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Three of us, the brother/sister team of Nick and E.B. along with yours truly, started our planned ninety-five mile trek on the John Muir Trail late in July. I can't remember leaving anyone behind on a backpacking trip before, but by the second morning it was pretty clear that the combination of a serious chest cold and nasty looking blisters were going to be too much for Nick to continue for another week and a half with no relief from the trail. He opted to turn around, hike up to near the top of Dusy Basin, camp a night there, then hike over Bishop Pass and down to our original trailhead at South Lake. Fortunately, Nick's car was the one we'd left at South Lake.

Starting late at 10:30 in the morning, E.B.and I switch backed our way down three miles or so to Le Conte Canyon and the John Muir Trail (JMT). From there we faced a four mile slog, ever upward, in the afternoon soon, hoping to get a campsite at Starr's Camp, located atop the steep drop into Le Conte Canyon. Starr's Camp is the next to last place to camp before ascending another four miles or so to
12,000 foot Muir Pass.
Starr's Camp provides for at least five tent sites tucked amid stunted lodgepole pines at a sharp bend in the trail. Northbound it would be easy to walk right by, the tent sites are more or less invisible from the beaten path, though only a couple hundred feet from a relatively shallow stream perfect for soaking your tired feet or dunking your entire body.
Starr's Camp is named for Walter “Pete” Starr, the author of the timeless Starr's Guide to the John Muir Trail, a volume compact enough for any hiker to carry with them. Pete Starr was an accomplished hiker, backpacker, and mountaineer of the 1920s and 1930s as well as a Stanford graduate and attorney in the firm of Pillsbury, Madison & Sutro in San Francisco. Before he was thirty this disarmingly charming young man had spent his spare time successfully summiting at least forty prominent peaks in the Sierra and the French Alps. He disappeared in 1933 while climbing alone in the Minarets, a collection of sawtooth-topped peaks on the east side of the Sierra, not too many air miles from Mammoth Lakes. Missing in the Minarets, by William Alsup, is a compelling account of the search for Pete Starr. That search was defined by the dogged skills of fellow mountaineer Norman Clyde who refused to stop climbing and looking for Pete Starr even after everyone else had.
The equipment that Starr employed in the mountains of the Prohibition/Great Depression era was far different than today. He climbed without pitons or safety ropes. Whether backpacking or mountain climbing Pete Starr wore nothing more elaborate than tennis shoes. Those lightweight shoes didn't seem to hold Starr back. In one four and a half day hiking trip in the Sierra, he traveled more than 140 miles on foot.
While we trudged up from Le Conte Canyon at 8,740 feet toward Starr's Camp at 10,320 feet in elevation we were passed by a jogging summer ranger, asking on the fly if we'd encountered anyone in trouble just below Muir Pass. We answered that we were headed that way ourselves, but hadn't heard anything alarming from southbound hikers we'd met.
Summer rangers are posted in small cabins or tent cabin stations every twenty miles or so along the John Muir Trail (JMT). Usually arriving in June and staying until October (or the first heavy snowfall) they perform many thankless tasks, from picking up garbage to answering pointless questions from hikers who walk into the mountains without a map or a compass (E.B. and I possessed both)
as well as providing lifesaving work for injured or hopelessly lost hikers and climbers.
A strikingly detailed book on the life of a longtime Sierra summer ranger named Randy Morgenson can be found in Eric Blehm's The Last Season. Morgenson, the son of an expert on all things in nature throughout Yosemite Valley, served as both a winter and summer ranger in the Sierra for about thirty years, including Le Conte Canyon along with stations just north and south. Morgenson was among the first to recognize the value of protecting the Sierra meadows from over-camping. Ironically, there are many similarities between Missing in the Minarets and The Last Season. After a lifetime in the Sierra as well as a nearly year long sojourn in the Himalayas, Randy Morgenson, legendary for finding and rescuing others in the High Sierra went missing himself in 1996.
Despite this confluence of doom in the Le Conte Canyon and Starr's Camp
area E.B. and I pressed onward.

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We're at the Denny's in Bishop by 5:05 a.m. To beat the heat. It has been 106 degrees Fahrenheit or more in Bishop for days. A surprising number of other Denny's patrons have made the same decision.

