Every year over half a million open-heart surgeries are performed in the U.S. Many are being done by foreign-born surgeons, physicians whose accents may have prevented them from flawlessly explaining the procedure to their patients.
I was one of their patients. Recently I underwent a cardiac catheterization by Dr. N. Mathew Koshy, an Indian-educated cardiologist. The results were alarming, and in the early morning hours, Dr. Atiq Rehman, a Pakistani-educated surgeon, recommended emergency triple coronary-artery bypass graft surgery. My physician son spoke on the phone with Dr. Rehman and consented to the surgery on my behalf, but there had been no time to verify the surgeon’s expertise.
Are patients putting their lives at risk when they turn to foreign-educated doctors? On the contrary, a Pennsylvania study of 244,000 hospitalizations found a lower mortality rate for patients of foreign-educated physicians compared to those of U.S.-educated physicians.
Why this counter-intuitive result? Perhaps because only the best foreign-educated physicians succeed at the rigorous examination and application process required for them to come to the United States, and then they usually get further training at U.S. hospitals. A case could be made that receiving care from foreign-educated doctors may be the most prudent course of action. For example, we later learned that my surgeon had graduated with honors from Aga Khan University School of Medicine in Pakistan and had done subsequent surgery training at four major U.S. hospitals.
Faced with a crisis, I had no other choice, and I am thankful that the choice I had was a top-notch surgeon.
A lot has been said about the country being flooded by immigrants. Not enough has been said about how the flood includes highly skilled immigrants who are saving American lives.
Wednesday, May 28, 2014
Friday, May 23, 2014
Michael Gartner: THE CHERRY SISTERS
You know it’s going to be a great day for free speech when the Iowa Supreme Court mentions the Cherry Sisters.
And so it was last week.
The court ruled that Rick Mullin and the Iowa Democratic Party didn’t defame Rick Bertrand in a nasty political ad a couple of years ago. Mullin and Bertrand were running against one another for the Legislature, and the race got unpleasant.
Mullin then ran an ad implying -- at least to some people -- that in his role as a salesman for a drug company Bertrand sold a dangerous drug to children.
“Bertrand was a sales agent for a big drug company that was rated the most unethical company in the world,” the ad said. “The FDA singled out Bertrand’s company for marketing a dangerous sleep drug to children.”
The ad was true, but a possible inference --that Bertrand himself sold such a drug -- was not.
So Bertrand sued, and he won in state district court.
But the Iowa Supreme Court overturned that ruling and dismissed the case.
That was a good thing for the state of Iowa.
Political speech must be robust and free-wheeling, and therefore it must be harder to sue political figures for the careless remark, the inaccurate accusation or the nasty aside, courts have ruled. To win, a plaintiff must show that the speaker knew the remark was false or made it with reckless disregard for its truth or falsity.
Bertrand -- who ultimately won the election -- did not show Mullin violated either of those standards, the court said.
“More than a century ago -- and more than half a century before the Supreme Court [of the United States] decided [New York Times v. Sullivan, the case that established the “reckless disregard” rule] -- we recognized persons who place themselves in the public sphere are subject to a vastly greater degree of comment, criticism and even ridicule,” Chief Justice Mark Cady wrote for a unanimous court. And he cited Cherry v. Des Moines Leader.
The Cherry Sisters -- Effie, Addie, Jessie, Lizzie, and Ellie -- were from Cedar Rapids, and they were in show business. They couldn't dance, and they couldn't sing. In fact, they couldn't do much of anything. Their act exerted a ghastly fascination over its audiences.
And that was what the great Oscar Hammerstein was looking for. The year was 1896, and he was going broke. He was desperate. "I've tried the best," he said. "Now I'll try the worst." So he sent for the Cherry Sisters.
They opened at the New Olympia Theater in New York on November 16, 1896. "Never before did New Yorkers see anything like the Cherry Sisters from Cedar Rapids, Iowa," the New York Times reported. "It is sincerely to be hoped that nothing like them will ever be seen again."
But the audiences loved them. Night after night, young men crowded the theater. Often, they brought vegetables: sidewalk vendors were said to do a brisk business every evening selling onions and rutabagas and melons. "There was scarcely a young blade in the late nineties," the Des Moines Register recalled in 1929, "but boasted he had heaved a cabbage or two at the Cherry Sisters."
Eventually, they went on the road, and they made some stops in Iowa. In 1901, the Des Moines Leader wrote:
"Billy Hamilton of the Odebolt Chronicle, gives the Cherry Sisters the following graphic write-up on the late appearance in his town: 'Effie is an old jade of 50 summers, Jessie a frisky filly of 40, and Addie, the flower of the family, a capering monstrosity of 35. Their long, skinny arms, equipped with talons at the extremities, swung mechanically, and anon waved frantically at the suffering audience. The mouths of their rancid features opened like caverns, and sounds like the wailing of damned souls issued therefrom. They pranced around the stage, strange creatures with painted faces and hideous mien. Effie is spavined, Addie is stringhalt, and Jessie, the only one who showed her stockings, has legs with calves as classic in their outlines as the curves of a broom handle."
