Rx: Hope and help at the Carlyle

Gary Mulvey hasn’t been the same since he stuck a .22-caliber pistol in his mouth and pulled the trigger 25 years ago.

He survived, but the bullet blew away all hope of ever again having a job, a normal life or a house of his own.

He’s not your average patient and one day last week, he wasn’t treated like one.

Dr. Christopher Goodwin makes house calls at the Carlyle Care Center, where Mulvey, 55, has been living since a brain seizure laid him out in a Spokane street two months ago. Before that he had been homeless.

Goodwin, 44, has been visiting the Carlyle twice a month for about a year. He’s the doctor of record for about 80 percent of the 115 patients currently living at the residential care facility. They are 20 to 94 years old, and mostly mentally ill or brain-damaged.

“This is the best part of my job,” Goodwin said. “This population doesn’t have a voice, and not a lot of trust.”

Winning the trust of people who have been kicked around by society is what Goodwin is all about.

His patients came to the Carlyle with schizophrenia, bipolar disorder, depression or a history of substance abuse, but they suffer physical ailments as well. Some have been laid low by muscular dystrophy, multiple sclerosis, diabetes or stroke.

Others have a history of crime, and a court might have sent them to the Carlyle for 72 hours as the “least restrictive alternative” or committed them indefinitely for criminal insanity.

They are all here, in this seven-story former hotel that saw its best days at the turn of the 20th century and its worst as the 21st century approached. About six years ago, Jim and Fay Delegans sunk several million dollars into the Carlyle to turn it into a residential care facility that Spokane can be proud of.

If Goodwin’s patients won’t come down to the ground-floor miniclinic to see him, Goodwin goes up to their rooms to see them.

“Some of our patients are pretty tough to get them to see a doctor at all,” said Becky Ford, a registered nurse on staff at the Carlyle, who knows many of the patients from the 10 years she worked at Eastern State Hospital.

“He interacts wonderfully with them,” she said of Goodwin. “He has the patience of Job. We feel we are fortunate to have him care for our folks.”

So, after seeing about a dozen patients for everything from hemorrhoids to headaches, Goodwin went upstairs Wednesday to see a 60-something patient named Louie, who had not been seen downstairs for a couple of days, not even at dinner.

“Are you dizzy?” Goodwin asked the patient he found face-down in his bed.

“Real dizzy,” came Louie’s muffled response.

“Have you had a headache?” the doctor asked.

“I’m so dizzy I can’t stand up,” said the patient, who hadn’t gotten past the first question.

So Goodwin and Ford checked the diabetic’s temperature, blood pressure and circulation, told him to get something to eat, but let him go back to sleep.

Goodwin’s work at the Carlyle is an outreach of the Spokane Falls Family Clinic, where he is a staff physician. The clinic bills his patient’s insurers, whether public or private, for their care.

Another patient Goodwin saw had “the potential for higher function.” He was about 30, new to the Carlyle, and cautious about authority figures. He was not straightforward with the doctor about why he was there, so Goodwin checked his chart.

“Family can no longer allow him to stay in the home due to emotional problems,” the patient’s history read.

“These are the guys that end up in jail or a shelter,” Goodwin said of his younger, more alert patients. “They don’t want to have someone in authority tell them what to do so they go out and get beat up or overdose.”

The hardest part of his job, Goodwin said, is finding what would make some of his patients healthy, but they choose not to pursue a course to wellness.

The most satisfying part is knowing he makes a difference in a population used to being shunted aside.

As a medical student in the summer of 1988, Goodwin spent a summer volunteering at a Philippine refugee camp for Southeast Asians. Perhaps it was there, among the world’s most disenfranchised, that he found his calling among America’s neglected.

“I’m becoming very frustrated and disenchanted about the state of health care,” he said, “but passionate about being a physician.”

He wants people to know that when funding gets cut for places like the Carlyle, “these people are going to end up in jail or Eastern (State Hospital),” where they will cost society far more.

Dr. Tom Rodgers, a Spokane Mental Health psychiatrist who sees patients at the Carlyle every Wednesday, shares Goodwin’s passion for treating these patients and admiration for this particular residential facility. Both men say they want lawmakers and the public to know that when funding is cut for residential care, this is what will be lost – a place where people like Gary Mulvey are treated with dignity and respect.

Back in Goodwin’s examination room, Mulvey talked about that time 25 years ago, when a bullet seemed like the only answer to a life that was crashing down – his marriage, his job at Kaiser, his 18th drunken driving ticket.

“Life seems to mean more to me now than it did then,” Mulvey said.

What saved him?

“God saved me.”

Is he glad to be here?

“You better believe it.”