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Take me to Grady

A look inside the state's largest hospital right now with the people who know it best

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LIFE SUPPORT: Paramedics responded to more than 120,000 911 calls in 2011, bringing patients from across the metro area to Grady’s emergency room.
  • Joeff Davis
  • LIFE SUPPORT: Paramedics responded to more than 120,000 911 calls in 2011, bringing patients from across the metro area to Grady‚Äôs emergency room.

Did we have cable service and good TV reception before? Yes. But now I'm saying, "Hmm, let's talk to our patients. What else can we do?" They were getting limited channels so we enhanced their experience by [adding] ESPN, ESPN 2, CNN — things that consumers want to see.

We still have to make sure, based on patient needs, that we have enough staff. We're not compromising. Because of the new [nonprofit corporation] and an infusion of cash ... whatever the nurses need, I'm able to purchase that. ... We actually lowered the cost of the services we were providing and [have] provided more services to the patient, so it's not one or the other.

Quality and patient care have to trump everything. It will always be my priority, so I have to be sure that we're giving the right care to the right patient at the right time. You could be with us for 24 hours or six weeks.

One part of Grady where patients could stay for weeks, or months, is in the sixth floor's intensive care unit. Dr. Omar Danner is an assistant professor at the Morehouse School of Medicine and has been an attending trauma surgeon at Grady for four years. Morehouse takes trauma calls and tends to the ICU patients on a regular basis.

As Danner's team makes its rounds through the ICU, it reviews a teenage male that was shot at least 10 times. He entered Grady in hemorrhagic shock and experienced numerous setbacks along the way to healing.

The trauma service is a 24/7 service, 365 days a year. Each day, a different attending [surgeon] with a staff and team of residents will be responsible for patients in the trauma bay. [It's] one total system [between Emory, Grady, and Morehouse]. Everybody does [his or her] part to make the whole system work.

The patients here either came to the operating room or the intensive care unit for injuries that needed a higher level of monitoring, intervention, and care. ... We try to get patients to a point where they are safe to be transitioned to another level of care at a different facility without causing additional harm.

[The gunshot victim] had multiple injuries and complications related to the bleeding, the fractures, and the blood-thinning medication. He's been adequately resuscitated and will now [head to] orthopedic surgery once he's stable. ... He'll be set to resume a normal life, and that's the most important thing. ... Including ancillary staff, maybe 40 or 50 people are working in concert. It all goes to care for that one patient. When you're talking about a level-one trauma center, this is the level required to get people through the system safely.

Several floors above the ER, specialized centers have been added not only to provide care for the poor, but also to attract patients with private insurance. Frankel says the Marcus Stroke and Neuroscience Center, filled with 18 ICU rooms and state-of-the-art technology, has become a regional leader since opening in 2010.

We created the Stroke Center at a time when we saw an aging population and a huge demand in an evolving field. It's a field that [will] evolve the same way that interventional cardiology evolved 20 or 30 years ago. ...

[The angiogram suite] differentiates Grady from other hospitals. ... It allows you to look at things in three dimensions and allows the endovascular surgeon to approach the brain from inside the artery and fix aneurysms or blocked arteries that cause a stroke. Those arteries can be opened up just like you open up a coronary artery to keep the heart from dying. Here, you open up a brain artery to minimize the injury and hopefully eliminate paralysis or difficulty with speaking. It all happens very fast. We're talking about minutes.

I think the emotional baggage that comes with neurological disease is very heavy, and it cuts across socioeconomics. If that's a poor person with no resources, they cause tremendous [problems]. ... For those who are insured or employed, when they are disabled from neurological disease, it's devastating.

We can have the richest person in Atlanta in one bed and the next room can [have] the poorest person. We'll take care of them the same way. We're including everyone and elevating the care at the same time.

The Stroke Center stands among the niche clinics that make Grady a destination hospital. While some administrators think such resources could be the key to Grady's survival, others aren't as convinced. When chief hospital psychologist Dr. Nadine Kaslow came on board in 1990, she wanted to work in a health care system invested in caring for people with chronic mental illnesses. She remains committed to Grady, but has concerns about its direction amid recent cuts.

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