COLUMN: The ivory tower of medicine

From Malik Wilson's, "RosZ," Fall '99 From Malik Wilson's, "RosZ," Fall '99I don't particularly like doctors. It isn't anything personal about the medical profession, but being around them makes me very nervous. I can't really enjoy ER. Part of the reason for this is my own masculine belief that taking medicine and complaining when you're hurt is for wimps. My latest visit to the folks at HUP was on account of a severely bruised thumb. When I went to Student Health, they announced they had to drill a hole in order to release the pressure on the nail, which was now a deep purplish blue. The nurse explained the process to me: "All that they're going to do is take a special tool that will burn a tiny hole in your nail so the blood can come out." When the doctor arrived, he examined my thumb and then retreated to a side room where the nurse asked him if he was going to use the "burny thing" again -- "burny thing" was not actually the name of the tool. He replied, "No, don't you know how expensive it is each time you use that? We can save money doing it the other way." When he came back he had a paper clip and a book of matches. He untwisted the paper clip, lit a match and put the paper clip into the fire. So this is what my mother is paying a thousand dollars a year for insurance, I thought. He tried it the first time and it didn't work. The pressure he had to place on my thumb was tremendous and the nurse gave me something to squeeze with my free hand. There were now other people in the room watching. He tried it again, relighting the clip with another match. Again, it didn't work. He applied more pressure to my thumb and I growled out loud. He tried it for a third time, then a fourth, then a fifth. At this point, one of the nurses suggested he use the specialized tool designed for this sort of thing. After trying two more times, he gave in. The nurse brought him the tool and he pressed the button, put it on my thumb, and put a hole in my nail. It took 30 seconds. The burnt paper clip, used matches and old blood sat on the table. Before I thanked him, he said to the nurses in the room, "See, that just cost us $25!" I thanked the doctor and left quickly. I was slightly bewildered, but not quite offended. I didn't think I had a reason to believe something wrong had been done to me, although I have had much more caring and professional doctors. Trying to decipher what that doctor was thinking is a hopeless exploit. And to tell you the truth, I really don't care. Maybe he is a career cheapskate -- Dr. Save-a-lot -- hell bent on rescuing the medical profession from waste. In the back of my mind though I couldn't get rid of those nagging questions that always accompany an experience like this. I wondered if I were a middle-aged white man in a pin-striped suit, if the $25 would have been worth it. I wondered if he would have been so quick to grind a paper clip into the finger of a well-dressed white woman of 50. Part of me thinks he wouldn't. When I returned home from break, I told my mother about what had happened and how I felt. I told her that I wasn't sure why the doctor had been so unwilling to use the "expensive" treatment. My mother shook her head. She told me that whenever I got hurt as a child and had to be rushed to the emergency room, she would go into her bedroom and put on a business suit, so that the doctors would not assume she didn't have insurance or that she was a black woman who didn't know what she was talking about. Riding on the train back to Philadelphia, I thought about what my mother told me. I thought about her, 10 years younger than she is now, working in her study or cooking dinner in the kitchen as I played. I thought about myself as an 11-year old boy, screaming because I had just dislocated my thumb, or wailing because I was bleeding on the carpet. I thought about my mother, rushing to me to see what on earth had happened, struggling to calm me down, being the doctor that I needed. I thought about my mother, going into her room, taking off her sneakers to put on pumps. Looking for the outfit that would give her the best chance of being seen as something other than just another black woman. She did all this quickly and resolutely, probably without pausing to consider this profound infraction forced upon her life. She did this for her knuckle-headed son, who had somehow managed to injure himself again. Originally, I wanted to write a column using a host of facts and figures to show how blacks are denied the most advanced treatments, the most promising new drugs and the best doctors. I had scores of figures on how the public health system denies African-Americans equal rights before the doctor. But in the end, my mother's story encapsulated the relationship of black people to the American public health system. It is a relationship of black people to the American public health system. It is a relationship based on necessity, not comfort; on need, not desire. While students sometimes assert that blacks are too conscious of their race. One statement I have often heard from my white colleagues is, "I don't even think of myself of being white, why should you think of yourself as black." If only everyone could be so lucky. My mother can't afford to be oblivious. If she is, she puts her son's life at risk. In America, your race is something much more than a categorical distinction. It is something that subtly shapes your life chances, deeply impacting your very chance of survival. Unfortunately for some of us, it can be a matter of life and death.