Nick says they are mostly fishermen. Who knows? Nick's got a summer cold and the evening before he'd skipped the usual handshake greeting for a remote shoulder bump/hug outside the Elms Motel.
Eggs, bacon, hash browns, and a glass of milk to fortify each of us, then we are on our way. We leave E.B.'s Honda in an inconspicuous part of the huge Von's parking lot, where, the previous night, we bought last minute additions of food for our backpacks. My car's already stashed on the outskirts of the Mammoth Mountain Resort, our hoped for exit point after ninety miles and twelve days of backpacking.
Nick's SUV takes us west out of the dawning light of Bishop, twenty-two miles west, and up to our trailhead beside South Lake at an elevation of over 9,000 feet.
The six mile climb from South Lake to Bishop Pass is broken by a stretch of flat hiking past Long Lake, though in our morning ascent the mosquitoes by that lake keep us from any prolonged breaks. The rest of the way is an arduous, switch-backing slog over granite to Bishop Pass (just over 12,000 ft.).
While we're collapsed at the top of the pass, @ the noon hour, two lean women in their early twenties reach the same Bishop Pass summit practically perspiration free and genuinely gleeful about their resupply jaunt from the John Muir Trail (JMT) at Le Conte Canyon (more than three thousand feet below) up and over the pass, down to South Lake, then Bishop, and back again – all in a day and a half. Before we regain the energy to shoulder our backpacks again, they are gone like a light breeze. We learn later that they are not only through hiking the JMT, but also the Pacific Crest Trail in 25-30 mile chunks per day when they are not slowed down by resupply efforts. Such long distance hikers often acquire trail names. The pair are simply known as “The Beast.”
We are not planning to pack all the way down to Le Conte Canyon and the JMT that day, but rather down just far enough through Dusy Basin to overlook the canyon. I set out ahead of Nick and E.B. to capture the best campsite at the lowest reaches of Dusy Basin.
Almost all this downward stroll is wide open to the afternoon sun, though the farther I march clouds tumble in to shade any and all wearying backpackers. When I reach the last possible overhanging spot for camping, in the three o'clock hour, the splatter of rain and the roll of thunder approaching inspire me to new speed records of pole arcing, rain fly tossing, and tightening. I'm inside my “two person” tent with only a modicum of dampness for accompaniment. Full backpack alongside, I tug out my air mattress and sleeping bag while lightening flashes bright and close enough to be seen oh so clearly through the orange REI tent and rain fly.
Between the booms of thunder and lightening the sounds of Nick and E.B. setting up their larger tent trickle through the storm. The typical Sierra rain or hail lasts a few minutes, maybe a half hour or so. This puppy went on for about two and a half hours with just the tiniest of let ups for a minute or so interspersed each hour.
Fortunately, both tents survived with only small amounts of rainwater puddling inside. However, by the following morning it was apparent that Nick had paid more attention to the cold settling into his lungs than he had the silver dollar-sized blisters splotching his feet. One day in and it was time for a decision, continue on or turn back.

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The Logan Trace is a branch of Daniel Boone's Wilderness Road in central Kentucky. In this context a “trace” is a trail, particularly in a wilderness area. The Logan Trace takes its name from Benjamin Logan, an officer in the Virginia militia during the American Revolution. Later he followed Boone's path to Kentucky where he did battle with the Shawnee native to the region, burning a dozen or more of their settlements.

Near the end of Logan's Trace, down the trail from Boonesborough and below Hazel Patch, rests the early pioneer station of Crab Orchard, Kentucky. Daniel Boone himself references it as early as the autumn of 1777, when he recorded that a band of Indians entered upon an excursion into the district known as the “Crab Orchard.” The first recorded official settlement in Crab Orchard was noted in 1788.
Fish and game were so plentiful in this region that its original inhabitants, known to us today as the Shawnee and the Cherokee, fought almost constantly over boundary rights to the streams and hunting grounds. When the whites, predominantly of Scots and Irish descent, invaded in the late 1700s, the native peoples gave way only grudgingly, so much so that Kentucky become synonymous with the phrase, the dark and bloody ground. The weak of body, mind, and spirit fared poorly in such a place on into the early part of the next century when one Thomas L. Smith was born in 1801 at Crab Orchard. Even as a youth he could be picked out from a crowd with his dark hair and eyes that appeared blacker than black.
