Home (Away from the Hospital) for the Holidays

EDITOR’S NOTE: As Thanksgiving approaches, RACmonitor Publisher Chuck Buck asked Marvin Mitchell, director of case management and social services at San Gorgonio Memorial Hospital in Southern California, to share a few personal thoughts on the holiday – and what it means to him in these tumultuous times.

Thank you, Chuck, for inviting me to share some thoughts on what the Thanksgiving holiday is like this year – a second one during this COVID-19 Public Health Emergency (PHE). Things are still not like the “before times.”

Before I answer your questions, I would like to share something personal. This is a time totally without frame of reference for me. It’s nothing like my parents, part of the Greatest Generation, had to live through, but still with a huge impact on society – and almost everyone has been affected. 

This year reminds me of that first Thanksgiving after Dad died; I had just gone through a divorce. It was like a Chevy Chase holiday movie, without the laughs. It was just Mom and me, so, with her pluck and the tenacity that an 84-year-old acquires, having just lived that long, we had dinner at Denny’s and enjoyed what we had, which was pretty much just us two. We persevered, but pieces were definitely missing. 

• Describe your service area and your hospital’s mission in your area?
  
• San Gorgonio Memorial is a semi-rural district community hospital in an area, I am told, is the fastest-growing in the state of California. A beautiful location in the San Gorgonio Pass. And not too far from my wife’s favorite place, Palm Springs. 

It’s an interesting demographic. Working from west to east, we have the affluent, working families; a middle class that is retired, and generally affluent and largely white; then there is an area that is more ethnically diverse, with a household income that is half of that of the reset of the area. About half of my staff is Hispanic or Filipino. 

Because of the elderly, many with financial insecurity, we have a lot of challenging situations in our ED – people brought to us who are failing at home. Most do not have family anywhere near the area. Methamphetamine use disorder is endemic. Homelessness is not a big deal here right now. It gets cool here at altitude, and, well, Palm Springs is just down the interstate (I-10).

Oh, and the tallest building in the Inland Empire is here in town: a 20-plus-story Native American casino. 

• You mentioned to me that in the past, the hospital’s foundation was instrumental in raising funds for community needs. Please describe how your foundation has had its fundraising activities impacted by the PHE?

Chuck, this last 18 months has not been kind to any fundraising efforts. Two large annual galas where a huge amount of money is raised have been cancelled. The community has been very generous in donating food and such for staff, to show their appreciation. Yet a lot of that has died down now. 

This year there was no food drive for Thanksgiving, although I’m hopeful we can emotionally pull it together for the Christmas toy drive. 

• What has the foundation been able to do in the past to make Thanksgiving, perhaps, more enjoyable for the disadvantaged?

We would support a community agency, Carol’s Kitchen, that provides meals to the homeless and elderly poor via staff going to rotating locations to serve. There were food drives, and we would donate turkeys to families in need. Sadly, some of these were hospital associates, who were often living in multigenerational situations and had limited income from one or two working family members. These might be EVS workers or nurses’ families. You can never tell. Charity does need to begin at home. With staff shortage-induced pay increases, maybe there will be a little less need this year. Some of the increases were substantial. 

This year I have seen no appeals from Carol’s Kitchen looking for holiday volunteers.

• Will you and your team be working on Thanksgiving? Have you personally worked on Thanksgiving in the past?

No, I won’t be working this Thanksgiving, but will be back home in Phoenix, where all but one of my kids still live, although it will be a bit different this year. I am literally having to rent a place to have Thanksgiving dinner, and catered at that, because two of my kids have had to downsize because of skyrocketing rents.

But I have worked on Thanksgiving before, and actually, happily so. It’s hard to describe. But you know that your patients would not be in the hospital or ED on Thanksgiving if it was at all avoidable. Sharing that separation from those Thanksgiving Day traditions we engage in during their time of need is one of the reasons I became a nurse. Then there’s that pesky preacher’s-kid guilt thing I struggle with. But seriously, I get a little misty remembering those particular work days.

I try to have as thin a crew as possible, but the census isn’t allowing much these days. With the cultural diversity in the department, there are many for whom Thanksgiving was not a thing growing up, so there’s that bit of relief on staffing.

• What kind of cases are you expecting on Thanksgiving? Will your ED be in full operation?

There’s no rest for the weary. There was a time when you could count on a low ED volume, which would then explode the day after. That hasn’t been the case for a while. 

As to patient mix? Expect more homeless folks, overdoses, mental health crises. We brace for those. 

Chuck, to be honest, we are all just plumb tuckered out, as Mom used to say. In this very polarized time, when nothing seems right anymore, truth has morphed into relativity, and doing good for others offers a chance to be grounded in a way we really, I think, need.  

I find that everything comes down to a movie line, but today, being a preacher’s kid and all, a favorite Bible verse comes to mind: “and let us not be weary in well-doing: for in due season we shall harvest, if we faint not.” And another: “as we have therefore opportunity, let us do good unto all.”