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THE SUNDAY PROFILE : A Doctor's Order : In the world of public medicine, where supply never meets demand, it's one crisis after another. Dr. Sol Bernstein has spent his life managing the chaos at County-USC.

November 06, 1994|PAMELA WARRICK | TIMES STAFF WRITER

Most people enter Los Angeles County-USC Medical Center through the emergency room. Gang-bangers riddled with bullets. Mutilated accident victims. Cyanotic drug addicts. Destitute women ready to deliver.

But young Sol Bernstein, fresh-faced and unscathed, came in through the front door.

It was 1956, and the experience stopped the first-year medical student in his tracks.

"It was like entering a cathedral. On the ceiling (were) those stunning gold-leaf murals of Aristotle, Hippocrates and Aesculapius, father of medicine. And directly over the entrance, her wings outstretched, stood the Angel of Mercy. . . . I was completely in awe."

Bernstein can't count the number of times that he has since paused beneath the stone angel, but every time, he says, is inspirational.

And, in Sol Bernstein's world of public medicine, one can always use inspiration. Wards are overcrowded, staffs are overworked, budgets are overdrawn. There is never a surplus of anything, it seems, except patients.

Nurses strike, doctors walk out, earthquakes crack the buildings--and still the sick people come.

Until he retired this past summer, Bernstein was the one person who could make sense out of the crises and the chaos.

As an intern, a resident, a professor and, for the last two decades, chief of the medical staff, the erudite cardiologist has been a steady hand in turbulent times for Southern California's last-resort, deficit-plagued institution.

"More than any other single man, perhaps, Sol Bernstein has been the soul of this place," says longtime associate Harvey Kern.

And, others say, its guts as well.

That he would choose a career of fighting for public dollars, public respect and public sympathy for the county's sickest poor suggests that Bernstein was as much inspired by Hercules as by the Angel of Mercy.

*

On a dark Monday in early February, 1993, Damascio Ybarra Torres, 40, reached the end of his rope.

Pacing through a crowd of more than 100 ailing people lined up outside the county hospital emergency room, Torres pulled out a semiautomatic pistol and opened fire. Three doctors were hit--one point-blank in the head. As the victims were pulled to safety, Torres grabbed two hostages and held them for five hours behind an X-ray machine.

"It's their turn to wait," Torres told SWAT team negotiators. "They made me wait. Now they can wait."

Although horrified by the rampage, which ended in the gunman's arrest, Bernstein understood.

Long waits of four to 14 hours had become a fact of life here, the nation's busiest emergency room. "For the great majority of people, the ER is the front door of this hospital. They may have to wait many, many hours," Bernstein says. "And when people have to wait, sometimes people get angry."

Some say it was a turning point for a hospital that had always been open to all comers.

"No longer could we assume that we were a sanctuary--a place where people came to be healed. The violence changed all that. We were fair game, like churches, like schools, like the rest of society," Bernstein recalls. "It was very sad when it came to this. Very, very sad."

But the history of violence at the county medical complex had begun long before Torres walked into the ER that afternoon, yelling for pain medication.

In 1991, one of the many panhandlers who once routinely roamed the corridors stabbed a nurse in the neck with a pair of scissors.

In 1990, an 18-year-old gang member was shot in the face during a melee involving 20 youths who were visiting patients. And back in 1984, a patient was shot to death by a security guard after he allegedly reached up from his gurney, grabbed another guard's gun and fired.

"With every act of violence in that hospital, Sol and a few other really caring and sensitive people were personally wounded," recalls one retired county physician. "It wasn't the way we had viewed our relationship with our patients. Suddenly, we were forced to look at some of them in a different way. Almost against our will, we had to be wary, we had to be on guard."

That may explain why a year before the Torres shooting, Bernstein and his hospital staff had asked the county Board of Supervisors for 143 additional security guards. Their request was denied.

"Although I was shocked by what happened later in the ER, I cannot say I was surprised," Bernstein says.

Diplomat that he is, Bernstein never said, "I told you so."

*

"From the time he was a little boy, Sol wanted to help other people, he knew instinctively he wanted to be a doctor," recalls his older sister, Gertrude Zelenitz. "But unlike other little boys' wishes, you had absolutely no doubt that this boy would be what he said he'd be. It's as if he were born for this very purpose."

As a child, Bernstein spent many an afternoon in public libraries in New York City or his sleepy hometown of West New York, N.J. Hour upon hour, he would sit in the company of the Greek philosophers or Louis Pasteur and Albert Schweitzer.

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