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Indiana University Studies 



the full length of time necessary to complete an orthopedic 

 correction. The convalescent cases are crowded out by emer- 

 gency cases needing the beds, and a child once released from 

 the hospital is difficult to bring in again for the frequent 

 examinations and careful observation of developments that 

 are necessary. To secure the return of one of these out-of- 

 town cases requires correspondence with either parents or 

 local social agency or both; and in many cases necessitates 

 a visit by the state worker of the department. The state 

 worker is a valuable asset for this particular work, and also 

 for ''follow up" work — ascertaining the subsequent condition 

 of patients after leaving the hospitals and lining up the home 

 situation. 



The greater per cent of the children in the Long Hospital 

 come from out of town ; of these 150 cases 98 or 65 per cent 

 are state cases. As the after-care of these orthopedic cases 

 is of such vast importance, the state cases are obviously the 

 biggest problem the department has to deal with among its 

 crippled children. 



The dispensary cases here included are those referred to 

 the Social Service Department for following from one of the 

 various clinics : pediatrics, general medicine, or orthopedic. 

 The orthopedic clinic is held once a week, and here the cases 

 previously diagnosed as orthopedic in one of the general clin- 

 ics are examined by the attending surgeon. A diagnosis of 

 the kind of crippled condition presented is made and orders 

 for subsequent surgical care are prescribed. At this point 

 the Social Service Department dips its finger in the pie and 

 lends its invaluable assistance, for there is ''many a slip 

 'twixt" the examination in the dispensary clinic and the ad- 

 vised surgical correction in the hospital! The word "hos- 

 pital" inspires fear in the minds of most normal children, and 

 no less in the minds of ignorant parents. The first usual 

 reflex to the doctor's advice of surgical care is a positive re- 

 fusal to comply on the part of patient and family. A doc- 

 tor's time is too valuable for him to argue and plead with each 

 individual, so that it becomes the job of the social service 

 worker to talk to the patient's family and point out the ad- 

 vantages and advisability of hospital care. 



Case H. G. 6,900. In the case of a small nine-year-old 

 boy, H. G., who was brought into the dispensary for examina- 



