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Show Wednesday, July 5, wan street wizard is 'guardian angel' for Iowa community : By SHARON COHEN Associated Press Writer - NEW YORK (AP) New York over the weekend became the first state to limit the grueling work hours of interns and residents to reduce the risk of error by dazed and exhausted The arrangement has brought Fayette hundreds of thousands of dollars that have helped build a new city hall, expand utilities and buy a street sweeper, lights, two ambulances and two police cars. "He really understands a small town in the middle of nowhere has needs," Karlson says. "Fayette exemplifies the best of middle America," the New Jersey financier says, by way of explanation. "People are school. g. 100-ho- ur 36-ho- ur 24-ho- ur of passage for years and years," said Dr. Joseph Sachter, chief emergency room resident at Metropolitan Hospital in New York City. "But there's Starting then, and continuing through the 70s and '80s, Bobeen an astonishing change in lger, business partners and some clients arranged to donate two years." some 20 commercial properties Proponents of the tradition to leased and say shunning sleep toughens they'd owned young doctors to the rigors of corporations. A7 Health Department study hospitals with high mortality rates raised serious questions about the quality of supervision and the dangers posed by resiA of dent fatigue. Axelrod appointed a panel to address the issue after the 1984 death of the Siddaughter of author-lawyer ney Zion. Libby Zion, 18, died after going to New York Hospital for treatment of an earache and fever. A grand jury, while indicting no one, found Ms. Zion's death resulted from inadequate care and errors by unsupervised interns and residents. "We have a sense that there are problems related to fatigue. But it's harder to attribute a poor decision to fatigue and much easier to determine that supervision was not present," said Health Department spokestime," said Sachter. woman Faith Schottenfeld. The Hospital Association of In February, Drs. Dennis H. New York State and Blue Novack and David B. Reuben medstate the backed Cross, by ical society, have sued to block of Rhode Island Hospital demisthe regulations, charging they scribed fatigue-induce- d will be too costly. The hospital takes in a letter to the Journal industry estimates 4,500 to 5,000 of the American Medical Assoworkers must be hired state- ciation. wide to implement the plan. They told of a get-togeth- er where residents admitted "giving the wrong antibiotic, overlooking diagnoses, mistranscribing orders and falling asleep while writing up a history." But traditions die hard. d When Axelrod and Dr. Albert at Bell, professor Einstein College of Medicine, started pressing for reform in 1987, they were "lambasted and torn apart by the New York Ber-tran- medical establishment," said Sachter. "Older physicians say: 'I did it they're going to do it. ... I think we're coddling these kids,"' Axelrod said in a May speech. "Our elders don't recognize that medicine has changed." AccreditaThe Chicago-base- d tion Council for Graduate Medical Education, the accreditation body for all teaching hospitals in the United States, is about to issue work limits for some specialties and strengthen supervision for all of them. The guidelines will be phased in as each hospital comes up for accreditation over the next three or four years, said James Weinlader, director of residence review committee activities. real or not?" But manna from heaven it was. "I think he was looking for someone to give a charitable gift to," Karlson adds. "Thank God it was us." Does saying the same thins twice have beside yourself? you g, big-tim- speck-on-the-m- - Page Initially, the offer created "a lot of suspicion" and liability concerns, Karlson says. "Small town, big millionaire. Is this This year, Fayette received relatively quiet checks including $247,500 for and reserved. The city is of the sale of a Michigan retail people and by people. ... They store and $30,000 for its share in an Ohio shopping center that care for each other." And he cares for them, was sold. through a friendship that beIn some cases, Fayette owns longs in a Frank Capra movie: the land, in others, the building, e businessman embraces too. Bolger maintains some town, spreads ownership of all properties, greenbacks and good cheer. which include an Illinois can No strings attached. factor', a Texas cold storage house and several Cleveland When Fayette got new Main Street lights, thanks to Bolger, supermarkets. honors went to Experts say giving property his wife, Barbara. to a municipality is a tax savA sandy spot in ings the donor deducts the encorn country? Bolger paid to tire fair market value when the bulldoze a riverbank area, and is given. But the money Bernard "Scorch" Pattison, the gift saved is less than if the propergrain and feed mill owner, is sold and taxes are paid. hauled white silica sand from ty No one knows exactly how his company's underground much money Fayette has remine to create a beach named ceived, though Karlson estiafter guess who? mates it's more than half a "He gets a kick out of seeing million dollars. many things happen because of A committee determines how what he's contributed," says to notspend the "Bolger fund," Mayor Denny Dumermuth, e in which totaled to taxes would have be that ing council The recently apraised or services cut back proved a committee recommenwithout Bolger. Fayette needs help: many dation to use most of the cash streets have potholes, houses for street renovation, for razing an old sewer plant, for an are in disrepair. To Bolger, good deeds are ambulance and for a loan to the "what my parents taught me to local development group. "There's a feeling of respodo put back in the community nsibility," Hurley says. "We what you take out." Bolger, whose Fayette link want to put it to good use. We goes back 25 years, visits occa- want to have a nice town in sometimes by priyears." sionally vate jet. He eats at Lucy's Bolger doesn't participate, Garden of Eatin' cafe, chats saying: "I think it's appropriwith Kenny, the hardware store ate the community decides what they want. Once I get e owner, and is on a basis with other shopkeepers. something together, I pull No corporate pinstripes, no back." Bolger, however, did provide stuffy meetings. Bolger goes in long-ter$140,000 or and financing hunting fishing antique for Blessing Industries, a sometimes brings back his metal fabricating firm. wife's favorite Iowa smoked he leaves behind to "What pork chops. "He works with Wall Street Fayette is something he's been Blesspeople 350 days a year," ex- a part of," says Blaine owner. "He the firm's plains city attorney Charles ing, to it ... make for wants better a world. cutthroat "It's Hurley. He loves to come out here the people who are here. He where the pace is slower. I wants to be remembered for think he's doing some good something positive. He wants to things with his generosity, not leave that in his legacy." hard-workin- medicine and lets them study the progression of a patient's illness. Critics say bleary-eye- d residents endanger patients and can even kill them. "You come in pretty blind in it's no July and August secret the mortality rates are New York, which trains 16 the highest when the interns percent of the nation's doctors, are brand new. You don't know is leading a national movement what's going on even with an tradaway from the century-ol- d enormous amount of direction," ition of shifts and said a New York work weeks for postgradwho intern spoke on condiuate trainees in medicine. The City of tion anonymity. Health Department now limits shifts to 24 hours and the work State Health Commissioner week to 80 hours. Dr. David Axelrod said today's Several hospitals in the city doctors must learn more than had already implemented the their predecessors, make more rules, and a medical decisions and treat sicker pacouncil is preparing guidelines tients. that will be enforceable nation"Is it ideal if a resident wide. works 24 hours? No but it's a Long hours have been "a rite lot better than 36 hours at a doctors-in-trainin- squandering it on wine, women m Mayor Roy Karlson. Bolger and some friends and clients have donated to Fayette the ownership of part or virtually all of some 20 properties, ranging from a can factory to a bank. THE HERALD, Provo. Utah, New York limits interns' hours - and song." Fayette, population 1,500, has Fayette, (ap) There's a Bolger Drive in town. made Bolger honorary mayor. A smiling Bolger portrait in His wife is honorary police City Hall. And, unlikely as it chief. This spring Bolger received seems, a Bolger beach amid the cornfields. an award from Upper Iowa But the name doesn't belong University. In the early 1960s to a founding father or local when Bolger worked at a Wall hero. Bolger wasn't born here. Street securities firm, he arHe has never even lived here. ranged financing for a dormitory-fSo who is he? service center there. ood In Wall Street circles, David Years later, the school's lendBolger is a wealthy investment ers called on him when the banker. In Fayette, Iowa, he's university was $3 million in a guardian angel. debt. Bolger arranged a refi"He kind of feels we're his nancing plan, secured loans and adopted community. And we've canceled $1.8 million in long-teradopted him," says former mortgages he held on the iowa 1989 ap mid-Jun- $366,-00- '''''' 0. 50-1- first-nam- m fast-growi- ng Why repeat yourself when you can talk with two people on the phone at the same time? 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