By Marilyn M. Singleton, MD, JD
May is Mental Health Month and it should inspire us to think about family, community relationships, and our growing disconnectedness. It is not an invitation for Congress and other troublemakers to lose their collective minds.
While folks of all colors and lifestyles are quietly living and working together and building relationships, the professional malcontents are looking for offense around every corner. Take the sports teams shunning Presidential Medal of Freedom recipient Kate Smith for having performed some songs with racially offensive lyrics in the 1930s. One of the songs, thought to be satirical, was also sung by black actor and well-known civil rights activist, Paul Robeson. Apparently, no one looked into Smith’s motives or other aspects of her life before shrouding her statue in black. How ironic that the very teams that excluded black players are “virtue signaling” at someone else’s expense.
Will the memorials to the progressive icons Eleanor and Franklin Roosevelt suffer the same fate? Historians note that Mrs. Roosevelt called black folks “darkies” and “pickaninnies.” Yet she was instrumental in having black opera singer Marian Anderson perform in an integrated setting and flew in an aircraft piloted by a Tuskegee Airman, among other things.
The beloved President after whom many black American children were named, had a questionable racial record. He appointed Hugo Black, an ex-Klansman to the Supreme Court. He did not allow black reporters at his press conferences. And he did not support anti-lynching legislation for fear of losing Southern support. The Roosevelts’ personal lives were not exemplary: they both had continuing love affairs—not with each other.
And Harry S. Truman who as president desegregated the army, had made liberal use of the N-word. In a letter to future wife Beth, he wrote, “I think one man is just as good as another so long as he’s honest and decent and not a n***** or a Chinaman…” And as senator he called Mrs. Roosevelt’s wait-staff “an army of coons.” Should we topple his statues and remove his name from all buildings and universities?
People are complicated and must be judged as products of their times.
And when did using salty language while angry become a capital offense? When President John F. Kennedy discovered that the Air Force spent $5,000 for a maternity suite for his wife, he ripped the bark off the general in charge, saying, “This is obviously a f***-up” politically.” Presidential candidate John Kerry and Vice President Joe Biden famously added to the mix.
Instead of looking for reasons to tear us apart, our congresspersons should be focusing on proposals trying to move us in a positive direction. Who cares what side of the aisle originated the ideas? Communities and their legislators must find solutions for hypodermic needles and human feces on the streets, the homeless, and drug addiction to name a few. There are 130 people a day dying from opiate overdoses with no easy answer as to the root cause. The Department of Health and Human Services formed a Pain Management Best Practices Inter-Agency Task Force including physicians and other professionals involved in caring for patients with pain and addiction issues. The task force concluded what most physicians already know: patient care must be individualized.
Our congresspersons should be having town halls seeking input from their constituents about their concerns. They may discover that many patients are reluctant to seek treatment fearing loss of privacy. For example, in some states, law enforcement can access the Prescription Drug Monitoring Program (PDMP) database for opioids without a search warrant. Moreover, these privacy intrusions may not be worth it. A 2017 study found that “PDMPs were not associated with reductions in drug overdose mortality rates and may be related to increased mortality from illicit drugs and other, unspecified drugs.” These findings were confirmed in a June 2018 review.
The Centers for Disease Control and Prevention (CDC) has similarly found that the rapid rise in overdoses is due to street drugs. Preliminary research shows that patients who are weaned off long-term prescription opioids are twice as likely to seek out street drugs.
Disturbingly, many physicians are frightened into declining to prescribe opiates or to care for patients with pain by well-intentioned but draconian government programs. One such program is California’s “Death Certificate Project.” Here, Medical Board investigators mine prescription data and cross-reference with death certificates to improperly initiate discipline against physicians although their prescription was not necessarily the fatal dose.
Save for a few rotten apples, physicians are doing their best to care for patients with complex problems. Mental Health Month offers physicians the opportunity to reaffirm that we are not automatons and patients are individuals, not data points. Congresspersons should take this month to stop squabbling and jockeying for power and explore legislation that allows physicians and patients freedom to choose their own path to a healthy life.
Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist. She is President of the Association of American Physicians and Surgeons (AAPS). She graduated from Stanford and earned her MD at UCSF Medical School. Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard’s Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law. She interned at the National Health Law Project and practiced insurance and health law. She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers. She lives in Oakland, Ca.