The Garren Auditorium in UCSD’s School of Medicine satisfies every preconception an undergraduate could have of a graduate classroom. It was there, among the well-lit stadium seating and combination blackboard-whiteboard, that Vice Adm. Don Arthur, the surgeon general of the U.S. Navy, extolled his views on the correct incentives for entering the field of medicine and the allure of Navy health care. His message was simple and clear, recapitulated through personal memories and stories of patients: Those entering the field of medicine should do so with the well-being of their patients in mind – not the status of their bank accounts.
The crowd that Arthur spoke to on January 18th consisted of undergraduates interested in entering health care at the event sponsored by the Pre-Dental Society. In her introduction of the vice admiral, Ellen Beck, the director of community education for the UCSD School of Medicine, could only describe Arthur using the language of her Jewish heritage – he’s a “”mensch,”” or an upright person. Beck is also a founder and adviser of the UCSD Student-Run Free Dental Clinic Project, a case study founded in the attitude that Arthur implored the crowd to emulate in its pursuit of medicine.
Arthur – who at one point quipped that he graduated third in his class from the College of Medicine and Dentistry of New Jersey only because they ordered the graduates alphabetically – entered the Navy on a scholarship that helped pay for his schooling. Although many of his colleagues left the Navy after completing their requisite service, Arthur stayed on, earning qualifications for parachuting and submarines. He completed his residency in emergency medicine and, after deployment to southwest Asia, served as the director of medical programs for the U.S. Marine Corps at its headquarters in Washington, D.C. His reasons for remaining in the Navy stem from its medical practices.
“”We never ask our patients how sick they can afford to be; never look in a book for the procedure with the highest remuneration,”” he said. “”And, all of our patients are patriots. … [In the Navy,] you are always with a family who cares for you.””
During his speech, Arthur recalled a story of a pregnant woman that, through its lack of specific details, reached the status of a medical allegory conducive to his message of compassion. A young woman in the later stages of her pregnancy approached him with complaints of abdominal pain. Her symptoms were concurrent with an ectopic pregnancy – a fertilized egg that has planted itself outside of the uterus. It can be a fatal condition for the mother if not operated on. Worried about her health, Arthur called a physician and asked for his help with the girl. The physician cleared out his schedule, promising to examine her.
While he was at the clinic, Arthur was surprised to see the girl leaving moments after she arrived and asked the physician about her condition. The physician responded that he was unable to examine her because she did not have insurance. Fortunately, Arthur was able to find another physician who examined and immediately operated on the girl. Her ectopic burst on the operating table; any hesitation and the girl would have died. Arthur fused his Christian and medical morals to explain the story: “”She was a child of God … but all that physician saw was a paycheck,”” he said. One example of the altruism-outside-of-insurance that Arthur discussed can be found in the UCSD Student-Run Free Dental Clinic Project.
Irvin Silverstein, the UCSD dental director and adviser to the Pre-Dental Society, explained the clinic’s importance.
“”Our program teaches students at a young age that it’s important to give back to the country,”” Silverstein said. “”We’re the only association in the country that gives hands-on experience to undergraduate students.””
The dental clinic was founded nine years ago and has since expanded to four locations where patients can go to receive full-service dental care from community professionals, along with a staff of student volunteers, regardless of whether they health insurance. Beck has strong views regarding the current status of health insurance and the subsequent treatment of health
care in the United States.
“”It is a tragedy that this country has not matured enough to provide health care for all … I consider access to public health care as a sign of maturity for a country,”” she said.
Many of the patients served in the clinics are low income, uninsured or homeless persons in need of care.
“”We make sure that we treat every patient. We do full services, not just extractions,”” Silverstein said.
Arthur’s discussion of health care and medical liberality seemed near-perfectly timed, trailing the recent release of Gov. Arnold Schwarzenegger’s plan to require health insurance for every citizen of California – a proposal based upon “”shared responsibility, shared benefit.”” The surgeon general answered questions after his speech, where he discussed the viability of the proposal.
According to Arthur, “”If we mirror the British and Canadians who have social medicine, we will still have two tiers: the social health care and then the upper-crust. … [Currently] anyone who opens their mouth, you can tell what class they belong to.””
For more information regarding the UCSD Student-Run Free Dental Clinic visit their Web site at: www-acs.ucsd.edu/~ucsdfdc/clinics.php