Perhaps childhood in Crab Orchard was too rough or that particularly American urge to explore the frontier caught hold in young Tom for he ran away in his teen years, taking on work aboard a flatboat on the Mississippi River. When the vessel reached St. Louis, then the westernmost of Anglo settlements, young Tom Smith hopped ashore. More or less immediately he procured employment with John Jacob Astor's fur trapping enterprise. Readers interested in Astor's attempt to conquer the worldwide trade in furs and set up a permanent American community on the northwest coast of North America in the 1810s should seek out Peter Stark's Astoria.
Young Tom Smith encountered, and was tutored by, legendary frontiersmen like Jim Bridger and Kit Carson. In 1824 Smith joined Alexander Le Grand's (Yes, it translates as Alexander the Great and this frontier trapper, surveyor, explorer is worthy of his own tale.) wagon train of traders heading from St. Louis to the New Mexico territory and Santa Fe. Smith left the train at Taos to set out on a trapping venture in the San Juan Mountains in Colorado, traveling as far north as the confluence of the Green and Colorado Rivers in present day Utah. In 1826 and on into 1827 Tom Smith joined with noted trapper Ewing Young, who had been a part of the very first overland wagon train to traverse the trail from Missouri to Santa Fe, on the initial Anglo expedition into Arizona, wandering as far afield as the point where the Gila River meets the Colorado. At journey's end Tom returned to Missouri, but a year later we find him trapping north of the Platte River in Colorado with about twenty other men.
Often trappers such as these worked in pairs or with a third man, but Smith liked to trap alone. One particular day a Frenchman named St. Vrain followed Smith out to his lines to convince him to work with him and another trapper. While St. Vrain cajoled Smith, a lone Indian rose up nearby with a rifle in hand. The gunshot that ensued shattered bones slightly below Smith's knee. St Vrain carried his wounded companion back to camp. All the while Smith screamed in agony and begged each successive trapper who returned to camp to amputate his leg. St. Vrain temporarily silenced Smith by dosing him with whiskey until he passed out.
When he came to again there were more pleas for amputation assistance, but all the trappers refused. Whether it was the excruciating pain of the wound or a knowledge of the effects of gangrene, Smith ordered a knife be sterilized over a flame and brought to him. There is some debate whether the tool was Smith's own skinning knife or the camp cook's butcher knife; nevertheless, the instrument was delivered. Smith tied a length of buckskin tight immediately below the patella and embarked on slicing through his own flesh. The other trappers gawked for a time then took turns fetching fresh water, rags to mop blood, and more whiskey, for the wound and Smith's mouth. The knife dulled as he sawed at the bone, so his fellow trappers filed teeth into the blade and Smith took up sawing again until he passed out.
Seeing Smith's commitment to the task, trapper Milton Sublette grabbed the knife and finished carving through the bone. Blood gushed from the surgery until another trapper seared it shut with a red hot iron straight out of the camp fire. The men wrapped the stump in Smith's cleanest dirty shirt and covered him with a buffalo robe.
Smith woke the next day, cursing everyone in sight. His fellow travelers were ready to move on to more plentiful grounds, but they lingered an extra day, expecting Smith to die any minute. For whatever reason, he didn't die, so a makeshift stretcher was built to be pulled along behind a horse.
The men traveled more or less westward, pursuing better trapping grounds, with Smith in tow. At some point Smith became aware of two smaller bones protruding through his skin. He commandeered Sublette to jerk the bones out, apparently without complaint.
The trappers finally found some sympathetic Utes, who allowed Smith to recuperate with them through the coming winter. A section of a sapling was brought to Smith. This he used to whittle a wooden stump. By spring the Indians were calling him “Wa Ke To Go.” In English, from this time on he was called Peg Leg Smith.
No shirker to adventure Peg Leg was back on the trail in a year, trapping with several others along the Santa Clara and Virgin Rivers in Utah and Nevada. About half way through the season Smith and one of his companions set out to deliver the group's furs westward, across the Mojave Desert, over Cajon Pass, all the way to Los Angeles.
