100 Years of Healing
Children’s Hospital celebrates a century, but will it be here for another 100 years?
Courtesy of Children’s Hospital and Research Center Oakland
In 1912, nurse Bertha Wright and social worker Mabel Weed began planning a 38-bed baby hospital in an old mansion in Oakland. It would be the first medical center on the West Coast focused exclusively on the care of children, regardless of their families’ ability to pay.
Since those noble beginnings, Children’s Hospital and Research Center Oakland has grown into a national model for pediatric care. It’s also the trauma center for injured kids in the East Bay and boasts a nationally recognized research center that has pioneered treatments for cancer, sickle cell disease, and other blood disorders.
Unfortunately, the nonprofit lost more than $80 million from 2006 to 2010. While the hospital’s financial model—now with 73 percent of its patients on Medi-Cal—has always been bold, it is no longer working.
In 2010, Children’s laid off roughly 1 percent of its staff and restructured its outpatient services. It has also launched an ambitious $425 million campaign to rebuild and modernize its campus by 2019, and administrators are working on a partnership with UC San Francisco.
In recognition of the hospital’s 100th anniversary, here are some of the people who hope Children’s will be around for the next century.
Doctors, nurses, and families work together to fight the Big C.
Ashton Carter was diagnosed with aggressive cancer in his right shinbone in October 2011, and his parents wanted to include their bright, inquisitive eight-year-old in consultations they had with doctors.
Carla Golden, M.D., Ashton’s primary oncologist at Children’s Hospital, was happy to respect his parents’ wishes, even though she had to deliver difficult news. The state-of-the-art treatment to eliminate Ashton’s bone cancer would put him in the hospital, on and off, for months while undergoing grueling courses of chemotherapy. He might also need to have his leg amputated.
“I would ask, ‘Do you know what’s going on?’ And he would say, ‘I have cancer and need medicine for it.’ For an eight-year-old to comprehend, that’s pretty amazing,” says Golden.
In the end, Ashton thought it would be best to have his leg amputated, after hearing that doctors could save the limb but he wouldn’t be able to run. He saw how a former drumming teacher at his Livermore school, Joe Michell Elementary, got around very easily on a prosthesis, after losing his leg to cancer. Golden also shared an article with Ashton about Oscar Pistorius, the Olympic sprinter and double amputee.
“There were good things and bad things about each,” Ashton says. “With amputation, I would lose my leg, and that would be bad; but with a prosthesis, I’d be able to run again, and that would be good.”
Just as difficult for Ashton and his family was the chemotherapy, which spanned nine months before and after his amputation in February 2012. Ashton’s brown hair fell out, and nausea dogged him. His mom had to leave behind Ashton’s two younger brothers to stay with him in his small hospital room.
The people who helped Ashton and his mother stay hopeful during those days and nights of chemo included nurse practitioner Molly Selfridge, who oversees kids undergoing chemotherapy, and the hospital’s Child Life Services specialists, who brought art projects to his room and took the time to explain uncomfortable procedures, like having a feeding tube inserted through his nose.
“They were friends and shoulders to cry on,” Ashton’s mother says. “As a mom, I didn’t have to worry if I had to leave the room for a couple hours because I knew my son was in great care.”
In August, Ashton started fourth grade. Golden says his prognosis is excellent. “The majority of kids diagnosed with cancer today are cured [or go into long-term remission],” Golden says. “It’s so different than it was 30 years ago. Ashton has a good chance of never having cancer again.”
Average number of kids taken to Children’s trauma center per year.
Number of volunteers in 2011.
Number of hospitalizations per year.
Pioneering Research: A Time Line
The Children’s Hospital Oakland Research Institute (CHORI) opened in 1959, with five scientists working to improve children’s health. Over the years, CHORI scientists have discovered cures for blood diseases and cancers, developed new vaccines for infectious diseases, and discovered treatments for previously fatal or debilitating conditions. They now focus on sickle cell disease, blood and bone marrow transplants, critical care and genetic medicine, and vaccines.
Children’s Hospital researchers establish the Northern California Comprehensive Sickle Cell Center, which becomes one of the best in the world.
CHORI establishes the world’s only nonprofit sibling donor cord program, curing children around the country of cancer, leukemia, blood disorders, and other transplant-treatable diseases.
President and CEO Bertram Lubin is working to preserve the hospital’s future.
When Bertram Lubin, M.D., first visited Children’s Hospital in the early 1970s, it was love at first sight. He saw a small hospital where he could make his mark, both as a pediatrician and as a scientist.
