Saturday, March 19, 2016

If Heart Surgery Was Like School Reform

The operation to be performed on Mr. Viall, scheduled for Monday, would be complicated to say the least. So the experts gathered. The leader of the medical team which would soon transplant a heart was an Internet billionaire who first became interested in improving health care after watching Patch Adams on cable TV. Naturally, Mr. Gates, the billionaire, was having his say. “I think, because I have made billions in the Internet field, everyone should listen to me. And I believe we need better doctors and nurses in hospitals. I think we should test them on what they know every few weeks.”

Mrs. Viall, a former educator, like her heartsick husband, had been asked to attend and a keen observer might have noticed her raise an eyebrow in a first sign of disbelief. Polite to a fault, however, she held doubt in check. She would listen with care and not rock the medical boat.

A second gentleman in a white lab coat spoke up. His name tag read: “Arne Duncan.” Mrs. Viall wondered: Where had she heard that name before?

“I believe,” said Dr. Duncan, “that we should amputate Mr. Viall’s left leg.” I might not be a medical doctor,” Duncan admitted. “But I did serve as administrator of a hospital once.”

Mrs. Viall seemed about to spit out her coffee at Dr. Duncan’s remarks. “I don’t see why you’re in on this discussion….” she offered.

A fourth individual at the conference table interjected. Like all the other experts she wore a lab coat. But where her name tag should have been, the words “Pearson Education” were embroidered in green, followed by dollar signs. “You know,” offered the Pearson person, “you can never have too many tests. I think we should test Mr. Viall for glaucoma and probably Ebola.

“That would be an additional $20,000,” she added cheerfully, smiling in the general direction of Mrs. Viall.

“But those tests couldn’t possibly help. My husband has a heart condition,” Mrs. Viall tried to object.

“We have to test patients on everything, Mrs. Viall,” suggested Dr. Ripley, another expert on the team. “That’s how we know how sick they really are. Did you know patients in Finland and other advanced nations live longer than American patients? In life expectancy, we finish 26th, which only proves that other countries have superior doctors and nurses. So we need to raise standards in our medical schools.”

“I’m not sure I agree,” Mrs. Viall replied. “I think the fact my husband likes to finish off a bag of chips every time he watches The Muppet's Show might have something to do with his condition. I’m not sure the fault lies with…”

“Don’t be ridiculous,” Ripley remarked with a slight hint of disdain. “All of us here at this table agree: America’s health care system is failing. And besides, you have to listen to me. Because I wrote a book on the topic! As for Mr. Viall, I believe we should also remove his spleen.”

By now, Mrs. Viall was deeply worried. It seemed these “experts” had no clue. She looked round the table at the twenty men and women in the room. “How many of you have ever performed actual surgery?” she inquired with a frown.

Not a single expert raised a hand.

“I once worked briefly in a pediatrician’s office,” a woman named Rhee offered with a forced smile. “Now I like to give speeches about how to fix our nation’s health care system. In fact, I can talk to you for an hour if you like. I only charge $35,000.”

“Are you kidding? Who are you people,” Mrs. Viall exclaimed. “What makes any of you think you know anything about heart surgery? It doesn’t sound like any of you even went to medical school?”

“It doesn’t matter. We’re all experts, don’t you see,” Dr. Duncan replied. “We’re all really smart. And some of us are rich, too.”

“I’d like to talk to an actual doctor,” Mrs. Viall tried again.

“Don’t be old-fashioned,” said another white-coated figure at the end of the table. The elderly fellow looked familiar. Then it dawned on Mrs. Viall. This was Senator Mitch McConnell, taking a break from a busy schedule talking to lobbyists in Washington, D. C. “We politicians understand heart surgery better than doctors and nurses ever will. We have just passed an expanded version of No Patient Left Behind. We call it the “Every Patient Lives Act” and it’s going to be great! As a result of this legislation, we can now guarantee that every patient will survive. If patients die, we will close failing hospitals and fire all the doctors and nurses.”

“Also, we will need to create new batteries of tests, to find out what doctors know,” chirped the happy Pearson lady. “We should probably test patients, too. I mean, we’d be talking billions!”

“Who here is in charge of surgery tomorrow?” Mrs. Viall asked, looking nervously around the room. A man with “Klein” on his name tag raised a hand.

“I’m a lawyer,” Klein replied. “So I know exactly what doctors and nurses should do. I wrote a book about how bad the doctors and nurses we have really are.”

“I’ll be in charge of hooking up all those arteries and veins and positive and negative wires,” offered a younger woman seated to his left. Her name tag read, “Kopp.” For once, Mrs. Viall recognized a name. Kopp was founder of Stitch for America, an organization dedicated to bringing smarter nurses and doctors into hospital across this great land.

“My god,” Mrs. Viall gasped. “Have you ever been part of a heart surgery team, Dr. Kopp?”

“Not really. But I went to an Ivy League college! So you have to do what I say.”

“You know, I was an educator for more than thirty years,” Mrs. Viall offered. “So, if you asked me, I wouldn’t offer opinions on medical care, because that’s not my area of expertise. I only know education. My husband would say the same. Frankly, I don’t think any of you have the slightest idea what you’re talking about. You’re not trained in the medical field.”

“Doesn’t matter,” piped up a fellow named Brill. “I also wrote a book about surgeons. That means I know everything there is to know about the challenges of being a surgeon. And I think it’s clear. Surgeons are at fault every time a patient dies. By the way, I’m a lawyer, too.”

“I made a movie about surgery,” interjected a fellow two seats to Brill’s right. Guggenheim was his name. “I’m a millionaire. So my wife and children and I enjoy the very finest health care available in the United States. But I want to see poor families have better care. I want them to have the best doctors and nurses. And it’s clear: doctors and nurses in poor neighborhoods are failing, because poor people die at a younger age than rich people…So my movie puts blame where it belongs, on doctors and nurses working with poor people.”

“Maybe poor people die sooner because they have poor housing and live in dangerous neighborhoods, Mrs. Viall tried. “Maybe gang violence is a problem. Maybe drugs are rampant.”

“I wouldn’t know about that,” Guggenheim interrupted. “I live in a gated community high on a hill. I mean, you don’t expect my family to actually interact with poor people, do you? I mean, I send my own children to private schools…”

“It might help if you wanted to understand the problems poor people face, and the problems a health care system faces in treating them, if you hung out with them once in a while,” Mrs. Viall muttered.

“Oh, ‘poverty, poverty, poverty,’ that’s just an excuse doctors and nurses offer for their failings.” Mrs. Viall stared at the newest speaker. No! It couldn’t be! This was no doctor, either. It was Patrick Dempsey, who played “Dr. McDreamy” on Grey’s Anatomy for many years.

For a moment, Mrs. Viall sat in stunned disbelief. Surgery tomorrow was going to be bad, really, really bad. The people who were going to do her husband’s heart transplant had no idea what they were about do. It reminded her of current trends in U. S. education, where so-called “experts” had spearheaded a naïve and entirely misguided—and expensive— movement to reform the nation’s schools.

Well, if she and Mr. Viall needed help with a will, at least there were several good lawyers in the room.

You don't have to know anything about education to become a famous education expert.
You only need an inflated opinion of yourself.

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