Time to clean up our act

by Dr Peter Brindley

@docpgb

The 45^th President of the United States- you may know him as Donald John Trump- is infamous for his utterances (1). One of these was when he called various countries “s***holes”. We should never excuse deplorable language or anything that smacks of racism. However, it did make me reflect on the state of our beloved public hospitals. Sadly, some hospitals, on occasion, would not be entirely unrecognisable to DJT. My current place of (proud) employment was built in the eighties during a spending boom. It originally resembled a hotel and there are stories of confused patients asking to be shown their suites. After shouldering a mighty burden, the paint is cracking and some staff are as burnout as the fuses. However, it’s the toilets that I want to get into, albeit figuratively. If how well we clean up correlates with how much we care then it’s time to admit to Houston- and to housekeeping- that we have a problem.

I am not prudish, and am also the first to laugh at the graffiti on the Anaesthesia washroom warning all to “beware of gas”. It’s just that “community” only works if we ALL give a damn, and that starts with the bogs. Melodrama aside- and I realise I’m discussing toilets here- we beat the Nazis because of the efforts of “so many for so few”. This is also why the hospital honour role should include valiant cleaning staff, browbeaten triage staff, and the indefatigable folks who (wo)man the phones. This is also why I get so huffy when people throw cigarettes on the ground, or shout at staff. Is it really too much to ask people to flush? If it is then society is going down the drain far faster.

I love my job, I love my hospital, and I am as excited that my ICU is reportedly next in line for a makeover. I just worry that we do our taxpayers, and donors, a considerable disservice if we treat the place with all the care of a petulant teenager. Alcohol hand dispensers have been removed because patients have drunk from them. Communal food has been limited because it decorated the floor. And while handing out yellow cards, let’s face it, the staff lounges aren’t that much better. Occasionally we speak up; mostly we offer up a shrug.

So, what to do? Fortunately, it’s not that hard. We just need to do those things that make Mums proud. Let’s celebrate the basic civilities. Let’s get back to “sir” and “madam”. Let’s stop in the hallway and offer directions. Let’s allow others to get off the lift first. For the docs, why not dress like a professional. This author believes that the start of a week means a suit and tie, it’s just a shame that people think I must be returning from court. Show me substantive evidence that smart clothes are truly pathogen-ridden, before resigning my portly body to hospital scrubs. Until then I’m rocking it Downtown Abbey style. If dressing nicely is a defiant act, then vive la revolution.

Back to Mr. Trump. New York was a dangerous and dirty place in the 1970s (2,3). That’s right, Mr. President, your hometown was a s***hole. Several New York mayors decided to combat minor civil infractions, and to crack down on graffiti. They reported major gains in optimism and safety. The “broken window” theory has been challenged, but the idea is that we all contribute to a general sense of pride or decay. It is why we doctors need to clean our coffee cups and reassemble the chart. If you have ever been to Singapore or Japan you will understand that cleanliness and order is a collective choice not an inevitability.

Our public hospitals are community focal points, even secular churches. They also contain more expensive equipment and more years of training that any other municipal site. I am just sad to see these once great buildings age so poorly. It’s time to fight back by being tidy, polite, well dressed, and courteous. It’s time to thank the cleaners, and it’s time for everyone to be their best public self. If so, then next time President Trump pontificates we'll be better able to tune him out.

References or if you want to know more:

1) https://www.shortlist.com/news/the-50-most-ridiculous-trump-quotes-ever/54443

2) https://en.wikipedia.org/wiki/Broken_windows_theory

3) https://www.npr.org/2016/11/01/500104506/broken-windows-policing-and-the-origins-of-stop-and-frisk-and-how-it-went-wrong