Sunday, September 9, 2012

Politics, 1

     The prevailing assumption is that doctors are conservative, therefore, by and large, Republican.
     When I was a mere third-year medical student pulling heftily on skin retractors to keep an incision in a patient's right upper abdomen wide open enough for the surgeon to dissect out a purple, bloated gallbladder, I was often privy to political commentary.  Surgeons talk incessantly in the operating room, while the patient is unconscious, but I said very little, following an unwritten rule based on hierarchy that I was there to listen and learn, not to spout my neophyte's opinions onto the surgical field.  Occasionally, a surgeon would deign to speak to me, asking if I agreed with something he said, and sometimes it was political.
     "If Clinton gets elected, taxes will go ballistic, and all hell will break loose.  We just can't spend, and spend when the coffers are dry," the surgeon's diatribe would go.  "Don't you agree, you, over there-- what's your name?"  His elbow, through the sterile gown, might flap into my ribs, like the wing of a great bird.
     "I don't really know," I'd mumble through my surgical mask, fully aware that the more invisible I kept myself in situations like this, the more likely it was I'd pass the rotation.
     "Oh, come on.  You must have an opinion," the more senior of the two surgeons would goad me--for there were always two surgeons on a case.  The nurse-anesthetist, seated on a high stool to my left, might glance in my direction, raising her eyebrows as though in warning.
     I had to be careful.
     I gratefully accepted food stamps from the welfare office through the lean financial years of medical school, and the WIC program had been a lifesaver for me and my babies because I had insisted on breast-feeding them as long as they wanted.  Every month I used vouchers to pick up generous quantities of beans, milk, juice, peanut butter and cereal from the grocery store--all without having to spend a dime, because a liberal-minded government had authorized such expenditures for women like me.  I knew that an analysis of WIC spending had shown that three times as much money was saved, for the government, as was spent on the program, when expenses associated with perinatal morbidity were factored into the equation.
     It seemed to me that the surgeon must suspect I had a liberal mentality, and that he considered it part of his duty as an educator to inculcate me with the ideals of conservatism.  I wouldn't be poverty-stricken forever, after all.  My student loan debt, $200,000, would be paid off, in due course, and then I'd need the umbrella of tax-protection to keep from losing all my assets to government programs like the ones that had helped me get where I was going in the first place.
     Women like me--pregnant, poor, frumpy, tired, unmarried, and broadly considerate of others--were democrats without exception.  I had two woman-friends in medical school, both pregnant, one gay--and the three of us were an unusual triumvirate, announcing to the world that we could do it all, be barefoot and pregnant, and go to medical school.  I wouldn't recommend this course of action to anyone, if only because sleep-deprivation doesn't allow for good decision-making, but that was a different era, and men seemed to look at us with a mixture of awe and disdain.  We were like creatures belonging to another species.  Gloria Steinam and Jane Fonda had set up a beacon in the distance for us, and we could see it flickering, through the fog of our hardship, often enough to keep us on track.
     So, when a surgeon insisted that I make a comment on politics, my answer was, invariably, "I'm too busy studying to follow politics."  Untrue--but it got me through the narrow, precipitous pass and sometimes yielded a chuckle of resignation from the surgeon.
    What I knew was my own experience.   It was Reagan's politics that had obliterated the National Health Service Corps for new recruits, exactly when I had hoped to sign on, and it was during his presidency, too, that the interest rate on my student loans rose to 18% per year--without any allowance for interest to count as a tax deduction.  How hard did the Republicans want to make it for us?  Since when was an educational loan with 18% interest a government "handout"?  But "handouts" was how the doctors who trained me seemed to characterize such things.
     And the miscarriage of Nixon's reign, back then, was not out of reach of my memory--a gross embarrassment of our justice system for the entire world to see, and clear evidence of how far lying and cheating can take a person, whether in a small venue--like the one occupied now by self-purported whistleblowers who hope to gain from the government's so-called investigation of my clinic--or in realms as high as the executive branch of the United States of America.
     I didn't stay out of politics when I was in training--but I had the good sense to keep my mouth shut when the subject came up around other doctors.  I chose Family Practice because it was the most liberal of the medical specialties.  It got up close to people's lives--and from that vantage point, who could deny that children living in poverty needed help--from somewhere--to have a fair chance at the American dream?
     The patients I saw in medical training were often those on the welfare rolls, who have Medicaid, who crowd the waiting rooms of residency training clinics, because most private doctors don't accept their low-paying insurance.  I knew there were abusers of "the system"--as there still are--but I hadn't abused it, when my children and I needed support, and in the twenty years since then I've paid back the favor in taxes and services to the poor that more than make up for the cost of the food programs that sustained me through medical school.
     I know I should be a Republican, in light of the inflated government's wasteful and destructive attack on my clinic and my livelihood.  I know I should want to restrict government power, because it has hurt me.  I know that restricting government is one of the Republican party's tenets, and could save me a lot in taxes.
     But I can't forget my personal past, and I can't help seeing the ways in which government spending on social programs has helped so many of my patients that the ones who abuse the system and waste our money, become irrelevant.  Government programs helped me--therefore, I'm more than happy to pay whatever taxes our government, flawed as it may be, imposes, so that others like me can reach the apex of their potential, without going hungry along the way.

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