Interview 04 - Stan Patterson - Thirty Years of Mercy Oral History Project

Thirty Years of Mercy Oral History Project

Stan Patterson Interview 004 2/5/21 Edited 3/15/21

Interviewers: Dr. Daniel Hutchinson Dr. Mary Ellen Weir

Biographical Note:

Stan Patterson served as the CEO of the House of Mercy beginning in 1997. In his 21 years of service, Patterson oversaw operations, fundraising, and management of HOM, as well as numerous unexpected responsibilities, as his interview reveals. Patterson retired from House of Mercy in 2018.

Daniel Hutchinson [DH]: This is interviews 04 for the Thirty Years of Mercy Oral History Project. My name is Daniel Hutchinson. And today I have the pleasure to talk with Stan Patterson. And, Stan, is that how you prefer to go by for the interview today?

Stan Patterson [SP]: Yes.

DH: If you could tell us a little bit about your background and your story before you became a part of this experience of the House of Mercy.

SP: I joined House of Mercy in 1997 after having worked at Mercy Hospital and Carolinas HealthCare System Center for fifteen years. I had been involved in a federal health planning organization and got to know a number of people from 00:01:00Mercy Hospital before being recruited to serve as vice president of planning in 1982. I worked at Mercy Hospital from 1982 until 1995, when it was merged with Carolina's HealthCare system. And then worked another couple of years over at Carolina's HealthCare managing physician practices.

Prior to the sale of the hospital, I got to know one of the ER physicians at Mercy who, unfortunately, acquired HIV disease long before there was an effective treatment. Although I was not responsible for ER services, I was asked to meet with him and explain that he would need to resign from his position with the hospital. At that time, there was such fear of AIDS the hospital could be significantly harmed if it became known that an ER physician had acquired the 00:02:00disease and was treating patients. While he understood the reasoning of the decision, it was quite difficult for him to leave the ER, a position he certainly loved. Subsequently, I remember visiting him at his home and this overall experience humanize for me what it meant to have AIDS. The physician ultimately died, but interestingly he had become involved in the creation of House of Mercy although I didn't know it at the time.

After having worked at Carolinas HealthCare for a couple of years I became weary of managing physician practices and decided to resign. The first week following my resignation, I received a call from Sister Rosalind Picot and Sister Mary Jerome Spradley asking me if I would be interested in taking a temporary position as interim CEO at House of Mercy. They noted the facility had experienced some management issues and needed assistance for 60-90 days. I had 00:03:00not decided on my next career move so I agreed to the offer. I had no idea that I would ultimately work for the Sisters of Mercy for 21 additional years working at House of Mercy and on other projects and ministries in Belmont. At the time, I remember feeling drawn to the House of Mercy ministry even though I knew very little about AIDS and the ministry itself. I knew the Sisters of Mercy and I thought a lot of them. I thought it might be an interesting opportunity to work with an organization congruent with my own values. And so that's, how I got involved.

DH: Thank you. in coming to the House, for the first time, as it was getting under operation and getting going, did you have any initial impressions of your experiences and seeing the House, or people you met in that first interaction that sort of gave you a sense of the House? And what you thought of it?

SP: Yeah...my first interaction with House was actually coming to the board 00:04:00meeting when I was selected to be the CEO. And of course, I knew some of the people on the board. But I'd never been down to the residence. The administrative offices were at a different location than the actual residence where people stayed.

But I remember going down to the residence later on, and had a sense of foreboding in terms of what it might be like to be involved with House of Mercy. Initially, I imagined it might be quite depressing, but that's not at all what I found. I found that it was a place where you had people who cared for each other. The staff cared for the residents and the residents cared for each other as well, and there was a lot of laughter. The meals were served family style 00:05:00around a big table with residents and staff eating together. Occasionally, I would have lunch at the residence and there was always a lot of banter among the residents and staff, just like you would have with a normal family. I found that I liked working in this cordial atmosphere in which I could get to know residents and staff on a personal level. Although AIDS is a terrible disease, House of Mercy provided a place for life to go on to the fullest extent. People were very comfortable with each other, and I also remember some of the early residents that I met, and how much I just enjoyed talking with them.

DH: Thank you. Yeah, that that's been a common theme we've heard, I think, in these interviews is the experience of folks stepping into a home and seeing the 00:06:00dynamics of men and women, in this space, living together, sharing, sharing a home, and sharing a journey, hopefully towards reconciliation and healing, if not, of necessarily the body than certainly in the spirit.

