Category Archives: News

News, topical

Distracted Healers

Scores of doctors serving patients across Kentucky are from the six Muslim-majority countries under President Trump’s revised temporary travel ban. Those doctors, many of them in underserved rural areas, provide over 100,000 appointments in a year. Across the U.S. there are about 7,000 practicing doctors from those six countries.

These statistics come from a recent study by Harvard and MIT research economists. Their work also found that a large proportion of these doctors are cardiologists and neurologists, specialists much in demand because of the immediate attention required to treat people with heart attacks and brain injuries.

Article-Doctor-Shortages

An estimated 25 percent of all physicians working in the U.S. are foreign born, according to the American Medical Association. Some are immigrants, and some are non-immigrants who received their medical training in the U.S. and are here temporarily with special visas. Many of these doctors are working in underserved communities providing treatments for patients’ needs that would otherwise go unmet – unmet because of an ongoing shortage of doctors.

The Association of American Medical Colleges in March released its updated study projecting a shortage of doctors in the U.S. that could reach as high as 104,900 by the year 2030. That breaks down into shortfalls of up to 43,100 primary care physicians and up to 61,800 specialty physicians.

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The shortage of doctors is a longstanding one. In 1994 Senator Kent Conrad of North Dakota introduced a bill that has evolved into the Conrad 30 Program, which allows foreign-born doctors who received their medical training in the U.S. to apply for temporary visas to practice here in exchange for a commitment to work full-time for three years at a medical facility in a designated underserved area.

In early March, the White House rolled out a revised anti-Muslim travel ban which was immediately blocked on constitutional grounds by federal courts, the same fate of its predecessor. But the administration’s intent has been made clear, prompting The American Medical Association to write to the U.S. Department of Homeland Security: “The AMA is concerned,” stated the letter, “that this executive order is negatively impacting patient access to care and creating unintended consequences for our nation’s health care system. Specifically, there are reports indicating that this executive order is affecting both current and future physicians as well as medical students and residents who are providing much needed care to some of our most vulnerable patients.”

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Further complicating the situation, as reported in the New York Times, the government has altered processing rules for H-1B Visas. The temporary H-1B Visa allows highly skilled foreign workers to join the U.S. workforce. The majority of these visas have been used for high-technology and engineering enterprises, and that use has been mired in controversy with claims that qualified U.S. workers in some cases have been displaced by cheaper foreign workers. Doctors from foreign countries who have received their medical training in the U.S. also require the H-1B Visa to work here. Starting on April 3rd, the U.S. Citizenship and Immigration Services is suspending for up to six months the expedited processing for the H-1B Visas, which, for a fee, could have the visa approved usually within a couple of weeks, otherwise the process can take months. Medical facilities that rely on expedited visas to fill doctor vacancies will be left without critical services for an uncertain period of time.

The atmosphere encouraged by the anti-immigrant rhetoric and actions of the Trump administration certainly is having negative impacts. Consider that there are near 50,000 Indian physicians practicing medicine in the U.S. providing hundreds of thousands of medical appointments and treatments for patients. On February 22nd, Srinivas Kuchibhotla, an Indian engineer, was shot and killed and his fellow Indian friend wounded at a bar in Kansas. The shooter, it’s reported, mistook them for Iranians. He shouted at them to get out of his country and fired on them. This incident shocked U.S. Indian communities and reverberated in the media of India. It’s impossible to discern how far reaching the negative impacts will be in the future. Is enrollment of foreign students at medical schools dropping and will less foreign doctors trained in the U.S. opt to practice medicine in the U.S. for underserved communities?

Photo credit: Baltimore Times

Photo credit: Baltimore Times

There are no medical school enrollment figures available for this piece. A spokesperson for the University of Kentucky Medical School wrote that it’s “too early to tell about any impact on College of Medicine recruitment. While we have a few international students enrolled in medical school, the majority are Kentucky residents.” What is known at this time is that some engineering schools are experiencing sharp declines in international applications, this according to the publication Science. The University of Massachusetts in Amherst has seen a 30 percent decline from the 2016 level of international applications for electrical and computer engineering programs. Vanderbuilt University in Nashville reports an 18percent decline in its international applications for the graduate level engineering department.

“University administrators worry,” reports Science, “that the declines…reflect heightened fears among foreign-born students that the United States is tightening its borders. A continued downturn, officials say, could threaten U.S. Global leadership in science and engineering by shrinking the pool of talent available to carry out academic research. It could also hinder innovation in industry, given that most foreign-born engineering students take jobs with U.S. companies after graduation.”

Such reports from other sectors may reflect as yet undiscerned trends in the medical world. There’s great risk here given our dependence on foreign doctors to help provide medical services to vulnerable and underserved populations in the U.S.

Related links:

What Immigrant Doctors Bring to America

Trump Travel Ban Spotlights U.S. Dependence On Foreign-Born Doctors

Rural Areas Brace for a Shortage of Doctors Due to Visa Policy

Physician Supply and Demand Through 2025

Will Trump’s Ban Cause Foreign-Born Doctors to Look Elsewhere?

