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Drs. Quentin Young, Ron Shansky and Mike Gray talks with Studs Terkel

BROADCAST: Dec. 3, 1975 | DURATION: 00:56:01

Synopsis

Interviewing Dr. Quentin Young and others about Cook County Hospital and public health services in Chicago and throughout the country.

Transcript

Tap within the transcript to jump to that part of the audio.

OK

Studs Terkel And so, in yesterday's press conference Dr. James Haughton, executive director of Cook County, said no reason will be given why Dr. Quentin Young, head of the Department of Medicine, was fired peremptorily, and so this morning we have it live, and Dr. Young is in the studio with two of his colleagues Dr. Ron Shansky, who is head of the out, out medical--

Ronald Shansky Outpatient Clinic.

Studs Terkel Outpatient Clinic, and Dr. Mike Gray, who's a resident and secretary of the house staff. So I thought as we hear, for those people who may not know what's going on, we know a good deal of what's going on at Cook County Hospital, there was a doctors' strike and, or an action. And you, you recall yesterday's program, those who heard it, three young interns were talking as to why they did what they did, took part in the strike. At the time of yesterday's conversation, that, that particular conversation you heard yesterday took place about three weeks ago, while the strike was still on, before some of the spokemen had served time in jail and since been out. And--oh, Mike, you were in, you're a jailbird!

Michael Gray Right.

Studs Terkel You were in the pokey, as--they're out, because he was one of the spokesmen, and--but this morning's program will be a continuation of the theme. What it's really about, and where to, what next, and about the governing board that is appointed of Cook County that ordered Dr. Haughton, executive director to, for a long time, fight the strike, find an agreement and then fire Quentin Young because he supported the young doctors and middle-aged doctors, too. So in a moment, this program after we hear from, first from Paul Vodicka and this message. [pause in recording] And so here we're seated around at this very moment, Dr. Shansky had his beeper going, so it was a call from the hospital or a patient, and that's taken care of, I take it,

Ronald Shansky Yes, it is.

Studs Terkel By the way, this is not accidental that you three are doctors, and yesterday three young interns, I asked them why they took part in this action. I asked them why they did and they said, "Well, we're, we're interested in patients." And one said, "I became a doctor 'cause I want to, I want to assuage human pain." And here we have, suppose we hear the voice of a couple of them now, yesterday's, as to what it was about. I think this is Dr. Bonnell.

Mark Bonnell The, the issue, really, is, is whether or not the physicians who are taking care of the patients are going to have some input, significant input, in determining what the conditions on the hospital are, and this, this has really been the issue. I think, last spring, in starting out with these improvements that house staff members felt were necessary, there -- at that time there were in the range of 150 or so items, and the house staff has unilaterally reduced this list to the range of 40 here now, and there are, perhaps, a dozen that we're really pushing for that, that if we get a settlement, you know, it'll be in the range of 10 of these things that, that we would be willing to settle for.

Studs Terkel The

Mark Bonnell And yet, until this week, none of these items were ever discussed at the negotiating table. The, even the principle of these being the kinds of things that doctors can discuss in relation to their contract, in relation to their working conditions, the principle was not recognized, and this--

Studs Terkel This is just a thought. They're talking about the need for interest in patient care and need for, when someone is having an emergency not to run elsewhere to find that machine, to have a Spanish interpreter for Spanish patients, to perhaps reduce some of the terrible waiting periods. This is what it was about. And so here we are this morning. Dr. Quentin Young.

Quentin Young Yep.

Studs Terkel Are you a member of the Cook County Hospital staff or aren't you?

Quentin Young I certainly am. It's true that on Wednesday last I was summoned up to the executive director's office and handed a very terse paragraph that said that, that he was directed by the governing commission to terminate me at that day, it was 11:15, and that I should be out of my office by five PM. It sounded fishy to me, and I called my lawyer and he said, "Of course, it's an illegal act," that like most people who, who serve in a job, you have to have some notice, some hearing, and some proof of the kind of conduct that would justify summary dismissal. So I went back to work and I've been there ever since. In fact, one of the most remarkable things is that the governing commission chose to fire me and not name a successor, so that as of this moment for, what is it, a week now, there would be nobody running that department, which is a very big department. It took place over the holiday weekend when our patients are usually much sicker, and I can just say that's the most recent irresponsible act, to, to, to fire somebody without a replacement. Yeah, I'm on the staff, even though they, they think I'm not.

Studs Terkel Dr. Ron Shansky, you, you're backing Dr. Young.

Ronald Shansky Right. Well, the entire, it's fair to say that the entire medical staff, and as a matter of fact the representatives of the executive medical staff, have affirmed and reaffirmed the fact that the firing was illegal, that Dr. Young is the Chairman of the Department of Medicine, and as recently as yesterday, when the division chiefs, the heads of subspecialty divisions were notified by Dr. Haughton that they were no longer to take administrative direction from Dr. Young, these same division chiefs notified Dr. Young in a memo that they would only take, as a result of the, their direction from the executive medical staff, they would only take their direction from Dr. Young. So it's fair to say that in terms of the attending staff at the hospital, the house staff the hospital, all of them, all of these physicians feel that Dr. Young is the legal Chairman of the Department of Medicine.

Studs Terkel You know I was thinking, before Dr. Gray says something, I know he intends to, looking at this morning's Sun-Times on this thing that Dr. Shansky was just talk, Shansky was just talking about, that Dr. Haughton sent a memo to the medical--I'll read this from John [Jomeck's?] reportage in this morning's Sun-Times: "Later Tuesday (that is yesterday), Haughton sent a memo to medical department division chiefs telling them to operate without consulting Young. And eight division chiefs in a letter back there they refused to do so." To operate without, without consulting the head of the Department of Medi--we're talking now about a hospital in which human lives and health is involved.

