Leigh Dittman was just 4 when she stumbled on the carpet and broke the bones in both her thighs. Her mother and father rushed her to the Shriners children's orthopedic hospital in Tampa late on a Friday afternoon. The hospital doesn't have an emergency room. Most of the staff was leaving for the weekend. ¶ But Shriners had treated Leigh since birth for brittle bone disease. The hospital decided it would become an ER for a few hours for Leigh. For her dad, David, everything came into focus the night Leigh's bones were set. ¶ "No one left until Leigh was taken care of." ¶ That was five years ago. The hospital that set her bones now contends with another kind of fracture — a crack in its financial framework. It must cut $1 million from its budget this year. Six of its 21 sister hospitals may be shut down for good. Shriners will vote on a drastic restructuring at their national convention in San Antonio starting July 5. ¶ Leigh Dittman already knows what she needs to do.
The Shriners pediatric care network is like the fez itself, a grand old anachronism. Its 22 hospitals specialize in esoteric medicine ranging from burns to orthopedics to spinal cord injuries. An experimental bone-strengthening drug Shriners supplies to Leigh costs $1,000 per dose. This sophisticated, expensive system is supported largely by gray-haired guys in fezzes who remember Dino and Sammy and call each other Illustrious Sir.
They are proud of their anachronism. Since 1922, when they first waged war on polio, the Shriners have provided care at no cost to children or their families, regardless of income or whether they're covered by insurance companies or HMOs. Among all 22 hospitals, there's not a single billing department.
Patients feel less part of a pediatrics network and more part an old family that never mentions money. Staffs typically include former patients. Jamie Lynn Parker, public relations specialist at the Tampa hospital, was treated for muscular dystrophy there and at the Shriners hospital in Erie, Pa. Ron Gingras, director of orthotics and prosthetics, was treated for polio as a boy at a Shriners in Springfield Mass.
Ralph Semb, the CEO of Shriners Hospitals for Children, headquartered in Tampa, has a son who suffered strokes while still in the womb. The boy was treated at the Springfield Shriners until he was 18. He's in perfect health today.
Semb has recommended closing six hospitals to save the system. It's the only way, he says, to save all the others.
One of the six he would close is the Springfield hospital, the same one that saved his baby son.
• • •
Leigh Dittman is now 9. She reads four books a week. She talks in complex sentences, and often starts them with "Basically ..." She knows almost all 206 bones in the human body. She watches Dr. G: Medical Examiner on the Discovery Health Channel. When her dad comes home from work, she says, "Guess what, Daddy, I watched an autopsy."
Before she fractured her two thigh bones, her parents had held small fundraisers for Shriners Hospitals in their Lutz home, raising several thousand dollars.
But as David Dittman watched the doctors set her legs, watched the nurses and technicians hover over Leigh, he decided his family hadn't done enough.
David told himself: "We need to step this up."
To find things to auction, Leigh and her family made a trip to Buccaneer Heaven, the football store on Florida Avenue in Tampa. It so happened Michael Clayton, then a Bucs rookie wide receiver, was in the store. They chatted. She looked 5, but sounded like an adult. He didn't know anything about her disability. A few days later, Leigh sent him a beaded key chain with his photo on it that she had made.
He gave it to his wife as a gift. "She still carries it," he said recently.
Soon after, Leigh was invited to Bucs training camp. Clayton didn't know she was there. He didn't see her until both were leaving to go home. He found her in the parking lot. When she saw him coming toward her, she burst into tears.
"I didn't realize what I meant to her," he said. "She had me from that day."
Before long, Clayton was sending the Dittmans boxes of jerseys, gloves and footballs signed by Bucs.
The family moved its fundraiser to the India Cultural Center in Tampa. There was nothing anachronistic about it. Backed up by sports celebrities, loads of Bucs gear, and a charismatic little girl with long brown hair, the auction became a hot event.
In the past five years, the Dittmans have raised $200,000 at the auctions. They raised $50,000 last year.