So, you mentioned a little bit earlier about your colleague, the physician, who had AIDS, and how that touched you and sort of brought this issue in a personal way into your imagination... For those, perhaps who didn't live or understand that time period of maybe say, the late 80s, the 1990s, what needs in the community do you think Houses of Mercy responded to in terms of what the climate and what the dynamics were for people living with AIDS back then? Why House of 00:07:00Mercy represented the service and the place that it did, if that makes sense?

SP: When AIDS first began to be recognized as a specific disease, and when patients with AIDS first began to be admitted to hospitals, there was real fear patients with the disease would soon overwhelm hospital capacity. The rate of infections was growing rapidly and methods of transmission were not entirely understood. I mean, there was just a lot of concern. It wasn't clear whether the disease could be spread through touching or through the air. I remember when I visited my friend who was an ER doctor in his patient room, it was very similar to what you now see with COVID. People were gowning up so that they wouldn't acquire the disease, nor did one wish to transmit anything to the patient's compromised immune system. And so, there was a tremendous amount of fear because 00:08:00people didn't understand fully how the disease was transmitted.

When I came to House of Mercy, some of the societal fear had passed. But, the non-acute components of the health care system were not stepping up to take care of terminally ill persons with AIDS. Normally, when someone has a terminal disease, there are healthcare facilities that are available to them, or they go home and they stay with their families. While this may have happened for a number of persons with AIDS, many families were fearful of the disease or having difficulty admitting that their family member might be homosexual. There was a great deal of shame involving the disease and families didn't want their neighbors to know why their family member was sick. Many caregivers who provided services at nursing homes were also not sufficiently educated about the disease and these facilities were not options for post hospital care. This resulted in a number of people with AIDS having nowhere to go once they were discharged from the hospital. I believe the Sisters of Mercy recognized this problem when they 00:09:00chose to create House of Mercy. It was the first facility of its type in North Carolina and it later served as a model for the creation of other facilities in the state. The Sisters wished to provide both medical care and a residence where patients would be accepted and spiritually nourished. The feeling of being accepted was a significant reason residents have chosen to come to House of Mercy, both initially and throughout the years. Also, House of Mercy has been specifically dedicated to caring for persons with HIV disease and this has resulted in the development of expertise not available at other residential facilities.

Ellen Weir [EW]: Can I ask a question here, just going on that? Was it difficult for you, Stan, to go from a from a working in a medical facility to a home health care type situation? I forgot the name for the House of Mercy. It was a family license something...

SP: Yes. I think that it was a challenge in the sense that when you work in a large institution, you had different departments to perform financial services, human resources, or maintenance and all these kinds of things. And when I got 00:10:00the House of Mercy, it was me, one fella. And the rest were nurses and two-three administrative staff. There were a host of licensure issues involved in operating a health care facility combined with the challenges many small business face. We were so small and many of us had to preform a variety of tasks that would normally be delegated in a larger organization. But I found that I enjoyed the diversity of the work. In addition to providing normal administrative oversight, I often would bring my tools and perform maintenance at the residential facility in order to save money. Shirley Stowe, the Director of Nursing, would also handle a variety of tasks needed to keep the facility operating efficiently.

It was definitely a culture shock transitioning from an office in a nice medical tower to the little framed house that served as our offices. The building was cold and it had squirrels in the attic. The building was later town down, 00:11:00thankfully, and we were able to move into a renovated space. But, early on I had to deal with a variety of personnel and operational issues that would not normally be present in a larger organization. Fortunately, we were able to build a good team within a year or so that really helped stabilize the organization.

DH: In your description of that atmosphere of the time and then your connection to what's going on today with COVID, fear of passing stuff on, the challenging prognosis of that era....Did you observe in the stories or the experiences of the men and women who came to the home, any sort of impact of discrimination or stigmatization or inequality? Did the difficult dynamics of that time make itself felt in the lives of the residents, as you saw?

SP: I probably didn't have as many encounters in that way as some of the staff who dealt with residents day-to-day. But I do know there was prejudice against 00:12:00both being gay, having AIDS, and for many of the residents, being low income. And all the things that go along with not having any resources. And not being able to get housing, because residents didn't have resources, or there might be a criminal record. Finding housing, especially in the later years when survival from the disease became possible, became a major issue for House of Mercy as we attempted to discharge patients who had stabilized.