Ronald Shansky See, what's difficult for people to understand, but what is crucial is the fact that the Department of Medicine, although it has division chiefs, is almost entirely directed by the Department chief in terms of the beds, because most of the beds in the department are general medical beds, so they're not responsible, the responsibility of any division chief. They are the responsibility of the Chairman of the Department. Likewise, the general medicine clinic, which is the largest single clinic at Fantus Clinic and sees roughly 1500 patients a week, is again not the, under the purview of any division chief, but under the purview of the Chairman of the, of the Department of Medicine. The same thing, of course, is true as to the services at Cermak Hospital and the Cook County Jail. All of those things fall under the purview of the Chairman of the Department of Medicine, who is of course Dr. Young.

Quentin Young My guess is they don't, they don't even know that. One of the amazing things about that governing commission is that it never sets foot in the hospital. There have been--they're people who have served for six years, they meet about once a month for three hours, sometimes in crises like these, this, they meet a lot more often. Their headquarters is literally across the street from the hospital, and to the best of our knowledge, not one of them has set foot--

Studs Terkel Pardon me. We hear the phrase "governing commission." Who, who are, there are nine, how many members

Ronald Shansky There are supposed to be nine members on the governing mission, two have resigned. So there are now seven. I think it's important that their names be mentioned, because they make a very sig -- serious effort to remain anonymous and hide behind this smokescreen of anonymity. The members of the governing commission are Edwin Brashears, who is the president of the Drake Hotel, George Hill, who is a, an accountant or an auditor, Mrs. Miles Burns, Charles Davis, who is an advertising executive, Dr. Richard Kessler, Dr. Ellsworth Hasbrouck, and John Hadley. Those seven members that I have mentioned are the remaining members of the governing commission. Two people have resigned, so there are two vacancies.

Studs Terkel Of the seven, two are doctors, and five are not.

Ronald Shansky That's correct.

Studs Terkel I see. And of the two who resigned, one, Duke McNeil, condemned his colleagues.

Ronald Shansky Exactly. Exactly.

Quentin Young Yeah, Duke said he couldn't take it any longer, and if I may, Attorney McNeil is going to chair a meeting we're having tonight, Studs, if I can mention

Studs Terkel Oh, sure.

Quentin Young We're having a meeting at the hospital.

Studs Terkel Where?

Ronald Shansky The meeting is at 720 South Wolcott at seven-thirty PM tonight, that's seven-thirty PM. The address is 720 South Wolcott, which is Karl Meyer Hall, and it will be a mass community meeting on the third floor of Karl Meyer Hall, and we invite any people who are concerned about this issue to attend this meeting tonight to find out the facts and find out what they as individuals can do in this crisis to save Cook County Hospital and reinstate Dr. Young.

Studs Terkel By the way, I, I did call Dr. Haughton, I hoped he'd appear on this program with you this morning, see. It would have been Young and Haughton. I did--or Haughton and Young, I should say, on the basis of--

Quentin Young But Jim Houghton--

Studs Terkel And he couldn't, that is, people said he, he was unable to, and they, they have no intention, they said, of explaining to anybody why it was you were dismissed. I said, "Any reason given, it's a public hospital here, right?" No, I think, no reason given.

Quentin Young It's, it's remarkable. And I just don't know how much the public will put up with it. Here's a, an institution with its other counterparts into about 150 million dollars of the public money and, and huge public trust there. This is a day when dollars come hard for service to the poor. There's much suggestion that there's an over-swollen bureaucracy. It's almost amazing, they have floors and floors of carpeted air-conditioned offices there, while it has to be said that the personnel of the hospital, including doctors, don't frequently have a chair to sit down in, and it's one of those classic examples of an overweening bureaucracy and I think it comes, Studs, from their secrecy. These people always meet in secret. They have a peremptory public meeting where they unanimously confirm everything they did in private. And that's part of the problem.

Studs Terkel Well, Mike Gray, I think Dr. Gray, resident, and you were very active as spokesman during the time of that job action of the doctors there that resulted in your serving several days for, I suppose, contempt this was, was it not?

Michael Gray Right. This is the claim of the court.

Studs Terkel Why the--in a way, perhaps you can recapitulate what was the case. Why did it happen?

Michael Gray Why did the job action

Studs Terkel Yeah.

Michael Gray The job action happened because for a period of five and a half months the negotiating team for the house staff association had been pressing a series of requests or demands, if you will, with regard specifically to our working conditions, which in a situation where we are the closest interface between that institution and its patients in terms of patient care, there is no way to separate the working conditions for us and the conditions that patients are receiving care in. So in essence, they are the same. By making specific demands with regard to our working conditions, we felt we would have an avenue for making improvements with regard to the patient care delivered at the hospital. Now the difficulty was, that from the very outset, as early as June twenty-first this year, the representatives of the governing commission at the negotiating table made it exquisitely clear that they had no intention of ever negotiating patient care with the house staff, taking the position that this is management's rights, and you are interfering with management's rights. Now our argument was that, while management certainly has its rights, we also believe that in an institution which is serving the public interest that they also have certain obligations, and those obligations must be fulfilled, and while we had no desire to administer the hospital, we certainly felt that we had a, a say in what the minimum standards should be for patient care.

