THE SUNDAY PROFILE : A Doctor’s Order : In the world of public medicine, where supply never meets demand, it’s one crisis after another. Dr. Sol Bernstein has spent his life managing the chaos at County-USC.

Most people enter Los Angeles County-USC Medical Center through the emergency room. Gang-bangers riddled with bullets. Mutilated accident victims. Cyanotic drug addicts. Destitute women ready to deliver.

But young Sol Bernstein, fresh-faced and unscathed, came in through the front door.

It was 1956, and the experience stopped the first-year medical student in his tracks.

“It was like entering a cathedral. On the ceiling (were) those stunning gold-leaf murals of Aristotle, Hippocrates and Aesculapius, father of medicine. And directly over the entrance, her wings outstretched, stood the Angel of Mercy. . . . I was completely in awe.”

Bernstein can’t count the number of times that he has since paused beneath the stone angel, but every time, he says, is inspirational.

And, in Sol Bernstein’s world of public medicine, one can always use inspiration. Wards are overcrowded, staffs are overworked, budgets are overdrawn. There is never a surplus of anything, it seems, except patients.

Nurses strike, doctors walk out, earthquakes crack the buildings--and still the sick people come.

Until he retired this past summer, Bernstein was the one person who could make sense out of the crises and the chaos.

As an intern, a resident, a professor and, for the last two decades, chief of the medical staff, the erudite cardiologist has been a steady hand in turbulent times for Southern California’s last-resort, deficit-plagued institution.

“More than any other single man, perhaps, Sol Bernstein has been the soul of this place,” says longtime associate Harvey Kern.

And, others say, its guts as well.

That he would choose a career of fighting for public dollars, public respect and public sympathy for the county’s sickest poor suggests that Bernstein was as much inspired by Hercules as by the Angel of Mercy.

*

On a dark Monday in early February, 1993, Damascio Ybarra Torres, 40, reached the end of his rope.

Pacing through a crowd of more than 100 ailing people lined up outside the county hospital emergency room, Torres pulled out a semiautomatic pistol and opened fire. Three doctors were hit--one point-blank in the head. As the victims were pulled to safety, Torres grabbed two hostages and held them for five hours behind an X-ray machine.

“It’s their turn to wait,” Torres told SWAT team negotiators. “They made me wait. Now they can wait.”

Although horrified by the rampage, which ended in the gunman’s arrest, Bernstein understood.

Long waits of four to 14 hours had become a fact of life here, the nation’s busiest emergency room. “For the great majority of people, the ER is the front door of this hospital. They may have to wait many, many hours,” Bernstein says. “And when people have to wait, sometimes people get angry.”

Some say it was a turning point for a hospital that had always been open to all comers.

“No longer could we assume that we were a sanctuary--a place where people came to be healed. The violence changed all that. We were fair game, like churches, like schools, like the rest of society,” Bernstein recalls. “It was very sad when it came to this. Very, very sad.”

But the history of violence at the county medical complex had begun long before Torres walked into the ER that afternoon, yelling for pain medication.

In 1991, one of the many panhandlers who once routinely roamed the corridors stabbed a nurse in the neck with a pair of scissors.

In 1990, an 18-year-old gang member was shot in the face during a melee involving 20 youths who were visiting patients. And back in 1984, a patient was shot to death by a security guard after he allegedly reached up from his gurney, grabbed another guard’s gun and fired.

“With every act of violence in that hospital, Sol and a few other really caring and sensitive people were personally wounded,” recalls one retired county physician. “It wasn’t the way we had viewed our relationship with our patients. Suddenly, we were forced to look at some of them in a different way. Almost against our will, we had to be wary, we had to be on guard.”

That may explain why a year before the Torres shooting, Bernstein and his hospital staff had asked the county Board of Supervisors for 143 additional security guards. Their request was denied.

“Although I was shocked by what happened later in the ER, I cannot say I was surprised,” Bernstein says.

Diplomat that he is, Bernstein never said, “I told you so.”

*

“From the time he was a little boy, Sol wanted to help other people, he knew instinctively he wanted to be a doctor,” recalls his older sister, Gertrude Zelenitz. “But unlike other little boys’ wishes, you had absolutely no doubt that this boy would be what he said he’d be. It’s as if he were born for this very purpose.”

As a child, Bernstein spent many an afternoon in public libraries in New York City or his sleepy hometown of West New York, N.J. Hour upon hour, he would sit in the company of the Greek philosophers or Louis Pasteur and Albert Schweitzer.