Peg Leg more or less settled in Los Angeles; less is probably closer to the truth because at this juncture his life slips deeper into legend. Despite his one stumpy leg Smith joined with “Old Bill” Williams and Jim Beckwourth (a mixed race man, born as a slave in Virginia, originally with the surname Beckwith) in one of the largest horse trading operations the old southwest has known. In actuality most, if not all, of their horses were stolen from northern Mexico before being sold anywhere from the Arkansas River to California.
Eventually hints from law enforcement ended this endeavor and in the late 1840s Peg Leg started prospecting around Borrego Springs in southeastern California. Now we plunge headlong into legend. Peg Leg was reportedly wandering nearly blind through a three day sandstorm in the Borrego Badlands when he picked up a handful of pebbles at the top of a butte. At first he passed them off as copper only to have others identify the rocks as gold nuggets. Possibly due to the sandstorm conditions or Peg Leg's propensity for drink in those days, he never was able to relocate the precise spot where he found the nuggets.
Peg Leg spent his last years in San Francisco. He could oft be found along Montgomery Street telling tales in return for shots of whiskey. For a full bottle one could get vivid recollections as to the whereabouts of his gold find. But no one yet has ever found it.
So if you are looking for adventure this summer or fall, you can travel down to the Borrego Badlands. There are many disparate claims about the particular sight of Peg Leg's lost gold strike. Pick one and follow your adventurous spirit to wealth and fame. If you should fall and break a leg badly in that wilderness, make sure you've brought along a large, jagged edge knife and your own disinfectant.

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Another Sniece Day

Ed Sniece walks the river road like his daddy and grandfather before. Some days he strides along, taking much of the waterway for granted, lost in thought or trailing the distant calls of a pileated woodpecker pair.
After the first rains of autumn he often lingers, searching for a spawning bed or where the stream laps under and around a hollow stump that stretches its gnarled trunk from the riverbank. Salmon and trout have thought themselves hidden there, for generations.
But the steelhead don't run like they did before, when Ed, as a lad, watched schools so thick they shoved each other onto gravel bars. Ed and his siblings would pick up the stranded fish, pick them up and toss them ahead to deeper waters. Of course, they had their long-handled spears back then, too, for lantern light salmon hunts in tidewater.
This particular damp, fall day, Ed ducks beneath a tangle of willow to lean against an alder where a logjam covers the river; twenty-five feet across and twice as long. Drift piles his dad had called them. And they were double-edged swords: a quick way to scramble over the river to the other side when the water was high; a quick way to drown when someone slipped between the shifting logs.
Before his daddy's time, when grandfather cruised the woods and the great-uncles chopped the big trees down, the river was dammed, not far east of Ed's place. After the Second War the lumber company blew out the dam, cattails reigning there now.
In those halcyon days of logging restrained only by the terrain, Ed knew that drift piles were a rarity. Young men, less skilled than choppers and millwrights, were employed to keep the occasional drift of
cull logs and large branches broken apart, so hundreds of freshly sawn logs could ride the force of a freshet downstream to the boom and the mill itself.
For a half hour Ed stands his ground in the shadows, letting the willow thicket scratch his neck. Once he could smell the salmon coming; now, just the rushing water lifting the faintest hint of mud from his nostrils. He waits, to spot a fish, a single one. Though his vision isn't hawk-eyed as it once was, nary a steelhead passes.
Time slides on while the mind is apt to idle or slink back. Ed's great-uncle, Fin, had started out breaking drifts apart when he was scarce twelve or thirteen. Corkscrew boots and a long, steel-hooked pole proved the tools of the trade. His grownup sister, Lil, warned, “You don't know how to swim.”
“Don't intend to need the skill, sister,” said Fin, a boy then, sprouting near six feet, prone to pie, but stuck between string and bean. He'd never fill out.
“Fin they call me, not Irish,” he informed strangers who jumped to conclusion, “Finley for full; Highland Scots by heritage.”
Ed always chuckles at the mix in his ancestry. The Snieces were Normans in origin, blown across the English Channel by the fair winds of William the Conqueror.