Studs Terkel You know, isn't, isn't this--this deals with a public hospital, County, a huge one. At the same time, aren't the issues really universal, at least society-wise, in that you speak of management, you speak of bureaucracy. We're talking now not about a factory where things are made, we're talking about a place where human beings are who may die or live.

Ronald Shansky I think that's an important point for the, for the following reason. A crucial thing to say about this particular governing commission and one of the hopefully outcomes of this, of this very sorry chapter in the history of the hospital, is that this commission are really absentee landlords. As a matter of fact, they're able to build a bureaucracy to cut back services, to destroy staff morale, because in fact there they are not intimately involved or concerned with the hospital, because in fact if they were to get sick they wouldn't be hospitalized there, nor do they know anyone who would be hospitalized there, nor as Dr. Young has stated, have they ever spent much time there. We don't think that people on a commission who were sincerely committed to that hospital would have allowed there to be a nursing strike, a house staff strike, nor would have stated after the longest strike, medical strike in the history of this country, that the strike didn't hurt them at all. That strike hurt everybody at the hospital, house staff, attending staff, nurses, because where people are concerned with that hospital, only absentee landlords could make such a statement and we hope a new commission will be one committed to the hospital and who will be intimately involved with the flow of services.

Quentin Young I'd like to say something because it gets lost sometimes, and I want to have a love song to County Hospital. I trained there a long time ago, over 25 years I started. It took me six years to get through. I was a slow learner. I stayed on as an associate attending for a number of years, and then there was a hiatus when my practice and the demands of the hospital I was at made it impossible to do decent work at County and then I came back three and a half years ago, big switch in my own personal professional life, and there's something about County that only people who work there can describe, and I'll, so I'll try and do it even though I have just said that, and it's not just of course the doctors. Maybe it's especially the doctors because like all of us at this table, we, we work there those 24 hours followed by 12, and then another 24, and maybe that's what gives you the vaccination to, to, to be hooked on the place. My best definition is it's a place where almost everything you do makes a difference. Often life and death difference, always some difference. The people you see there are the whole panoply of victims of our society. And while they're rejected by most of the cultures, the alcoholics and the drug addicts, the very poor, the, the chronically ill, the aged, it is such an intense important emotional experience that people get hooked, and, and you know, not only people who are on the radical fringe, very conservative people have a love for that place that is hard to describe. Whenever people from County, they call them County men, these days I guess you'd have to call them county people, get together anywhere, there's always talk about County and that enormous human experience. That's what makes the, the, the particular travesty that's taking place now so unpalatable, so tragic. It is the interface Godzilla meets humankind. It's the interface between that mindless bureaucracy that meets secretly, that has no responsibility, that is unaccountable, that can get up and say we don't have to give a reason for firing somebody, and it's not for me to self-inflate, but I worked hard there for three and a half years and I think there's some accomplishments. Maybe we can even talk about it.

Studs Terkel I think that'd be worth talking about, the hospital and the time since Quent Young's been there as head of medicine, and comments and observations made by other doctors as well as yourself, yourselves. Ron, Dr. Shansky.

Ronald Shansky Yeah, I think there's a, a whole range of accomplishments. But if you, if you had to narrow them down into the key ones, I think, of course, it's important that the program when Dr. Young took over was totally non-competitive in terms of attracting people from this country who were interested in staying and excellent people from outside this country. In the three years that he's been there, that situation has been totally reversed, and it's a highly competitive program. We have about 10 applicants for every position that we have in an internship class.

Studs Terkel These applicants are, what, different parts of the country?

Ronald Shansky Yes, yes. From medical schools around the country.

Studs Terkel What was

Ronald Shansky Before, let me just say that in terms of, of applicants from this country in the internship class when Dr. Young took over, there were two, I believe, two Americans in the entire hospital out of 135. So I, now for 40 positions just in the Department of Medicine, there are 150, to give you some example. But in addition to that, part of the reason why that's occurred is because there has been recruitment of division chiefs and attending staff, junior attendings, who are clearly committed to teaching as well as improving the patient care. And what you see with--under Dr. Young's leadership most importantly is a role model that's dedicated to service to the people, that's dedicated to the understanding that what this society needs is more physicians who are concerned with delivering primary care in the underserved areas. And we know that the type of people we recruit and, and what we're trying to do is to be able to produce physicians who are going to provide solutions to some of the severe shortages we have in underserved areas. In addition to that type of role model, which I think is the most important thing we're doing in terms of, of feeding back to society the, the products which are most important. In addition to that we've built programs, for instance our TB program, which helped save the County a tremendous amount of money in terms of closing down the TB sanitarium, and yet provided much more humane and much more excellent follow-up in terms of the care of TB patients. We're talking about an outpatient clinic that has changed the old version of a clinic with a patient relating to an impersonal institution, to one where the patient relates to his or her physician and relates to that physician the same way a patient in a private office would relate to that physician. We're talking about a department under Dr. Young's direction where in fact a jail healthcare system was set up within the past three years which is now a model for jail health care systems around the

Studs Terkel You're talking now, too, about the Cermak Hospital, and Dr. Lambert King, who by the way came out yesterday with a comment blasting the commission

Ronald Shansky Right. So, I think, I think in all of these areas it's fair to say that Dr. Young has done exactly what this society needs, what the community being served needs, and in fact according to the governing commission and its executive director, has served the hospital and the community in an excellent fashion. Time and time again, Dr. Young has been commended by the executive director for the different programs that he's established and for the excellent of the serv -- excellence of the services which are being provided.

Studs Terkel Dr. Gray, you've been a resident there a couple years now.

