Doctors are not always "free to treat patients as they deem best." The cheapest treatment does not work for every patient, and many communities lack modern technology and specialists. The threat of frivolous malpractice litigation promotes unnecessary tests and consultations, and published research cannot always be trusted. For example, the evidence-based research of health insurers concludes that patients require no more than two joint injections yearly, while the research of drug manufacturers and the FDA promote the safety and efficacy of weekly joint injections in chronic conditions. Doctors don't hate science, but we do dislike spurious evidence being allowed to trump trusted experience.
Bernard Leo Remakus, M.D.
Thanks to All 2.9 Million
There are 2.9 million people in the United States who are qualified to write "R.N." after their name. On behalf of my fellow nurses, I want to thank NEWSWEEK and Jerry Adler for the article "The Nurse Will See You Now" (HEALTH MATTERS, March 9). Nurses may not receive appropriate respect from physicians, but the rest of the population appreciates the skill and empathy of nurses. A Gallup poll measuring honesty and ethics among 23 occupations has put nurses at the top of the list for seven straight years (doctors are ranked fourth). Nurses today do more than follow doctors' orders. They use clinical judgment to advocate for their patients and are often the intervening factor in saving a patient's life. You were right on, Mr. Adler. Thanks for your support.
Lila Anastas, R.N.
When I first went on the wards as a medical student, it was obvious who really knew what was going on—the nurses. My common sense squashed any stupid sense of superiority because I had an "M.D." behind my name. I am no dummy. For 35 years, listening to nurses has been one of my most trusted resources. Doctors who regard nurses as anything other than crucial to good medical care are idiots, plain and simple. I've been a patient for the last 10 weeks. Whatever prior respect I had for the nursing profession has increased—exponentially. There are two nurses in particular to whom I literally owe my life. I just hope I don't see one of my M.D. or D.O. colleagues treat a nurse with anything other than appropriate respect. I'm liable to pop them in the nose.
Jeffrey R. Waggoner, M.D.
Should Smart Kids Get Funding?
Thank you to Stephanie Lindsley for eloquently bringing to light the terrible educational-funding gap between the disabled and the gifted ("Autism and Education," MY TURN, March 9). We too have a gifted child and have been utterly shocked at the lack of resources available for America's brightest students. Too often it is said that they are smart, they can look after themselves. Do we not want to be leaders in the worlds of science, medicine, literature? Where is the encouragement for the kids at the top of the class? When our son skipped first grade and went into second, his teacher told us she did not want him in her classroom. She said, "He's a year younger. When his buddies are 21 and drinking, he won't be allowed into bars." We were disgusted. No Child Left Behind? Even those who are ahead have little hope.
Deborah Halliday Mills
Stephanie Lindsley has touched on a problem with education in this country. We often hear that American students are becoming less competitive in mathematics with foreign students. Our solution has been to set a minimum standard of desired competency and try to bring the nonmathematically inclined up to those standards. Imagine if the U.S. found itself falling behind other countries in basketball. Identifying students who are short and clumsy and teaching them minimal ball-handling skills would not win us gold medals. Our schools should concentrate on teaching mathematics to aspiring mathematicians, art to aspiring artists and woodworking to aspiring carpenters.
Taking on Huck Finn
My reaction to "Rethinking race in the Classroom" (March 9) was immediate and furious. When students ask, teach. If you don't know, learn. Why is the character of Jim in "Huckleberry Finn" "childish"? Because big strong male slaves were beaten and whipped into submission, and any personal initiative or resistance shown by slaves was punished by death. Jim knew that he had to appear weak and lazy in front of all whites, including children like Huck. Why does Tom Robinson speak poorly in "To Kill a Mockingbird"? Because Georgia's slave codes, for example, read, "If any slave, Negro, or free person of color, or any white person, shall teach any other slave, Negro, or free person of color, to read or write either written or printed characters, the said free person of color or slave shall be punished by fine and whipping." Why does Twain keep using the N word? Because in the era Twain was writing about, the word was in common use, and not nearly as pejorative as it later became. Teach how and why Jim Crow took power, and how it developed tools like the N word, "separate but equal" and lynching to preserve white supremacy as long as possible. I'm beginning to think Eric Holder was right, that in terms of race, we are a "nation of cowards." I'm also beginning to think that teaching has replaced sarcasm as the resting place of small minds.
For five years I taught "To Kill A Mockingbird" to my juniors. I would read the first three chapters aloud and then we would discuss the characters introduced and their relationships. As I read the section in which Scout tells about Atticus's first law case and the attitude of some of the local people, there were students who would gasp and shake their heads. They would tell me I couldn't say the N word and it wasn't right and people shouldn't talk or feel that way. I would allow their indignation to simmer before reminding them that what I read to them was very common and acceptable in the 1930s. And then I would tell them that in the 1990s they should be shocked at what I had read aloud. It wasn't right then and it isn't right now. Removing "To Kill a Mockingbird" and "Huckleberry Finn" from the classroom would be like removing the civil-rights chapters from American history textbooks.
Wendy O. Royse
Allison Samuels wants to lead the group that clings to the past and continues searching under every rock for possible wrongs. If having a black president and black judges, congressmen, generals, governors, mayors, aldermen, college graduates and teachers throughout our society doesn't mean things have changed, then one has to wonder what it might take to get people to take that chip off their shoulder, to be free at last.