Racism, Sexism: We Join a New HMO (#5)

Racism in the MD Profession or Just Jiving?

Sometime in the mid-80s, my university switched its health care from an insurance plan to an HMO.  We selected PruCare (owned by Prudential) because it saved the most money.  That’s how most companies and universities make their health care decisions:  cost-savings, not best health practices.  With the rate such care goes up each year, I can understand why.

The San Antonio MedBiz

PruCare was new in town and occupied a large building in the Methodist medical center in the city’s gigantic health science center.  Hospitals and medical practices tended to huddle together in those days to avoid duplication of very expensive medical equipment like CTscanning equipment.  Now, they do it for the convenience of doctors.  The health science center in San Antonio rivals downtown in terms of most impressive skyline.  It is host to Southwest Methodist Hospital, Methodist Transplant Center, Humana Hospital, St. Luke’s Baptist Hospital, Christus St. Rose’s Hospital, the University of Texas Health Schinece Center (UT’s San Antonio Medical School), the Audie Murphy VA Hospital, and dozens of other medical towers and facilities.  There are other clusters of hospitals around the city plus various military hospitals (most famous is Fort Sam Houston’s Brooke Army Hospital with its burn center).

Anyway, I think that kind of clustering these days is absurd and serves few cities very well.  Still and all, PruCare was brand new and had a fairly large staff of doctors and nurses.  Those first few months my university was its only client.  You could call for an appointment and get to see a doctor the same day.  Usually, two doctors would see you (they were bored) and spend an hour or two with you.  That was, also, if you recall, the decade of AIDS.  First called GRID (Gay-Related Immune Deficiency) because almost all cases had been seen only in the Gay community, the plague was, by then, called HIV and had been found in various heterosexual communities.

I woke up one morning to discover lesions on my bottom and on my back.  I had no idea of what they were but had seen one of the doctors on General Hospital (television show) get scratched by a female fried and develop a lesion that looked much like my two.  He went quickly from HIV to full-blown AIDS.  So, I called PruCare and they set up an appointment for that afternoon.  A friend of mine who had been an actor in college and played Romeo in Romeo and Juliet had contracted HIV and would die of AIDS a few years later.  I wrote this for him:

Romeo Is Dead (first published in A Fine Frenzy, U of Iowa Press)

I was Capulet to his Romeo,

my daughter the target of his lust.

Just fourteen, she ripened, ready.

Her nurse, hands full, delighted

in her wish to rid herself of that

slight tissue that would marry

her to a Parisian count.

Years later I read about him,

this Romeo, young handsome man

that I remembered still from school,

romantic, love writ large upon his face.

His Juliet still lived, settled into

matronly mediocrity, two sons

in law school, a daughter married to

a teacher at the local college.

              Juliet

pickets abortion clinics in her spare time,

sells cosmetics for Mary Kaye, hosts

each year two tupperware parties for

a highly select few dozen friends.

But Romeo? He had a brighter life,

strutted his hour upon the stage.

I read about him in the local paper:

“Actor, 42 years old, best known

for playing a crack addict on 'Hill

Street Blues,' of AIDS, New York,

September 13, 1982.”

          Romeo

is dead and Juliet doesn’t care.

She reads the paper, smiles, thinks

of him beneath her balcony,

dreams they married, made love

when she was just fourteen and died

together in the family tomb.

When the quilt came to our town,

I searched closely for his name

and found it, obscure, one among many,

not at all like the man 

who saw Juliet in the east

and thought he saw the sun.

Two doctors saw me that afternoon and they hemmed and hawed around my lesion-wrought body, looked concerned, said they needed to bring in another doctor to consult.  It was, alas, heart-breaking.  The third doctor was an attractive young black woman who, unfortunately, had a fairly deep Mississippi accent.  She took one look at the things and said something like “cirrhosis”…the young white doctors looked sober and concerned and said, no, we’ve ruled out cirrhosis.  She said the word louder and the other docs started laughing.  “Yes,” they said.  “It is psoriasis.”  She gave them the finger and walked out.  

What I had was “the heartbreak of psoriasis.”  I was fortunate and was able to clear it up though it comes back in times of stress.

I was, though, fairly disgusted with the two young doctors who had not only frightened me needlessly but had, more importantly, also played a cruel practical joke on their colleague.  It wasn’t just that they had too much time on their hands and it may have been sexism instead of racism, more likely a combination of the two.

They gave me a prescription and I asked them for their cards.  They gave them to me and asked why I wanted them.  I told them I wanted to be sure to request any doctor but them the next time I needed an appointment.  I looked at their cards and called them by their first names, Tom and Barney.  They told me I should call them “doctor” and I said I’d be happy to when they called me the same.  They objected that I was just a Ph.D. and I reminded them that people were calling people in my field “doctor” when people in their field were called “barbers,” “physicks,” “medecins,” and “chirugeons.”  They failed to believe me.  I suggested that they broaden their reading material.

I confess that I had fun with them and that that was petty of me.  But I had participated, though inadvertently, in my first sit-in in Beaumont, Texas, back in 1964 and hated to see that kind of assholerly continuing in the 1980s.  Later, I would devote much of a year's writing to the hate crime committed against James Byrd, Jr, in a place where I used to hike for miles.  

This is all just a reminder, I guess, that racism and sexism remains pervasive, even among highly educated people.