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consists of the name, age, social condition, birthplace, occupaion, husband's name if a female, mother's maiden name, birthplace of both, date of admission, address of friends, religion, and records it in the pedigree book. In this book is also kept the date of discharge, date of death, cause and time of death. The hospital register, which is kept for convenience only, and to facilitate the making of reports, was kept under the supervision of the attending physician. In this, from day to day, are copied from the pedigree book the name, age, and date of admission; also by the physician's orders, the disease, date of discharge or death, condition at time of discharge, and any remarks of importance. The death book is now kept by the clerk of the institution as part of our institution records. It was formerly kept in the hospital. In it we keep the name and age of patient, institution number, date, time, and cause of death, and what disposition is made of the body, whether taken by friends or buried. Then we keep what is called a " clinical history book." This contains as hort pedigree of the patient, a short history of his life, sickness, his family history and the history of his present disease and its treatment while in the hospital. These records were started by me in June, 1893.
Up to March 20, 1893, Long and Rainsford Islands were under one resident physician; the two hospitals were considered as one; all the record books were kept in that way, and all on Long Island, though part of the female patients were at Rainsford. When the administration of the island was changed all the books containing female records were taken to Rainsford Island.
For a month or two we copied the female names into a portion of the male register, then we fixed them up in the old Rainsford Island register book, the use of which was discontinued when the men were moved to Long Island. It was at this time that Charles Coakley, an inmate who did the copying, was sent to Rainsford Island to fix up the books; and it was done, as you can see, not because there were no records kept, but because they had taken over there the books containing the records of the patients that were left with us, which were necessary for us to have in order to keep our books in a satisfactory manner. The pedigree books, which are the basis of all our records, I can show you are kept in a continuous manner. Now for the so-called mistakes.
Dr. Parker says there were more deaths recorded in the deathbook than Mr. Hinds, the clerk, had on his books. That was so, because Hinds' books showed only the deaths of people on Long Island, while the book contained all deaths up to March 20 that occurred whether at Long or Rainsford Island.
The record of O'Brien's death, which appeared on the institution books, no mention of which could be found on the hospital books, came about in this way: O'Brien was loaned to Rainsford Island for a few days, as a milker, I believe. While there he was taken down with pneumonia and died very suddenly. As he still remained on our books as an inmate of Long Island, we bad to account for him, so he was put down as discharged by death. His name does not appear on the hospital book records for the reason that he was not there.
Dr. Parker says I told him it did not occur to me to look at the register until a few days before the making of our annual report. I never told him so. It has always been my custom to look at the register quite frequently to see if it was kept up to date.
Any mistakes that occur in the records as to ages, diagnoses, condition when discharged, dates, etc., are due to neglect of duty on the part of some physician, and they have not all occurred since March 20, 1893, nor were we free from them after November 15, 1893. I looked, as it was my duty, to see that the books were kept up to date. I did not seek to verify them, nor do I consider that I should have done so. I might just as well be expected to pick over a field of corn to see if the farmer has planted it properly.
Dr. Parker says the children were not given an airing from October until March. If he does not know any more about this detail of the nursery than he did about its ventilation his testimony on the subject does not amount to much. I depend for my information on Miss McKenna, the nurse in charge, who tells me the children were taken out up to December. Now, gentlemen, come down and spend the winter with us, and if it is anything like last winter you will not wonder why it is the children do not go out through January and February as often as during the summer months.
Dr. Parker says he reported the shortness of milk in the hospital to me every day in December, and if you remember Mr. Morphy's testimony he said it was for a few weeks in December only that we had any continual shortage. Mr. Morphy's statement is correct, and it was from the fact that Dr. Parker did not report it to me until the 26th day of December that the shortage continued as long as it did. If he had done so I could have probably righted the matter just as well on the 8th as the 27th of December, and it was from the result of my investigation into this matter that I took unto myself some duties, as I have said before.
