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tv   Key Capitol Hill Hearings  CSPAN  November 30, 2013 6:00am-8:01am EST

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the counsel of the americas and the america society. t a pleasure to have the opportunity to review this book today, and to talk a little bit about the latino immigrant experience in the united states. our guest is ray suarez, who has written a really terrific book entitled "latino americans: the 500-year legacy that shaped a nation." it's a companion to the ground breaking pbs series on latino americans. in barely 250 pages, ray takes the reader through the broad sweep of latino history in the united states. even before there was a united states. from the spanish explorers to the modern day. it's a majestic effort, in my view. seeking to discover and highlight the history and future of the latino experience in the united states, and to put in context in order to build a broader appreciation for lot teen experience. it helps us understand, frankly,
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some of the issues that have become so important to washington politics today. as all the you know, the america society and the coinlt of the americas are generally known for our work in the western hemisphere, including latin america, and canada. the immigrant experience is something that each of our nations have in common. we are a hemisphere of immigrants. for over five years, our immigration and integration initiative have sought to advance dialogue around the economic contribution of immigrants and latino to the united states. we believe that greater integration and appreciation for the socioeconomic contribution of the migrant community will support national leaders in -- as they pursue a sound policy framework within which we believe comprehensive immigration reform must play an important role that encourages the full participation of the immigrant community within the u.s. economy as a critical pillar of economic development, growth, and community strength.
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and that's precisely why the book is so timely. it must be said that the latino experience in the united states hasn't been all perfect understood. and the integration process is not always perfectly smooth. ray gives us the story. that's what makes it so powerful. it's a story of resilience, sacrifice, and ultimately success. it's a story of america. and there is perhaps no better person than ray to wrinl it. you will know him for the national correspondent for "newshour" and npr "talk of the nation." and the interviewer tbeeched on the mesh -- americas last may he interviewed anthony kennedy in one of the most thought-provoking rule of law issue in the hemisphere i have ever heard. i have to say that my assignment
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today as the interviewer of an interviewer -- [laughter] is a little bit like going one on one with michael jordan. i'm looking forward to the experience. he's a prolific author. -- he's received numerous awards for his groundbreaking awards in journalism. you have his expanded biography, if you care to look tat. ladies and gentlemen, would you please join me in welcoming ray suarez. [applause] i want to get to the story you told, ray, on the latino experience in the united states. as i join you here before we do. i want to explore a little bit of your motivation for writing the book. what was it that attracted you to the story. what if you hope achieve? >> when pbs decides it was going to start raising the considerable millions of dollars that it would take to put a project like this on the air, i
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should tell you a little bit about what is going on in modern television. you don't just do a documentary anymore. these days when you go to the big philanthropic organizations in the arts and humanities -- in the social sciences, they want to know what your ancillaries are. so you can't just make a tv show, there's also a school curriculum. there's also a dvd. there's also an online presence. there's an interactive portion of the whole project where people who read the book or watch the tv series upload their own stories of their american journey online and interact with other people. the big givers want to know about engagement. so from the very beginning there was always going to be a book, and the producer of the series approached me to tell me the
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series was coming. i said, great. when can i start working on the narration? and he said, no, no, no. i don't want you to do the tv show. i want do you write the book. [laughter] and i said, all right, well, that's fine. just at the same moment i was shopping around proposal with new york publishers for a new book and meeting with some mixed interest. so here it was a book in my lap. it was time to get going. it was perfect. the topic was right on time. and also, the discipline was good because unlike a book where you decide what is in it or not in it from beginning to end, i had to work with the producers of the television series all along the way. i was watching what they were doing, they were watching what i was doing. some much my chapters changed the way they saw their episodes, and their episodes shaped my chap -- chapters in return.
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we had to mirror each other to a degree. right at the outset i said to the producer, so can i just go away and write a book about the latino experience in the united states? and he said, no, actually it has to kind of go with the tv show. [laughter] and so, benjamin did a lovely job are in rave -- arenarrating the tv series. i did a couple of promotional appearances around the country with benjamin and watched as we ended m perhaps. as people rushed the stage. they took his picture. [laughter] i actually -- actually a little hard to do with camera phones. they were able to narrow it to the point where they just got the very handsome and talented benjamin. he generously said why continue you -- put ray in the picture too? it cuts you down to size in washington a city where tv journalists think they can act like movie stars to be with the
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real movie stars is a imriewfl and humbling experience. [laughter] >> did you find the story in any particular way to be personal? , i mean, did you take it as an academic exercise? did you take it as an exercise, as you mentioned, in term of working, obviously, with the television series and that side? did you put a little bit of yourself in to it. explain how it worked. obviously i would have written it a different way based on my background, et. cetera. >> that's a great question, obviously, i'm implicated in the story. my reason my family is here because we are implicated in the story. as a reporter and as a writer, i had to think, all right, well, do i put that in the book? it's not in the tv series. do i make personal notes along the way about what i remember about specific era or tell my own stories in covering, for instance, the immigration reform and control act of 1986?