Over time, the prejudice against persons with AIDS abated somewhat. I saw both the good and the bad. And it was difficult to predict sometimes where you would see it. I remember, we were hiring a chief financial officer one time, and had a gentleman who was very interested in the position until he found out that we 00:13:00took care of persons with AIDS. Then he withdrew his application. He said, "I just don't think I can work there." But then you had churches that you might consider to be very conservative and judgmental, step up to assist House of Mercy. I think they viewed assisting House of Mercy as a kind of a stretch opportunity for their congregants. Oftentimes they would support House of Mercy financially, and sometimes through volunteering or working on fundraisers. In many cases I believed House of Mercy served as a place for spiritual development, for residents, staff, and the many volunteers who became involved.

But, when I think about many of our residents, it is probably fair to say that they experienced prejudice in many forms their entire lives. Residents of House of Mercy were overly represented from low income, minority communities and generally lacked education. Many were Gay and subject to prejudice that is hard to understand today. If they hadn't had AIDS, life would have still been 00:14:00difficult for them. It was just the latest insult from life they had to experience.

DH: Thank you. In in your work and reaching out to the community and trying to build support, build fundraising, and interacting to try to carry out your mission and the House's mission, what were the greatest challenges or opportunities in in doing that work of connecting with the public?

SP: There were the normal challenges of managing a small nonprofit, where you have to devote a lot of energy to fundraising. Fortunately, we were able to 00:15:00access grants specifically available to organizations caring for persons with AIDS. The topic of AIDS was receiving a lot of visibility in the early years and House of Mercy was able to attract a number of donors from religious organizations and community groups. A major source of funding was the Sisters of Mercy of NC Foundation. Without the support of the Sisters, House of Mercy would not have been able to operate. DH: I know the work is filled with many challenges. What joys did this position bring? In what ways did you see your work contributing to the restoration of health of the residents there as well as for the larger community? What are some of the things you take great pride in from your service at House of Mercy?

SP: Well, there was much to enjoy about working at House of Mercy. And I think the obvious ones would be when the new medications came in, and people were able 00:16:00to get stabilized. And some of them were able to return to the community. You knew that without House of Mercy, without the great clinical staff that was there, these residents would have died. And to see them being discharged, to see their families come get them, was very rewarding. There was a lot of joy associated with helping residents stabilize and return home.

But there was also I think, joy in the context of knowing that when persons came to House of Mercy, even if they were going to die, it was going to be a so much better experience at House of Mercy than it would be anywhere else. And I think that residents many of them knew that. For those who didn't have family, House 00:17:00of Mercy staff became their family. There was a lot of satisfaction in knowing that, while death was unavoidable, patients could receive services surrounded by those who really cared for them.

DH: That sense of dignity is so important. And I think that is an important part of the House's story. That moment in the I guess, late 1990s, or that moment when these new drugs, these new therapies came in and really changed the medical prognosis for those with AIDS. I know it didn't happen all at once, but was there a sense of real excitement and real opportunity, of real change? I mean, did that sort of develop slowly? Or what was that atmosphere of that time, like 00:18:00when it seemed like the nature of living with this disease might change?

SP: It was interesting. I remember during the early years when I was there, we had about 25 people on the waiting list to get into House of Mercy. By the time you would get to many of them, they would already have died. In response, we developed a strategic plan to expand. We had building plans developed and had begun to secure funds for expansion. All of a sudden, the demand for services began to drop significantly. The board was faced with, "what do we do?" We stopped the process of expansion to see if patient demand would necessitate expansion. History has shown that holding off was a good decision. Because 00:19:00demand did drop dramatically from what it had been due to the effectiveness of new medications. The medications were so much better than what we had previously. Interestingly, the rate of infections for HIV disease was not dropping dramatically, but the death rate was.

We were of course very happy about the lower death rate, but from a planning perspective, and how our organization should respond, we were a bit mystified. Kind of "what's going on here?" And then it was, "where do we go from here?" Is there going to be sufficient demand to keep the facility going and how should we respond?

DH: Well, that's sort of an excellent question. The future of House of Mercy. I 00:20:00imagine that continuing to care for those living with AIDS will always be a part of the House's identity. But obviously, the disease, its prognosis, its treatment, and maybe the demographics involved have changed over the last 30 years. I know the future is always difficult to predict, but where might you see the House of Mercy as it looks towards the future in sort of carrying out the tradition and mission that it's had? Where might there be opportunities? Or where could you see House of Mercy, fulfilling that same need when it was founded thirty years ago?