Michael Gray Right.

Studs Terkel What have you noticed?

Michael Gray I think that Ron hits on the highlights when he indicates that Dr. Young and the people who he has surrounded himself with in terms of attending staff have added a different dimension to healthcare delivery and to training of young physicians than can be found in almost any other institution in the country, and I say that because I know that when I came to interview as a medical student for a position at County, the interview took a very different form than it took at most other institutions. At most institutions, the primary concern was just straight academic credentials. Well, that wasn't not a concern here, for sure academic credentials were looked at. But beyond the academics, Dr. Young and the people who were interviewing us, and I have to assume that it was at, you know, at his, you know, direction, were concerned about the question of "Where am I going to practice when I finally get finished with my training? Did I have any idea of what I was going to do in the long run?" And clearly a response that said I'm committed to the kind of patients, to the community which is served by County, that I intend to stay in the inner city, in my case I happen to have an interest in occupational safety and health as well, these things were all taken into consideration in a manner in which they, they were not even discussed at other institutions. And I think that that's that social dimension which looks at medicine not as some scientific impersonal thing but, indeed, as something which is an adjunct to getting involved in every aspect of the patients' lives, is a very different thing than you'll find at other places, and that's one of the things we're struggling to preserve and that we think would be terribly harmed if Dr. Young or if any of the better attendings at our institution are just summarily dismissed without cause and, and so forth.

Studs Terkel Certain kinds of young doctors, men and women, came to this hospital as well as to the jail part, Cermak, who were interested, you know, more than would seem to be the case with the bedroom-type doctor we read about in these novels and AMA-type stuff we hear about. They came because--Dr. King came because of you, didn't he? Lambert King?

Quentin Young Well, this is getting a bit much. I, I, I think No,

Studs Terkel that-- No, I want to ask this because yesterday's column by Mike Royko if you recall, dealt with Lambert King and his difficulties there at the jail.

Quentin Young King is something special, and in a sense I came because of King. He was a, he was a resident there, and one of the things I'm most pleased with is, I was the, the nominee for my post by the residents and interns association, and that's uncommon, but at County there's been a strong tradition of respect for the house staff up until quite recently. And although they enjoy the respect of the attending staff, the administration seems to want to put them in jail. But when I was offered the post by nomination of the resident intern association, I had to, had to stop saying it's a ridiculous idea and look at it. Bert King was an intern then, and he completed his training. Bert King is an M.D., Ph.D., his Ph.D. is the prize-winning work in basic science, he's just, he could go to any university he wants and rise to the top. Instead he, he took the toughest job in the whole complex. He, he asked, and of course I grabbed him to take a shot at the, at the jail, and he became medical director there. He was 31 at the time. I don't know, you met Bert, he's a remarkable guy.

Studs Terkel Well, he was some of those sessions that you'd conducted earlier, I think, even before you were appointed.

Quentin Young Yeah, yeah.

Studs Terkel Director of Medicine. He was there.

Quentin Young Yeah.

Studs Terkel A

Quentin Young Well, Bert has done things that, you know, are impossible to describe in the time we have. Jail medicine is such a curse. There's no doctors. The very nature of the place is repressive, the attitudes of the people who work there when they work there is hostile, the whole prisoner/guard mentality, in an extremely sensitive way that has enjoyed support, I mean solid support from foundations, and very little support from the governing commission which confounds them every, every way they can, as Mike Royko so sardonically demonstrated. Bert has, has, has become a giant in the whole national picture, and while there's a long way to go, it always will be, but for example he's, he's, he's developed some 33 corpsmen who are, are learning special skills. We actually have a health worker out in every tier. Well, that means something if you've ever been out in the tier. You just don't get to line up for sick call once or twice a day, there's somebody to talk to you all the time, and that's made a big difference. He's developed an important psychiatric program which is an enormous problem in a jail situation. And I can say that the health care level at Cermak Hospital, an 80-bed hospital which is backed up by everything we've got at County, has saved the lives of many, many people who had the misfortune of being pent up in a jail.

Studs Terkel Well, in view of the accomplishments that have taken place since you've been there and your colleagues and Lambert King, we'll have to ask you after we take a slight pause, have to ask you, how come you were canned? So we'll come to that, we'll come back to the question of what is a hospital, who should play a role in the hospital, and what is the public's interest in this hospital? And we'll ask this in a moment after we hear from Paul Vodicka and this message. I think I should describe the scene in the studio right now with Dr. Quentin Young, Dr. Ron Shansky and Dr. Mike Gray

Ronald Shansky How about dropping the handle, Studs?

Studs Terkel What's that?

Ronald Shansky How about Quentin?

Studs Terkel All right, Quentin and Ron and, and Mike, and that, that's's--they're on the phones there now, because their beepers, doctors have beepers, and I suppose there are patients and there are needs. And so, as they're talking, and back and forth, they're, they're heading for the phone, to see who needs what and what new emergencies come up. This is part of a, a, a committed doctor's life, all--I guess any doctor's life, isn't it?

Ronald Shansky Absolutely. Absolutely. And the important thing in terms of the patients that we serve is that historically, and it's still true today, there aren't enough doctors to service them and therefore their only resource is a hospital like County Hospital. Particularly nowadays with the cutbacks in Medicaid, there are even patients with green cards are being turned away from the private institutions who are demonstrating their usual disdain in times of economic crunch. And as a result, this particular crisis at County Hospital, which threatens the potential demise of the hospital as a result of the irresponsibility of this particular governing commission and its executive director, jeopardizes the care of hundreds of thousands of poor people who look to County Hospital as their only medical resource.

