"Woke up in the back of a tre / on my way to MLK // That's the county hospital jack / Where niggas die over a little scratch"
— Ice Cube, "Alive on Arrival"
Drawing less attention than the more racially charged songs on Death Certificate, Ice Cube took a significant amount of local criticism from the media and medical community for "Alive on Arrival."
In the song, he describes the conditions at Martin Luther King Jr./Drew Medical Center, the county hospital serving the South Central Los Angeles area, otherwise known as Killa King — a moniker bestowed on the hospital by local residents thanks to substandard medical treatment and tragic patient outcomes.
The hospital was founded after the Watts Riots to serve the health care needs of the chronically under-served and impoverished residents of South Central Los Angeles — an area that ranks number one in the city in coronary heart disease, diabetes, homicides, poverty, uninsured children, teen birth rate, un-vaccinated elderly and total death rate. In 1965 the facility became the teaching hospital for the Charles R. Drew University of Medicine and Science.
By the time Death Certificate was released in 1991 the horror stories coming out of Killa King were urban common knowledge, making the backlash from the media, politicians and health care professionals to "Alive on Arrival" even more bizarre.
Did they not know what seemingly everyone in the area already knew?
As with other songs and topics on Death Certificate, outrage should have given way to examination as, once again, Ice Cube proved prophetic.
In the song Ice Cube details crowded conditions, less than professional responses to patients, extensive waiting times, substandard treatment and eventually death through medical neglect and negligence.
Was Ice Cube correct or engaging in a misguided attempt to be controversial by making "obtuse political statements?"
Edith Isabel Rodriguez
On May 9, 2007 Edith Isabel Rodriguez was brought to the King/Drew emergency room suffering from severe abdominal pain. She was prescribed pain medication and released.
While waiting outside the emergency room she collapsed to the ground. County police officers, responding to a call of "female down" in front of the hospital, and a member of the hospital staff placed Rodriguez in a wheel chair and took her back into the emergency room waiting area where she collapsed, falling out of the chair.
According to a police report, emergency room nurse Linda Ruttlen told Rodriguez, "get off the floor and onto a chair."
Rodriguez was helped back into the wheelchair and, shortly after the officers left, she collapsed to the floor again. This time there was no help.
When her boyfriend, Jose Prado, arrived at the hospital he found Rodriguez on the floor of the waiting room writhing in pain, bleeding from the mouth and vomiting.
Unable to get assistance from hospital workers inside the emergency room, Prado and another woman called 9-1-1 to report that Rodriguez was dying and being ignored. Both callers were told by dispatchers that the situation was "not an emergency."
In a video of the incident, eventually obtained by the media, a janitor can be seen cleaning the area around Rodriguez as nearby hospital staff ignore her and go on about other business.
Unsuccessful with 9-1-1, Prado approached police officers at the hospital for assistance. Instead of providing assistance, police took Rodriguez into custody after a computer search showed an outstanding arrest warrant for a parole violation. As officers wheeled her out of the hospital, Rodriguez became unresponsive.
Forty-five minutes after being brought into the emergency room, Edith Isabel Rodriguez was dead.
The county coroner said she died of a perforated large bowel — an injury that would most likely not have been fatal had she received proper treatment.
A county health officer said Rodriguez was the victim of inexcusable indifference by hospital staff.
And the Rodriguez case was not an isolated incident. Rather it was one of the final incidents in the hospital’s infamous history.
Security video of the Edith Rodriguez incident:
- From 2002 - 2006 the hospital was cited more than a dozen times for patient care lapses and blamed for a series of patient deaths.
- In January 2004 the federal Centers for Medicare & Medicaid Services (CMS) deemed King/Drew "out of compliance" with standards for federal funding eligibility, threatening the Hospital's Medicare and Medicaid revenue. By March CMS elevated their warning to that of "immediate jeopardy," meaning that in the opinion of CMS, patients at King/Drew were at risk for harm or death due to medication errors.
- In 2006 CMS issued a 124-page report detailing dozens of errors and failures by the hospital staff
- Medical equipment was not sterilized properly, potentially exposing patients to infections.