He came from humble beginnings, working in his family’s produce market in a small town in Pennsylvania. After medical school and stints at children’s hospitals in Philadelphia and Boston, he came to Oakland in 1973 to head Children’s hematology and oncology departments. Eight years later, Lubin became director of medical research. He advanced treatment for sickle cell anemia and started the hospital’s sibling donor blood cord program while growing Children’s Hospital Oakland Research Institute into a 315-member international leader in creating treatments for pediatric disease.
The grandfather of five stepped into the hospital’s top job in 2009, when Children’s was losing millions of dollars and administrators wanted to raise money to upgrade its aging campus. Lubin talks about how his love of medicine and research has prepared him to meet Children’s future challenges and opportunities, including the likely partnership with UCSF.
Q: What’s so special about Children’s Hospital?
A: We have two major roles: We’re a safety net, where we serve every child who comes in, and a preferred provider, where we have subspecialty care that is equivalent to, if not better than, any of the other children’s hospitals in the United States.
Q: Do most patients come from the East Bay?
A: We have about 260,000 outpatient visits a year. Approximately 80 percent come from Alameda and Contra Costa counties. We have two county hospitals that are great, but they closed their pediatric beds years ago because they said pediatric services would be better at Children’s.
Q: What prepared you for this job?
A: When we moved to Bellevue, a small town outside of Pittsburgh, my father started a fruit and vegetable stand. I had to work there while I was in high school, college, and medical school. I used to sell little baskets of peaches for 39 cents. I grew up in sales. To run Children’s, I use things I learned in that store almost as much as my background in science and medicine. My father’s store was very small but very good. It was real high quality—like this hospital.
Q: How did you end up at Children’s?
A: A lot of friends I studied with were at UCSF. I flew to San Francisco and thought, “This is gorgeous.” I asked, “Do you have any jobs here?” They said, no, but recommended I look at a little hospital over in Oakland that had a research lab. When I walked in the door, I felt so good about the place. It sort of made my heart sing. It cares about kids. I ended up having the same career as an academic as I would have had I been at UCSF or Stanford the whole time.
Q: Why do you like doing research?
A: It is discovering why something is happening.
If you understand the why—the mechanism—you can start thinking about ways to treat or prevent a condition. When I first started here, I got a small grant to screen newborns to see if they had sickle cell anemia. Eventually, I was able to show that if a child has sickle cell disease at birth, you need to treat the child’s first fever really aggressively. If you didn’t, the child would become susceptible to a certain kind of bacterial infection. Based on that, the state started to implement universal sickle cell screening.
Q: How did you grow Children’s Research Center?
A: When I started, we had $500,000 in grants.
When I left, three and a half years ago, we had roughly $60 million. I didn’t write those grants; I created the environment. I’m a musician and see myself as a bandleader. I recruited people to join the orchestra and to play music that was accepted, supported, and recognized.
Q: Of the many challenges Children’s faces, what is the most daunting?
A: The biggest thing is that we have spent very little money on the physical plant of this hospital over the years because we’ve put that into doctors, nurses, social workers, and our Child Life program. Child Life helps kids cope with what they have to cope with while they are at the hospital. I was at one stage of my life where I felt like that’s nice, but it’s icing on the cake. You really need good doctors and nurses; you don’t need the rest of this. Wrong. That’s not true for Children’s Hospital. I can tell you we don’t get paid for that. You can’t bill insurance for Child Life.
Q: What is the status of the UCSF talks?
A: They are continuing. Their mission and our mission are closely aligned. We recently reached another milestone, with the signing of a Letter of Intent, and anticipate that we will reach a final decision by mid-year next year.
Q: What would this partnership look like?
A: There would be two campuses, one in San Francisco and one in Oakland. We would create a new children’s hospital that would be among the leaders in pediatric research and comprehensive care in the United States, in terms of size and skill and number of doctors.
Q: What would happen to the research?
A: It would continue. What we’re talking about is a collaborative opportunity to build even better pediatric care. If this happens, it would be the first University of California hospital in the East Bay. And when we go out to Contra Costa, we’d go out with the UCSF brand. We shouldn’t need the UCSF brand. But for some families, that offers some comfort.
Life and death battles are fought in this high-tech trauma center.
Like many East Bay residents, Paul and Laura Ackerman mainly knew Children’s Hospital as the yellow building with the inflatable rubber duck they passed on Highway 24, going into San Francisco. That’s until April 2010, when the Alamo couple’s 13-year-old son, Christopher, fell 10 feet out of a tree, slammed his head against the street, and suffered a brain injury that nearly killed him.
Christopher was airlifted to Children’s trauma center, where doctors operated to drain excess fluid from his swelling brain and inserted a pressure monitor.
Over the next eight days, he lay in a coma, tubes from high-tech machines snaking in and out of his body to keep him breathing and maintain other vital functions. Staff continually made pinpoint adjustments to keep Christopher alive.