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i decided to keep an arms length distance. to not drop out of the voice that i was using to tell the story and get personal very often. one time i broke character was to note that when i was a kid there were only two latinos on television of any note. one was dezi and bob. the little friends with the crazy spanish accent. and use that as a moment to note how much things had changed in the fifty years since i was a kid. since now it's a little better. you can see people like me on the air. i don't have to wear a some -- some -- sombrero. there were times where i was temped to break character.
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i thought maybe i should tell people how i thought about it and decided not to. >> as an author that would have been a i dynamic tension to figure it out. i think you did it remarkably well. i think it was a passionate book, but clearly done from the perspective just as you say as somebody a little bit dissipation nate and distanced so you can tell the broider sweep. i want to get to the broader sweep and the actual book. you know, you're telling 500 years of history and projecting a little bit to the future. that's a long time period to cover in 250 page exps you give us some of the highlights? you know, in term of the overall sweep of history, what are some of the things you think define the latino experience in the united states? even smaller issues that might have a broader residence? >> from the very beginning, in working with the producers of the documentary, we sort of
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gamed out how we were going use individual stories to be stand in for era in history. so we would explain what was going on in the wider story by using one person's experience. you couldn't tell a highly in-depth academic history. you have to write a shelf full of books not a modest 250-page volume or indeed, six hours of television. you couldn't do it. we looked for stories that helped explain a wider truth about what was happening to millions of people at once. so -- who came to california as a foundling in the early areas from mexico city. she was put on a ship. brought up the coast, was brought to the missions as a
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young child. talked to -- taught herself to sew and read. and gained the trust and made her a manager of mission holdings. eventually when the missions were secularized, and seized from the church and given to others after mexican independence. she became the largest woman landowner in northern mexico. quite an outstanding thing to happen in mid 19th century mexico. yet she lost it all when the united states came after the mexican war. so both her rise, her existence. her life coming from an or fan inch in mexico city to the rough raw frontier was to northern
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mexico. to end up 80 years later sitting and telling her story to an american historian who was chronicling the story with the assumption that these people would disappear. that the mexico cultural deposit in that part of the world would be overwhelmed by the yankee arrival. and you needed to take this story down so that we would use it to remember that once upon a time there were mexicans here. it showed a misconception on the part of the english-speaking new kids coming west. it showed a misconception about how people interact with the land of their living on and how they remain in place. it was also a great story. it served all the masters. the story of who lead spanish-speaking regimen
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fighting for texas independence against the government of mexico. who ends up in exile in mexico. a country he took up arms to fight against. we felt that was an important story. it showed that constant due alty and the constant challenge which people do you belong to? which country do you belong to? are you really here and stale part of there? once again, thank god, writes a passionate, fascinating memoir at the end of his long life to discuss how he felt he had been used and -- betrayed by both the americans and the mexican government of the time. it made his story easier to write. we knew from the historical record. but his hem moisture, which -- memoir which is a fascinating time to the history of both countries. inspect 20th century, stories
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like that of who goes to the supreme court of the united states to establish in law the ability of puerto rican to move to the american mainland as people coming from another part of the united states instead of as immigrants. her fiancè is living legally in new york city. in the first years after the spanish-american war. is comes to new york harris harbor. two people come on the deck. the customs inspector of new york harbor and the inspection inspect per. he tells the woman from san juan she has to go ellis island. she said i don't have to go to ellis island. i'm from puerto rico. you took this place from spain in war. how can i be an immigrant? even after the case becomes
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legally moot because she marries her fiancè and becomes legally resident in the united states, because she has a head of steam over the issue she fights it to the supreme court, wins, and establishes the right of puerto ricans to look at the united states as the wider country instead of being trapped in this legal nether word -- world of 3500 square miles floating in the caribbean. great stories that help explain why you're here. we're here, and how the history of the hemisphere is intertwined from jump street. if you read the writings and speeches of san marcin, they talk about jefferson and washington. they were on fire for the american revolution just as they were on fire from the french revolution. when you read marcin, he talks