- Three nurses took more than three minutes to find a vial of medicine. Another did not know how to mix medication during an emergency drill.
- Los Angeles police officers, sheriff's deputies and firefighters all reportedly opposed being taken to the hospital if they were hurt in the line of duty.
- Since 2004, 260 hospital staffers, including 41 doctors, were fired or resigned as a result of disciplinary proceedings.
- In June 2004 CMS stated that patients were in jeopardy, citing the use of Taser stun guns to subdue psychiatric patients.
- The American College of Surgeons revoked its approval of the quality of King/Drew's trauma unit in 1999 and 2003 because it failed to properly investigate questionable patient deaths and because doctors routinely skipped meetings held to discuss treatment problems.
- In 2003, the Los Angeles Times reported two women connected to cardiac monitors at King/Drew died after their deteriorating vital signs went undetected.
- In December 2003, DHS closed the cardiac monitoring ward at the hospital after a third patient died under questionable circumstances.
- In February 2005 the Joint Commission on Accreditation of Healthcare Organizations, citing the medical center for failing to correct severe lapses in patient care, revoked the hospital's seal of approval. (99% of hospitals pass Joint Commission audits).
- In March 2005 three patients died as a result of insufficient care.
- In 2005 the Los Angeles Times won a Pulitzer prize for its coverage of the hospital’s problems.
- In 2006 a federal inspection revealed problems in nursing, pharmacy, infection control, surgical services, rehabilitation services, quality control, patients' rights and the hospital's governing body and physical plant.
- In June 2007 federal health officials declared the hospital put emergency room patients in "immediate jeopardy" of harm or death, that it was in violation of the Emergency Medical Treatment and Active Labor Act.
- In April 2007, 60-percent of the hospital's 285 registered and licensed vocational nurses failed one or more parts of basic clinical competency assessments
Accusations going back to the '80s included:
- Nurses slept through patient trauma and death.
- Nurses turned down noisy heart monitors, missing fatal cardiac arrests.
- Patients with minor injuries died in the emergency room of neglect or mistreatment.
- One patient had a hysterectomy after a King/Drew doctor told her she had cancer that she did not have.
- One patient won a large settlement after she was given HIV-infected blood at the hospital and developed AIDS.
The hospital’s trauma center was forced to closed in closed in 2005.
The hospital’s emergency room was closed August 10, 2007.
The rest of the hospital was closed August 27, 2010.
Life & Art
Ice Cube's stark assessment of King/Drew Hospital came 14 years before the hospital began shutting down and 16 years before the death of Edith Rodriguez essentially led to the hospital's demise.
The parallels between the scenario he describes in the song and what happened to her are eerily similar.
Sittin' in the trauma center / in my back is where the bullet entered. // Yo nurse, I'm gettin' kind of warm / Bitch still made me fill out the fuckin form — Waiting in the trauma center, Rodriguez made an appeal to multiple indifferent trauma room nurses.
Coughin' up blood on my hands and knees / Then I heard, "Freeze nigger don't move!" // Yo, I didn't do a thing / Don't wanna go out like my man Rodney King // Still got gaffled / Internal bleeding as the bullet starts to travel — Laying on the floor, coughing up blood and vomiting, Rodriguez was taken into custody by police officers instead of being treated for her life-threatening condition.
People steppin' over me to get closer to the TV / just like a piece of dog shit / now will I die on this nappy ass carpet? — Having fallen from her wheelchair, Rodriguez lay on the waiting room floor, writhing in pain, as patients and staff passed by and a janitor mopped the floor around her.
One hour done passed / done watched two episodes of M.A.S.H. — Rodriguez was left on the floor for 45 minutes.
Why oh why can't I get help? / 'Cause I'm black, I gots to go for self // Too many Black bodies the hospital housin' / So at 10pm I was Audi 5000 — Having spent the last hour of her life begging for assistance, Rodriguez died at the hospital
Much like "Black Korea," "Alive on Arrival" represented the loudest and most prominent voice attempting to draw attention to what was a festering crisis that ultimately exploded on TV screens and the front page of the LA Times.