Quentin Young That, you know, that may sound like a mouthful, "the demise of the hospital," and you know, people may say "He's under the gun" or "They're under the gun"--

Michael Gray Let me, let me try to take

Studs Terkel Mike.

Michael Gray I think that, you know, the question is, are we, are we pushing a panic button when there really is no crisis, and how can this, how can this be? The reality is that if, if Dr. Young is forced to leave the hospital, and as a result of his being forced to leave, many of the attending physicians, the senior physicians, feel insecure because they see that as soon as they make any statement that is in any way critical of the governing commission that boom, they're getting the can, or they're going to get bounced, they find themselves in an untenable situation and indeed, even if for no other reason than protecting the civil liberties of one of their own members, they feel that they must make some statement, that they in fact may resign, that the situation is untenable. If enough of the attending physicians indeed do resign, or feel constrained to speak out in an institution where if one cannot be aggressive it can also often mean the difference between life and death because the, the, the small battles that have to be fought each day for the patients are, are of great significance. In fact, that's really what it's about. But if the climate turns to the point where everyone becomes submissive then, indeed, many of the house officers who came with the purposes we talked about before in mind will in their own turn begin to leave, and the complexion begins to revert to what it was in 1971, where nobody came. People just were not interested because there was no light at the end of the tunnel at all. Working at County is a very difficult job to do for everyone, not just for the physicians, but for most of the paramedical personnel as well. Some of the reasons for it are, are beyond clarity at this point. But be that as it may, people there at all levels are highly committed. If the morale continues to sink, continues to drop, and it becomes more and more and more difficult to work, people will leave, and if they leave, the result will be in fact a slow demise of this institution, which as Ron points out, is the only institution which serves as a guaranteed service, the medically indigent of Cook County. And by the way, the medically indigent is an ever-growing number of people. It's not just the people on welfare, it's those people who are not the beneficiaries of third-party paying insurance who may work every day of their lives but simply do not earn enough to be able to cover the gigantic costs in, in today's society of a medical crisis.

Ronald Shansky Let, let me add that this is not just idle musings of a few people. It is a fact that when the attending staff, a large body attending staff think about the fact and they are thinking about the fact that the reward for outstanding achievement is summary dismissal, they have, and they realize that they have many other options that would be much more pleasant, it is a fact that many, many, many, the majority of attendings in the, in the hospital and the vast majority in the Department of Medicine are seriously beginning to consider their other options. And if the, if Dr. Young's termination is upheld, and if he is not reinstated, it is fair to say that Cook County Hospital as it exists will come to an

Studs Terkel Then we have to ask the obvious question, why? In view of this, and the evidence is overwhelming, not simply you two here as doctors and colleagues of Quent Young, but others, you know, throughout the country, why did Dr. Haughton, under the orders, at the orders of the governing commission, can Quentin Young?

Quentin Young I'll, I'll give you all I know. First of course, he, in a press conference which was well attended, well guarded, we're told, he said he fired me because he has the right to fire me. And maybe that's it. You know, they say those who don't exercise their rights, they become atrophied.

Studs Terkel The right of the first night. This is the right of the 255th night. [laughing] That was, we had Marge Figaro not too long ago.

Quentin Young All right, if we can draw you back into the discussion, the point is--

Studs Terkel Divine right, too. You hear the phrase "divine right of kings."

Quentin Young The association. In any event, that's the reason given. I, I find it an insufficient reason for a bunch of reasons. First of all, I want to stay on my job. Second of all, I know it's illegal. Third of all, I think it's a coverup. There is some evidence why I was fired. During the terrible days that came upon us during the intern house staff negotiations and the governing commission and the attending staff, not Quentin Young and not three or four outspoken people, the entire medical staff, on six different occasions, behind the scenes, nothing in the press, petitioned the governing commission in the many encounters we have with them or their representatives, to put some some, some people on that negotiating team that know, that know how to deal with the house officers and end what we saw was a, a ridiculous charade of oppressiveness, denigration. We saw it every day. Just put some people on and we can resolve these things promptly. That started, Studs, six months ago, repeated over and over again. When finally the strike came, many of us felt it was an unnecessary strike, a provoked strike. And there is such a thing, a provoked strike. But why provoke a strike? I hear you say. Well, there -- a lot of reasons. My pet theory is that the governing commission, which is a tough governing commission, wanted to bust these smart young doctors and make a reputation nationally. You can read everything they did in that light and it comes out right. You don't know, because they don't say. Well, they weren't--they didn't bust them. It takes a lot, lot more than, believe me, a assembly line guy to go off the job when things get bad, for a doctor to go off. He is torn by a hell of a lot of contradictions, and it's to the credit of the house staff when they went out, they guaranteed service for everybody who was in the house at the time. They created special teams to take care of emergencies, all this I afraid got lost in the press. They were working, if you please, but they were not going to man the admitting areas, the clinics, that was their view. You know, just to clear up something about the strike. I, I think by and large the attending staff was not in support of the tactic of a strike. Indeed, some of the conservative elements really felt the strike was bad, wrong. But all of us felt that this was unnecessary strike, that it was provoked, and we all felt that the pro -- the demands that were mentioned earlier and patient care areas were eminently worthy, and did need to be given attention. But what we felt most of all is that this provocation was going to cost us dear. In money that strike must have cost two million dollars in just lost revenues. In, in human hurt, in disintegration of staff morale, immeasurable. So we called it to the attention of the governing commission, and they refused. They stonewalled. They said, "No, you can't be on that." The reason given, and this, I think, gotta rank with Marie Antoinette "let them eat cake," the reason why they wouldn't accept our offer of putting one to four of our ranks on that negotiating team when we made a pledge of enormous size. We said, "We'll wrap it up quickly with no fiscal imprudence and no jeopardy of managerial perogatives," the things they were worried about. That's a big offer. It's obviously a no-lose offer. If we're proven wrong, then the attending staff would have to either subside or come out against the house staff. "No, no, no." And the reason given was, "To add you to that negotiating team would embarrass our negotiating team." On one side is health care for hundreds of thousands of people, on the other is embarrassment for three highly paid industrial negotiators, and that was their scale of values. Well, of course we got on finally as you know, the strike was into the sixteenth day, the staff, which is a very docile staff, doctors just don't, you know, get active, said this is it, you know. They saw not the light at the end of the tunnel, the, the disintegration at the end of the tunnel. We had a meeting, a showdown meeting with the governing commission. By this time as a staff we had become so frustrated, so wrathful, that we had gone to the only recourse, the only accountability sector there is. And let me explain that. This governing commission did not, despite their feelings about it, come from heaven as a gift of God. They were chosen by five selectors. These selectors--