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about the united states as the republic of freedom and until he spends 11 years in exile and gets to see both the down sides and the upsides of life in the united states, he's a fascinating chronicler of late 19th century american life seen from outside. so it was a great privilege to be able to bring these stories who readers who may think they know a lot about this. before they sit down and as i said in the introduction, i haven't done my job if at least once a chapter you're saying i didn't know that. >> i think you did the job well. i consider myself one of these people that at least aware of these issues, and by definition -- >> well, -- [laughter] presumably but it was a constant learning. when i thought was successful. another success of the book was
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clearly you talked about the positioning latino history as american history or u.s. history. which, i think, is absolutely true. and i think do you an effective job doing it. let me ask a question that follows from that, then, and it's not necessarily an easy question. but, you know, you point clearly in the book to periods of time when latinos have not been accepted. there has been discrimination and difficulty. i guess the question i ask is, you know, why has it been some cases so difficult for the latino community? i recognize the latino community is not a uniform community and you clearly discuss that in the book as well. there are different heritages, different history, different country of origin, et. cetera. help us understand a little bit the experience has been as difficult as it has been considering that, you know, again, if you point out the spanish con keys doors were in the united states before the english.
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and not to say there's not a melting pot aspect, it. it seems to be a disconnect there. >> well, terrorist two pillars to the answer. one is the real world of power and wealth and the ability to project power and win the long game, which the anglo americans clearly did in this part of the continent. the other part is what goes on in your head. the idea that some people are naturally fit, naturally prepared by nature to rule. which was living inside the heads of the people who stormed west and basically won the argument. i begin the book by remienlding the reader -- reminding the reader that the story starts with contending empires, and, you know, the english clinging to a bunch of coastal colonies facing the
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eastern sea board. the french empire -- if you look at the map of the french empire in the 18th century in north america. it's really stunning that it takes in. and spain, of course, and how all three big empires had their elbows out and were bumping shoulders, and vying for dominance in the continent. russia was heading down from alaska. they get as far as northern california, one of the reasons the missions were sent as a networking as far north as they were, there was a fear of -- [laughter] russian expansionism down the west coast of north america. all the empires vying for resource, vying for influence, vying for territory. it ends in this part of the continent. english speaking united states and canada basically winning the
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argument. yet, that doesn't mean you totally erase or efface everything that happened before. so we end up with a kind of funny america where people sit fuming in traffic on the i-5 between san diego and los angeles complaining that people don't speak english. we have fight ourselves the status of spanish in florida where spanish was spoken for a century before anybody spoke english. they treat it like it's a new thing that people want to speak spanish in florida without thinking too deeply where the word "florida" comes from. there's a symbolic and cultural and sort of attic full of archetype we carry around in our
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head. there's the rough and tumble word of trade and ports and rivers and money and resources and both of those worlds are part of shaping what happened after he was wandering and and what become new mexico and arizona and west texas. not sure where he was. so it's tough to come prez it at -- compress it all. sometimes i i felt doing a quick recap to tell you. in other words to understand it you have to remember the thing i haven't told you yet. it was challenging sometimes. >> one of the areas that you point to in term of clear successes where the latino population has clearly broken through, and then you mentioned dezi are nez and some of the cultural -- we've seen it grow over the
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years. one aspect it's on my mind because the baseball playoff. one aspect you don't touch on in the book is the whole sports contribution. actually there was a fascinating documentary on pbs sometime ago called the "republic of baseball." which referred to the dmin con contribution to baseball and the san francisco giants. it's fascinating stuff. you can project that. some of the heroes in playoffs this week. why did you choose to focus on what you did and maybe not go deeply to the athletic experience? >> i'm glad you asked me that. [laughter] i'm a huge sports fan. and i love particularly love baseball. i felt that that part of latino life in america had been adequately covered and is adequately covered in 100 other places. if i have a finite space to tell
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the story, i thought better use that time telling you things you don't know instead of retelling things you already know. my editor came to me after the complete man script was in, and he said, you know, i think you really do have to say something about all of this. [laughter] and so i wrote a couple of pages about baseball, but being a pain in the neck, again, didn't concentrate very heavily on beltran, even though i love them. but more on how baseball was exported from the united states to latin america, and then how it that echo came back to shape the game in the late 20th century. >> in fact growing up as i did in chicago, someful my first introduction to the hispanic folks with the hispanic background were chicago cubs.