They'll do better next time, Leigh says. She has a way of making direct eye contact. She wants her dollar target for next year clearly understood.
"We're going to triple it."
• • •
Over at the Shriners international headquarters, the financial picture looked far more bleak. No matter how Ralph Semb, the CEO over hospitals, looked at the numbers they added up to looming disaster.
About the time Semb's own baby was saved by a Shriners hospital, the national membership neared a million. Its hospitals endowment was climbing toward $9 billion. Bequeathals poured in, underwriting nationwide expansion of specialty hospitals for burn care, orthopedics and spinal cord injuries. The Tampa orthopedic hospital opened in 1985, and other Shriners hospitals were either renovated or replaced.
All was paid for by the Illustrious Potentates and Ancient Arabic Nobles who had stamped themselves on American culture — their Harleys, clown brigades and tin lizzies the stars of every Fourth of July parade down Main Street.
But as Semb's son grew up, Shriners membership never quite topped a million. Those parades down Main Street somehow took a wrong turn toward a quaint past. Just 350,000 guys wear fezzes today, 100,000 of them over 70.
Medicine also headed in another direction. Costs of technology soared. The rods and hardware used to straighten the spine of a single child with scoliosis can cost $50,000. Doctors who once referred children to Shriners hospitals fell under the domain of managed-care networks. A trend toward outpatient care left hospital beds empty. The whole concept of free care got fuzzy. Did "free" mean not as good?
Wall Street collapsed. The Shriners Hospitals' endowment shrank to $5 billion. This year, Semb's budget for 22 hospitals runs $825 million — "$350 million short," Semb said. If he started tapping the endowment, Semb figured the 22 hospitals would go broke in five to seven years.
In the spring he recommended closing six of them. Besides the one in his hometown, Springfield, Mass., they include hospitals in Erie, Pa.; Shreveport, La.; Spokane, Wash.; Galveston, Texas; and Greenville, S.C.
• • •
In early June, Shriners paraded around the parking lot at the Egypt Shrine Temple in South Tampa. They were about to induct Leigh's father, David, and 28 other men into their ranks. Once this Shrine temple had 10,000 members. It now has 3,500.
The Shriners celebrated the induction of their 29 reinforcements with a parade of clowns, Harley riders and tin lizzies. After, they packed their auditorium for the induction. A spotlight trained on the stage, where a jeweled fez rested on a pedestal below an arch.
Each of the 29 were called out, one by one, to stand under the arch.
David was summoned. He took his spot with his wife, Ellen, beside him and Leigh in her arms. He had been sized for his fez the night before at Tampa Shriners Hospital, where Leigh has been treated for all her fractures since birth — about 25 of them. David took a size 7. As his name was announced, Ellen placed the fez on his head, and Leigh straightened it. The fit was perfect.
The clowns, the Harley guys, the Trike Patrol, the Midget Motors and all the others invited Noble Dittman to join their parade units. He smiled politely. He can't picture himself yet with a clown nose. He doesn't see himself on a Harley. He's a captain with Tampa Fire-Rescue, he moonlights, and he has two daughters besides Leigh. He's not as certain of his Shriner role as Leigh is of hers.
He watched Leigh — who was wearing a Shriner T-shirt over a floor-length gown — glide among the red fezzes. She was thanking them, calling them the greatest guys in the world. Everyone made way for their champion fundraiser.
The Ancient Arabic Order of the Nobles of the Mystic Shrine is 137 years old.
A 9-year-old girl looked like its future.
John Barry can be reached at jbarry@sptimes.com or (727) 892-2258.
The Shriners
Shriners Hospitals for Children offers free care to children up to the age of 18 with orthopedic conditions, burns, spinal cord injuries and cleft lip and palate.
If you know of a child Shriners Hospitals might be able to help, call (800) 237-5055
For more information on the Shriners or to donate to Shriners Hospitals for Children, to to www.shrinershq.org.
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