Students Critique Quality of Care at UHS, Cite Misdiagnoses

Like the food in the dining halls, health care inspires gripes and jokes at summer camps and on college campuses alike. But some students say getting adequate treatment at University Heath Services (UHS) is a serious cause for concern.

Explaining the Undergraduate Council's recent decision to study patient care at UHS, council member Noah Z. Seton '00 says when he speaks to students about their experiences at the College, "invariably one out of three will say UHS needs to be looked at."

While complaints about mental health care and concerns about how health services deals with alcohol-related emergencies have been voiced in recent years, some say adequate treatment is hard to come by across the board.

Although Thomas A. Suarez, a resident tutor in Cabot House who is also a doctor, says he believes the majority of care at UHS is good, he was alarmed by an incident last spring.

Suarez brought a student who was suffering an allergic reaction to peanuts and had gone into "acute anaphylactic shock" to UHS.

He says he was disturbed by what he saw. Events that evening gave him the impression that his own medical training could help the student and he found himself taking an active role in the treatment.

"I feel my particular training in critical care situations allowed the kid to live," he says. "That's why I became dismayed at UHS."

But UHS Director David S. Rosenthal '59 says the perception of health care on campus may be skewed.

"If one or two visits don't go the way they should have gone, that pervades the college environment and becomes the `norm,'" Rosenthal says.

While none filed official complaints, seven students shared their own negative UHS experiences with The Crimson. They say their stories suggest major flaws in campus health care.

Citing experiences ranging from broken bones not detected to serious illnesses misdiagnosed, these seven say they are left with major misgivings about health services at Harvard.

Bad Breaks

Accidents led Zachary H. Smith '00 and Natasha J. Magnuson '01 to UHS, but both emerged with undiagnosed broken bones.

In the spring of his first year at Harvard, Smith was hit by a car as he ran across Memorial Drive between Leverett and Dunster Houses.

Although he was thrown into the air and dazed by the accident, Smith says he refused an ambulance ride to the hospital.

But later that night, with his leg and hip "killing" him, he hobbled into UHS. Although Smith says he told the attending doctor he had been hit by a car, he says she looked at his leg for "30 seconds" and declined to take an X-ray.

"She said, `Okay, you're going to be fine, just go home,'" Smith says.

The next day, in more pain, Smith returned to UHS after struggling through a chemistry final.

A second doctor took another X-ray and diagnosed a broken tibia.

Smith says a doctor he consulted at home told him the mistake could have had grave consequences.

"I was really lucky that I didn't need surgery," he says. "I could have compressed [the bone] into some weird position."

Rosenthal, who says he was not previously aware of Smith's case, says the difficulties may have resulted from an initial mistake by emergency personnel on the scene. Someone who has been struck by a car should always be taken to an emergency room, he says.

But Magnuson, who injured herself falling down the stairs of her dorm last spring, also made two trips to UHS before she was properly diagnosed.

After an initial X-ray, Magnuson says the attending doctor told her the foot "wasmildly bruised, but he couldn't see any damage onthe bone."

She says he advised her that she could play inan upcoming water polo tournament if the painsubsided.

But over the next week, Magnuson says her footwas painful and swollen. Her parents, who werevisiting, took her back to UHS and requested anorthopedist.

"I had severely fractured [the foot] in threeplaces," Magnuson says.

Magnuson wore a cast for three and a halfweeks.

She says she could have played an additionaltwo weeks of the water polo season if her foot hadbeen cast immediately after the accident.

Overlooked?

Lauren F. Klein '00 and Willougby Anderson '00say UHS failed to identify their illnesses.

Feeling ill, Klein, who is a Crimson editor,went to health services and was told she had avirus. Her doctor at home diagnosed her withpneumonia a week later.

"[The staff at UHS] weren't particularly meanto me, they just failed to identify what was wrongwith me in a sort of major way," Klein says.

During Anderson's first year, after sufferingfrom stomach pains and throwing up after meals formonths, she became extremely dehydrated one nightand went to UHS at 3 a.m.

