"To Cause To Accept Something Unpleasant"

There has been a lot of talk in Greensboro about “reconciliation” lately. I looked this word up on an Internet dictionary and this is what it means: (1) “to restore to friendship or harmony, to settle or resolve, (2) To make consistent or congruous (i.e. fitting, suitable, or appropriate), (3) To cause to submit to or accept something unpleasant, (4) To check (a financial account) against another for accuracy, or to account for.

It remains my opinion that anyone who thinks this is going to happen with the klan/nazi/cwp fiasco is smoking some reallygoodstuff in their peace pipe. I did my undergraduate studies at UNC-G . . . and I took some classes across town at NC A&T. A decade after the shoot-out, black and white students studied together and worked and played and partied together – there was no rancor. When trouble happened and the police were needed/called (rarely), they came quickly and they helped. I personally think the city of Greensboro has done an admirable job of learning from, and coming to terms with, its past.

I also think that those who stir the ashes nearly thirty years after the fact are in it for some kind of personal gain.

On the other hand, upon further reflection, I realized that “reconciliation” is what I have been trying to do for all of eight years in my own situation – after working my tail off for a bunch of greedy ingrates and liars who threw me out on the street for doing exactly the job I was recruited home to do. I’ve been trying to come to terms with . . . to “reconcile” what the higherups of my own hometown dished out. But I cannot reconcile anything. For what these people did was not “fitting, suitable or appropriate”. The bold-faced lies they told, in public and in court, did not allow for a proper accounting or settlement. The “resolution” we came to was based on a series of lies. Those in a position to “police” this situation – continue to accept the lie (because it is more convenient), and perpetuate it with their silence. I cannot accept it. Our laws are not supposed to accept it.

So here I am.

I’ve been promising to tell this story for a while. Today’s as good a time as any. It actually has nothing to with black and white. But it’s still relevant, I think, to the notions of race and reconciliation – especially as we look to a future where the "rainbow" is less & less dichromatic. Several people have asked me why I’ve adopted what some would consider such a hard, “legalistic” line on illegal immigration. The question can be answered in something that occurred during my tenure in Asheboro. My outlook changed in an instant. It was THE “heart-hardening” moment for a naïve/young physician in public service.

Only a few people know this story. I think it’s time that changed.

As background, when I was recruited to Asheboro, I understood that part of the “non-profit” mission was to serve an “underserved” patient population – and that would include a fair number of children of illegal immigrants. It’s part of the job and you deal with it. And I WANTED to do it . . . I WANTED to give something back to my hometown. Conventional medical wisdom these days says you’re not supposed to quiz these parents of Hispanic children about their origins and backgrounds too closely – for fear you might scare them off and prevent the child from getting good care. As just one example, on several occasions over the years, I’ve actually had the experience of calling a Hispanic Mother who knew to expect a follow-up call from the doctor (and who gave me the number to make the call) . . . and then had the Mother deny that she had a baby (if I didn’t get hung up on the moment I said anything in English). The reason for this kind of behavior (frustrating and time-consuming as you deal with it) is that these people live in fear of discovery and deportation. But given the fact that I have not ever heard of any of my patients’ parents getting deported, I’m not exactly sure why they’re scared.

I personally think that most physicians are terrified of speaking up about the problems intrinsic to illegal immigration and medicine . . . because of the names they might be called . . . or “the business” they might lose. But hey, I’ve already been called a liar (by professional liars) in my own hometown. And I lost my practice in Asheboro to good old-fashioned greed disguised as "non-profit" charity. There’s not much left to be scared of.

Anyway, once upon a time in Asheboro there were three lady Pediatricians. One of the doctors was fluent in Spanish, the other two had only rudimentary Spanish skills and needed assistance from translators (for the record, in all of the “free time” I have as a physician, I’ve tried to learn conversational Spanish – it just hasn’t worked). Now, one would think that our local “non-profit” hospital (for all practical purposes, run by the mill-owners who cultivated the “pipeline to Mexico” that increased the Hispanic population nearly three-fold in less than a decade) would have had the foresight and charity to hire a small staff of translators to assist physicians, nurses and other healthcare providers. But that was not the case. We used hospital & practice employees . . . receptionists, janitors, security guards, whoever we could fine to help us communicate (and generally, they were glad to do it). We used handouts and even remedial sign language. And when all else failed, there was the (very expensive/un-reimbursed) AT&T language line to fall back on. It wasn’t a perfect system, but it worked. The kids got seen and the work got done.

But what did the Randolph Hospital pencil-jockeys do when something worked? They screwed it up. An edict suddenly came down that the janitors and receptionists and security guards were not good enough to translate . . . you had to have someone with training in medical lingo to communicate with patients. So we went from having a fairly decent system borne of ingenuity and a common sense of mission . . . strung together with spit and bailing wire . . . to an officially-sanctioned system that was, practically speaking, next to useless.

This leads to the incident that forever altered the way I look at the question of illegal immigration, medical entitlement and language:

One day, one of the Spanish-speaking doctor’s Hispanic patients was brought in by its Mother. As was often the case with this patient population, the Mother had “walked-in” with no appointment. My other partner and I were very busy and heavily booked, and Dr. “Bilingual” was off that day. The patient was a very young infant who had some colicky symptoms – but nothing remotely serious and nothing that required immediate medical attention.