Dr. Parker says, in speaking of an operation on a colored woman. Amanda Tabb, that I said it would not do to operate, that there were no facilities for surgery there, and that he would be only criticised by the public if he performed any operation. What I did say was, that it was not a suitable case for operation ; that the woman was so exhausted she would probably die under the operation, and as for relieving her pain we could do that by strong opiates, as she would not live many days and she didn't Afterwards, in talking in a general way, I told him we would never do any operation there without the consent of the patient, and if it amounted to much, to get not only the consent but the written request from patient or friends; that we would be always liable to criticism, and especially if the operation turned out unsuccessful, and I don't think I was very far wrong:
The true aminus of Dr. Parker's testimony and his striving after defects, is shown where, in an attempt to prove the necessity of an ether cone, he illustrates the case of Dr. Murphy's cutting an artery, and their having to wait until they made up a Laying aside whether for such an operation ether should not have been given in the first place, we will discuss the case as
A small artery cut, two doctors present, one could put on pressure and control the hemorrhage indefinitely, while the other could make the cone. Every argument he advances for the presence of an ether cone, is in reality an argumeut for the giving of ether before the operation was commenced. Dr. Parker says in answer to the question "What difficulty was there in putting your thumb on the artery until you got the ether cone?" Well, there was only two of us there, and while giving the man the ether, his struggles would move my thumb from the part, and he was a very powerful man, a very large man, and we had a very hard time to get him under the influence of ether." What an answer for an honest, well-intentioned man to give to that question! Would the presence of a dozen ether cones have made the man less powerful, less in size, or less hard to put under ether? Again, when trying to think of some cases where the absence of any instrument has caused serious results to a patient, he hits on the case of Herrick, who, he says, died from a piece of meat in his trachea, and says if he had had a bristle probang he thinks he could have saved his life, although he was a very old man; and the papers picked up the statement and printed it in head lines. Now, any doctor who valued his reputation would tell you that it would be the greatest folly to try and get a piece of meat out of the trachea with a bristle probang. Look at his other attempts to mislead: iodoform cheap and good enough for a pauper, aristol expensive and only a Back Bay patient would need it. I guess you understand by this time, that as far as their effect is concerned, one is practically as good as the other.
He says I instructed him in the beginning that expensive medicines were not to be ordered. I never did anything of the kind, and you can judge somewhat from the drug requisitions before and after January 1st, the two periods when he was cut down and when he got everything, according to his story.
He says he did not get the aristol and sulphonal that was on the November 15 requisitions. You will find that the aristol was ordered by me; the reason he did not get the sulphonal was, because there was nearly as much in the hospital at the time as he had ordered, and I knew it.
He says Dr. Dever ordered phenacetine the day before he left, November 15, and did not get it. That is false, as you can see for yourself it was not ordered.
Dr. Parker gives the impression that requisitions were not sigued until recently. Ever since I have been there they have been signed by the superintendent or deputy superintendent, or the goods were not delivered.
Just after Dr. Parker had said that he never knew of a case on Long Island, that needed a trained nurse, a recess was held, so that the next time he was asked he thought of several, and yet every case he mentioned would have been covered by an order for a nurse not to give any medicine unless ordered to do so by a physician.
Dr. Parker gives his explanation of why Mr. Reed asked a question on bed-sores. He knows, or at least ought to know, that
it is not a correct one. Bed-sores are very often the result of carelessness on the part of the nurse. As we have a great many old debilitated, bed-ridden patients, fit subjects for bed-sores, and have very few bed-sores, it shows good care and attention on the part of the attendants.
Dr. Parker's first statement of ten per cent. acute cases did not please Mr. Brandeis, so after the recess he explained it, that we would have eight or ten acute cases one day, and then eight or ten more on another day of different diseases, so that in the course of a year out of the 1,500 cases we would have 400 acute, a much larger per cent.; that may be a fact, and yet his reasoning is fallacious, as you, of course, at once saw, for the proportion of acutes to chronics is the same each day. If you have 135 chronic and fifteen acute, it does not matter whether the fifteen are measles one week and typhoid fever the next, you have only the fifteen on any one day to be cared for. I have instanced these points merely to show with what ready facility Dr. Parker turned to the shedding of light on a dark spot.