She was given I.V. fluids, but says the doctordid not seem alarmed by her condition.

"He told me it was a virus and not to worryabout it even though I'd been throwing up for thepast two months," Anderson says.

Her father, a gastroenterologist, knew that heraunt had had gallstones at her age and ordered anultrasound when she returned home for springbreak.

The exam showed gallstones and Anderson had hergallbladder removed that week.

While Klein and Anderson point to misdiagnosis,Rosenthal says doctors at UHS are comparable tothose at Harvard's world-renowned teachinghospitals.

"If you look at the face-book, you will seethat everybody is a Harvard doctor and has beentrained in Harvard hospitals," he says.

Seeking Further Treatment

Other students say while they were properlydiagnosed, they believe UHS did not provideadequate treatment.

Larry Malm '00 went to UHS one night last yearfollowing an eye injury. He had tripped on thestairs in Leverett House while carrying a plant.

Malm says he was given an eye patch andreturned the next day to see an ophthalmologist.He says the doctor told him he had scratched hiscornea, but that the injury would heal quickly andhe should return in four days.

A trip to the Mass. Eye and EarInfirmary--inspired by his roommates' "cynicism,skepticism and sarcasm" about UHS--confirmed thediagnosis but produced more aggressive treatment.Staff at the hospital told him swelling and thescratch's odd location complicated his condition.

"They had me on a whole regimen of drugs andUHS hadn't prescribed anything," Malm says.

A woman in Leverett House who had her navelring ripped out in a bike accident this fall saysgetting adequate treatment required persistence.

Concerned about infection after the area aroundthe injury swelled, she saw a nurse at UHS.

The student says the nurse told her "it wasn'ta big deal," and did not offer treatment.

Feeling "weird" about being turned away, shemade another visit and saw the same nurse. For asecond time, she says she was told the wound didnot need treatment.

Last week, the student, who is a varsityathlete, visited UHS for a third time.

She says because she felt staff would not lether see a doctor during her first two visits, shelied, telling them her trainer had told her shemust.

The student said the doctor she saw--whom shedescribes as "really, really nice"--diagnosed aninfection and told her "she didn't know why thenurse had sent [her] home twice because it wasobviously infected."

Another student says she believes UHS createsbarriers to care. Sarah M. Demers '99--who has arare blood disease that requires extreme vigilanceto possible infections--went to UHS the spring ofher sophomore year feeling feverish.

Although she says she explained her chroniccondition and asked to see a physician, Demerssays she was dismissed. She says a receptionistasked her to repeat the name of her condition andthen said, "You pronounced that very well. How'bout you come back tomorrow at 2?"

"My frustration was that she was socondescending towards me," Demers says.

Rosenthal says Demers' description of herexperience does not reflect UHS policy. Studentscan get an appointment the same day if they wish,he says.

"Anybody who wants to see a physician or aclinician can see one," Rosenthal says.

Meeting Students' Needs

While Rosenthal readily acknowledges "we canalways do better," officials say structures are inplace to represent students' interests.

Kathleen Dias, the patient advocate isdesignated as a liaison between students and UHSdoctors and administrators.

Dias says UHS welcomes patients' feedback andpoints to several changes that have been made inthe past few years in response to requests.

UHS has added routine obstetrical care anddental care at the Holyoke Center, andconfidential HIV testing and billing procedures,she says.

"Sometimes people think that if they complain,their complaints are not taken seriously, butthat's not true," Dias says. "We do try to resolveindividuals' complaints and complaints of a moresystemic nature."A-7COMPLAINTSCrimsonKurt D. Mueller

She says he advised her that she could play inan upcoming water polo tournament if the painsubsided.

But over the next week, Magnuson says her footwas painful and swollen. Her parents, who werevisiting, took her back to UHS and requested anorthopedist.

"I had severely fractured [the foot] in threeplaces," Magnuson says.

Magnuson wore a cast for three and a halfweeks.

She says she could have played an additionaltwo weeks of the water polo season if her foot hadbeen cast immediately after the accident.

Overlooked?