Please remember that (except in Emergency Rooms these days – a whole nuther topic) “walk-in” patients are always seen at the doctors’ discretion, and non-emergent problems can be triaged and scheduled for another time. Except when a physician is dealing with an emergency, patients who call to make appointments deserve to be seen preferentially and on time . . . moreover, people who do not call ahead are not “entitled” to be seen when they walk in the door. My nurse at the time (a skilled and conscientious RN) appropriately triaged the baby . . . and determined that the child’s problem was not an emergency. She thought the patient would benefit from some time & tender-loving-care . . . as well as some parent education (by the baby’s own physician – someone who spoke the Mother’s language). So the nurse arranged to have the baby brought in the next day when Dr. “B” was in the office. It was a very appropriate triage decision . . . .that was both in the child’s best interests AND used our resources most effectively. The nurse cleared her decision through me (in passing and between patients).

I initialed the nurse’s note when the chart wound up on my desk.

A day or so later, I was called into the Assistant Director’s office and rudely interrogated as to why I had “refused” to see the child. The accusation was, of course, a bold-faced lie. I have no idea if the Mother had complained about being rescheduled (which was something that could be reasonably answered). But what came next blew my mind. The administrator (who knew better before she said it) added that “Dr. “B” thinks you have a problem seeing her Hispanic patients.” I was stunned speechless – my throat dropped to my stomach – my skin went ice cold – my pulse raced. I could not believe what I was hearing!?! My so-called “colleague” was calling me a racist. She didn’t even have the decency to do it to my face . . . moreover she was using her mastery of Spanish and my disadvantage with language-barrier as a weapon!

This doctor knew better. I had covered her patients (ALL of her patients) . . . many times over . . . many bad situations . . . AND busted my tail to make sure everybody that walked in the practice door got treated equally & well & according to their individual needs. She KNEW that I did not give a rat’s tail what color people were or how much money they had or where they were from . . . and that the children/parents I offered special consideration to NEEDED the consideration. Yet she had the unmitigated gall to pull this kind of power-mongering stunt . . . to fling this vile accusation.

Think of EVERY name you might want to call someone who did that to you and know that, in that instant, I thought them all.

It’s no secret that there had been friction between this doctor and I long before this happened. Each of the three Pediatricians working for the practice at that time had her individual strengths and interests – and good practice management (which we clearly did not have) would have figured out how to integrate it all without pitting doctor against doctor (as I did not schmooze with management – and I had this annoying habit of telling people the truth – I usually got the raw end of that deal). I’m not going to rehash what was in the complaint I filed with USDHHS Secretary Shalala (it's all water under a pre-Katrina-soaked-bridge), I will say that my other partner and I were feeling very much taken for granted and dumped upon . . . assailed from all sides and from within by conflicted and selfish interests.

Here’s an aside (while I’m “reconciling” the past) . . . another “moment in time” that I’ve kept to myself for far too long: the one time that this same colleague visited my home, her “nurse/Girl Friday” stood in my kitchen (after the “tour”) and announced to everyone that my house “would be perfect” for her boss.

Hello? I’m standing right here. It’s my house. And it’s @#&% perfect FOR ME.

It was a shadow of the, “I will have everything you have” act to come.

I digress. The despicable stunt . . . the playing of the race card from a stacked deck . . . went too far. In this case, the chart notes were very clear as to what had happened. But when the game is one-upmanship, and the card one is playing is race or prejudice, the truth does not matter . . . all one really needs is the accusation . . . to hurt . . . to smear . . . to scar . . . and to destroy. At that moment, any residual professional/personal regard I had for my so-called “partner” flew out the window. There was nothing left. Exasperated and totally demoralized by the baseless accusation, I struggled to compose myself . . . wrestling with the simultaneous desires to throw something or vomit or just weep. But any of that would have given my accusers more ammunition, so pulling the invisible knives out of my back, I quietly told the Assistant Director that Dr. “B” was dead wrong (something the Director knew anyway) . . . not to mention WAY OUT OF LINE . . . and walked out of her office.

But something had died inside. In that instant, a light went out. I would never look at “public service” . . . those who were served by it . . . or those who benefited/profited from it in the same way again. I’ve joked to others that it is the moment my transition from the pseudo-liberalism of my college days to the conservatism of my Father was complete (well, maybe not THAT far to the "right";). But it’s a weak joke . . . not funny at all. I learned the hard lesson that while one might want to save the world . . . most of the time the world will kick you in the teeth for the wanting.

You can give and give and give. But people just want/expect MORE.

It gets old. I suppose I could digress some more about the difference between government-sponsored “entitlement” and genuine charity (today the Greensboro News & Record tells one story that warms the heart). I could talk about the difference between expecting and appreciating these things . . . but not today.

I have not ever been able to “reconcile” what this doctor did that day . . . particularly as it relates to the Christian values she frequently espoused when anyone passed near her orbit.

I share those values. I’ve interpreted them differently over the years – and paid dearly for the difference in interpretation. But I sleep well at night.

Oh . . . one more thing for those who harp on "reconciliation". I never got an apology. It makes the forgiveness thing much harder.

Again, this incident foreshadowed things to come. I should have listened to my inner voice:

"Run Forest! RUN!"