Studs Terkel The select, five selectors. And who choose the select?

Quentin Young Right. The selectors come from three constituencies. The governor chooses one through the Department of Public Health Director. I'm sorry, two. Two come from the governor's designation. Two are chosen by the County Board President, Dunne, and the, the fifth one, that's five, the fifth one is chosen by the Council of Academic Medical Deans. There are seven med schools in town, they meet as a council, the deans doing--who's ever the current chairman for a year serves as the fifth selector. Now, selectors have two powers, only one of which they, they've used really: the power to select. In other words, when term's up, they either reappoint or they, or they find somebody else, somebody resigns, what have you. They fill the places. There's another wonderful provision in the law called "removal of commissioners," and I must say I like that. A very, very gifted legislator put that in, and Studs, it's so

Studs Terkel Very gifted indeed.

Quentin Young I, I've committed it to memory because I think this is our only hope. It says if it appears, appears, to any selector, there are five, any one of them, not two, three, or five, to any selector that a commissioner shall be disqualified, well, that means he doesn't live in the county or something like that, or are guilty of misconduct or malfeasance in office, or unable to serve or unwilling to serve, the selectors shall inform the commissioner of the fact, and the commissioner shall reply in writing showing cause why he should not be removed. That's pretty good. I like presumption of innocence, but when you've got people like this who don't have to account anybody, I think they should show cause, and then the next short paragraph says, "A hearing shall be held, and if the facts are sustained by at least three of these five selectors, the post shall be vacated and a new person chosen for the expired term." Now that's pretty legalistic, but that's the name of the game. So

Studs Terkel So these members of the governing commission need not be summarily dismissed as you were.

Quentin Young No indeed, they get a hearing.

Studs Terkel So they get a hearing.

Quentin Young Oh, indeed they do, and I hope they

Studs Terkel Let's get that straight

Studs Terkel Yeah we want

Studs Terkel They're entitled to a hearing, right?

Quentin Young They're entitled and I, I for one would fight for their right for that hearing. Well, we're hoping the selectors, who now have in their hands, or more accurately in a day will have in their hands a rather large, well-documented series of allegations about the conduct of, of those commissioners, and I, I'm not going to touch on them because we want those selectors to look at it without prejudice, but they're, they're heavy, and they, they document the, the mismanagement, the irresponsibility, not just during this period of course, but over the years. Now, what I'm saying, Studs, is that the staff put that on the table, and then the selectors suddenly changed I'm sure--excuse me, the commissioners suddenly changed their tune. We had this meeting where we said, "You know, you've got to, you've got to put some of us on, this strike will wreck us." They, the first question from the chair was, "Have you, have the, has the medical staff requested the removal of the commission through the selection committee?" Turns out we could answer that question "No," because at that point all we had voted was to, was to share our information with the selector, since then we voted to remove them. But what I'm saying is that that was what was on their mind. For once, after six years, they were going to be held to public scrutiny and after, and immediately they gave our demands, "Yes, you can get on that committee. Yes, your complaints about jamming the hospital with patients with a phony 'business as usual' policy which was really jeopardizing lives." We had, my, Ron'll tell you, four attending physicians seeing 175 patients whom they'd never seen before in one day's clinic. It was mad, and they gave in on everything. And guess what happened? These four doctors went on that committee in two tough sessions, and they were tough. Nobody was, was, there was no set-up. In two tough negotiating sessions, that strike ended. Now, horror of horrors, the governing commission, as is usual in such situations, signed a no-reprisal clause, an amnesty clause for all the actions, that's just standard practice. And in addition, the executive director pledged to have his attorneys go to court the next day when Judge O'Brien was going to make his judgement on their violation, alleged violation of his order, and plead for clemency. They went into court and their lawyers didn't say a word. Quite the contrary, they prosecuted as hard as they could. The judge only had the record before him, and when he came to his sentence, he socked them with a 10,000 dollar fine and put seven of them in jail for ten days.

