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Into the Void: The Tragedy of Lynne Spalding's Disappearance Is How Close at Hand She Was Lost 

Tuesday, Nov 4 2014
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She was sick and confused.

She was brought to the hospital. She ended up stuck in a gray concrete stairwell filled with white noise. It was like being underwater.

On the other side of the locked door was the muted business of a hospital, the busy white coats deceptively near. Looking through the tiny window cut into the blue emergency exit door was like being a submerged swimmer gazing at beachgoers through watery goggles.

Outside, where she was trapped, there was the rhythmic din of an HVAC somewhere below and a freeway nearby.

Did she slam her fist against the locked door? Did she yell for help at the nurses and doctors inside the hospital?

Maybe. But no one came for Lynne Spalding.

Spalding — a white, 57-year-old mother of two with shoulder-length brown hair and a broad grin — wandered into a little-used emergency stairwell of San Francisco General Hospital one day in September 2013.

And, though only a few feet from help, it was as though she disappeared completely.

San Francisco General Hospital, wedged between Highway 101 and Potrero Avenue in the Mission District, is the city's trauma center and the last line of defense for much of the city's poor and homeless.

Consequently, on most days people come through the door like unwinding spools — some in cars, some walking from the bus lines running up and down Potrero Avenue. Nurses and doctors getting off long shifts or just starting new ones pass wheelchair-bound patients, families, and the limping wounded. Delirious patients rant and mumble not far from ambulance crews waiting for their next call. Gunshot victims often drive themselves to the front doors.

Somewhere in that busy world, Spalding turned a corner and vanished.

A lot had to go wrong for San Francisco's premier public hospital to lose a patient. Human error, institutional failings, and sheer bad luck contributed to Spalding's ordeal. When hospitals fail in such ways, they become, however fairly or unfairly, symbols for society's disregard for its weakest and neediest.

But they remain the only health care option for many people. They cannot turn away patients, so those most in need flock to their doors, making already busy and chaotic places more so. Like the DMV, they draw in all sorts, and like any system, they occasionally break down.

There is much we don't know about what happened to Spalding. Even with federal, state, and local investigations, many details are missing and may remain so. Trying to tell her story is akin to reconstructing the story of someone lost at sea.

In the fall of 2013, Spalding had been complaining for weeks about stomach pain, and over-the-counter medicine had done little, her then-boyfriend Mark Casey tells me recently. On Sept. 18, he got a text at work from Spalding's 19-year-old daughter: "My moms not feeling well." They took her to the hospital the next day, despite Spalding's protests.

She was given a bed on the fifth floor, and doctors tried to determine what had caused her recent weight loss and confusion. "She was a little confused when we brought her in," says Casey. He still isn't sure what was wrong with her. His only theory is that she had a bad reaction to the antibiotics they were giving her for a urinary tract infection.

The next day, Casey came to visit and Spalding seemed better. She wanted to leave.

But her doctors noted that her confusion didn't dissipate in the hospital. At times she didn't know why she was there or what day it was. She kept wandering away from her room. An alarm was attached to her, meant to notify the staff when she left her bed. But she wandered off so many times that it was turned off.

Increasingly concerned about her walkabouts, her doctors sent a note to the nursing staff to keep an eye on her at all times. The note never made it to anyone on the fifth floor.

When Spalding was left without supervision after 9 a.m. on the morning of Sept. 21, two days after she was checked in, the nursing staff returned to find her gone. She had taken all of her belongings, as if she meant to go home. Nearly everything — her clothes and purse and the $20 inside — was gone. The only thing she'd left in her room was her cellphone.

Forty minutes later, at 10:25 a.m., the staff reported her disappearance to the hospital's security staff, run by the Sheriff's Department out of an office inside the hospital. A perimeter search was conducted soon thereafter, which turned up nothing.

Spalding hadn't gone far. She ended up in the nearby emergency stairwell, only yards from her room.

The low-ceilinged hallway leading to the stairwell door is lit from above, and trafficked by orderlies, doctors, and nurses. At the hall's end, an exit sign glows like a beacon. Signs warn that an alarm will sound when the door is opened. But if the alarm went off, no one heard it or, if they did, didn't pay much attention.

It was one more noise in a noisy hospital.

When Casey came to the hospital around 11 a.m. with one of Spalding's friends, they found an empty room. "They were like, 'She got up and left,'" he recalls the nurses telling him. "We said, 'How does that happen?' They said, 'We're looking for her.'"

Even her doctor was surprised she'd gone. "I came into the room to discharge her and she was already gone... But she's very confused and not safe out on her own," Spalding's doctor, whose name has not been released, told a sheriff's deputy at 11:12 a.m.

The fifth-floor staff told security about a missing patient that morning, but they incorrectly described her. In the first call at 10:25 a.m., an unnamed medical staff member said, "I sent a CNA [Certified Nurse's Assistant] to look all over the place but we could not find her. She's [an] African-American lady, 57 years old. Female. She's wearing a hospital gown."

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Jonah Owen Lamb

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