosen to horde it all in Lou’s family bank.

For the past year, $300 million has already been languishing there, more if you really want to know.

So, we are all living through a horror movie where the monsters keep popping out from under the overcrowded beds at GMH: dirty, dilapidated facilities suffering from deferred maintenance and payroll politics; overdue accounts payable to medical vendors threatening the hospital's supply of essential medicines including oxygen for dying patients; and a bloated hospital payroll stuffed with expensive nonessential staff. These are the monsters of hospital mismanagement that Gov. Lou and our legislature have been afraid to confront.

The real monster is the politician who would sacrifice public welfare for personal pleasure. The voters of Guam must now elect leaders who have the courage to confront their own personal demons and do the right thing for GMH.

These brave new heroes must do what Lou did not do: pay for public service rather than patronage salaries, prioritize patient care rather than spin doctoring, and kill the monster that is payroll politics.

Dr. Vince Akimoto practices Family Medicine at the American Medical Clinic. Send feedback to

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