A few days into their ordeal, the Ackermans noticed that Christopher’s heart rate and blood pressure stabilized whenever they talked to him or held his hands.
They told a nurse, who told Christopher’s lead doctor, Vivienne Newman, the pediatric ICU’s associate medical director. Given the high-tech nature of his treatment, they wondered if Newman and staff would dismiss the idea that Christopher was responding to a nonmedical intervention.
Newman’s response surprised them. She took their observations seriously, said brain scans don’t tell the whole story, and encouraged them to keep talking. But she also warned that she didn’t know how long Christopher would be in a coma or to what extent he would recover his physical or mental functions, and even his personality.
“She said, ‘What I can tell you is that Christopher will let us know. His body will let us know,’ ” Laura Ackerman recalls. Newman’s honesty and willingness to respect Christopher’s natural healing process reassured his parents.
Newman, who has been at Children’s since 1979, says the key in the pediatric ICU is making parents partners in treatment. “In pediatrics, we are very family and holistically centered,” she says.
By day eight, staff removed Christopher’s breathing tube. Soon after, he said, “I’m cold.” Christopher left the ICU after 12 days and the hospital after four weeks—tired but walking, and beginning to joke around like his pre-injury self.
The Ackermans know firsthand the value of having a child-focused medical center in the East Bay. “They have all these outstanding high-end treatments for trauma and cancer, and then they are in this really poor community, and are the primary health care for a lot of people,” says Paul Ackerman. “You never know when you’re going to need something like this, and the community needs to have it.”
Number of patients cared for at Children’s Hospital in 2011.
Amount in dollars used for charity care in 2011.
Amount in dollars of annual operating budget.
Pioneering Research: A Time Line
CHORI research teams bring about the first cure for alpha thalassemia, an inherited blood disorder, and develop a vaccine to prevent meningitis in sub-Saharan Africa.
CHORI opens the Center for Nutrition and Metabolism to explore connections between diet, nutrition, and disease.
The hospital’s Global Health Initiative wins a United Nations Association’s Global Citizen Award for efforts to reduce child mortality.
Ervin H. Epstein Jr., M.D., coauthors a study showing that a new drug helps dramatically reduce tumors in patients with basal cell carcinoma, the most common type of cancer in the U.S.
Comeback Kids: Sports medicine center keeps athletes in the game
On September 23, 2011, College Park High running back John Croft was playing the best game of his varsity career when he was tackled and tore the anterior cruciate ligament, or ACL, in his left knee. The injury sidelined him for the rest of the football season of his senior year. It also kept him from doing other sports he loved, like spring track.
The prospect of a slow rehab—with no guarantee that he’d regain his former strength and mobility—was daunting, especially since this was the second time in two years he had injured the knee. “It took the wind out of my sails,” Croft says.
But Croft is rebuilding his strength and confidence through physical therapy at Children’s Hospital Sports Medicine Center for Young Athletes. A focused, disciplined athlete, he started in an intensive two-day-a-week program that makes it possible for him to walk without pain and retrains his body and mind to play football again.
The center, with facilities in Oakland and in Walnut Creek’s Shadelands office park, opened in 2004 to meet the growing numbers of East Bay kids injured playing football, soccer, baseball and other sports. About 15 to 20 percent are recovering from ACL injuries, half of those from non-impact injuries, says Nirav Pandya, the center’s co-director and a pediatric orthopedic surgeon.
“It’s a great resource for the community because so many kids are doing competitive sports,” says Pandya.
The center only works with young athletes, unlike other rehab centers in the area that also serve adults.
“What I’ve found is that kids go to an adult facility, and you’ll have a 15-year-old soccer player working alongside an 85-year-old lady with a hip replacement,” he says. “There are different expectations for an 85-year-old, and the kids don’t get pushed as much.”
During a workout in early October in a spacious second-floor fitness room in Shadelands, Croft stretched and used a resistance band to do hip-strengthening reps. Physical therapist Tom Clennell put him through a set of exercises that worked directly on the muscles and reflexes he’ll use in football. Croft had to catch a football while landing his left foot on the gelatinous surface of a Bosu ball and balance for a few seconds while crouching down into a squat. The move gave his butt and thigh muscles a workout while teaching his body how to safely let his recovering knee take the weight.
“After an ACL injury in athletes, we work on helping them with their stability, range of motion, and strengthening their hips and hamstrings to protect the knee,” says Clennell. “At the end of therapy, we do a lot of sports specifics moves.”
In his first year at Diablo Valley College, Croft is deciding between playing football or lacrosse next season. “It could have really stunted my recovery if I had had different care.”