Studs Terkel So that's why, Mike Gray, you spent, because of what appears to be a vindictive attitude, he spent 10 days. Did you

Michael Gray Yeah, I think that, there is more than--yes, I spent 10 days. I was released on Saturday at nine-thirty. But there was a vindictive attitude that went even beyond that. The governing commission, in spite of a desire on the part of the judge spoken to us as we were being sentenced that while we were there we should work in the hospital of the jail and we should provide our services, which virtually all of us were willing to do, many of us having worked at that hospital for a period of time before as part of our normal duties. In spite of the desires of the judge, the governing commission saw fit to, to block even that effort. Once we were in jail, they sent out a memo that said we're not employees, which was contrary to the contract, etc., but these are all side issues. I think that the, the primary question--

Studs Terkel They didn't want you to work while you were in jail,

Michael Gray They refused to let us work, that's right. Right. They said that if we worked, they would not cover us with malpractice insurance, and this was a direct contradiction to the contract. Be that as it may, your original question was, "Why are they canning Quentin?" I think that it has to be looked at in the context of, of, you know, the larger social picture and the usual kinds of responses when a, when a, you know, when a governing entity is socked with some criticism. There's always invoked, it seems it's a habit, it's a time-honored habit of our, of our political representatives to invoke a conspiracy theory, that there's some kind of outside agitation going on and so on and so forth. And we saw this happen. First it was, some national physicians' conspiracy headed up by the physicians' National House Staff Association, who while they did send us copies of contracts and, and we did have a history of other institutions before us, they never had any direct involvement with us. Then when that didn't pan out, it was Quentin Young. And indeed, during our contempt hearing, a question was raised by the counsel for the commission to one of our witnesses, "Is it not true that Dr. Young has been working for the house staff for the last five and a half months, for the house staff association?" Patently absurd. Dr. Young has his own responsibilities, the house staff had its own concerns, in essence what they were saying is, never could they look at the objective conditions of the hospital, which had given rise to 15 pages of very specific detailed concerns and grievances on the part of the house staff. That was not within the purview of the governing commission or their representatives. They had to find somebody to scapegoat. They could never assume the responsibility themselves, and I think that's the name of the game, and that is where the problem is, and this is why it is so critical at this time for the public interest to be defended by holding the governing commission accountable, and the selectors indeed are the people who have the power to do that. And, and obviously, we feel that the selectors at least should hold a hearing as to whether or not there is cause for questioning the tenure of these governing commissioners.

Ronald Shansky I'd like to go a little further than that. I think the hearing, obviously, is critical from my perception of what the charges and gross irresponsibility of this governing commission and in terms of their abrogation of their responsibilities, both legal and moral to the community at large, to providing this absolutely crucial service to the community, it's absolutely essential as far as I'm concerned that the selection committee take the responsibility of saving the hospital by getting rid of this governing commission. Each and every commission member must be removed. The commission must be reinvigorated with new people who are committed to saving the institution and to not cutting back services, but increasing and, and, and doing everything they can to promote services for this sector of society, which is being of course most hard, harshly hit by the economic crisis

Studs Terkel in And there's an undercurrent to this, and that's the danger that Quent has offered, as well as Mike Gray and, and Ron Shansky, and that is that if this keeps up, if Quent's firing is sustained and nothing is done, other doctors won't come or leave the place, and eventually the hospital itself might go. What would happen to the scores of thousands of--

Quentin Young I think

Ronald Shansky What's at stake is, is really care for the poor people of this county. And unless something happens with, in terms of action and accountability of this commission and hearings, et cetera, and Dr. Young's reinstatement, what you're gonna see is that ultimately it won't be so much that the commissioners are hurt, because they've proven time and time again that they really don't care. What's gonna happen is the poor people of this co -- of this county which number in the hundreds of thousands and are increasing every day as a result of layoffs and cutbacks in industries around the county, the poor people and the working poor of this county are going to suffer greatly.

Quentin Young Yeah. That, I think you're getting close to at least one of my theories on why I was fired. Not obviously, it's not susceptible to proof, you just have to look at the facts. There's been a, a long-time reigning theory at County about dephasing the institution, and it comes under the cover of a acceptable public health practice of having outreaches. This is a huge county, and of course it's a, it's a, it's not sound to have only one institution. We need many outreaches in the, in the areas where our people come from, and as you know, they come all the way from the far West side, the far South side, and now many parts of the North. This town, this county, needs good satellite clinics and indeed some what we call 'secondary-level hospitals' in the further reaches of the community. But, under the guise of sound public health planning and decentralization, we get the governing commission giving us the first half of the equation, cutting back County, and of course they've been doing that every single time. After the nurses' strike which they provoked, they, they, they fired 1000 people. After this strike, there's been a number of layoffs and a lot more in the offing. So, my perception is that they are, this is part of a plan to bring this down past the viability point, because there are certain critical masses in a hospital of this kind that are necessary to achieve certain levels of training and teaching. I'd like to say, you know, you've heard repeatedly, "Remove the governing commission, et cetera, et cetera." There, there's's another, I think, very important reason to look at that group. One is, that who's--not who by name, but what kind of people are on the governing commission? We've had labor trouble of enormous magnitude. You know, that's what it's all been about in recent weeks. There's not a single trade unionist, you know, there's not even a working person who belongs to a union to the best of my knowledge, certainly no trade unionist. There--we County now we're seeing 10 to 15 percent Latino, and one of the important demands of the house staff was to deal with the terrible problem of, of language difference, where people come in and we, we unfortunately feel we can document neglect, not out of any malice, but out of poor communication. At least five cases of, of newly delivered mothers who wanted to nurse were inadvertently given suppressive hormones so they couldn't nurse, because it was misunderstood. Another interesting figure which our chief of surgery is very concerned about, appendicitis is a serious disease, but if it's caught early and operated, everything comes out fine. If it's neglected, as you know, it can be fatal. We had in a relatively brief period of time 16 cases of perforated appendices that occurred after the patient had come in earlier for something. And nine of these 16 were with Spanish-surnamed people. And, you know, it's not a scientific experiment, but with only 10 percent of the population that we see being and from that group to have well over 50 percent have that terrible complication, you have to figure that somebody wasn't communicating well, and one could go on and on. Part I'm getting at is that these, the people who sit on that board are not those people. There's not a single person, nor has there ever been a single person on that board who, if he or she got sick tonight, or somebody in his family got sick tonight, they'd come to County. And that makes a difference. I'm saying I don't believe they care.