His only real-life medical model was the Bernstein family doctor, who lived a block and a half away and who saw as many patients in their homes as he did in his modest office.

Bernstein’s father was an auto dealer and his mother an artist and homemaker. She spent every Saturday of the Depression delivering baskets of food and clothing to less-fortunate relatives in New York City.

When Sol was 13, she died suddenly. He was devastated, his sister says. “Sol had always said he would take care of her when he grew up. Her early death was something we never really recovered from.”

The young Bernstein, who had been bar mitzvahed in the neighborhood temple, gave up on his religion. His dream of becoming a doctor was never shaken.

After a stint with the Army’s occupation forces in postwar Japan, Bernstein entered USC and four years later became the first in his family to earn a college degree.

Medicine was changing fast in the mid-1950s when Bernstein arrived to begin his medical training at General Hospital, the flagship of the county’s massive hospital system. (Many know its imposing facade as the exterior set for the daytime soap opera of the same name.)

Polio had been nearly wiped out by Jonas Salk’s new vaccine. Thanks to advances in antibiotic therapy, wards of tuberculosis patients were emptying. One of the nation’s largest leprosariums was closed.

But inside “the Rock,” as the great white stone structure is affectionately known, the practice of medicine was still a desperate business.

There were no intensive-care units, few elevators, and many patients from prison or psychiatric wards were manacled to their beds.

“It was a dark and noisy place,” recalls Bernstein, 67. “The floors were a dreary brown linoleum and the walls were that nauseating green color. The care was the best that could be had, but the surroundings left much to be desired.”

When Bernstein graduated from medical school, his father shipped him a record player as a gift. And that record player quickly became the property of the hospital--or more accurately, the patients.

“I used to bring it to whatever ward I was on. I’d bring in the record player and play the music for an hour or two for each patient--classical and show tunes, mostly. We did this to fight what we called the institutional depression,” Bernstein says. “In those days, patients stayed in the hospital for a very long time. I got the feeling that it was not just the body we should be trying to treat but (also) their emotional well-being, their sense of person.”

Until such programs as Medi-Cal and Medicare began underwriting the care of the uninsured, only public hospitals would take them in. For County-USC that meant finding room every night for as many as 3,300 patients. They lived 10 or 11 to a room. One bathroom for 30 patients, a single shower shared by 70.

“So many of the patients were elderly, with no resources, their families unable or unwilling to care for them. Their gurneys or mattresses lined the corridors because there were simply not enough rooms for them all,” Bernstein recalls.

“In the wards, you’d have beds against this wall, beds against that wall, and then beds in the middle of the room. We would literally have to crawl over people in their beds to get to the next patient.”

Gradually, Bernstein gave up his hands-on cardiology practice and the heart-surgery research that had earned him a national reputation. As he moved into the ranks of the administration, he saw his beloved hospital grow into a high-tech medical center with a vast complex of specialized facilities.

There was Women’s Hospital, for many years the birthplace of one in every 200 babies in the nation, as well as Children’s Hospital, Psychiatric Hospital, a nursing school and busy research centers spread across a 72-acre campus.

Suddenly, Bernstein found himself juggling the demands of the patients with the demands of their caregivers. Nurses wanted more money and more supplies. Residents and interns wanted more help--and toilet seats for the patients’ toilets.

“Sol always did what he could to get the patients what they needed. I don’t know how he did it since there was never enough money from the county, but he would work his magic and things would get better--until the next crisis,” says Dr. Joe Lindenbaum, a pediatrician who trained and worked with Bernstein.

To give the medical center’s 900 interns and residents “someplace to go in the middle of the night for guidance,” Bernstein created County-USC’s first hospital ethics committee. “The house staff needed to think about issues beyond just prescribing and diagnosing,” he says. “They had to begin weighing other ‘quality of life’ considerations such as how the family feels, how informed is a patient’s consent when he’s worried, in pain or heavily medicated?”

Bernstein’s own ethics are liberal. His motto: “The patient always comes first.” And, according to his colleagues, Bernstein stood by that credo even when county budget cuts and hiring freezes threatened to dictate medical values and patient-care decisions.

“Sol always stood for the right thing. No matter what the pressures,” recalls former county health services director Dr. Liston Witherill.

When Bernstein assumed the chief of staff’s job in 1974, the medical center was a firecracker with a very short fuse. “It was a time,” according to an understated USC history of the medical center, “marked by harassment (by) certain county supervisors as well as great activism by interns and residents.”

