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Battle of the Bulge

Sharma Vaughn, RN, MPA
Executive Director, Community Care Alliance
Western Healthcare Alliance
March 23, 2020

Years ago, when I was visiting Belgium, I met a man in the Bastogne War Museum: The Battle of the Bulge. The man was 11 years old during World War II “when the GI Joes liberated the city,” he told me. I was amazed to see his genuine delight at meeting the unaccomplished nobody of a granddaughter of a “real American GI Joe.” It didn’t matter to him that my grandpa fought in the South Pacific. He had hero-worshipped the GI Joes since he was 11. And who wouldn’t? I had hero-worshiped that generation, too.

It was easy to worship them with their stories of bravery and selflessness. Such stories flowed without acknowledging the immensity of what they had done at 18 years of age!

I remember my grandmother telling me about sugar rationing, darning socks, and wrapping bandages for troops overseas. She had assumed her brother’s teaching post as he had gone to war. This was not unusual; she would point out. “Everyone just did the best they could with what they had been given.” It was business as usual.

That was simply the habit when you grew up during the depression. It was no big deal to make the best of what you had. You stretched the soup with what you had been given. No car? No problem. You’d make do with the horses. You shared, you did without, but you made it work because nobody had excessive resources. Everyone was pinched. It was business as usual.

In fact, that generation was so accustomed to doing the best they could with the little they had been  given that it was business as usual to stand between the German Army and people they had never met
in a foreign land. They took what they had been given, holding the line, and turned the tide of the war. We now know the significance of the Battle of the Bulge. They knew the right thing to do was to make do with what they had been given.

By contrast, I looked at my generation with their pants too low, dependency on cell phones, and preoccupation with pop culture and thought how unlikely it would be to see heroes rise again.

Inspired by my grandmother, I went to nursing school. It was not long after that I found myself working in small Western Slope hospitals. There, in the hospitals, I saw daily the stories of natural selflessness that made the world right again. That is the world I live in. These are no-account, under-resourced, local, small, rural and frontier hospitals who by habit and heritage simply keep doing the best they can with what they have been given.

So naturally, I was astounded to hear the news recently that hospitals were the bad guys. Didn’t I know that hospitals were responsible for overspending in healthcare? Hadn’t I heard? They were selfish, preying on people’s bad fortunes in order to make shameful profit margins! Wasn’t I aware? We should band together and set them straight. Legislators told us that Denver knew best, and they didn’t trust hospitals – ANY hospital.

No. I wasn’t aware of that. Because that was not the hospital world I knew. I knew hospitals with negative or starved profit margins that fought on because they were the only source of healthcare in their communities. I saw nurses give up holidays with their own children to staff the ER. I saw hospital CEOs bring pizza on a Saturday to overrun nursing units. I saw administrators repeatedly show up after hours to comfort a community in the wake of an accident involving a local teenager or toddler. I saw physicians do house calls. I saw countless meals skipped, lunch breaks abandoned, vacations cancelled, schedules swapped, shifts extended, meals donated, and car rides offered. I’m not just talking about clinical staff, either. I’m talking about kindnesses done daily by all kinds of staff like maintenance and the business office, housekeeping, administration, dietary, and reception.

Just a few weeks ago, the media was ablaze with furious reports over the villainy of hospitals. Me? I just don’t see it in the hospitals I know.

In the wake of the Coronavirus, I simply see these hospitals continue business as usual: taking care of their communities, by doing the best they can with what they have. Many of the hospitals have suspended accounts receivable believing collections would cause hardships to their communities who are out of work. They do this knowing it could make finances even harder on the hospital.

Overrun amidst the pandemic, the hospitals are doing what they’ve always done: the best they can with what they have, answering the shortage of vital personal protective equipment (PPE) with creativity. They have come together to purchase equipment that will allow them to sterilize and re-use PPE. Some communities are helping by sewing face masks from vacuum cleaner HEPA filters… anyone up for darning socks next?

When one hospital was offered financial assistance, they turned it down, asking that it be offered to another hospital that needs it more. Not only are the hospitals looking out for their own communities, they are looking out for each other’s communities. These are not the money-hungry, price-gouging, villains we were told they were.

The Battle of the Bulge reminds us there were heroes who stood in the gap, putting their very lives on the line. They turned the tide of a war. It was business as usual: good people doing the right thing. There are heroes still, who stand in the gap, putting their lives on the line. They wash in. They wash out. They hope they don’t bring it home to their families. They’re turning the tide of a war. They’re doing what they always do: the best they can with what they have been given. They’re good people doing the right thing. It’s business as usual.

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