Ronald Shansky I think it -- people ask what can they do at this point, and, and the answer is that they can do at least a few things. First of all, they can contact the governor, Governor Walker, or the President of the County Board, Commissioner, Commissioner Dunne, who are people who are responsible for selecting two of the select -- each for two of the selectors. In addition, they can contact members of that selection committee, and the members of that selection committee are Carol Johnston, Mr. Sengstacke, who is the publisher of The Chicago Daily Defender--

Studs Terkel John Sengstacke, and I think Ed--William--Bill Berry was just appointed, wasn't he?

Ronald Shansky Mr., Mr. Bill Berry and of course Dr.

Studs Terkel Edwin C. Berry, Dr. Fishbein, and there's one more member.

Ronald Shansky Morris Fishbein and Dean Hejna, H-E-J-N-A, Dean at Rush-Presbyterian St.

Studs Terkel Well are they going to meet, is this select committee going to meet, isn't this

Quentin Young Well, yeah, they were supposed to meet, Studs, this Thursday. That's tomorrow, isn't it? And because we were going to have our, our, our allegations and, you know, so much depended on that, and that meeting was canceled, and we're worried about procrastination, and this is one case is, "Justice delayed is justice denied." I'm pleading for a hearing. I think a lot of people are pleading for that selection committee to get on with hearings, and we get concerned when people who have power which is delegated proceed to avoid their responsibilities and in that process rend the very institution, the very work force.

Studs Terkel Perhaps we should point out before the hour is over, I want to ask each of you a question very quickly. First, there's this meeting tonight, this gathering tonight at--

Quentin Young I hope you'll come, Studs.

Studs Terkel I shall. At Karl Meyer Hall, that's at County, 7-2-0 South Wolcott, and that's at seven-thirty tonight.

Quentin Young Right.

Studs Terkel And this whole matter will be discussed, and it's open to the public, is it not, 7-2-0 South Wolcott, it's in the Cook County area, Karl Meyer Hall.

Quentin Young That's the house

Studs Terkel Seven-thirty tonight. And now, one last go, quickly, we have about a minute or so. Why--each of you three are very excellent doctors, I know. I know, excellent. Why are you guys, why are you guys going to all this trouble? Why couldn't you just go to a suburb somewhere with your good life, you have Wednesdays off, go golfing, go yachting, and have a pretty good, you know, suburban clientele, do very well, indeed, and make six figures a year. Why, Mike?

Michael Gray Well, I, it's a difficult question to answer, Studs, in the sense that there is a lot of thinking that goes into this kind of thing, but very simply, I guess I feel a commitment to serve those communities from which I myself came. And I think that it's important to recognize that the society has invested more than, you know, 20 to 30 thousand dollars a year in my education as I got up in my medical training, that there are vast sectors of the society which are not reaping the benefits of what should be the best medical care system in the world, and certainly is seeing us pour thousands and thousands of man hours and, and millions in terms of money. I, I, I am a little bit at a loss, I don't know. I just--

Ronald Shansky Studs, I mean, simply, I think as far as I'm concerned, I think most of the people at County feel the same way. This is where we're most needed. Sure, you can go to a lot of other places, but we know that other people are going there. There's no question about that. The people that are served, the vast numbers of people that are served by this institution have no recourse. And if they don't have a viable institution and committed physicians and nurses and employees at an institution like this, they're out of luck. The ballgame is over for them. They're going to die at home.

Studs Terkel Now, Quent, I know that Saturdays you meet, I know some of the patients that they're on the South side, the one day you meet patients you have and know the schedule you have now. I know very well that you could easily be, oh, Grosse Pointe or wherever, or, or Lake Forest or Winnetka, anywhere you want to be, or any of the suburbs, or Scarsdale, and you could have it easy, why, what's the matter with you?

Quentin Young My problem is much simpler than my young colleagues', I get violent headaches every time I think of that life. No, the facts are that, that I really enjoy what I'm doing. I guess I'd be inaccurate if I said it wasn't very hard, and at moments like this, at least, very frustrating and very occasionally discouraging. But the opportunity to do so much at at a place like County is irresistible and I'm sorry that for the moment at least that that opportunity is being compromised. I hope it isn't destroyed, not for me of course, but for the hundreds of doctors that are training in that wonderful milieu. I think it's in danger. I hope your listeners look at it that way. I hope that they will do everything they can to help us.

Studs Terkel So this roundtable with Dr. Quentin Young, Dr. Mike Gray and Dr. Ron Shansky. And I may, I should point out for those who may have tuned late, I did invite Dr. James Haughton, executive director of the hospital, but unavailable. And so this is our program, this is two, the second of two programs dealing with Cook County. Remind the audience of this gathering tonight. Those interested. Everybody welcome at seven-thirty at Karl Meyer Hall of Cook County Hospital complex there, 720 South Wolcott, and thank you very much. And these men are doctors! After we hear from Paul Vodicka and our sponsors, Paul can perhaps tell me who my guest is tomorrow.