Slow Healer: Dr. Victoria Sweet sees medicine’s future in Laguna Honda’s past

“I love this place,” said Dr. Victoria Sweet, staring up at the grand, old entrance to Laguna Honda Hospital and Rehabilitation Center, the last remaining almshouse in the country.

“There’s a history behind Laguna Honda that’s just fascinating and still has me mesmerized,” she said. The hospital’s history and its residents’ stories are among the threads running through Sweet’s 2012 book, “God’s Hotel,” which also covers her journey as a modern-day physician with a serious interest in ancient medical tradition. Her latest book, “Slow Medicine,” goes deeper into how she came to prefer a style of doctoring rooted more in the past than current trends.

Despite the changes in her profession and the hospital itself, Sweet, who has since left Laguna Honda to travel the world telling its stories, remains certain about one thing: “San Francisco still takes care of its sick poor like nobody else does.”

We started our tour of the grounds at the sculpture of nurse Florence Nightingale, by Works Progress Administration artist David Edstrom, then moved to the stairs where Sweet expounded on the credentials of architect John Reid. She pointed to a plaque commemorating philanthropist Charles Wollenberg, the hospital’s former superintendent.

“He’s one of my heroes,” Sweet said. “He used to convince The City’s rich people to bring their food here when they would go hunting and he would throw a big November party for the patients with fresh game roasted on a spit.”

Established in the 1860s to serve miners when their Gold Rush dreams turned to dust, Laguna Honda has helped San Franciscans with no other visible means of support, whether after the 1906 earthquake or during epidemics from smallpox to AIDS. You might say its storied past and hospitable present are tangible signs of “the old San Francisco,” not only in architecture but in spirit and perhaps something more ineffable.

“It’s sort of alive to me,” said Sweet, whose best of both worlds-style of doctoring is as iconoclastic as the historical characters she admires. And while small in stature by her own description, Sweet’s observational powers and abilities for quick thinking and navigating the hospital’s expansive corridors with authority are mighty.

Elizabeth Saiz, right, a registered nurse, orientation coordinator and 16-year colleague of Dr. Victoria Sweet, shares photos of her granddaughter. (Kevin N. Hume/S.F. Examiner)

“It was fascinating to watch Dr. Sweet and wonder why she did what she did,” said registered nurse and orientation coordinator Elizabeth Saiz, who worked side by side with Sweet for 16 years. “There were times we’d wonder, ‘Why is the doctor sitting there staring at the patient,’ and then she explained it and it made so much sense.”

Concurrent with her time at Laguna Honda, Sweet was doing her dissertation on the scientific and medicinal work of 12th century Christian mystic Hildegard of Bingen.

“Laguna Honda was the only place at the time that was willing to be flexible enough for me to work part time and get my PhD at UCSF,” said Sweet as we walked on a hospital path lined with native plants and herbs. “It was purely serendipitous.”

As were so many events during her 20 plus years at the hospital.

“When she was doing her dissertation, she was learning the way of doing medieval medicine,” Saiz recalled. “She started asking us culturally what we did, and she tied that into some of our evidence-based practice. She is ahead of her time, the way she thinks.”

Drawing open the heavy copper main doors of the hospital’s last remaining old structure dating back to the ’20s, Sweet paused to point out the foyer’s colorful tiles: “All crafted in San Francisco.” We stopped at more WPA works — murals depicting the four elements — past the goldfish pond and toward a painting by Glenn Anthony Wessels titled “God’s Hands.”

“I only discovered this after I finished the book,” said Sweet, who borrowed its title from the Hôtel Dieu in Paris; established in the seventh century, it remains a charity hospital. While writing “God’s Hotel,” she didn’t tell her colleagues or patients she was working on a book, though in the end, she changed their names for confidentiality and privacy considerations.

As for her own story, “My family got here in 1836, when it was still called Yerba Buena,” Sweet said. “They came by boat from Germany and arrived before the Gold Rush.” Born in Los Angeles, she studied at Stanford and UC Irvine and moved here to begin practicing medicine at Kaiser, drawn to The City by her family’s tales of classic, colorful San Franciscans, specifically Emperor Norton, who her grandfather was said to have met as a child. Taking a special interest in homeopathy and alternative healing, her curiosity led her to the ways modern medicine grew from ancient modes of healing.