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white sox players. and, you know, but you see them as the part of the american past time. it's really interesting how that works. and thank you for that discussion and explanation. we're going do go to those in the audience who may have questions or thoughts. before we do, one other question i want to, i mean, you're an expert on the issues. surely you learned perhaps some things too. you didn't know. i like to ask what was the most surprising thing. in all of your research, writing, and the things you put in the book or maybe some of the things that were on the cutting room floor. chaffs the most surprising thing you found you didn't know. you said, first of all, i didn't know that. second of all, it's an important thing. >> i knew a little about the rise of the mexican -- basically. latino civil rights movement after the second world war. like the blacks civil rights movement was very much rooted in
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the experience of g.i. in world war ii who went to go free asia and europe from murderous, fascist countriesble to come back to the united and find after accomplishing this great task, they were treated as other than fully enabled first class citizens by their own nation. and the story of hector garcia, mexican born, comes like tens of thousands of other family to the mexican revolution. settles in south texas. despite all the impediment in his past, becomes an m. d. before the beginning of the second world war. has to convince his superiors, who don't believe him, that he actually is a medical doctor.
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imagine. he has to bring his diploma and show them his physical diploma and the picture of his graduating class of residents from creighton university in nebraska. because they can't believe that a mexican is a drp. they take him out of the infantry and put him in the medical corp. and fights his way across europe as a decorated veteran and comes back and finds that less educate g.i. the people he grew up in border towns in south texas, can't use their g.i. benefits are prevented on purpose, by the poll tax from voting. i think americans, and rightly so, think of the broad term the civil rights movement. as a black american thing. and as a black american experience. but across the southwest, segregated housing, segregated schooling, incum beanses put on
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the right to vote. out barring the right to vote. the use of drawing 77 district line to make it impossible for mexicos who are were often the majority in the towns which they were living to sit on the county count. to sit on the school board, to sit on the town board. all of those things finally made hector garcia say, spawn the american g.i. forum which becomes a spearhead for court case and activism across the southwest which changes that for mexican-americans. but also in a way that, i think, is touching and a little sad. the g.i. forum also gets mixed up in the politics of the day over immigration. and becomes a very unpredictable player. not a friend of the exploited american agricultural worker
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being brought across the border. the g.i. forum puts out a publicly indication called "what price -- where correspondents from the forum head out to the field and chronicle the life experience there not create sympathy or empathy for the most downtrodden people in america who get the lettuce to your table. get the strawberries to your table, if you create an impression that these people are a danger to the united states and should probably be removed. so you this life trajectory of hector garcia from a refugee from the mexican revolution, to reaching the pinnacles of success in mid century america. a friend of senators, a friend, eventually of president lyndon johnson. but similarly cesar chavez during his career.
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not all that sure that bringing mexican workers up from mexico to work in american industries is a great thing. it's a complex and fascinating story. and one i knew only the vague outline of before i went work on the book. [inaudible] >> let's go those in the audience who may have questions. we have some circulating microphone to the extent people are interested in following up with the specific thoughts or questions. if you can identify yourself by name and organization, if you're representing an organization, that would be fine too. please. >> good morning. jane terri from organization of american state. i have a question about foreign policy and about the future. we talked about in our community the human bridge between united states and the rest of the region and how it can express itself in modern diplomacy.
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i know you're a specialist not only in this but foreign policy. i wanted to hear your thoughts on that. >> if you look at the broad arc of american history, every group that has come here has, first, had to find its feet, then has something to say about what is going on back home. earlier in our history, a germans were active in german affairs in the late 19th century. keeping their links to their homeland alive through language societies and the movement and ore things in american cities. italians, after the first world war, when they finally start to find their footing in america. have organizations that speak to the united states government about what is going on back home.
