i don't think that i would be talking to you today if i was at laguna honda. and i am concerned about myself and other patients there is a shuttle, so for, if i had a problem, at dialysis, say, my access and i had to leave, and i would have to catch a shuttle to forest hill, a bus, up the hill, to get on the 48, and that would finally take me to general. that is three buses. and i am already having a problem. so i am sorry that the doctor haves to go around to three sites, but to put more burden on the patients, to take it a little inconvenience from the doctors. >> ma'am, i think that supervisor mar has a question for you. >> i really appreciate the packet and a statement from you in the packet. >> you leave in district ten and how long does it take to you get to sfgeneral now? >> well, i take a van service. sf general. so i would probably use a van service to go to laguna honda, but it does not take us to appointments i go to hemotology and 4 c for chemo and the woman's clinic and i have a lot of appointments at general. and so, that is the problem with the

and also it shows miles to sfgh and smiles to laguna honda. and so we recognize, transportation, is an issue, and as part of this process, we are committed to doing anything that we can to bring resources to help to mitigate any transportation barriers that might be presented as a result from the move from san francisco general to laguna. >> can i ask you about this slide, what does it mean when it says ward 17 and com sites? what is the difference between the two? >> the award 17 is the building, the building 100 at sfgh, that is where the current facility is located and community sites represents the number of patients who are followed by the sfgch but they are actually out in the community sites, say north beach, webster street because we don't have the capacity to follow them at sfgh. >> thank you. >> in terms of transportation, those patients who are currently coming to ward 17, this is the information in terms of how they get there currently as best as we know it. about 40 patients are using a van service. and about 12 come by private ca

i also want to say that with respect to laguna honda, i also want to make sure that in the discussing whether or not the move is appropriate, we also acknowledge that laguna honda is also pretty remarkable place that offers amazing service for people and there is a lot of great work that goes on at laguna honda and so, i am very gratified, you know and proud of that. so the fact that someone may be against this moving to laguna is not because laguna is not an amazing place, it is just a question of whether or not it is the right fit. but i want to be very clear about that. that said, you know, there was a lady, so many of the patients, it was so difficult to really hear them testify and it is clear that for all of them, it is a real challenge, physically, to come to a place like city hall and the fact that notwithstanding the fact that there are going through dialysis and that they are willing to make the trek to come to city hall tells me that this is a pretty serious issue. i will tell you that it kind of goes down to or comes down to one of the ladies said which is, sf general is a

of moving to laguna honda. >> let me just make sure that she gets her message is cross. >> sf general is such a big hospital, why can't she figure this out and otherwise, right now they are burdening the patients this is not the patient's burden. this should be a decision made at sf, general which you would have the management who should think on behalf of the patients and the patients should not burden this. >> thank you very much. >> and on top of that, i want to emphasize one thing, she does go to other services because due to her dialysis she has, and she needs to check on the liver and the lung, and all kinds of services that we use from the san francisco general hospital. >> okay. >> and as her son, i do want to say my part. i just work graveyard last night to 7:00 a.m. in the morning and i will be working my second job at 2:00 p.m. and yet i chose to be here in stead of sleeping at home, why? because the medical staff and the clinic is like the second family to me and my mom. there is smiles are genuine and they truly care about the patients when you are there, they sang songs

she talks about her experiences working at san francisco's laguna honda hospital. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] >> i see and we will get started. my name is arlene tuchman and i'm a historian of medicine at manville university. i want to thank amenities tennessee and the robert penn warren center and the communities of vanderbilt for sponsoring this talk today and in fact for sponsoring a series of sessions taking place the rest of today and tomorrow entitled taking our polls promises and pitfalls of modern medicine and we have some pamphlets appear if you are interested in any of the other talks in the series. please feel free to come and take one. i am delighted to introduce. their victoria sweet who is an associate clinical professor of medicine at the university of california san francisco and a prize-winning historian with a ph.d. in history. she practiced medicine for 20 years at laguna honda hospital in san francisco a chronic care hospital founded in 1867 for the care of the city's de