As I drove down Lancaster Avenue to Lewis’ office the other day, I noticed that the buildings seemed to get smaller and shorter the farther away from town I was, as if they were pieces in a dollhouse. They were also rough-looking. Barbed wire sprouted from the tops of fences. Metal rods shaded windows. Lewis’ administrative office sits inside a pallid building. A sign out front informs visitors that they are being watched by mounted 24-hour surveillance cameras.
Lewis pulled up in a black late-model Mercedes. Carrying a blue doctor’s coat, he grabbed his briefcase from the passenger floorboard and limped to the front door, a door that even during business hours remains locked. He’ll be 67 years old next month.
His office is decorated with plaques and commendations. In one of them, from 2011, Lewis is thanked for his service to the Texas Medical Directors Association as president of the board. In another plaque, from 2005, Lewis is named one of America’s top family doctors. Behind Lewis’ chair hangs a painting of a white horse with a Bible verse: “For God hath not given us the spirit of fear; but of power, of love, and of a sound mind.”
A former nursing home director who worked with Lewis for years said families are often quick to sue medical professionals.
“You have to be in the medical field to understand,” she said. “Their loss is too big. Their loss hurts too much. So whatever we do, we are automatically wrong.”
The former director tries not to discuss patients or employees to protect their privacy, but she was willing to speak off the record to me, because she believes Lewis is a scapegoat and needs to be defended. Lewis, she continued, should be honored for his efforts, not lambasted.
Katie Flippo, the administrator of Park View Care Center, one of the homes overseen by Lewis, said that families suing physicians after a resident’s death is not uncommon. “I don’t want to say that it’s inevitable,” she said, “but in this industry it has become par for the course because you do have family members that don’t understand, and their first reaction is to take legal action.”
Al Sutton, owner of Fort Worth Manor Nursing Center, where Lewis is also medical director, has seen it all before.
“Families that are very emotional are looking for reasons why certain outcomes occur,” Sutton said. “Anytime there is a negative outcome, you have the potential to be sued.”
Expectations, Lewis said, are high as more advancements in medicine and healthcare are made.
“Things can turn badly, and some of those families have trouble accepting end of life issues,” Lewis said. “Our healthcare system has made people think and expect that medicine can cure anything, any disease they got, any problem they have. So when they get to a point that there is not more medicine, where do they go from there?”
Sutton said Lewis is “the best physician I’ve encountered so far, and I’ve been doing this for 30 years.”
Fort Worth Manor deals mainly with mentally ill residents and people with behavioral issues, Sutton said. These residents can be tough to handle, he added. Lewis, he continued, treats them with respect and dignity. “He cares about the residents and the staff,” Sutton said.
Hospitals are not like nursing homes, Lewis said. A patient in a hospital gets to go home. For a resident in a nursing home, that is their home. Many of the residents seen by Lewis don’t have relatives who visit. Lewis and his staffs strive to make the residents as comfortable as possible, Lewis said. Some residents admitted to the nursing homes are accustomed to their vices. For instance, Lewis said, one 80-year-old woman who has drunk a glass of wine every night for decades still wants that glass of wine, even as a nursing home resident. Lewis writes wine prescriptions for some of the other residents. A “Smoke Time” sign hangs on the wall of a physical therapy room in Park View, notifying residents of designated smoking times.
“That’s what they value,” Lewis said. “That’s what is going to make life more bearable and more normal for them. If that little bit of pleasure will impact them, then I think I should try to allow them that freedom. And you’d be surprised what that really means to them.”
Lewis’ staff members receive the most face-time with the residents. He has certified nursing assistants, licensed vocational nurses, certified medication aides, dietary staff, and psychiatrists tending under his watch daily. As Lewis bounces between all 10 of the nursing homes, he tries to interact with the residents as much as he can to ensure they are getting their care met, he said.
Lewis, said the former nursing home director, “is not their direct personal care doctor. He comes in, looks at you, and reviews all the charts and sees that you are getting the care you should be getting, and if you’re not, he will address that with the other doctors or the residents themselves.”
Many families, Flippo said, aren’t aware that nursing homes do not always have a physician onsite. But Lewis tries to make himself available to his staffs. During our interview, he politely excused himself and answered the phone every time it rang. He said his staff members have access to him by phone around the clock.
As Lewis walked down the hallways of Park View the other day, he called some of the residents “Sugar” or “Baby.” Some of the wheelchair-bound residents reached out to him for hugs as he passed. Most of the staff and residents smiled when he walked by, calling his name.
Flippo said that everyone in the nursing home –– staff and residents alike –– love Lewis.
“When you see someone that has as much compassion for the residents, it’s just not something typical,” she said. “He meets with them, where he sits down and has one-on-one conversations with them. They know him, so that is special because we don’t have a huge family involvement.”
Lewis believes the nursing homes where he serves as medical director regularly face staffing challenges.
“What I’ve noticed is that the people that work in the nursing homes are the most caring, hardworking, and committed people that I’ve ever encountered,” he said. “Most of them work double shifts because there’s not enough help … . [The healthcare workers] don’t have access to healthcare, and they’re out there taking care of people all day every day.”
Caring for elderly and often mentally incapacitated people day in and day out can be taxing and stressful, Lewis said. He wiped away tears as he recalled some of the nursing home employees who dropped dead on the job from high blood pressure and strokes.
Lewis plans to remain in the East Side area, advocating for a community that lacks resources, staff, and healthcare accessibility. It is his home, and those people are his family.
“It’s a poor dog that won’t fight in his own backyard,” he said. “This is my backyard. And I have to fight for them.”