The ladies sued, and a lower court -- after watching them perform and after noting that the act was so bad the piano player left at intermission -- threw out the case.
They appealed to the Iowa Supreme Court, which ruled that ridicule is often a writer's best weapon. The case is considered a landmark of First Amendment law, for it upholds the notion that fair comment -- even intemperate comment -- is a valid defense of libel charges. It said, in effect, that anyone is entitled to his or her opinion without the threat of being sued.
As Justice Cady noted last week, that was more than 50 years before the Supreme Court of the United States came to the same conclusion.
And last week, the Iowa Supreme Court reaffirmed that principle.
Good for them. And good for Iowa.
And so it was last week.
The court ruled that Rick Mullin and the Iowa Democratic Party didn’t defame Rick Bertrand in a nasty political ad a couple of years ago. Mullin and Bertrand were running against one another for the Legislature, and the race got unpleasant.
Mullin then ran an ad implying -- at least to some people -- that in his role as a salesman for a drug company Bertrand sold a dangerous drug to children.
“Bertrand was a sales agent for a big drug company that was rated the most unethical company in the world,” the ad said. “The FDA singled out Bertrand’s company for marketing a dangerous sleep drug to children.”
The ad was true, but a possible inference --that Bertrand himself sold such a drug -- was not.
So Bertrand sued, and he won in state district court.
But the Iowa Supreme Court overturned that ruling and dismissed the case.
That was a good thing for the state of Iowa.
Political speech must be robust and free-wheeling, and therefore it must be harder to sue political figures for the careless remark, the inaccurate accusation or the nasty aside, courts have ruled. To win, a plaintiff must show that the speaker knew the remark was false or made it with reckless disregard for its truth or falsity.
Bertrand -- who ultimately won the election -- did not show Mullin violated either of those standards, the court said.
“More than a century ago -- and more than half a century before the Supreme Court [of the United States] decided [New York Times v. Sullivan, the case that established the “reckless disregard” rule] -- we recognized persons who place themselves in the public sphere are subject to a vastly greater degree of comment, criticism and even ridicule,” Chief Justice Mark Cady wrote for a unanimous court. And he cited Cherry v. Des Moines Leader.
The Cherry Sisters -- Effie, Addie, Jessie, Lizzie, and Ellie -- were from Cedar Rapids, and they were in show business. They couldn't dance, and they couldn't sing. In fact, they couldn't do much of anything. Their act exerted a ghastly fascination over its audiences.
And that was what the great Oscar Hammerstein was looking for. The year was 1896, and he was going broke. He was desperate. "I've tried the best," he said. "Now I'll try the worst." So he sent for the Cherry Sisters.
They opened at the New Olympia Theater in New York on November 16, 1896. "Never before did New Yorkers see anything like the Cherry Sisters from Cedar Rapids, Iowa," the New York Times reported. "It is sincerely to be hoped that nothing like them will ever be seen again."
But the audiences loved them. Night after night, young men crowded the theater. Often, they brought vegetables: sidewalk vendors were said to do a brisk business every evening selling onions and rutabagas and melons. "There was scarcely a young blade in the late nineties," the Des Moines Register recalled in 1929, "but boasted he had heaved a cabbage or two at the Cherry Sisters."
Eventually, they went on the road, and they made some stops in Iowa. In 1901, the Des Moines Leader wrote:
"Billy Hamilton of the Odebolt Chronicle, gives the Cherry Sisters the following graphic write-up on the late appearance in his town: 'Effie is an old jade of 50 summers, Jessie a frisky filly of 40, and Addie, the flower of the family, a capering monstrosity of 35. Their long, skinny arms, equipped with talons at the extremities, swung mechanically, and anon waved frantically at the suffering audience. The mouths of their rancid features opened like caverns, and sounds like the wailing of damned souls issued therefrom. They pranced around the stage, strange creatures with painted faces and hideous mien. Effie is spavined, Addie is stringhalt, and Jessie, the only one who showed her stockings, has legs with calves as classic in their outlines as the curves of a broom handle."
The ladies sued, and a lower court -- after watching them perform and after noting that the act was so bad the piano player left at intermission -- threw out the case.
They appealed to the Iowa Supreme Court, which ruled that ridicule is often a writer's best weapon. The case is considered a landmark of First Amendment law, for it upholds the notion that fair comment -- even intemperate comment -- is a valid defense of libel charges. It said, in effect, that anyone is entitled to his or her opinion without the threat of being sued.
As Justice Cady noted last week, that was more than 50 years before the Supreme Court of the United States came to the same conclusion.
And last week, the Iowa Supreme Court reaffirmed that principle.
Good for them. And good for Iowa.
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