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both pro and antimussolini. a strong strain of hard left activism, antifash schism in american cities. and also a group strong group of americans who believe that italy is finally on the right track after the rise much mussolini. similarly in the cold war period, captive nations week wasn't some odd holiday on the calendar. but in places like cleveland and pittsburgh and chicago was a day where the console from country under the domination of the soviet block held demonstrations and marches begins denouncing the continued domination of lithuania, poland, and so on. so i take the view that once the bread and butter issues are more adequately taken care of,
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latinos will be more steadily log attitudely and predictably heard on the issue. even if you look at the congressional hispanic caucus even over the history since the '60s ed doesn't found it with herman and others in order to have a voice in the united states foreign policy toward mexico, he wants to improve the lives of his constituents in east l.a. and herman of his constituents in spanish harlem in the south bronx. so we're on on that verge. i mean, certainly the post revolution, cuban-american members from south florida have never been shy about having their say about affairs back home. i think you're going more
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reliably see hispanic-elected officials be heard on issues outside bread and butter issues, which is still pressing in a world of sub standard schools and segregated housing and lower family incomes and so on. you are still going to hear them, first and foremost, on bread and butter issues. they're also like the germans, like the italians, like the polls other eras be heard more on issues. i think you're seeing that, certainly, among civic organizations who have an interest in what is happening in central america. who have spoken out on planned colombia and everything involved there. free trade with peru. i think you're starting to see a more confident voice from people of influence and also from elected officials. but no, it's not there the way it's been with other communities in our history, and certainly among american jewelry and their
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voice and their influence in the united states relationship with israel. >> [inaudible conversations] and also former -- chicago where i had the pleasure of meeting you in many occasions. my question is i haven't read the book yet. [inaudible] is becoming uprising and important and actually it will have a social political type of function and very different. do you see can that the middle class is an actor of political change? >> i i only touch on it lightly
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in chapter six. because the am bit of the book, the interest of the book, is most squarely on latinos in the united states who are disproportionately still working class and poor. when their demographic profile more closely resembles that of americans at large, i think the middle class will even more commit to its own, sure. it's happening now. it's happening already. and in the rest of the hemisphere, it's a big deal. but since i write so little about what is going on in other countries. it's a great -- it's a topic for my next book, actually. it's a great book for something else to write about. [laughter] it's not yet a big part of the inquiry that goes to the book. a great question. >>let go to the back. >> john feelly from the state
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department. ray, causes -- congratulations on the book and the documentary. my book that is to do with the prejudices. the arc type we have floating around. in one of the documentary bit you covered and got old footage from the english-only florida movement and the irony is pretty rich about where the people were saying why don't they speak the language of this country kind of thing nap said, that persists. and as primarily mexicans but all latino-americans have moved across the country we see in district by district in places like north carolina and washington state. places you don't tradition nayly consider latino or hispanic communitieses. you see hispanics bumping up against anglos. and one of the persistent, i think lessening criticism is, they're different than our german, greek, irish grandparents. because they don't assimilate.
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they don't learn the language. we know statistically it's not accurate. but perception is still out there. with that -- >> part of the wonderful golden sepia tone past nap drives me up a wall. i grew up in a neighborhood in brooklyn with kids who had to go with their parents, i mean, i waited in terror as my parents went to open school night to hear what they would to say when they came home. but the kids i was growing up, with a lot of them had to go with their parents to translate. this idea that everybody learns english right off the plane and right off the boat is so nonsensical. once grandma and grandpa conveniently die and no one can hear how they talk anymore, you can have this "fantasy" land where they're quoting hamlet and --
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all of this stuff. and then compare them favorably to today's latinos, who by every single serious study of the topic, are acquiring english at the rate no different from any other immigrant group that has ever come here. and when i hear people tell these stories, i mean, depending on whether it's deliberate to me in a sort of wonderful ellis island, golden life sort of reverie or done in an aggressive way, i call them out on it. because i knew their grandparents and the shopkeepers in my neighborhood who could say little more than number of what i owed them for what i bought for my mother's list on the piece of paper. i knew the nationals from other
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countries who learned english as they could. if they were working long hours as other jobs and came as adults. it was adult for them to acquire english. instead of being em pathetic and saying, yes, your experience resembles ours, because once you went to the garment factory and the steel mill in northern indiana and pennsylvania, once you went to the coal mines. you worked all the time too. just like we do, and your hungary speaking, polish-speaking great grandparents had as much trouble learning english as we co. do. i was touring the "about to be closed" steel mills.