Sweet recalled when the U.S. Department of Justice showed up at the hospital in the ’90s. “They said, you have these big open wards and patients have a right to privacy, so you either have to tear this thing down or build a new one.” Of course, the open plan was by design, a result of Nightingale’s studies in mathematics and public health.

“Nightingale was really into fresh air, sunlight, all the windows open. Everything flows. There’s no place where you hit a dead end. People had space to move around. The new place is beautiful, but here you had space,” Sweet said, pointing to a sunny alcove. “People smoking, playing poker.”

Not one to balk at an unmarked door or secret passage, “I always found the most interesting stuff behind closed doors,” said Sweet, flinging open the unlocked door of the hospital’s mini-museum or archive. “Look at this!” she gasped, scrolling through bound, oversized volumes of handwritten doctor’s notes. “Now these are medical records.”

The DOJ visit led to a bond measure to rebuild, led by a committee headed by former Supervisor and City Attorney Louise Renne. Overwhelming passed by San Franciscans, the new hospital, the nation’s first LEED-certified all-green facility, opened in 2010 and continues Laguna Honda’s tradition of serving the underserved. But once the new building opened, Sweet opted out of becoming one of its health care providers (she prefers the terms “medicine” and “doctor”).

But what of the old Laguna Honda and its healing history? Can it still be used to serve San Franciscans in dire need of shelter and services? And why is it mostly empty?

“That would take many hours to explain,” said Dr. Michael McShane, though Chief Operations Officer John Grimes assured us there was a plan afoot. We ran into both administrators during our tour. I was mostly interested in what a visionary like Sweet thought could be done with the space for potentially 1,000 beds in the old hospital than the official version, which could take years to manifest.

“It seems like you could have a dedicated wing for each of the groups Laguna Honda admits,” she proposed. “Because of the way Florence Nightingale arranged it, you could have a floor for the mentally ill who need treatment but they’re not so sick. The next group would be the drug abuser rehab floor …” She paused, perhaps in consideration of the realities of modern health care.

Escorted by Grimes across the seamless bridge from the old hospital to the new, we paused to admire the unique, historic tapestries and were handed off to our next guide, through the therapy pool house and to the farm outback.

“Look how beautiful it is,” Sweet enthused. “It’s gorgeous.”

There’s no denying the magic quality of the grounds — its flowers, fruits and vegetables and the squawking chickens and fluffy rabbits, allowed to visit the hospital’s art studios once a week for socialization. Sweet engaged everyone present in conversation, made friends with the animals, including a resident’s visiting dog, and admired the plant life before we headed back up the hill to the old building.

“I thought that was you,” said one of the nurses who caught site of Sweet leaving the hospital. I asked RN and activities therapist Tracy Griffin her thoughts on Sweet as the doctor stepped away.

“Dr. Sweet was so kind and so genuine and she took so much time with the residents and really cared about their well-being,” Griffin said. “There were a lot of difficult patients, but she never stopped trying. She always persevered. The patients miss her, and I most certainly miss her.”

Sweet misses the place and its people, too, though her dedication to slow medicine is perhaps too fierce to abide electronic medical records and the other accoutrements of modern health care that she finds counter to healing.

“I would love to do something here,” Sweet said of starting a pilot program, much like ones she’s seen at Yale and in San Antonio, Texas, effective at getting mentally ill people off the streets and stabilized. “We are at the best moment there’s ever been in known history. It would take nothing to walk out of our house, treat the mentally ill, stop the wars … we’re fighting about nothing.”

“It wouldn’t take much.”

Sweet’s next trip will take her to Geneva, Switzerland, for a medical conference. As we parted, I thought of my own relatives who’ve passed through the gates of the hospital and of the wisdom Saiz shared with me that she gained from working with Sweet.

“We have to look at the patient as a whole. We need to find out why, what happened to him, why is he here? The root cause. You have to find it in order to see the person as an individual,” Saiz said. “That’s what I teach my new nurses. They should make more doctors like her. She’s one of a kind.”

Denise Sullivan is an author, cultural worker and editor of “Your Golden Sun Still Shines: San Francisco Personal Histories & Small Fictions.” Follow her at www.denisesullivan.com and on Twitter @4DeniseSullivan.

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