Silent but Deadly

A week ago, Haaretz correspondent Ran Reznick revealed that Prime Minister Ariel Sharon had suffered from a long list of serious heart problems. The existence of his conditions, and of the vascular disease in his brain, had been discovered during hospitalization after his first, minor, stroke. But the public was told only about the hole in his heart which required catheterization.

His doctors, personal and the ones at Hadassah Hospital, gave two interviews about his condition. One was an improvised press conference the morning of his first stroke, inside the hospital grounds. The second was an official press conference a week later, called to present his medical file.

In both these meetings with the press, his doctors delivered soothing messages, and it turns out, very selective ones. They did not mention the vascular condition in his brain, nor were most of the problems with his heart. One disease was mentioned, with no detail about its gravity. Their tone suggested that almost all was well with the prime minister.

"Other than the minor cerebrovascular incident, we were glad to discover that Sharon does not suffer from significant health problems," one of the Hadassah doctors said. His personal physicians told Yedioth Aharonoth  that "at age 78, Sharon is a healthy man".

Confessions of the heart

Healthy, we now know, he was not. It turns out that his doctors did know it, too. Slowly the admissions are mounting over at Hadassah about the diseases discovered upon his first hospitalization, and they were not minor. The treatment they prescribed was based on the big picture of his health, and in view of the facts, that treatment was reasonable.

The doctors' admissions rescue them from bad trouble. Now that the truth is known, it cannot be said the treatment they prescribed was wrong. Now their good name can be restored.

The possibility that his doctors had prescribed the wrong treatment had badly stained the good name of Hadassah, the most highly esteemed medical institution in Israel. It did bad things to the reputation of the hospital, of its doctors, and its ability to attract patients to its private healthcare service.

Doctors who err, especially when they are of the top of their fields, are unforgivable in the health establishment. The confessions at Hadassah helped allay suspicions that its doctors had fallen into human error.

The fact that the admissions meanwhile reveal the doctors abetted in misleading the public, in the guise of providing full disclosure, is something else entirely. Abetting in misleading the public, and there is no telling whose idea it was, that is forgivable. In fact the health establishment dies the same thing even when the issue at stake is not the prime minister.

Try to elucidate for instance how it spends NIS 1.1 billion a year, of taxpayer money, on "health corporations", which is a fancy word for "overtime for hospital workers". These are people working in the afternoons, but instead of simply paying them "overtime", what the hospitals did is shift their employment to a structure of a subsidiary, hiding the tracks of the expenditure.

How much  do doctors earn for overtime at these health corporations? The rumor is that it's millions, and that the managers of the hospitals use the health corporations' budgets as a means to reward their pet doctors. Since the hospital managements refuse to report on the health corporations' budgets, the rumors cannot be verified or negated.

It could save your life

It is not only the prime minister's vascular condition and budgets that are kept under wraps at hospitals. Life-saving information is also hidden, deliberately.

Which are the worst hospitals in Israel? You can't find that one out. Once, ten years ago, the Health Ministry carried out a survey of deaths from cardiac disease at the hospitals. It revealed higher rates at Wolfson and Soroka and aroused a storm.

The Health Ministry hastened to reach the right conclusions: instead of making sure the erring departments cleaned up their act, it decided not to publish studies like that any more. In fact, to be on the safe side, it decided not to conduct any such surveys at all.

it's best for the public not to know which are the worst hospitals in the land, and it's even better for the Health Ministry not to know, either. With its denial firmly in place, it can continue managing a health system that is an example of excellence.