For over an hour Kevin Spiegel, the CEO of a now-thriving Erlanger Hospital and “the man of the hour” as mean-spirited rumors now swirl, and I had volleyed back-and forth, long and short, over “our” hospital’s plunge into an unexplainable morass yesterday afternoon. The idea was for Kevin to help me understand why the ruckus of starved trust and barren promise has now developed after unparalleled growth for the six years he has been here. Face it, no one can deny he has confidently guided Chattanooga’s top hospital to heights unlike we have ever known.

In candor, I have known Kevin since the first day he arrived and watched, often with a jaundiced eye, his admittedly stunning turn-around of our most important asset. On Labor Day I wrote an article stating I was virtually certain his exit – yes, cruel -- would be made within the week. I have received dozens of emails and phone calls about the mission of Erlanger Hospital, yet I remain perplexed why I haven’t read more in support of this doer-of deeds who came to us from Memphis. He has done what he said he would do, that and more.

We have $250 million in cash. There are drawings in his office for a $200 million tower that will rise some 14 stories in the air to the relief of ICU and pediatric patients, and now the promise of a spectacular neuroscience building where our world-famed Tom Devlin will further nurture his Stroke Center. This – and may I say rather spectacularly – blossomed in a way construction will start in months.

So, here is Spiegel, asking me what has warranted the “lack of confidence” by the hospital’s Medical Executive Committee? “Honestly, let’s pinpoint it,” Kevin challenged. Well, there is easily-proven greed on the part of non-institutional physicians. Between 300 and 400 doctors are now on ‘staff,’ actually full-time employees of the hospital while more than twice that are in contract groups. The rub? A good example is the group that has the emergency medicine contract. They supply two doctors whereas at Vanderbilt they have six. Clearly, that is not enough for Erlanger, but the contract is in place. Oh my gracious, help me! Rewrite the contract. Re-negotiate! Fix whatever’s broken and let’s eliminate whatever is causing our emergency room to malfunction. Understaffed nurses and support? Please -- it’s cheaper to rectify than fight. This is no-brain land.

I told the CEO that such nonsense is so maddening it is beyond deplorable – this in the eyes of the patient who has been waiting for over 24 hours for a bed and, kindly remember, is sick. Erlanger’s care-givers are the ones who are wrong before a public jury and there is no humane defense. Sports teams have repeatedly proven that doing the little things well assures the best results with the big things time and again. “Erlanger needs to go back to the very simplest things, like treating patients and visitors with as much courtesy as well as professionalism,” our conversation was now in earnest and – it’s true -- while we now must wait to learn how the cake tastes when It comes out of the oven, the lesson is boiler-plate.

Now buckle your seat belt. “Kevin, our nurses are our greatest strength, yet we worry so much about a disgruntled medical staff we clearly disregard Erlanger’s great heroes who appear alone at point-of-contact. This is so simple. When I was a small child the black man who raised me taught me two lessons well. ‘A smile never goes out of style,’ and ‘Sonny boy, if you love people, they’ll love you back.’ Think about it … don’t order a nurse, who is already a professional, to do a task … instead, a true leader will get her to yearn to conquer the simplest task in grandiose fashion. When she over-performs, the patient feels she cares … and the patient holds the only vote.

“It’s as old as time,” I reminded Kevin. “We don’t need to reinvent kindness and compassion with consultants who waste time, silly counselors who require insomnia preventives, or others who get in the way to shield their own short comings. King Solomon, the smartest man who ever lived – right? – wrote in Proverbs, ‘A merry heart doeth good like a medicine: but a broken spirit drieth the bones.’

“You know that’s true. But we haven’t given nurses raises in over two years! They’ve got kids who need school supplies, struggles in life just like every single person on the Erlanger Board of Trustees who takes up air worrying about inane stuff that our floor nurses can’t begin to transcend into real life. Now, when will Erlanger nurses get a significant raise?”

Kevin nodded … “I hear what you’re saying … soon … it will be soon.”

“Isn’t that ironic … I heard this morning that Halloween will come soon. So will Santa Claus, the Easter Bunny and the Tooth Fairy … Soon. When is soon? We are going to announce a shiny neuroscience building as ‘eye candy’ but an army travels on its stomach. That means zilch to a single-mom nurse who needs to pay her son’s fee for the basketball team. Can’t you see why Erlanger has allowed ‘little things’ to become so stagnant it is maddening? This is nuts … when do Erlanger nurses get raises?”

Spiegel let a smile tickle his mouth’s corners: “Next month.”

“Huh? Kevin, this is important. This isn’t play …” I was startled by the direct quickness. “This won’t save your job, but if you mean it, and nurture a new spirit of ‘want to’ instead of ‘have to,’ you can change the face of Erlanger in such a way they’ll build a monument of your likeness for the pigeons. Spiegel, you promise this is really real?

“I believe nurses raises are now our top priority. I’ve felt that way for a while so … yeah … next month,” he said at approximately 2:45 p.m. yesterday.

“Spiegel, you lie to me and I know boys who will tie you up, drive to the Everglades and feed you to some python … this isn’t lip service … tell me you really mean it. Kevin, I’m writing it. I’m gonna’ hold you to it. And it better not include a dessert coupon or, God forgive them, some mandatory pledge card to the ‘I Believe’ Club. Find out what employee’s idea it was to put the pinch on all the other employees who struggle, and kick them all the way to United Way. ‘Forced charity’ has fertilized more unions in today’s ‘us-versus-them’ employee relationships than you do colonoscopies in a month. Never, ever, prey on anyone with ‘forced charity.’ Such nausea will send the faint of heart to the E.R.”

“Tell me one more time? When are the nurses getting a raise, one that means sometime with key bonuses to superstars. I’m talking about money, stuff that doesn’t happen where every employee gets ‘a bag of M&M’s to prove our affection.’ You make the raises mean something after a two-year embarrassment because you’ll see … the little things win the big things.”

I don’t know if changing an 8,000 employee entity from one who revers top-to-bottom to a new style that works instead from “bottom to top” will make a difference, but if we can change a negative into a positive, an entire city will notice and maybe they can do it too.

royexum@aol.com