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i happened to walk to the cafeteria. at beginning of the line it was clothe -- it was glossily and weird, but up on the wall was a sign that said in five languages, don't throw out the trays. [laughter] if everybody had learned english as i keep hearing they did. right when they got here. yeah, quoting robert frost but, you know, they wouldn't have had to put up there in five languages "don't throw out the trays." and so i know in the immigrant past people who came as adults and people when had to work long hours had sometimes a spotty command of the language. we used to assume it was part of the immigrant experience. now we want something from people who just got here in some cases nap we never asked from our former selfs.
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it shows you the anxiety. to have a little compassion for the people who are feeling that rising dpred about a country they don't think they recognize. they don't think they understand anymore. we have to remember this is a time of tremendous economic and social anxiety. wages have barely budged at the middle point in 40 years. and so if you're working flat out and you see people around you just getting here and you have the feeling like, this was my birthright, and yet what are these people doing here? also making a golf it in the united, and why don't they learn english? somebody was once yelling at me. i don't use the term lightly. they were yelling at me. why it was an absolute requirement there be a literacy test for voting. i said, you know, i understand
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why you say that. i also think of my grandfather, who came here in 1951 worked like a dog for the remaining 50 years of his life, probably wept to the third grade, if that, and i think he spoke a kind of english. my wife tell me he didn't really speak english. [laughter] and the idea that he would not be able to vote after president mckinley and the cabinet decide they want puerto rico to be part of the united states without asking anybody that live there had. that 100 years later be able to tell my grandfather he can't vote seems problematic to me. if you go throughout in to the world, and united sphriewt building railroads and picking governments and causing the
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downfall of over governments and so on. you ought to expect a little bit of historical and social blowback. it's not a cost three proposition in the modern world. there we are. [inaudible] [laughter] >> thank you for putting it out there. that's better than i could have said. it's a frustration. so the question is given all of that, what do you think the role of social media, internet, and telecommunications is going do for the younger generations as -- of hispanic in the united states whose parents are folks like our grandparent who speak a certain kind of english but consuming in english. is there a market for things like fusion or other web-sort of applications focused on young his pansic as opposed to young americans? >> the political scientist anglo
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has been a political activist. said something interesting is happening. latinos in the united states are being racialized. they're not. they're an ethnic group. they're being racialized by the way america does assimilation, by the way america does race. and so fusion, i mean, after jews couldn't read -- iiyiddish the "daily print" stopped printing in yiddish. after nor wee again couldn't read nor wee -- they stopped printing in nor wee began. fusion which is a joint venture is positioning itself for the world in which the grandparent
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of present day and recent-past immigrants. the grandchildren of those immigrants who will not be spanish-dominant will think of themselves as different than the american main stream and consume media that tells a different story about america than the one the main stream provides. it's an interesting and perhaps subversive idea about cultural assimilation. that you'll still watch "monday night football." you'll watch mtv, you'll also watch fusion because it has -- it presents a slice of north american culture that presumes that you have a slightly different set of interests culturally, socially, politically than that of your other neighbors who are not latinos. we'll see how it goes. the internet --
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the internet and modern communication, i mean, there was no -- for italians in the '20s. so eye italian proficiency is gradually lost over time until hundreds of thousands of people who consider themselves proudly italian today in american metropolitan areas know how to say the words of foods, the name of foods, a few curses, and some ode -- some old sayings in italian. yet no one say, hey, you're not italian. because you don't speak italian. and there's now the latino police who go around saying huh, you're not really latino because you don't speak such good spanish. we'll see whether the future belongs to the latino police or whether it belongs to the fusion
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viewers who say, yeah, i'm still latino even though like my eye italian buddies all i know is some cursing, sayings, and the names of foods. we'll see where that goes. our marriage shapes the future. large portions of self-identifying latino adults are marrying people who are not and having children of, let's say, indetermine -- yet to be determined self-identification. we'll see where it goes. when i was in scout, one of my kids was named greg hernandez. and i was shocked that i finally had a kid in my patrol named hernandez. so i go and say hernandez. he says, i'm not spanish. i'm not. i'm not. and where we were growing up, it was actually not the easiest
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thing to be. so i could understand why greg hernandez would say that. greg hernandez had a cuban great grandfather, and because of the way we do names in the united states, that was the only thing that was even remotely latino about greg hernandez. in 2040 there going to be millions more greg hernandezs and mary lopez and sally gomez who have this cultural real lick, their legal name, and little more than that will we count them in this projected 130 million latino population? will we? should we? does it make any sense if part of their self-concept is not that they are part of this big people that is trying to figure out what their influence on the