News, topical

Green’s Guide to Safe Refuge

For African-Americans, travel by car through Lexington and across the USA during the Jim Crow era was a harrowing experience. Some whites, like Lexington’s Joe Duff and his father and brother, welcomed motoring blacks to pull over, rest, refresh and fortify. But the Negro Motorists’ Green Book was a coast-to-coast Godsend. Here is its story.

~ O ~

For much of the nation’s history “the democratic idea of getting out on the open road, finding yourself, heading for distant horizons was only a privilege for white people,” observed Cotton Seiler in Republic of Drivers: A Cultural History of Automobility in America.

For traveling Americans who happened to be black, relying on the kindness of strangers was risk with a capital R.

Office of War Information Photograph Collection, Lib. of Cong

Office of War Information Photograph Collection, Library of Congress

The Kentucky Civil Rights Act enacted in 1966 prohibits discrimination in public accommodations based on race, color, disability, religion, or national origin. But before ’66 and prior to the 1964 passage of the Federal Civil Rights Act, the tripwires of racial segregation in Lexington and most everywhere else in America were strung taut across the country’s landscape.

A Washington Post account of the Green Book notes that “Jim Crow laws across the South mandated that restaurants, hotels, pool halls and parks strictly separate whites and blacks. Lynchings kept blacks in fear of mob violence. And there were  thousands of so-called ‘sundown towns,’ including in northern states like Indiana, Illinois, Minnesota and Michigan, which barred blacks after dark, an unofficial rule reinforced by the threat of violence.”

Green Books were sold at Esso service stations, one of the few gas station chains that served African Americans.

At the time, as today’s Baby Boomers were in their formative years, Joe Duff worked for his dad at the family service station on the corner of North Broadway and the newly constructed New Circle Road in Lexington, Kentucky.

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The year was 1954. There was a Jerry’s Restaurant across the street. It was for whites only. But the word was circulating among traveling African-Americans that although Duff’s was not an Esso station, Joe’s father was a kind and accommodating man…

For African-Americans increasingly on the move for work, play and family visits, there was a premium on reliable information about places of refuge like Duff’s Service Station in Lexington, Kentucky – knowing where to and where not to make a rest stop, let road-weary and irritable kids out of the car to stretch their legs, find a decent meal, relieve a bursting bladder or refresh with a good night’s sleep.

Eighteen years earlier, when Joe Duff was only a toddler, Harlem postal employee and civic leader Victor H. Green had heard one too many accounts of humiliation or violence against blacks traveling across their own nation and was inspired to come up with a credible improvement to often fatefully inaccurate word-of-mouth.  

'40 Edition - GreenBook_AOTM

The Negro Motorist Green Book organized by state and city places along the nation’s highways where it was safe and welcoming to make a rest or overnight stop.

An introduction in the 1937 edition states: “The idea of ‘The Green Book’ is to compile facts and information connected with motoring, which the Negro Motorist can use and depend upon. We are appealing to the Motorist and Business places for their whole-hearted cooperation to help us in our endeavor, by contributing ideas, suggestions, travel information and articles of interest.” It concludes with the appeal: “Let’s all get together and make motoring better.”

The guide listed cities and places across the country where black motorists were welcome to make a pit stop, check into a motel for the night and have a meal and even in some places like Lexington, enjoy some live music – if not much else.

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Soon, those who needed to know about “The Green Book,” had become well aware of it. To much of the rest of America, the “Go Guide” as some readers referred to it, was virtually unknown. The guide was in limited supply with no more than 15,000 printed annually.

And despite Green’s efforts to develop a network of correspondents across the country, there were gaps in the information that left travelers passing through places like Lexington continuing to count on the grapevine. Duff’s service station, for example, never appeared in its pages.

In an interview with NPR’s Neal Conan, the late social activist and civil rights leader Julian Bond recalled how his family relied on Green’s handy guide, by then tucked into the glove boxes of many black-owned vehicles from family cars to musician and baseball team tour buses. “It didn’t matter where you went, Jim Crow was everywhere then, and black travelers needed this badly,” he said.

Washington Post staff writer Courtland Milloy began his own account of a family road trip to the American south by recalling fidgeting in the back seat of his father’s Buick Special for the long drive to Grandma’s house. “The trip started with gaiety in the dark hours of the morning, but as the day wears on it becomes a nightmare. It is 1958. I am almost eight years old, quenching my thirst with bladder-busting cold drinks while riding through the hot, dusty South in an unairconditioned car with my two younger sisters.

Mom is seated attentively next to Dad. He is usually all-powerful and in control, but today, for some reason, he is uptight.”