On April 12 Dr. Parker tesitified that two or three weeks before he had seen a new screen door on the administration building. The door was not put on until June 20, so he could hardly have seen it there two months before.
In his testimony on the ventilation of the nursery and women's iufirmary wards, Dr. Parker says they can only be ventilated by opening the windows. There are two large ventilating shafts from the nursery ward to the roof, and each infirmary ward has three ventilators into the attic, the windows of which are kept open. As for there not being any room, as Dr. Parker said, at the end of the nursery where the women could go while the room was airing, if it had been necessary, there is a room nearly as large as the nursery itself.
Dr. Parker says I told him and Dr. Leach before this investigation began, at a conversation we had over their duties, "that the Board of Aldermen, even if they did have an investigation, hadn't any power to act, so that their investigation would not amount to much if the Mayor didn't want to take their report; that they hadn't any power to change anything, although they might have the power to investigate." Dr. Parker has got two conversations mixed. At a later date than February 27 we were talking over Mr. McCaffrey and his testimony and I was wondering what he expected to gain by giving such wierd testimony. I had heard he said it did not matter to him if he did get off the police force, that he had powerful friends behind him, that Mrs. Lincoln would look after him. It was also reported that he was to be appointed superintendent of Long Island or Marcella-street Home. What I said was that I did not belive the parties could deliver the goods, that the power to investigate and report rested with the Aldermen and the power to appoint or remove the commissioners, who could appoint superintendents rested with the Mayor.
Dr. Parker tried to give the impression that I ordered him to use up a lot of bad eggs on the patients. Nothing of the kind ever occurred. Last winter we, in company with many others, I guess,
used limed or cold-storage eggs. These will not keep very long after the cases are opened. On one occasion we ordered five cases of eggs. They came larger than we have been in the habit of receiving, so we had one hundred dozen more eggs than I bad intended, and in order that they might be used before they spoiled I told Dr. Parker to give them to the patients freely. I used them myself up to the last, and I know they were good.
He says I seldom went through the hospital unless when the Commissioners came down. He spends, perhaps, an hour a day in the wards; Mr. Morphy all day; and yet Morphy said I used to go through the wards about daily. So I have, and sometimes several times a day.
Dr. Parker says there were no rules posted up in the infirmary. Until recently the same rules which are hanging to-day in the hospital were posted in the infirmary before I ever went to Long Island, and were one of the most prominent objects as you entered the room.
Mrs. Evans said in reply to the question as to how the Board of Visitors happened to make their special report on Long Island, "After making a few visits we found there was reason to believe that things were decidedly wrong," and on January 13 they had an informal interview with the Mayor. Now, up to that time let us see how much time had been spent on Long Island by the committee and how many visits. December 19, 1893, Mr. Ring and Miss O'Sullivan came and spent one hour and twenty-five minutes. January 1, 1894, Mr. Farmer, Mrs. Evans, and Miss O'Sullivan came. Mr. Farmer stayed one hour and a half; the other two, two hours and a quarter. January 8 Mrs. Evans came and spent six hours and a quarter. So it seems two members had been there for an hour and a half; two for a few hours more, and one not at all. Their combined stay was only fifteen hours and five minutes. Up to the day the special report was made their combined time spent on the island was less than forty hours, and it took me nearly that length of time to investigate the facts connected with just one statement made by Mrs. Evans. This was in relation to the statements by inmates that previous to January 1, 1894, the supply of food was meagre, and that they went to bed hungry, whereas since that date they had had plenty. The facts are as follows: Our principal articles of food are bread, meat, fish, rice, and beans. Our books show that from the 1st of September, 1893, to January 1, 1894, two hundred and four and a half pounds of these articles were furnished per capita, whereas from January 1 to May 1, 1894, but one hundred and ninety-eight and three-fourth pounds per capita were furnished.
Mrs. Evans said that she was not aware that any records were kept of the character and history of each inmate with a view to classification. If she had asked me I would have told her that I had been keeping them for nine months, and would have shown them to her.
Mrs. Evans testified to considerable extent on our conversations on the milk question. She never seemed to me to be able to understand it, or able to grasp the fact that trouble over the milk