“Sniece,” Ed is fond of saying. “Rhymes with a piece of pie. Any way you slice it, still Sniece.”
Out in midstream, something silver and pink flashes by in a blur. “One,” he counts aloud then flips open his pocket watch. “One in forty-two minutes.”
The watch has passed down from Finley. If there'd been more ancestral hands on it, Ed wasn't aware, but like all his kinsmen he'd wound tight the memory of his great-uncle's fate.
For weeks, or was it months, Fin had hopscotched from shore to jam, prodding logs free from underwater rocks and snags, sinkers neither man nor boy could spy in the murky depths. Then a November day, not long after Halloween, and a week or more of rain swelled the river; they let the dam open and a thousand logs rushed westward with the tide. Redwood four, five, six feet wide and two or three times as long ran a watery stampede.
Young Finley stood on the bank just the other side of Slaughterhouse Gulch, parrying the first logs that stuck in the riverbank. Whether it was he or the pole that slipped no one knows, but off the slippery shore he went, left hip scraping peeled sap. Under like a cork with too much weight. Didn't let go his pole they say.
Fin couldn't swim, but he darn well had learned how to hold his breath. The current swept him under, but he swung that pole against the logs above like a man trying to beat the rapids. And in a minute, maybe two, he propelled himself out front of those logs, rose like a denim-backed fish and gulped a lifetime's fill of fresh air.
Tidewater shoved him down once more. He spun himself toward an open light, remembering his sister's words, “Even a non-swimmer can dog paddle under water.”
He lost the pole in the last flail and sprawl, but he made the south shore with a lunge and crawl.


Ed's aging hands flip the watch open again. An hour gone and just the one glimpse of a fish bound upstream. He smiles at the punch line of Great-uncle Fin's tale. How he'd have gotten out from under those logs sooner if he hadn't had to swim through thousands of steelhead headed the other way.
A Great Blue Heron alights on the opposite bank. Ed backs slow and easy through the willows, whispering, “River's all yours.”
Ed Sniece walks the river road like his daddy and grandfather did. Some days he stops at a particular spot. Other times he trudges homeward flooded by thoughts of those who trod before, until he glances over at a swamp of cattails. Then he shakes his head and mutters, “I've gone too far.”

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By the time readers peruse this issue of the AVA, yours truly should be embarked on a seventy-five mile section of the John Muir Trail (JMT). Getting to a JMT trailhead is easy if you're starting at Yosemite Valley. Of course you should never begin your JMT journey there.
Why? Here's why. You do nothing but trudge up, up, up with a full pack on your back for the first eight miles out of Yosemite Valley. We're talking four thousand feet in elevation gain, another thousand or more before you reach real respite at Sunrise Camp. Do not do this. Hike this section from Tuolumne Meadows to Yosemite Valley.
For some reason the north to south route, beginning at Yosemite Valley, has become the popular direction of backpackers in the 21st Century. Even the finest modern guide book to the JMT (by Elizabeth Wenk) describes the trail in north to south terms. That's fine for the rest of the journey, but I'm speaking to you out of experience, complete this section from Tuolumne Meadows to Yosemite Valley then take the shuttle bus back to Tuolumne Meadows and walk the rest of your trek north to south if you like.
If you are savvy enough to start at Tuolumne Meadows you'll encounter one moderate uphill section to the Cathedral Lakes area then more or less flat hiking to Sunrise Camp. Beyond Sunrise there's a brief climb then downhill to Yosemite Valley.
Been there, done that. This year our band of intrepid backpackers will be employing the section hiking method for the JMT. Unless you are in Yosemite or at Whitney Portal, getting to your chunk of the JMT is a production in and of itself. Our group is traversing about seventy-five miles of the John Muir Trail, from Le Conte Canyon in the Kings Canyon Wilderness northward to Red's Meadow, just outside the town of Mammoth Lakes. In the summer season backpackers have to take a shuttle bus (cost was $7 a year ago) from Red's Meadow on the JMT to the huge parking lot at Mammoth Mountain Resort).
