The hospital sat on top of a hill in the south of the city. Still within the city limits, it had been built in the late 1940s to handle a southward growth out of the downtown area. At one time, it had been the newest hospital in the city, accommodating new neighborhoods built shortly before and after its construction. Then, over time, over many years, the neighborhoods began to change, first around the edges, then moving into the center until some of them were thoroughly converted, with a population quite demographically different than the original.
For a very brief period of time during the middle 1950s, the hospital had actually been looked upon as one of the two best in the city, perhaps the very best for an even briefer period. People in the city government and the medical community still occasionally debated what had led to its decline. Was it the structure of the neighborhoods—the pure demographic change? Or was it that the hospital itself changed, and the surrounding population took that as one factor that favored a move to another, newer area?
Jeanne Ingrosa, a native of Queens, New York City, had lived in Nashville only about six months. She had graduated from a small college on Long Island, and had gotten her master’s degree and Ph.D. in political science from the State University of New York at Buffalo. During the past year, she had taken a teaching assignment at Belmont University and had settled into an older neighborhood south of downtown. A friend of hers who already lived in Nashville had convinced her that the area had good deals on existing homes, and that in a few years her investment would pay off handsomely. She was a little skeptical—her father had always warned her about using a home as an investment—but she decided the potential downside wasn’t too bad.
Although only in her early 30s, she took her health seriously, not only having routine visits to a gynecologist, but also having an annual physical exam. It was for the purpose of such an exam that she searched her group insurance carrier’s website and located a doctor in the area of the hospital. It was her first appointment, and she made certain to arrive thirty minutes before, putting her there around ten-thirty in the morning.
Now, as she sat in the waiting room, she began to grow slightly uncomfortable. The area in which she lived, and all the buildings up and down the main thoroughfare, had an older look to them that contrasted with what she was used to in a Buffalo suburb. Of course, Buffalo had plenty of old buildings, and she knew there was no reason to associate age of a building with lack of quality. Still, Nashville had a much newer look overall, and she wondered about the quality of care in her area.
She started to grow impatient with the situation. It was now past noon, and no one had advised her of when she would see the doctor. The two young women behind the counter had barely paid attention to her as she registered on the sheet in front of them, and since then the two had engaged in a non-stop conversation about people they knew, what those people were doing, how much they either hated or loved those individuals, and anything and everything that anyone who didn’t know those people would find quite boring. Their voices were incessant, and seemed to grow louder with each new thread of conversation. There was a certain animated quality about them that was interesting for a few minutes, but quickly became severely irritating.
Other patients waiting in the office seemed to accept the situation. None of them looked very irritated, and even though they all looked unhappy to some degree, none of the unhappiness seemed to be related to their long wait to see the doctor. They simply accepted it, in a way that Jeanne could not. To Jeanne, an attitude was being projected outward onto those patients, and her, an attitude that radiated not only from the two women behind the counter, but also from the doctor, who apparently was unconcerned about the situation, to the extent that her personnel made no comment about it, and offered no sympathy for the situation.
To Jeanne, it was a sign that something could be wrong with the overall practice the doctor was conducting. She wondered if, in this part of town, poor patient service was just part of the territory. The patients surrounding the hospital complex simply had to accept the situation, because they couldn’t go elsewhere, either because they lacked the proper insurance, or the funds to purchase the medical services they needed.
She decided to leave if no one had come for her by twelve-thirty. However, the longer she waited, the more irritated and angry she became, and by twelve-twenty, she could stand it no more. She thought about going to the counter and saying something, but by then she was tired of the attitude she had heard projected from the two employees. She stood up and looked around at the other patients; none of them were paying any attention to her. Everyone else in the room seemed to be in his or her own little world, shut off even from the person sitting next to them.
She glanced at the counter; the two women behind it were still talking to each other, apparently not having anything that required their immediate attention. They paid no attention to anything going on in the patient waiting section.
She pushed the door open from the waiting room and walked into the hallway. It was crowded; a number of people passed by in each direction, and she had to merge into a line of people. The elevators were crowded, also, but she was able to fit in on the first car going down from the eighth floor.
Outside, she felt relieved. The day was bright and sunny, the temperature was moderate, and there was a small breeze that provided just the amount of relief from the moderate heat. She stood there and looked up; there were a few white clouds off to her left that added a little character to an otherwise flawless sky.
She wondered if she would hear from the doctor’s office, once they realized she had checked in, but then had disappeared by the time they came looking for her. If they ever even come looking for me, she thought to herself. She doubted she would ever hear from them, but then she chastised herself for thinking that. She wondered who was to blame, and what she would wind up doing.