SP: When I think about the history of House of Mercy, it is clear that Sisters of Mercy in Belmont courageously stepped up to address a specific medical and housing issue that was controversial at the time. Across the nation facilities 00:21:00somewhat similar to House of Mercy were also being created, especially in the large urban areas. But, after the introduction of effective medications and the resulting decline in death rates, many of these facilities have closed. And they've closed, specifically, because the need for residential facilities specific to AIDS are not needed as much. From a business perspective, I look at it almost in the sense of a product lifecycle. For example, years ago we had hospitals specifically devoted to treating tuberculosis patients. As medications improved these hospitals closed or were converted to other purposes. Society has also closed a number of psychiatric facilities as medications and outpatient 00:22:00services improved. So, the need for specialized facilities can change. Given these factors, I think the future of House of Mercy with its current mission is quite uncertain.

Whether House of Mercy can evolve into a facility that cares for persons who may not have AIDS, who may have other chronic conditions...that's to be seen. Or is it the kind of thing where you say, from the Sisters perspective, you know, "We've done a great job, we stepped up when it was really needed. But medical care has changed. And we wish to now deploy our resources to other things." I 00:23:00think it's a perfectly defensible way to go.

The other thing is that, we don't really set up facilities so that cancer patients can all live together, or diabetic patients can all live together, because people don't ordinarily wish to live this way. They want to live in the general community. The future of House of Mercy is unclear and this presents a difficult issue for the Board and the Sisters of Mercy to address.

EW: If I could, yeah. Do you see any perhaps any non-medical needs the House of Mercy could meet if they wish to develop a total non-medical type of ministry? Homeless shelter or...I don't know.

SP: Yes. The challenge is that House of Mercy with six beds is too small to be 00:24:00efficient in terms of almost any medical service. I believe it could be converted to some type of residential home, possibly affiliated with a larger organization. In my view, the staffing model and overhead expense would need to be modified extensively from the current medical model and stand-alone status that is rather expensive. So, I wish I had a better answer for the future of the facility, but that's honestly the way I see it.

EW: Tough question.

SP: Yeah, it is.

EW: The whole future of the House, very tough.

SP: It is. And when I saw the question on your sheet, I thought, well, they may not wish to include my response to any of this.

EW: Right. I think that's why we're asking it. We were looking for people who have had experience with the House. Can we get wisdom from you folks? What direction should we go in? Or they go in?

SP: Yes. The amount of money that goes into House of Mercy both from the Sisters and from the community is significant. If you break it out on a per patient basis, it's an extraordinary cost. If you view it from the perspective of all the nonprofits in the community or worldwide that might need assistance, should you deploy your limited resources differently? My view is that I think you should.

DH: In regards to the Sisters of Mercy in your time working with them and supporting this endeavor, what general impressions or reactions did you have concerning their vision and their support for the House?

SP: Well, I wasn't there when House first got started so I'm depending on a number of conversations I had with Sister Rosalind Picot. She said that, at one of their meetings someone stood up and said, "What are we going to do to help in the area of AIDS?" And this was when the number of deaths was really, really bad. From that initial meeting the Sisters of Mercy put together a planning committee that developed the idea of creating House of Mercy.

Before the sale of the hospitals the Sisters, as I understand it, didn't have a 00:27:00lot of resources. But even despite this, they committed several hundred thousand dollars to open House of Mercy. I really do think it was a courageous thing they did. I have a lot of respect for their values and decision-making process.

When I arrived at House of Mercy the Sisters were nothing but supportive. Both financially and personally, they supported the mission and all of us who worked for them. They did everything to make the ministry as effective as it could be.

DH: Thank you. Are there any particular stories or experiences or topics that 00:28:00you think that would you like to you would like to leave us with or things that we've missed and in our exploration of the story? Is there anything in particular that jumps out at you?

SP: Yes, there was one story that means a lot to me. In recent years, we've had patients admitted to House of Mercy who were undocumented. Their access to health care and supportive services was quite limited. Fortunately, due to the support of the Sisters and other financial supporters, House of Mercy never had to deny admission to anyone based on their inability to pay.

