Doctor Takes His Medicine to Families of ‘Refuseniks’

As a matter of practice, Dr. Marc Richmond doesn’t make house calls.

But earlier this summer, the Irvine physician made an exception, traveling 8,000 miles to Moscow and Leningrad to look in on the families of would-be Jewish emigrants--known as “refuseniks” for their refusal to cooperate with Soviet officials.

“It’s much safer and better medical practice in most cases to be able to treat something in an office or a hospital setting, as opposed to a home visit, except under unusual circumstances,” Richmond said. “This was certainly an unusual circumstance.”

Richmond, together with his wife, Carol, were part of a small Orange County mission to the Soviet Union in July, sponsored by the county chapter of the American Jewish Committee. Hinda Beral, executive director of the chapter, and her husband, Hal, accompanied the Richmonds.

Both the Richmonds and the Berals initially planned to make summer pleasure trips to the U.S.S.R., but each of their group tours collapsed, so they decided to take a different trip together.

Before leaving for the Soviet Union, they were briefed by American Jewish Committee officials in New York. Richmond, 41, was also given information from the National Conference on Soviet Jewry regarding the health problems of families the group was asked to contact in the two cities, to provide them with appropriate medication.

“Everything they requested was available in this country,” Richmond said, although “a number of them were completely unavailable in the Soviet Union,” or, “not available to the refuseniks.”

The refuseniks, like all Soviet citizens, are entitled to free medical care from the government, Richmond said, but in practice, their politics put them simultaneously at the end of the line for clinical care and at the bottom of an extremely hierarchical health delivery system.

Once they apply to immigrate, usually to Israel, they routinely loose their jobs, places in schools and other benefits.

Based on the information provided by the National Conference on Soviet Jewry, Richmond approached Irvine pharmacies and drug company representatives, all of which provided him with free medicine, including heart and blood pressure medication, prenatal and pediatric vitamins and antibiotics.

The four travelers divided up the medicines, the women taking the vitamins, the men taking the heart and blood pressure medication. Like many other Jewish visitors to the Soviet Union, they took various religious books and articles to distribute as well.

Richmond, whose specialty is family practice, decided not to take his little black bag of medical instruments.

“We didn’t want to call any more attention to ourselves than necessary,” he said. “Taking in a black bag just would have singled me out.”

And, he added, “I wasn’t really planning to treat anyone.”

Despite the obviously excessive quantities, even for U.S. tourists, the four were told to explain that the medication was for personal use in the event that they were challenged by Soviet customs officials. As it turned out, no explanation was necessary.

The couples, who will give an account of their visit at 8 tonight at Temple Bat Yahm in Newport Beach, arrived in early July, when Moscow was at the height of its busiest tourist season, with visitors there for the Great Peace March and the Moscow Marathon.

“It was such a zoo when we landed at Moscow,” Richmond said. “It was so crazy we went right through. Nothing was opened at all. We did see other peoples’ suitcases open, with the contents strewn about.”

In all, the group made contact with about a dozen families, half of those on the list of names they had been given.

Getting together, Richmond said, “was a hit-or-miss kind of thing,” since “nobody expected us. That’s one of the problems.”

Language was less of a barrier than the group thought it would be. The Richmonds had taken a semester of Russian at Coastline College in Costa Mesa before leaving, and many of the refuseniks spoke English. Whenever possible, the four used public telephones and the subway.

Some of the medicines were turned over in quantity to individuals with medical backgrounds who were taking responsibility for medical care of groups of dissidents. In Leningrad, one such contact had a new copy, in English, of the Physicians’ Desk Reference, the bible of medication. Other medication was dispensed directly to individuals.

Although the medication they brought was welcome, Richmond was frustrated, finding that they had brought none of the medicines most requested: anti-depressants. Given their frequently drawn-out, ongoing battles with the Soviet bureaucracy, Richmond said, the need for anti-depressants is not surprising.

One severely depressed woman with a young daughter was in particularly dire straits.

“It was impossible for her to get treatment in the Soviet Union (through traditional channels),” he said. “I didn’t have anything for her, and the family didn’t have the money to go outside of the system (for care).

“We had a list of things that some people needed. It was not comprehensive by any means. We made notes of what else was needed for friends leaving the U.S. next month. They’ll visit the same people we did.”

There was also the dilemma of providing a limited supply of a regular medication, such as that for heart disease and medication for high blood pressure.

“That’s always a problem,” he said, but “it’s better to have some than none at all. That was one of the things that was so frustrating. It was just a drop in the bucket.”

With one woman in Leningrad, at least, Richmond was able to prescribe and deliver some peace of mind.

“Of all the families we met, this one was probably the most security conscious,” Richmond recalled and, in addition, the wife and mother of two was afraid that she had cancer, or at least some serious thyroid problem.

“The whole family was very concerned for her well-being,” Richmond said, “but it wasn’t apparent what was the matter with her. So, I figured, ‘I’m a doctor,’ ” and he agreed to do what he could.

The woman pointed to her neck, and Richmond examined her. He asked, through a friend who spoke English, what tests and lab procedures had been done. The husband brought out the woman’s medical records and charts, and the friend began to translate, although some of the tests, such as scans, “are the same in any language,” Richmond said.

Soviet doctors had told her she faced surgery, which the family believed carried with it a considerable mortality factor. But Richmond came to the conclusion that “because of the clinical system she was in, the diagnosis was not explained to her.”

Richmond concluded that she had a thyroglossal duct cyst, a condition that “was not as serious as a growth on the thyroid.”

The growth would eventually have to be removed, he told the woman, but “it was not an immediate surgical necessity” and they might be out of the Soviet Union before it would have to be done.

The woman and her family were greatly relieved to hear the diagnosis, Richmond said, “and I felt terrific, really gratified, to be able to give it.”