One of Us?

Anchorage to Denali - photo by JoAnn Sturman

by Scott Sturman

As the only conservative in America whose favorite magazine is the New Yorker, I long ago stopped reading the editorial page.  Unlike the op-ed page, which reminds me of a high school valedictorian’s commencement speech proclaiming how their generation will right every wrong in the world, the articles are informative, entertaining, and well written.

Like many in my medical group I share the view there is too much waste in medicine, which is often exacerbated by needless regulations which make our jobs more difficult.  As an example, we are forced to discard perfectly safe and effective drugs which are not only scarce but expensive.  The insanity reminds me of my experience in the Air Force in 1973 when the nation was in the throes of a fuel shortage.  With cars backed up for miles at service stations, we flew so many hours that our butts cried for relief.   Even without a valid mission, Lt. Colonel Michaels ordered his pilots to bore holes in the sky and waste tons of JP4 for fear if not used, the unit would be allocated less flying time the next quarter.

And then in 1998 some articles began appearing in the New Yorker Magazine written by Atul Gawande, a physician who was also a surgical resident.  How did he have time to churn out these in depth, poignant observations, when at the time most surgical residents considered a hundred hour work week to be short?  Essays followed which discussed clinical problems from a unique, but refreshing point of view and exposed inefficiencies within the health care system which were expensive and extraordinarily wasteful.  Here was an eloquent spokesman for the medical profession and one of us.

After the Presidential election of 2008 Dr. Gawande’s writings took on more of a political slant, and although medical problems and waste were frequent topics, his articles were suffused with comments supportive of national health care.  His solutions to the the health care crisis made no mention of market forces, competition, or health savings accounts, but relied on central control, as he extolled the merits of ObamaCare.  If this bright man, whose success as a journalist was based on exposing inadequacies in the system, why did he virtually ignore tort reform and fraud as contributing causes?  He was no longer a colleague but the voice of socialized medicine.

An author’s background offers clues about personal motivations, and a glimpse at Wikipedia was revealing.  Medical students and residents may have political views, but most are not political activists; there is simply not enough time or resources.  This is particularly the case of general surgery residents, who battle fatigue and sleep deprivation, and extra time is spent collapsed in bed.  Dr. Gawande’s history is unusual in this respect.  As a student he volunteered for the Gary Hart Presidential campaign and again for Al Gore in 1988.  He took a hiatus from medical school in 1992 to campaign for Bill Clinton and served as a senior advisor for the Department of Health and Human Service in the Clinton Administration before returning to medical training.  During this time he cultivated contacts within the Democratic Party and main stream media which catapulted his career and gave him access to resources far beyond those of the normal surgical resident or practicing physician.

Dr. Gawande is a gifted writer, and he has used his skills to popularize issues in clinical medicine and to propose sweeping changes to the health care system.  However, when it comes to choosing between national health care or private practice medicine, he is one of them and not one of us.