‘Can’t you open up?’ Madera residents want their hospital back

Existing peer-reviewed research demonstrates the closure of hospitals has a marked impact on rural communities’ access to health care. Additionally, one 2019 research paper found that hospital closures in California can lead to an increase in cardiac patients dying.

For decades the leading causes of death in Madera County have been heart disease, cancer, respiratory disease, diabetes and stroke, according to community health assessments by the Madera County Department of Public Health.

The most recent assessment found that Madera County residents have a higher prevalence of asthma and diabetes than California as a whole, and county residents die of cancer at a higher rate than the state as well. A big part of seeking treatment for any chronic health condition is seeing a doctor regularly, including specialists when necessary.

Madera residents adjust to care outside the county

In terms of emergency medical care, ambulances have rushed Madera residents to emergency rooms at Fresno and Merced County hospitals for close to a year now, and that long drive has proved fatal for some emergency patients, including at least two that local cardiologist Mohammad Ashraf used to see before the closure.

“I have patients dying all the time,”  Ashraf told Fresnoland in November. “I don’t know how they died. I read their names in the newspaper.”

Ashraf, who has worked in Madera and Fresno for the last 40 years, said he hasn’t heard from most of his former patients in the last several months. He doesn’t know how they’re doing, whether they’ve found care elsewhere or are going without care altogether.

“In the beginning, I knew that I at least lost two patients on my own,” Ashraf said. “But now in the last six months all the patients who go to Fresno, they never come back.”

Many of Ashraf’s peers have also left Madera, since there’s nowhere to perform surgeries in the county anymore. Ashraf said he does not know of any obstetricians, oncologists or urologists still in Madera County. 

That means residents have to go outside the county for specialty care and more. The hospital closure also left Madera with only one facility offering health imaging services, Madera MRI, where residents find it very difficult to get a timely appointment. 

Since her car accident in May, Singh has made 10 trips to Fresno just for X-ray or MRI appointments. That’s on top of regular visits to Fresno for physical therapy and neurological and orthopedic treatment. Even if the Madera hospital was still open, she’d need to seek some of that care in Fresno, but not for everything, including pain management. 

It’s not unusual for Singh to be jolted awake at night by intense pain in some part of her body ever since her accident. 

“When the pain in my arm or my neck is so bad, I’ll just take an extra painkiller because I don’t want to sit in the car,” Singh said. “Whereas if the [Madera] hospital was here, I don’t think I would be dealing with it — I would get in the car and go.”

‘Praying for the hospital to reopen’

The Madera hospital’s closure affected not only the health care of its residents, but also the health care of its own former employees, who had to scramble to find employment and health insurance after getting laid off. 

When Jaimi Kilcrease abruptly lost her job in January as a nurse at Madera Community Hospital, she found out she and her colleagues would also be losing their health coverage, despite hospital leadership saying coverage would expire at the end of January. 

That derailed Kilcrease’s plans for post-cancer treatment surgery that same month, as she was newly unemployed and without health insurance. She ended up canceling the surgery appointment, still processing how she lost her job at a hospital she worked at for 10 years.

Two weeks later, she and other former nurses from the Madera hospital were hired by St. Agnes Medical Center, and it provided her major relief. Kilcrease said she is accumulating enough paid time off so she can reschedule the delayed surgery.

“You have no idea how grateful I am for my bachelor’s degree and for the fact that nursing is a position that is in demand,” Kilcrease said. “I felt very, very bad and had a lot of empathy for those people that were scrambling and didn’t have as much access. I know there were a lot of people that struggled to find employment.”

Tammie Myers, who worked at the Madera hospital for more than 20 years, didn’t know what to do after losing her job. She told Fresnoland that at her age, she isn’t able to handle the stressful and demanding workload of a nurse, so that kept her from seeking employment at Fresno hospitals, known for their higher patient volume.

“I hear stories from some of my former coworkers that went to St. Agnes primarily,” Myers told Fresnoland. “They’re just working so hard — just running for 12 hours — I’m too old to work that hard.”

After the closure, Myers said she started working the occasional odd job, including babysitting, and is now living with her daughter and son-in-law. Losing her health insurance also became a major obstacle when she started experiencing asthma symptoms in March, and didn’t know what to do or how to afford medical care.

With her personal savings dwindling and no health coverage. Myers ended up borrowing her grandchildren’s asthma treatment to deal with her own symptoms. 

“When I was sick back in March, that was scary,” Myers said. “Of course, I could go to the emergency room and they’ll take care of me, and then charge me who knows how much money — but now I’ve got another bill I gotta pay.”

In early November, Myers turned 65, which made her eligible for medicare as well as social security. Both have helped her find some stability during a year that’s been anything but. 

“If I wasn’t sharing expenses with my daughter and her husband, I don’t know what I would do,” Myers said. “With getting Medicare when I did, it’s kind of all fallen in place but it’s been kind of sketchy.”

While she’s in a better spot now, Myers said she spent several months uncertain about what to do and what would happen next.  

It didn’t help the uncertainty that Madera Community Hospital’s bankruptcy case is a complex one that has slogged on for close to nine months now. 

But regardless of what happens in bankruptcy court, Madera residents have one thing to say: they need an emergency room that helps people in medical emergencies, and they need a hospital that provides care for common health conditions their communities deal with. 

Singh wants to make fewer trips to Fresno and said her family shouldn’t have to drive her to another county when she has unpredictable pain flares or needs emergency medical treatment. She knows her family members love her, so they’ll do anything to make sure she’s healthy, but she worries about being a burden on them.

“I’m praying for the hospital to reopen.”