Diversity of Disease

The VA Medical Center, Tulane Hospital, and Charity Hospital may well be the source of the greatest diversity of disease possible. The Tulane resident receives exposure to diseases that most residents in the US will only read about. Yellow fever, malaria, first diagnosis of congenital heart disease in adults, sarcoid, lupus, tropical sprue, fungal lung disease, West Nile, leprosy, are only a few of the examples that are frequently seen on the Tulane service. Combine this with the “bread & butter” disease seen at the VA, and the high-end technical disease seen as part of Tulane’s quantenary referral service (abdmonial, liver, renal, hearty-lung transplant; bronchial stents, left ventricular assist devises, etc), and you have a patient experience that is matched by none.

Diversity of Severity of Disease

The mission of the Tulane Team is to re-invest a New Orleans patient population that has been previously disenfranchised, and we are working hard to fix the historical problem of lack of access to primary care. The unfortunate consequence of lack of access to primary care is that diseases frequently progress to the severe end of the spectrum. If there is a silver lining, it is that the Tulane resident has the opportunity to see disease at its most severe manifestations. On a spectrum from the disease’s initial onset to late-term consequences, the Tulane resident sees it all. This allows us to better appreciate the potential consequences of early disease, and to heighten our aggression in treating this disease. It also furthers our resolve to ensure that each of our patients enjoys their right to have primary care.

Diversity of People & Systems

But most importantly, the Tulane Resident sees a diversity of people independent of their disease. Remember, requisite for becoming a great physician is a becoming a great person, and requisite for becoming a great person is understanding and appreciating diversity. There are few cities that have this type of diversity: New York City, San Francisco perhaps; New Orleans for sure. Since New Orleans is the “Ellis Island” to the Americas, your patients will be Cajuns, Creoles, African-Americans, Caribeans, Mexican-Americans, Central-Americans, and on and on. These people will make you a better person, exposing you to new beliefs, customs and traditions. It’s a rich life-experience in the Big Easy… one that you will never regret.

Charity Hospital was founded in 1737: fifty years before your country (assuming that ratification of the Constitution in 1787 was the start of the USA). It is the longest continually running public hospital in the country. It will be there long after we have all come and gone. Tulane’s involvement with staffing the Charity wards dates back to 1834. Almost since it’s inception, Charity and Tulane have been partners in delivering healthcare to the underserved.

Over 270 years, there have been six buildings that housed the Charity Institution. The most recent of which is pictured above. Prior to Hurricane Katrina, plans were set in motion to replace the 75 year old building, and the new Charity Hospital will find its place next to the Tulane medical complex (between Tulane Avenue and Canal Street). For now, the Charity institution operates through University Hospital, that sits four blocks from the Tulane Medical School, Tulane Hospital and the VA. It has 350 beds, and the average daily admission census to the medical service is 11 per night. There are no subspecialty services and no patients managed by private physicians at Charity, so all admissions go to the general medical ward team (the residency team). There are four teams, and each team is comprised of one attending, one resident and two interns (plus medical students). The ICU is comprised of three teams of one resident and one intern per team (every third night call).

So it is that Charity’s history continues to ebb and flow, but it always keeps marching on…as it will continue to do, and it will be Tulane Medicine that lead’s that march. That’s the nice thing about organizations and people who have a mission statement that is pure and right: there is nothing as powerful as an idea whose time has come.