Chest Institute staff, patients sad to leave old home
Hospital hopes to bring community feeling to the new Glen location
There is a popular sentiment among staff and patients at the Montreal Chest Institute: the Chest is different, they say.
Not just because it’s small, almost cozy, for a metropolitan hospital; not just because non-medical staff mingle with physicians in the convivial cafeteria; not just because of its highly-specialized program, unique in the province, which aims to wean patients off respirators.
It’s different because it’s a cohesive community with the kind of camaraderie and heart you can only find in those rare, special places.
“The community feel of the Chest charmed me from the moment I walked in 1997,” one employee wrote on a banner in the cafeteria to commemorate the Chest’s move this weekend.
So, as the hospital prepares to close its doors on St. Urbain St. on Sunday to move to the Glen site of the McGill University Health Centre, the hope is it will keep its collegial atmosphere — and gain a fabulous new, bright, modernized facility.
“It’s a very special place and there’s a lot of smiling here,” said Joan Ivory, a longtime volunteer and unofficial historian for the hospital. “We’ll miss that — but we’ll recreate it over there.”
“Over there” is the not-so-cozy, hulking superhospital in Notre-Dame-de-Grâce, where the Chest will have its outpatient clinic and day hospital on the main floor, while its ward for 16 acute-care patients and seven intensive-care patients will be up on the eighth floor.
While that sounds like the hospital could be severing its familial unity, medical director Ron Olivenstein said in an interview that what the hospital will be gaining at the Glen will be much more important for patient care than anything it could be seen to be losing.
“Yes, I’m sad to leave the building, it’s the only place I’ve ever worked,” said Olivenstein, adding that in Montreal patient surveys, patients always choose the Chest, along with the Montreal Children’s and Sainte-Justine hospitals, as their favourites in the city. “But I’m excited to go to the new building with its state-of-the-art equipment. We will be able to offer more seamless care there.”
The Chest follows the historic move of the Royal Victoria and Montreal Children’s hospitals to the Glen; moves that were pulled off without a hitch as a procession of ambulances transported patients to the new site. The Royal Vic moved about 150 patients on April 26 and the Children’s moved 66 young patients about a month later. On Sunday, in addition to the Chest, hematology/oncology and palliative care in-patients from the Montreal General Hospital will also be transferred to the Glen site, which will wrap up the move to the new superhospital.
The first part of the Chest’s move was more controversial. In January, 17 chronic patients suffering from severe degenerative conditions, unable to move or breathe on their own, were moved to the Camille-Lefebvre Pavilion of the Lachine Hospital. But many objected and weren’t pleased about the new location.
However, Olivenstein expects the Chest’s next move to be smoother. It will also be on a much smaller scale compared to the other MUHC hospitals, with only about 20 inpatients expected to move and a maximum of seven from the ICU.
Once there, Olivenstein says, the hospital’s in-patients and those using it for 25,000 outpatient visits a year will benefit from a full complement of radiology equipment that it doesn’t have at its current site, two “beautiful” bronchoscopy suites and a better facility for a specialized form of bronchoscopy known as EBUS (endobronchial ultrasound) which is done increasingly often to diagnose lung cancer, infections, and other diseases causing enlarged lymph nodes in the chest.
The hospital will now also have access to all kinds of specialists for diabetes, heart disease and neurological disorders that it didn’t have on St-Urbain St. and which Olivenstein said will improve care for patients. It will have upgraded facilities for more pleural procedures (which tests the membrane surrounding the lungs), a state-of-theart sleep disorder breathing lab and a pristine day hospital with 11 cubicles outfitted with comfy armchairs for people who don’t need to be admitted but require some intervention.
“It will be much better for patients,” Olivenstein, a respirologist, said. “Everything will be upgraded.”
Without air conditioning, and with four patients to a room in most cases at the current location, Ivory said she’s delighted with the move to a modern building.
Like all hospitals, however, the Chest is adapting to government cuts. It is going to 16 acute-care beds from 20 and its outpatient department will have fewer spaces as well.
“The overall provincial scheme is to have less patients seen in hospital clinics,” Olivenstein said. “But our overall care will be much better.”
It is all part of an ongoing evolution since the Royal Edward Institute opened in 1909 as a tuberculosis dispensary. Such was the fear and panic in those days surrounding TB, which was claiming 12,000 lives a year in Quebec, that the institute’s board didn’t even want to meet on site and would hold meetings out of harm’s way at the Ritz-Carlton Hotel, according to Ivory.
The Royal Edward became a teaching hospital and affiliated with McGill in 1932, but the introduction and distribution of antibiotics in the 1940s almost emptied the hospital of TB patients.
Over time, lung cancer, asthma, emphysema, chronic bronchitis, cystic fibrosis and respiratory illnesses associated with the HIV virus became the focus.
The hospital opened with great fanfare by King Edward VII in a sensational feat that was covered by newspapers around the world.
That’s because the king inaugurated the building remotely, by pushing a button in England while excited guests outside the hospital watched in awe as the institute’s doors swung open, the lights came on and the Royal flag flew up the mast.
“It was considered a miracle that it worked,” said Ivory. “It was amazing that nothing went wrong.”
So when the Montreal Chest Institute opens its new doors at the Glen on Sunday, there may be less flourish than when King Edward electrified people with his wildly revolutionary initiation in 1909.
But what Sunday’s opening at the Glen lacks in regal pomp, it will more than make up for with heart.
“It’s a special place,” said Ivory, recalling an architect who had visited the hospital when an expansion was discussed and who discovered that each department’s staff said another department was more deserving of the extra space.
“He couldn’t get over it,” she recounted. “He said it was the most extraordinary place he’d ever been.”