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.