CHAPTER XVII. Medical and Surgical Service of Ancon Hospital

MEDICAL AND SURGICAL SERVICE OF ANCON HOSPITAL

The medical and surgical service of Ancon Hospital rapidly developed so as to win the confidence of the civil population all around. Not only did patients come to us from the Zone and the Republic of Panama, but patients also applied for admission, and many of them, from the west coast as far south as Chili, and as far north as Mexico. Many hundreds of people who formerly went to Europe and the United States for surgical care and treatment, now go to the Ancon Hospital.

The charges for this treatment are so arranged that it costs the Commission nothing, but is actually a source of considerable profit. Hundreds of patients who can never hope to have means enough to go to Europe or the United States for medical or surgical relief, are able to go to Ancon and pay the very moderate charges there.

This is another item of peculiar charge on the Isthmus. If it costs $30,000 a year to care for these patients, in our accounts this $30,000 is charged to sanitation, but the $50,000 which the Commission receives for these patients is not credited to sanitation, but to construction and engineering.

An eye department was also established at Ancon by Major Theodore C. Lyster, of the United States Army, and was equipped with all modern appliances for eye, ear, nose and throat work. This department developed along the same lines as did the surgical work of the hospital, and was soon attracting patients from all the west coast north and south of us.

The hospital also had a well-appointed department for the insane. This grew from very small dimensions to considerable size. In 1913, we had two hundred and fifty patients in this section of the hospital. When we first went to Panama, the insane of the Republic were very poorly cared for. In most parts they were confined in the jails, and cared for with the ordinary prisoners. Knowing that, as time went on, we would have a considerable number of insane from the people in the Zone for whom we had to make provision, we proposed to the Panaman Government that we should take care of their insane in our institution, at a per capita cost of seventy-five cents per day. This they readily agreed to, and at present, considerably more than half of these two hundred and fifty patients are sent in by the Panaman Government.

The cost of caring for these Panaman patients was charged to the Department of Sanitation, but the seventy-five cents per day which was received by the Isthmian Canal Commission from the Panaman Government, was turned over to the construction of the Canal.

A large and well-equipped laundry was attached to Ancon Hospital, furnished with all modern appliances. It was originally intended merely to do hospital work, but it was so difficult for employees to get washing done that the functions of the laundry were gradually extended and work was done for Canal employees other than those sick in hospitals. A reasonable charge was made for this outside work, and it finally came about that the income from this outside work went a considerable way in paying the expenses of the laundry.

Under Colonel Mason, who succeeded Colonel Phillips in the management of the hospital, the waste fats and tallow from the kitchen were saved, and enough soap made not only to supply the laundry, but in good part to supply the hospital.

The amount of surgical work in this hospital was very large, and the quantity of surgical dressings enormous. A considerable portion of these surgical dressings were not at all soiled, or very little so. Colonel Mason had these picked over, washed and sterilized, and found that he could thus make a large saving in his surgical dressings.

In the early years of the hospital we bought such milk as we could get from the surrounding country at one dollar and twenty cents a gallon. Colonel Phillips brought cows from the United States and established a dairy on the hospital grounds, which accommodated about one hundred cows. After the dairy was well under way, he found that his milk cost him only from thirty to forty cents per gallon.

I merely mention these items to show how much can be saved by care and attention to details in a large institution like Ancon Hospital. I could mention many other items, but these suffice to show that the hospital was very economically as well as efficiently run.

All the adjuncts of a large and well-managed farm could be found on the Ancon Hospital grounds—a poultry yard, a piggery, a large garden, all of which contributed largely to the comfort of the patients, and to the economy of administration. The poultry yard contained some two thousand hens; also, pigeons, ducks, etc.

Ancon being in the suburbs of the city of Panama, and on the mountainside, was always considered a most desirable place of residence. Out of compliment to the Church, the French Company erected for the Bishop of the Diocese of Panama a residence just within the hospital gates, and fixed up the approaches to this residence in very handsome style. A macadam road led from the hospital gate up to the front of the building, and a broad flight of some thirty-five or forty steps led from the main roadway directly up to the building itself. A noble row of fifteen or twenty royal palms partially screened the building in front. This building was used by us as quarters for the superintendent of Ancon Hospital.

The laboratory for original research, which I described above, was located across the roadway some fifty or sixty yards in front of this house. I have also mentioned that part of the function of the laboratory was that of an undertaking establishment, and many of the funeral services for those who died took place in a small chapel connected with this laboratory. At one time in the early days when a number of the Americans were dying of yellow fever, the Governor of the Zone, like many of the others one day felt cold chills creeping down his spine. He went over to the laboratory to consult Major La Garde. The Major took his temperature, felt his pulse, made a careful examination and looked exceedingly grave. He insisted upon the Governor’s going up into his (Major La Garde’s) house, the one I have just described as overlooking the laboratory.

While the Governor was undressing and getting ready for bed, a hearse drove up to the laboratory, but from the location of the building, the hearse was also immediately at the foot of the broad flight of steps leading to the Bishop’s house. The Governor was naturally much depressed at the turn affairs seemed to be taking. Evening was drawing on, and the sun was sinking to rest. He knew from the history of yellow fever that many a poor fellow who had gone to bed as he was doing had not lived to see the sun rise again. So he made up his mind that he would take one more look at the sun, the trees and the outside world before he turned in. He went to the window, drew aside the curtains and looked out, and there at the foot of the steps, right at his front door, stood the hearse. With a groan he turned to his bed, sure now that Major La Garde regarded the case as one of those short and fatal ones, and had ordered the hearse so that it would be on hand and convenient when the Governor had need of it. But I am glad to say that the Governor was all right next morning, and the hearse had been ordered not for the Governor, but for some poor fellow in the morgue at the laboratory. This is not my story, but the Governor’s, and I wish I could tell it in the inimitable way I have many times heard it from him.

As stated previously, any sick employee was cared for in Ancon Hospital, or any other Department hospital, free of charge. If he were on the gold roll, he was allowed pay for thirty days’ sickness in each year. The gold roll practically meant white Americans, of whom there were about five thousand. The families of employees receiving more than fifty dollars per month were charged one dollar a day for treatment in the wards. If they asked for special consideration, such as private rooms, or private nurses, they were charged accordingly. No charge was made for surgical operations on members of the families of employees. If the employee received less than fifty dollars a month, a member of his family was charged only thirty cents a day in the hospital. Any person not an employee was charged two dollars per day for ordinary treatment in wards, and an additional charge for all extras, such as private rooms, special nurses, etc.

On October 31, 1913, we had in our hospitals three hundred and twenty-nine white employees, four hundred and forty-five negro employees, one hundred and ninety-nine white non-employee pay patients, and four hundred and fifty-six black non-employee pay patients.

The income of the Department from all sources during the calendar year of 1913 was about $250,000. This came principally from persons cared for in the hospitals.