Lauren F. Klein '00 and Willougby Anderson '00say UHS failed to identify their illnesses.

Feeling ill, Klein, who is a Crimson editor,went to health services and was told she had avirus. Her doctor at home diagnosed her withpneumonia a week later.

"[The staff at UHS] weren't particularly meanto me, they just failed to identify what was wrongwith me in a sort of major way," Klein says.

During Anderson's first year, after sufferingfrom stomach pains and throwing up after meals formonths, she became extremely dehydrated one nightand went to UHS at 3 a.m.

She was given I.V. fluids, but says the doctordid not seem alarmed by her condition.

"He told me it was a virus and not to worryabout it even though I'd been throwing up for thepast two months," Anderson says.

Her father, a gastroenterologist, knew that heraunt had had gallstones at her age and ordered anultrasound when she returned home for springbreak.

The exam showed gallstones and Anderson had hergallbladder removed that week.

While Klein and Anderson point to misdiagnosis,Rosenthal says doctors at UHS are comparable tothose at Harvard's world-renowned teachinghospitals.

"If you look at the face-book, you will seethat everybody is a Harvard doctor and has beentrained in Harvard hospitals," he says.

Seeking Further Treatment

Other students say while they were properlydiagnosed, they believe UHS did not provideadequate treatment.

Larry Malm '00 went to UHS one night last yearfollowing an eye injury. He had tripped on thestairs in Leverett House while carrying a plant.

Malm says he was given an eye patch andreturned the next day to see an ophthalmologist.He says the doctor told him he had scratched hiscornea, but that the injury would heal quickly andhe should return in four days.

A trip to the Mass. Eye and EarInfirmary--inspired by his roommates' "cynicism,skepticism and sarcasm" about UHS--confirmed thediagnosis but produced more aggressive treatment.Staff at the hospital told him swelling and thescratch's odd location complicated his condition.

"They had me on a whole regimen of drugs andUHS hadn't prescribed anything," Malm says.

A woman in Leverett House who had her navelring ripped out in a bike accident this fall saysgetting adequate treatment required persistence.

Concerned about infection after the area aroundthe injury swelled, she saw a nurse at UHS.

The student says the nurse told her "it wasn'ta big deal," and did not offer treatment.

Feeling "weird" about being turned away, shemade another visit and saw the same nurse. For asecond time, she says she was told the wound didnot need treatment.

Last week, the student, who is a varsityathlete, visited UHS for a third time.

She says because she felt staff would not lether see a doctor during her first two visits, shelied, telling them her trainer had told her shemust.

The student said the doctor she saw--whom shedescribes as "really, really nice"--diagnosed aninfection and told her "she didn't know why thenurse had sent [her] home twice because it wasobviously infected."

Another student says she believes UHS createsbarriers to care. Sarah M. Demers '99--who has arare blood disease that requires extreme vigilanceto possible infections--went to UHS the spring ofher sophomore year feeling feverish.

Although she says she explained her chroniccondition and asked to see a physician, Demerssays she was dismissed. She says a receptionistasked her to repeat the name of her condition andthen said, "You pronounced that very well. How'bout you come back tomorrow at 2?"

"My frustration was that she was socondescending towards me," Demers says.

Rosenthal says Demers' description of herexperience does not reflect UHS policy. Studentscan get an appointment the same day if they wish,he says.

"Anybody who wants to see a physician or aclinician can see one," Rosenthal says.

Meeting Students' Needs

While Rosenthal readily acknowledges "we canalways do better," officials say structures are inplace to represent students' interests.

Kathleen Dias, the patient advocate isdesignated as a liaison between students and UHSdoctors and administrators.

Dias says UHS welcomes patients' feedback andpoints to several changes that have been made inthe past few years in response to requests.

UHS has added routine obstetrical care anddental care at the Holyoke Center, andconfidential HIV testing and billing procedures,she says.

"Sometimes people think that if they complain,their complaints are not taken seriously, butthat's not true," Dias says. "We do try to resolveindividuals' complaints and complaints of a moresystemic nature."A-7COMPLAINTSCrimsonKurt D. Mueller