“Dr. Bernstein handled (these) situations with tact and finesse,” reports the hospital’s historian, Dr. Helen Eastman Martin.

In other words, say such colleagues as former director Paul Drozd, “Sol stayed calm, took the time to listen to all sides in every dispute, and worked darn near every night and day for 20 years to keep the place from exploding.”

*

“There is a saying among people who know about such things and who can afford anything: ‘Take me to (County Hospital) if I’m ever in a serious accident or am on the brink of death because of an acute condition. But Lord deliver me from the place if I have a lingering illness.”

Although the venerable former Times science writer Harry Nelson first let the world in on that secret back in 1965, there is little question that his words still apply.

When it comes to amenities--frills like air conditioning and fancy art on the walls--and even when it comes to such basics as piped-in oxygen and modern fire-detection systems, the County-USC complex cannot compete with newer and better-funded private hospitals.

But when it comes to emergency care, County, as they say, is the place to go.

Although most of them are very sick and very poor, patients here get the constant attention of the USC medical school and faculty--and, until recently, of Bernstein as well.

“There is no question that I was jealous at times of the hospital and of the patients,” recalls Bernstein’s son, Paul, a 27-year-old artist and musician. “But having a father like him is such a gift, such an incredible blessing, that I always got over it. His capacity for love is enormous.”

Like Marcus Welby with a high IQ, Bernstein has been a mentor to students who want to learn not just how to practice medicine but how to find the joy in it.

“Whenever someone tells me about a particular diagnosis or surgery or treatment where someone who otherwise would have died is saved, I am exhilarated. We all are!” Bernstein says.

“We had a little boy a few years back, for example, whose father got angry at him and cut off his penis and flushed it down the toilet. Someone was able to retrieve it and we were able to reattach it and make it fully functional.

“There are hundreds of stories like this, thousands of them. Children horribly burned. Older people abandoned and tragically left with us to die. These young people brought in off the streets with bullet wounds, knife wounds. . . . When we are able to do something to help somebody, it makes all the difference. Not only for them, but for us.”

*

About a year ago, Suzi Bernstein died after a brief illness at age 54 in a room at University Hospital, across the street from her husband’s office.

Bernstein was with his wife when a blood clot floated into her lung, killing her instantly. “It was totally unexpected and unspeakably tragic,” says longtime friend Kern. “Everything changed overnight.”

Suzi owned a travel agency, and the prospect of taking trips together had finally lured Bernstein toward retirement. They had met 30 years earlier--in the hospital, where else?

“Some friends were trying to fix us up, and they explained that I never left the hospital so she’d better come over here if she wanted to meet me. So she began volunteering and four months later, we were married,” Bernstein says.

“Until Suzi, I don’t believe I ever took a vacation in all the time I had been a doctor. She truly introduced me to the world--Moscow, Cairo, everywhere.”

Bernstein still hopes to travel, but plans are on hold while he completes a series of consulting assignments for the county hospital system.

Although public medicine may be more sophisticated than it was back in 1956, it is no less volatile. And Bernstein and others nearing retirement worry that their breed of doctor-to-the-poor may be a dying one.

“Not too long ago, I spent a little time in a rather well-to-do private hospital. I was sitting there in the doctors’ lounge and listening to the conversations about the investments they’d made, the yachts they’d bought, the Cadillacs they’d ordered. . . .

“And then I came back here to County Hospital to see the doctors in the dining room talking about their cases. How fascinated they were, how rewarded by the very practice of medicine here with patients who have nowhere else to go.

“That was their excitement. And it was mine.”

Dr. Sol Bernstein

Age: 67.

Native?: No. Born and raised just across the Hudson River from Manhattan in West New York, N.J. Lives in Los Angeles.

Family: Widowed. One son, Paul, 27, an artist and musician who lives in Minnesota.

Passions: Art and music, especially folk music; an overachieving Siamese cat named J. Robert Oppenheimer; Michael Crichton novels and anything about archeology, and TV’s “Seinfeld.”

On the rewards of working at a hospital for the poor: “The patients here are so grateful. People who have very little themselves appreciate things more.”

On the good old days: “In the old days, there was no need for bulletproof walls and uniformed guards and hidden cameras. There was no need for security. It was a hospital. “

On health-care reform: “Public hospitals like County are the no-frills airlines of hospital care. The doctors here have no grandiose plans for the mansion or the boat or the second home. Health-care reform? This is it. We’ve always had to get the most from every dollar.”