Thursday, May 6, 2010

Class and Medicine

Class is the one sort of taboo subject in this country. We like to believe that we are a classless society, but nothing could be further from the truth. We just like to mask the issues, and often this is done through the use of race to break up the classes, in particular among the lowest levels of society. If working class whites hate working class blacks and Hispanics, and believe that everything wrong in the world is their fault, then they will never band together to work on issues they have in common and to truly deal with issues. But class does exist, and here are two stories from medicine that indicate part of the problem.

A friend of mine was rushed to the hospital after a cyst on her ovary had burst. On intake she could not provide them with insurance information, and so her paperwork listed her as not having any insurance. She said the doctor's and nurses were sort of rude with her following the surgery, and then when she told them she did have insurance the treatment changed.

Then when the doctor found out that she lived on the largest ranch in the area, the treatment became spectacular and everyone was very doting. Then they found out that she just worked there, that she didn't own the property, and suddenly they were not as concerned about her well being. Finally, in conversation with the doctor, she told him that she was an alumnus of Columbia, and again she was put back into the upper echelons of society and was treated as such. She had gone to an Ivy League school so obviously she was someone of worth, and her treatment again reflected that.

She was shocked at how obvious the changes were, and realized that if she had just been a working class woman, without an education and without insurance, that her outcome and her treatment would have very different. She also had to battle the hospital during this in order to have her partner allowed to visit and to make medical decisions. Once the doctor knew who she truly was, he became an advocate for her on this issue. But this is also a huge problem for gay and lesbian couple.

And, here is a report from Kevin Jennings in his book Mama's Boy, Preacher's Son: "I've been all over the doctors throughout mom's stay, demanding information, questioning every decision they make until I am satisfied it's the right one, confirming every stereotype that Tar Heels have of Yankees from New York with their pushy-pushy ways. At first they're resistant, but then one day a surgeon takes note of my Harvard class ring and all of the sudden audiences are granted to me whenever requested. I am treated with a deference and respect that I note other families in the ICU waiting room, families with less means, families with little education, white-trash families -- families like the one my mother grew up in, families like mine before I got my fancy Ivy League education, which changed the balance of power -- are rarely given."

As someone who will be wearing a Harvard class ring in just 21 days I know that doors will now be open to me that were not open before. I also know that in large segments of society I will be treated differently. Sometimes treated better, and sometimes treated worse. This troubles me, but I don't know what the answers are.

One final story, a professor of mine was going to a tennis tournament with a very wealthy friend who drives a Rolls Royce. They pulled up, and the friend parked in a fire zone. My professor said he couldn't park there because it was a no parking zone and he would be towed, and was told "No one tows a Rolls." After they got out the man told the police officer to watch the car, and sure enough when they came back out the car was right where they left it, they thanked the officer and then drove off.

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