We had one gentleman admitted who went by the name, Cruz. I'm not sure if that was first or last name. He was from Honduras. And Cruz had immigrated illegally 00:29:00to the United States to work. His father was already here but they had not seen each other for an extended time. Unfortunately, Cruz acquired AIDS while living with five or six other immigrants who were unable to care for him. Although very sick, Cruz was admitted and lived for only a few months at House of Mercy. Although there was a language barrier, Cruz was loved by staff.

When he died, there was a question about what to do with his remains? He was eventually cremated but it was unclear how his cremains would be returned to 00:30:00Honduras as he desired. We learned that cremains could not be simply shipped due to restrictions prompted by illegal drug importation. During a meeting with a group of Sisters, I mentioned our challenge. A day or so later I received a call from Sister Debbie Kearns who had been in contact with a Sister of Mercy from Honduras. They were both scheduled to attend a meeting in Washington D.C. in the next few days. She said she could take the cremains with her to Washington so they could be transported to back Cruz's family. I agreed to the plan and eventually connected with Cruz's father in Charlotte who had taken possession of the cremains from the crematorium. We had difficulty communicating because my Spanish is limited as well as his command of English. Finally, we agreed to meet at a Bojangles parking lot. Cruz's father was understandably emotional as he handed his son's cremains to me and I was really honored with his trust. We hugged and Cruz's cremains were safely transported to Sister Debbie and eventually to Cruz's family in Honduras. This story is but one example of how the Sisters have been supportive of House of Mercy throughout the years. Years 00:31:00later, I am still struck with the humanity shown by everyone in caring for and bringing Cruz home.

DH: That's very moving. And I think it does, as you say, say a whole lot about the care of the Sisters, but also the care of you and of the staff and everyone in House of Mercy to ensure that those that live there, live good lives, and are remembered in dignified ways.

SP: Thank you.

DH: Says a lot. Well, when did your time at House of Mercy conclude?

SP: I was there 21 years. From 1997 to 2018.

DH: That's a remarkable span. In looking back at that time, what do you hope the 00:32:00legacy of the House of Mercy will be, your legacy in working there? And that sort of a big question, but any thoughts about how you would like this time to be remembered?

SP: Again, I think House of Mercy was a result of a very courageous decision by the Sisters to respond to a community need. This was not necessarily a response that a lot of other people would have thought advisable for a Catholic religious order, caring for persons who might have acquired AIDS through sexual activity. During my time at House of Mercy, I think we took care of 300 people. With our resources, and an excellent Board and staff, I think our services were unique and really first rate. We always received excellent reviews by state inspectors and funding organizations. We also had a number of great volunteers who provided vital support. In terms of my own role, I would hope that I will be remembered as a competent and committed leader who led the ministry with a focus on patient 00:33:00care. I am appreciative to the many competent and committed persons who joined me in carrying out the ministry's mission.

EW: Could I ask another? How did the House of Mercy experience, 21 years, change you as a human being? What was its impact on you personally?

SP: I am not sure that I know the complete answer to the question. I know that I benefited from getting to know individuals and groups I wouldn't have known had I not worked at House of Mercy. My own exposure to the gay community was pretty 00:34:00limited while growing up and working at the hospital. The gay community was extremely supportive of House of Mercy, with funding and through individual acts of kindness to our residents. I became friends with a number of individuals who are gay and attended a number of meetings hosted by gay groups. I was asked to officiate a funeral although I had never done this before. I just think the world of so many persons I met who I would not have known without my House of Mercy position. My education was both meaningful and a lot of fun.

Although I was born into a blue-collar family, I also began to understand that I had much to learn about the perspectives of persons from really low-income families. I remember joining the residents for lunch one day and a resident asked me if I was aware that one of the TVs had stopped working in one of the bedrooms. I replied that, "Yes, I heard that the TV wasn't working." And he 00:35:00said, "Are you going to get another TV?" And I said, "Yeah, sure, we'll get a replacement." And he asked, "So what pawn shop are you going to?" The staff laughed at my expression, because it hadn't entered my mind to go to a pawn shop; I was going to go to the store and buy a new one. This was simply one reminder, of many, that the life experiences of our residents were so different than my own. Working at House of Mercy helped to soften my learned prejudices. When one understands the life experiences of others and the hard choices they had to make, it becomes more difficult to hold on to harsh judgements about sexuality, poverty, race, etc. The letting go of such judgements made it easier for me to see the child of God that appeared before me at House of Mercy.