“The Green Book tried to provide a tool to deal with those situations,” noted Lonnie Bunch, director of the Smithsonian’s National Museum of African American History and Culture in an interview with the New York Times. “It also allowed families to protect their children, to help them ward off those horrible points at which they might be thrown out or not permitted to sit somewhere. It was both a defensive and a proactive mechanism.”

In the parallel universes of a racially segregated society, what had become a staple to some was virtually unknown to many. Green ceased publication in 1964 with passage of the Federal Civil Rights Act and its prohibition of discrimination in public accommodations. In theory, at least, selective “No Vacancy” had been outlawed. That’s not to suggest that bigotry at the lunch counter or registration desk magically disappeared. It takes quite a long time to bring about change of such magnitude. Vestiges of Jim Crow linger in America to this day.

Writers, artists, academics and the just plain curious have been dusting off Victor Green’s publishing legacy and finding within its pages a nuanced context for how things once were and what informs and influences the perspectives of today.

The reason Courtney Milloy’s father and so many like him steeled themselves when behind the wheel is illuminated in Candacy Taylor’s video, “The Negro Motorist Green Book Project: Documenting Sites of Sanctuary. Taylortravels-while-black” one of America’s most iconic highways, offering an eye-opening reminder of how the road trip, so readily taken for granted by many Americans, was for some fraught with gut-churning dangers of all sorts, mile after mile.

The guide, now reemerging from history’s shadows, is the focus of The Green Book Chronicles. A film crew led by Calvin Alexander Ramsey, author of the children’s book Ruth and the Green Book, and Becky Wible Searles, an animation professor at the Savannah College of Art and Design’s Atlanta campus have interviewed some of Mr. Green’s relatives and have tracked down families who owned sites mentioned in the books or who relied on it for travel suggestions.

Ramsey discussed the Green Book in an interview with public radio’s Rick Steves.

The Green Book is a central fixture in the 2015 film 100 Miles to Lordsburg, set in 1961, the fictional story of Jack and Martha, a young, African-American couple, traveling across the country for a new job opportunity in California.

The Dresser Trunk Project, a traveling exhibition organized in 2007 by William Daryl Williams, then an Associate in the University of Virginia School of Architecture and now director of the School of Architecture and Interior Design at the University of Cincinnati, used the Green Book to inform the designs of boxes based on a dresser trunk — the case musicians used to carry their clothing and gear — to tell the stories of African-American artists who traveled along the Southern Crescent train line. The trunks feature stories, photographs, maps, and computer-generated models documenting the clubs, hotels, boarding houses and other places that accommodated black musicians in eleven cities along the Crescent line (currently the Amtrak service connecting New Orleans and New York).

A dresser trunk created by artist Lisa Henry-Benham for the Carver Inn in Charlottesville, Virginia -- later demolished for the expansion of a street -- which was the only hotel listed for black travelers in the "Negro Motorist" Travelers Guide. Photo by Lisa Henry-Benham.

A dresser trunk created by artist Lisa Henry-Benham for the Carver Inn in Charlottesville, Virginia — later demolished for the expansion of a street — which was the only hotel listed for black travelers in the “Negro Motorist” Travelers Guide. Photo by Lisa Henry-Benham.

As the pages of the Green Book indicate, the Lexington of the 1950s didn’t offer much at all to the traveling African-American. Still, there were people like the Duff brothers and their dad, letting it be known that some empathy and accommodation could be found on one corner of North Broadway and New Circle Road.

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Duff, now 82, has had a lot time since those days to reflect and observe the people who pull up to his gas pumps or bring their vehicles to his service bays…

~O~

Related:

Art Shechet on status of Confederate Statues in downtown Lexington

Recent articles by Tom Martin:

Post Truth or Post Trust?

In Search of Another Way

Friendship in Troubling Times

The Wedding Day Kiss

News, topical

Is a picture any longer worth a thousand words?

(Illustration: Venice multi exposure by Stephen Wilkes)

With apologies to the written word, there may be no more powerfully influential medium of communication concerning global affairs than photojournalism. “Seeing is believing,” right? But what happens when we can no longer completely trust the veracity of the image before us?

Just as there’s a time to stop talking about girls and boys and to talk instead about women and men so it is with photography; something has changed so radically that we need to talk about it differently, think of it differently and use it differently. Failure to recognize the huge changes underway is to risk isolating ourselves in an historical backwater of communication, using an interesting but quaint visual language removed from the cultural mainstream.

– “The Next Revolution in Photography is Coming” by Stephen Mayes. Please read on.

All, Environment, News, Politics, Uncategorized

Watch what we wish for?

(Credit - Natural Resources Defense Council)

(Credit – Natural Resources Defense Council)

A nod to Randall Stevens for a provocative Facebook posting about contemporary progressive urbanism – “Smart Growth” – posing the question, “What can Lexington learn from this?”

Tiptoe gingerly through the ideologically argumentative minefield and you might recall some troubling cautionary tales taken from such otherwise “cool” places as Boulder and Austin.

Please read and offer your thoughts about our own aspirations for Lexington, Kentucky.