Conversation With Dr. Reed V. Tuckson : ‘Violence Issues Overwhelm Our Health System’
Martin Luther King/Drew Medical Center sits squarely in Watts. The emergency room handles more than 100 gunshot wounds every month. Dr. Reed V. Tuckson, president of the adjacent Charles R. Drew University of Medicine, chooses to work on the front lines.
The 42-year-old internist is also front and center in the debate over health-care delivery. He served on President Clinton’s health-care task force. Hillary Rodham Clinton visited Drew while formulation health-care reform. Reed, who came from Washington two years ago, was interviewed at the medical school by Times editorial writer Gayle Pollard Terry about his prescription for what ails inner-city America.
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Q: Is violence a national public health problem?
A: It is first and fundamentally a health problem. Our hospital, Martin Luther King, for example, sees as much trauma as any other hospital of its size in America.
It is an extraordinary event to participate every day in the life of that hospital and to see the numbers of our children and our young people who are wheeled in. (They) tie up massive amounts of resources--both economic and equipment and also pure human labor and medical expertise. So we know the violence issues overwhelm our health system. They push away our ability to do other health interventions like the prevention of disease, like the early diagnosis and the timely attention to management of many other diseases.
Q: When President Clinton announced his health-care plan, he noted the “outrageous cost of violence.” Is violence the No. 1 health problem?
A: We should not forget the No. 1 killers in (the African-American) community still are heart disease and cancer . . . (But) I would never want to minimize the overwhelming nature of violence.
I worked the emergency room at Martin Luther King Hospital (on a recent Friday night) and was distressed in the hours that I was there to see that one child died in front of us with a gunshot wound to the brain; three other children came in who had multiple gunshot wounds in various parts of their bodies, and (another) child came in with knife wounds all over his body that were very serious and very deep.
I would not for a moment minimize (violence). Nor would I minimize it after having been in the neurosurgical intensive care unit just a few days before--to stand in a room with beds all around and see three of the children were brain dead and being kept alive with artificial life support and another child who had become a quadriplegic because of a gunshot wound to the spine.
I would never diminish it, but all of (the African-American community’s) problems are very much interrelated. They are very much connected to a pervasive sense of hopelessness, the absence of the possibility of a meaningful future, a sense that there is nothing of value for African-Americans in the future. We, therefore, live in a very immediate present, and we live in that present in ways that imperil not only ourselves but those who are around us.
Q: What are the solutions?
A: The answers are extremely complex. . . . The work that is required must occur with intensity, commitment and perseverance over time . . . and on a very large scale. The work begins with being able to transform our communities in a way that people will believe there is a meaning and a value to life . . . there is the possibility of a meaningful future . . . so that it is worth it to change behaviors in a way that is consistent with realizing that future.
An overwhelming and profound transformation must occur. (But) we are so unwilling as a society to get at that work. It is frightening and disgraceful and shameful that we have not developed the national will and commitment to do it.
We also need a full push for the national health reform effort that the President and First Lady have been so courageous in leading because it is absolutely impossible for us to turn around the health statistics unless we have the resources available.
Q: How would you have saved that child who was shot and died in the emergency room?
A: He was shot by someone who is the specific product of a society gone mad. Such children are being produced every day by a society that is market-oriented, without values, a society that places very little premium on human life, a society that is more than prepared to tolerate the disposal of thousands and thousands of such children.
. . . I am outraged. I am so angry that we have allowed these problems to reach the point that they (have); that we can’t suggest simple solutions and things that we can do. But I also recognize that we are not impotent. We can’t appear to be beaten down by these problems. We must go to work every day with a certain courageousness, a certain fierceness, a certain confidence that energizes us and says to the children, “Don’t give up because the adults have not lost control of the world.”
Did we (as adults) do anything today to transform the reality of one child’s life? . . .. If we get enough of that, on enough scale, we begin to solve the problems.
The reality for African-Americans across this country is that 75,000 of us die prematurely. . . . That reality is intensely recreated here in South-Central Los Angeles. The numbers of people who die every day for no good reason are extraordinary and depressing, so (health-care reform) is a very urgent agenda.
Q: Are you lobbying for the President’s national health reform?
A: Absolutely. . . . This is the most important issue of our time. We are very tired of seeing people dying prematurely and suffering preventable misery because they don’t have access to health care.
I want the people of Martin Luther King Hospital to have a chance to be successful. Those people in that hospital are absolute saints. They work in an environment that is demanding. They work without adequate resources. They work with almost no public acclaim or thanks. Those people are heroes. The least I can do is support (them) and the people who live in this community.
Q: Should the President’s health-care plan cover illegal immigrants?
A: There is no question that we at Martin Luther King Hospital take care of human beings who are in need. We are unable as health-care providers to make distinctions about whether this particular individual is an eligible or ineligible human being. . . .
I must respond to human beings who are in misery and in suffering. Our hospital is called upon on a daily basis to respond to people from all over the world who are in pain, who are suffering . . . and who are part of the human family. We have a responsibility to take care of them to the best of our ability.