To get to Le Conte Canyon we will drive about twenty-two miles southwest from our last motel respite in the town of Bishop to the trailhead at South Lake. From there it is about a six mile hike to Bishop Pass (elevation: just under 12,000 feet). The first rest break may come beneath Chocolate Peak. After a few days and nights on the trail, cravings for things like chocolate sundaes often occupy a backpacker's mind more than the finest Sierra scenery.
By the way there's approximately a two thousand foot elevation gain in that first six miles from South Lake to Bishop Pass, compared to the four thousand if one ascends out of Yosemite Valley. Beyond Bishop Pass lies a view of Dusy Basin and the descending contours leading down into the Kings River Canyon.
Late starting hikers who've dawdled while gawking at the Inconsolable Range to the east may want to camp in the Dusy Basin area. Early risers will likely push on a full twelve miles during their first day to the campsites near the Le Conte Canyon ranger station, where the Bishop Pass Trail finally gets you to an intersection with the John Muir Trail.
From this point it's only three or four more days of backpacking to the Muir Trail Ranch and a chance for re-supplying. This is performed by mailing yourself a bucket (not a box) of supplies. Interested backpackers should see the Elizabeth Wenk book on the JMT for specific information about resupply post offices like the Muir Trail Ranch and VermilionValley Resort, alongside Lake Thomas Edison, a few days hike to the north.
Arriving at the Muir Trail Ranch area as quickly as possible is a goal for most hikers, whether traveling north or south. The reason: Blayney Meadow Hot Springs. The springs, just hot enough for humans to luxuriate in them, are about a mile above the meadow itself. The unfortunate if in getting there is that the springs are on the other side of the south fork of the San Joaquin River from the John Muir Trail. If the river is too high or swift... well, we shall see in the very last days of July.

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The Mendocino Coast District Hospital's Board of Director's hosted a public forum about the Obstetrics (OB) Department Tuesday evening, July 12th, at Fort Bragg's Cotton Auditorium. A crowd of a hundred or so coastal residents and hospital staffers first listened to and watched a PowerPoint presentation by hospital CEO Bob Edwards. The high or low light of this was Edwards' claim that the OB department is projected to lose over $9000,000 in the coming fiscal year. Edwards also sighted the high cost of registry nurses as a part of the price of doing business in the OB Dept., though he at no time repeated the simple declarative statement he made at a committee meeting this spring when the CEO said he was in favor of closing OB.
Several of the public speakers commented that they felt Edwards seemed to present figures and information that leaned heavily on the side of OB closure. More or less ninety percent of the members of the public who spoke in the following two hours strongly favored keeping the OB Department at Mendocino Coast District Hospital (MCDH) open. Many spoke passionately about their own birthing experiences. Several cited the hour and a half drive to Ukiah Valley Medical Center (UVMC) as an unacceptable alternative.
Dr. Brent Wright, the only local practicing OB physician, spoke early on, remarking that MCDH is not a business, but a health care district. He and others have acknowledged that annual births at MCDH have dwindled down to somewhere around a hundred for this past fiscal year, but he further stated that it is difficult to place a value on even one life. More than one mother talked about how either she or her baby wouldn't have survived if they had to make the trip to Ukiah for a premature or otherwise troubled birth.
Edwards cited both a parcel tax measure and/or switching MCDH to a “Hospital Fee” structure as possible methods that could raise millions more annually. It is important to note here, that as of this date the only parcel tax concept presented by Edwards has been a straight tax per parcel. That method ignores the geographic and financial realities of a hospital district that encompasses tens of thousands of acres of timberland. Under the method in which each parcel is taxed an equal amount, a simple town lot in Fort Bragg would pay the same amount as corporate timber companies which own many parcels that are hundreds of acres in size. Not to mention that a 1950s style house in Fort Bragg would be taxed the same amount as a home/mansion overlooking the Pacific Ocean. If MCDH's Board adopts a straight up “all parcels are the same” mentality, they will be heading directly into the 1% vs. the 99% maw that doesn't fly on the Mendocino Coast.
Then there is the MCDH Board itself. Past Chair Sean Hogan noted the upcoming November election when three Board of Directors seats will be picked at the ballot box. Retired orthopedic surgeon Kate Rohr resigned in late June; Hogan is not seeking another term; only current Board chair Tom Birdsell is seeking re-election. That means that by 2017 there will be at least two new Board members.
