David Cook: Diagnosis, please

David Cook

Moments after the Erlanger board voted Kevin Spiegel the new CEO, Holly Rivera was out in the hallway, holding her stomach, hoping her baby would not come too early.

"Pre-term labor," she said.

Holly and her husband, Jorge, had checked into Erlanger on Friday. Drove all the way from McMinn-ville.

"My hospital doesn't have the capabilities,'' she said.

Not 50 feet away, a new leader had just been named after months of drama. The Riveras had other things on their mind.

"It depends on who it is," said Jorge, "and how they think."

In that little sentence, as he pushed his wheelchair-bound wife down the hall, Jorge summed up so much of the Erlanger story.

Who it is.

And how they think.

The last few months, I've thought more about Erlanger than ever before in my life. Even dreamed about it (the very large hospital gown I was wearing turned into a golden parachute).

So much to think about. The hospital's governance. Its search for a new CEO. Its board and physicians. Orange money. Practice plans.

I've heard off-the-record stories that would make Aaron Sorkin drool, fit perfectly for some miniseries drama on humans, power, politics and money.

The personalities. Fear of change. Threats. Rumors (Vanderbilt University even showed up in one as a potential buyer for our century-old hospital). The heroic day-in-and-day-out work of making sick people healthy.

I've come to love this hospital. Its history. Staff. Its mission. Been on barstools and caught myself talking about Erlanger the way some people discuss UT football or "Downton Abbey."

After all of this, I am ready to wholeheartedly say one thing:

I still don't know what to make of it all.

Why did the board's search committee not include Charlsetta Woodard-Thompson (the interim CEO who's done a more than capable job) on its final list?

Why was so much of the search process secretive?

Is Spiegel a promise for brighter things to come or a wedge that will drive folks (like most valuable doctors Tom Devlin and Frank Kimsey) away?

Questions. More of them than answers. But I do have at least one hunch.

To keep dancing, Erlanger needs a strong partner. Who? The University of Tennessee College of Medicine and all that it offers: residents, research, physicians, an across-the-state connection to other hospitals.

To talk to some physicians Monday night, a stronger UT connection is about as promising as Enron; to others, it's The Orange Answer, the one big solution to many problems.

Like I said: still not sure what to make of it.

But while I was writing this column -- in fact, moments before I typed these very words -- the phone rang.

My friend was in the hospital. He'd had a stroke.

And they'd taken him, of course, to Erlanger.

This is what it always comes to, isn't it? Sweep past all the politics and money and we're left with the original intent of medicine: to make sick people well.

On the way out of the board meeting, one longtime Erlanger physician shook his head, still unsure what the future holds.

But he did know one thing.

This morning, there would be a 3-year-old patient waiting for him. Sick, scared.

The doctor was going to try to save the child's life.

Whoever becomes CEO, whoever is named to the board, whoever scrubs in each day or instructs residents or sets the budget: you can't forget this.

Whoever you are. However you think.