Arifeen Rahman: Hospital Dominoes

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Closures and cutbacks at California hospitals leave gaps in health care access where patients can least afford them. Arifeen Rahman has this Perspective.

For the first time in two years, I walked through the looming doors of the hospital without signing an attestation of my COVID symptoms. As the taste of normalcy flickers in the wind, I am finally processing coming of age as a young doctor during the COVID-19 pandemic.

I think often of how COVID amplified the cracks in our fractured health care system.

In the earliest wave, small community hospitals like Regional Medical Center near my home in San Jose were immediately overrun with COVID patients while other area hospitals braced with contingency plans.

Yet in the era of consolidation, community and safety net hospitals have been buckling under economic pressure at a time they are most essential. Seton Medical Center in Daly City nearly shuttered in March 2020 after its parent company filed for bankruptcy, threatening to leave a health care desert in its wake. Weeks later, the State of California leased the hospital for emergency COVID care.


Having easily accessible safety nets where patients can be screened is of paramount importance. As I evaluate patients in my work, I’ve witnessed the complications of barriers to care. Simple untreated infections become life-threatening as they invade deep spaces of the neck. Tumors grow unchecked, expanding until patients struggle to breathe.

In May 2020 when Regional Medical Center became a bulwark against rising COVID infections and a living example of the importance of local healthcare access, its for-profit parent company closed its labor and delivery unit, the only one exclusively serving expectant mothers in East San Jose.

I know the economics of healthcare is fraught. Yet if wartime language was so easily deployed to justify the effort of “healthcare heroes” during COVID, then the infrastructure to support them should be a matter of national security. For my generation of health care workers, I hope we will not forget.

With a Perspective, I’m Arifeen Rahman.

Arifeen Rahman is a resident physician in Otolaryngology— Head and Neck Surgery at Stanford.