The current board is hardly in accord. Board member Dr. Peter Glusker read a prepared statement that expressed some of the reasons why Dr. Rohr resigned. Quoting from Glusker's statement: “Dr. Rohr’s frustration at being prevented from analyzing the hospital’s finances and producing real change for the hospital was a major factor in her resignation. She has publicly stated, 'I cannot accept fiduciary responsibility for an organization in which I do not receive or trust the basic financial information'.”
Glusker's prepared statement began by citing a study by the Nicholas Petris Center on Health Care Markets and Consumer Welfare at U.C. Berkeley on the issue of OB closures in California hospitals. Again quoting Glusker's prepared statement, “They looked at 389 hospitals over an eight year period and compared those which closed OB departments to those which added new services. Closing OB departments resulted in deterioration in financial position related to a loss of patient relationship to the hospital and other factors. Hospitals did better financially when they added new services, instead of discontinuing them, particularly OB.
Therefore the assumption of administration that closing OB will help finances is not supported by available data. Contrariwise, adding a new service, for example palliative care which, we could do very well here, and which could utilize both swing beds and home health would be likely to improve the financial status.”
As Glusker read, it was at this approximate point that Chairman Birdsell attempted to gavel Glusker silent, apparently due to a three minute time limit or his distaste for criticism of MCDH's administration (meaning CEO Edwards and Chief Financial Officer Wade Sturgeon). The crowd wouldn't have it. Several voices demanded Glusker be allowed to finish.
He did so by relaying Dr. Rohr's response to the aforementioned study. “The absolute MOST significant finding of the study is that closing OB did NOT improve financial performance. In fact it statistically shows that closing OB had a disproportionately NEGATIVE effect on finances. That is, overall hospital business at those hospitals decreased more than could be accounted for by the loss of OB business itself. This is not a surprise to someone from the business world. If a business has a service that is part of the basic definition of its core mission, closing that service cannot possibly improve its finances. In this case labor and delivery is about as basic a core service of what it means to be a hospital. It is well known that if a core service cannot be made profitable the correct task is to streamline and make it as efficient as possible. This is the basic concept of the so called ‘loss leader’.”
Dr. Glusker then wrapped up with this, “My own attempts to obtain the financial details underlying the administration’s OB budget listing a one million dollar deficit were thwarted and resulted in more barriers being put in my way. I managed to get OB departmental statements for January and May, 2016. These reveal very disturbing inconsistencies, raising serious questions about the accuracy of the data. I suggest that this requires an independent analysis of the accounting for OB for the last year to determine accurate information, and then to plan HOW to manage OB.
“A recent study by Lorch et al, examining what happens to babies when regional OB units close, found an approximate 40% increase in infant mortality in the first three years. After that services were effectively redistributed to OB units geographically close enough to provide care. Our location does not allow OB services close enough to provide care for the kinds of problems that lead to infant mortality.
If OB were to be closed here, besides further losing the community’s trust in the hospital, we also put patients at significantly greater risk with ER doctors trying to deal with failed home births, malpositioned or crowning babies, placenta previa or a need for an emergency C-section. These problems pose critical medical risks for mother and baby, leading to infant mortality or potentially lifelong neurologic disabilities. The distance to the nearest obstetrician and hospital does not allow transfers in most of these situations. The medico-legal risks for the hospital are also increased. ER care for OB is not good quality care. When Sean Hogan was president of the board his emphasis was on quality of care. Finally, the administration needs to cooperate with the board and not try to direct the board as they are with attempts to close OB, and the Board needs to focus on planning and strategy.”
Clearly there has been an ever widening rift between the two doctors on the MCDH Board (now one) and the CEO and CFO. The questions over the OB Dept. are perhaps the tip of the iceberg at an institution with more than $16,000,000 in capital expenses still outstanding in the near future as well as the legal requirement to construct a more or less entirely new facility in thirteen and a half years at who knows what cost. Those folks who turned out, those who watched on Mendocino TV, and more, are going to need to stay involved and informed.