E. Martin Schotz, MD
Psychiatrist
South End Community Health Center
Boston, MA
                                       
Dear Santa,

Christmas is coming, and this has been a confusing and embarrassing year.  So with everything that is rolling around in my brain, I have an unusual holiday request.

It all began when I visited a very unusual place — Escuela Latinoamericana de Medicina (ELAM). ELAM, the Latin American School of Medicine, is a medical school whose campus is a former naval base in Havana, Cuba.  It is possibly the largest medical school in the world with over 6000 students from 36 countries, most of them from the Global South.  At ELAM Cuba provides medical education to all these students free of charge in order that they can return to their home countries to practice medicine and to help build health infrastructure.

The curriculum at ELAM combines traditional medical school education with courses on the morality of the physician and medicine as a calling, as well as courses in public health, preventive medicine, and the specific health problems of the student’s particular home country.    Given that ELAM is a six year program of study, Cuba is sending approximately 1000 new doctors into the Global South every year.  And what is the United States doing?    According the the New England Journal of Medicine approximately 25% of the practicing U.S. physicians are international medical graduates. “Reliance on international medical graduates in the United States… is reducing the supply of physicians in the many lower-income countries.”

At this point I am getting a little confused and even annoyed.  Hey, I thought the Cubans were supposed to be good at baseball and music.  But them showing us up on world health — that’s another matter.  And this is not the whole story.  Now comes the embarrassing part.

A few years back in response to a request from our Black Congressional Caucus, the Cuban government opened 500 seats at ELAM for young people of modest means from the U.S. to study medicine free in Cuba, if they are willing to come back to the US and work in under-served areas.  Right now about one hundred-twenty students from the US are taking Cuba up on its offer, and some have already graduated and are back here working as physicians.

So what we have here is a neighbor 90 miles off our shore, whom our government calls “evil” and “terrorist”, a neighbor whom we have attacked militarily, blockaded economically, and refuse to recognize diplomatically.  And how does this neighbor respond?  They offer to train physicians for us free of charge on a converted military base!  Talk about “beating swords into plowshares”, “turning the other cheek”, and “love thy enemy.”   And our Congress passes a resolution declaring we are a nation under God — somehow that just doesn’t do it for me.

I was thinking we need something more substantial, and then it dawned on me. Cuba is a country with less than 1/20th the population of the United States, and far less than 1/20th of our material resources.  What about if we did what Cuba is doing, multiplied by a factor of twenty.   In other words, imagine us transforming 20 military bases across the country into medical schools.  Imagine us inviting 120,000 students from the Global South to study medicine free, with a curriculum similar to ELAM’s, so that we would be sending 20,000 new physicians back to their home countries each year to help build health care systems and preventive medicine infrastructure.  We could do it. It just takes the imagination and the political will.

That’s my wish this season.  I want you, Santa, to plant this idea in the ear of every member of Congress — “20 ELAMS, we’ve got to have 20 ELAMS.”  I understand they they might balk at spending money on poor people, not to mention foreigners, so maybe you could sell it as a smart cheap way to strengthen national security.  What do you think peoples’ attitudes in the Global South would be toward us, if we were sending them 20,000 additional doctors every year.  And anyone who wants to help Santa out could just clip this article and send it along.

Wishing everyone a happier and healthier holiday season.

The two that I see hang around street corners and I pass them every day. I bought the paper from the guy near my office in longwood and when I did not buy it another time he said something nasty under his breath to me. That was last year and still a year later I run into him on a daily basis and when someone does not buy the paper he gives a curt in your face remark.

Near Trader Joes in brookline there is a woman who sits in a chair near starbucks. Last year she came up to me and I told her I did not have a dollar on me and the woman had the nerve to say that is not what I asked you!!!!

Being rude and sarcastic is not the way to have people buy your paper. I love helping people out and give money to different organizations but refuse to give Spare change anything because of these two rude individuals.