Slow Therapy

I had picked up a copy of the 2012 publication GOD'S HOTEL, by Dr. Victoria Sweet, so that I might gather background, then read another book with a similar theme. I discovered that Sweet ' s memoir of her career at Laguna Honda Hospital, the nation's last almshouse on the SW side of San Francisco, could have described a hospital where I once worked. GOD'S HOTEL deserves a careful look in its own right. In the evolution of my own SLP career, I have done quite a few Laguna Honda things. Like the country's last almshouse, my employer had been doing some medical care differently. But first, why the title? "God's Hotel?".

One function of the medieval hospital, grown out of the monastery, was to offer not only opportunities for healing, but also for social welfare; hospitality along with care. The SLP, especially in the medical setting but impacting every setting, lives that balance every day as a steward of communication and swallowing. Were there time and space in a setting like Laguna Honda, for taking time and space to bring quality service to all?

In France and other countries that hospital was called the "Hotel Dieu"; one had even existed in New Orleans, from the mid-nineteenth century until the time of Hurricane Katrina. Just like these institutions had fulfilled unique roles in the healthcare system to serve the poor, San Francisco's Laguna Honda had existed for those persons having nowhere else to go when ill. The physicians and staff had had the time and the resources to care for those persons.

Dr. Sweet had helped grow at Lagunda Honda the concept of ' slow medicine', to describe how she took ideas from 'premodern' medicine (p. 139); specifically, how the writings of the abbess Hildegard of Bingen inspired her dissertation on one approach to nourish and restore the life force of a patient  (veriditas = 'green truth'). In this view of healthcare, the patient is a garden to be tended, not a machine to be repaired. This approach is not compatible with the modern healthcare system, but occasionally with my employer there were openings with an individual patient that made me think - something else was possible.

With slow medicine in the form of gardening therapy, there were approaches to engaging patients at Chicago's Michael Reese Hospital that led to more successes with more patients.  With the open mind that it fed, - a mind open to creativity,  to individuality and compassion -  slow therapy was one sterling example of caring for the patient. Sweet cited in GOD'S HOTEL (p. 91) as a huge precursor of her work, the writing of Dr. Francis W. Peabody. Dr. Peabody is quoted - "...the secret of the care of the patient, is in caring for the patient". 

Slow therapy made its mark for me at MRH, when I was bringing patients out the east doors of the rehab unit, to work the plants and keep them healthy until harvest.  Gardening sessions allowed the patient to find her/his voice, while conducting routine gardening tasks (cultivating, weeding, watering). Individualized session activities stimulated and tapped the skill sets for cognition and communication. Then, just as the institution named Laguna Honda became a new medical center with new ways, so did Michael Reese become - a memory. 

Was that the end of slow therapy, as Laguna Honda's transformation appeared to be the death knell for slow medicine?