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wider society is. and greg hernandez, you know, founded in his interest to insist and that he wasn't spanish. a lot of the story is yet to be told. what latino assimilation is going look like in the coming decades may be a little different because it's a mixed race population. and everything from milky white to ebony is part of this presumed 53 million people who are part of the same thing, but maybe in subsequent generation it's going to be much harder for some portions of those millions to move in to the suburbs. to outmarry, to forget who they were fop have grandchildren
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named greg hernandez who insist vociferously they're not spanish. we'll see. i mean, it's an exciting story. thank god, in 2050 i won't still be writing books. [laughter] >> well, that's a great segue to the last question i think i have to ask. i know, we don't have any real time remaining. it's not fair to ask you to answer the question in a brief period of time. but all of that really leads up to -- and i thank you for the question. it was a very good one. what thoughts would so you in term of the state of immigration reform efforts in washington? , i mean, we just went through an incredibly polarized debate on un-related issues, but, you know, it's a polarized washington. this is an issue that the president has spoken directly about, it's an issue that kind of starts and stops and goes to different direction and open-end question from your perspective, and the folks you talk to where do you think it's going? what do you think -- where does the end get? >> i think it's very revealing
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that there was not this level of social anxiety about simpson me and the irca of 1986. the economy was growing, people had more money in the pocket, they were very happy to have spanish-speaking immigrants buff their tables, wipe their children's behinds, do everything they were doing. it was revealing when the number of arrivals was hiewjt -- hugely high during the late 1990s and early 2000s, there was not a fraught conversation it became. it's very hard to ask a country to take on more people. not only more computer programmers and software engineers, but also more agricultural workers and house painters and landscapers at the
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time when wages have hardly budged, or they have declined, actually, for most -- american families. when unemployment is stubbornly high. when unequality among workers and between families has never been higher. it's a really hard thing to ask that country, with that economic profile, here, take on 12 million people. and maybe someday down the road another 12 million of their brothers and sisters and mothers and fathers too. who will have some form of claim on the wealth created by this country, to be determined. but some claim on the future wealth of this country. i think when you put it that way, it becomes much more understandable that the -- there's been a sort of historical tone in some of these conversations. that is made more difficult by the reality that yes, among the
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11.7 million people. the most estimate from the pugh hispanic center. there are people who got here the day before yesterday. have been working steadily but can be sent home with very little harm or foul. and among the 11.7 million are millions who have long-term roots in the united states. families and associations and church -- membership and saturday softball league membership and a real life lived here in the united states. real contributions, kids in school, real estate taxes, and all that goes with being a full-fledged adult economic actor in the society. those people are harder to remove than the people who just got here the day before yesterday and overstayed a tourist visa. those people are a challenge to
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our ability to craft a law that is both workable, that people will obey and seem to be fair. not fair but seen to be fair. because fidelity to the law has a mystical connection not only with workability and the mechanics of a law, but also the willingness of people to follow it. which is a big ingredient. we have 0 voluntary taxation in this country where 90 million people file their income tax returns. if you don't file one, they won't find you for years. and yet we dutifully fill out, put it in the mail, and we do that with a feeling of some confidence if we don't do it nobody will know for awhile. yet we do it. it's that "x factor" of laws that are followed not only because they are laws but seen to be just, seen to be necessary
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to the working of a just society. whatever we do in immigration has to meet all of those tests. if it's so hard because we're shooting for something like fairness. because people broke the law. if we set the bar so high that we create an incentive for flouting the law, will it be a good law? it will meet people's tests of punishment and fairness and saying sorry to a country whose laws you have broken. if it becomes so unworkable that it doesn't ask for fidelity, people won't follow it. if you tell people they can't become legal residents quickly, if you tell people they can't make a permanent connection for the country for 12 or more years, they'll do it end around. it sounds crazy. if you tell them they have to go
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home and get on the back of the line but the line is 17 years long, they'll just sneak in. 17 years doesn't seem like a law that can be followed. so it won't meet that test. not only that is fair but seem to be fair, and able to be followed. if we change the highway speeds to 40 miles per hour. it would be the law. there would be signs all over. posted speed limit 40 miles per hour. no one would drive 40 because we would say, this is a crazy law. we can't follow this. so if you said, yes, we will allow you to stay but you center to go away and come back in 17 years, kiss your children goodbye, and quit your job. women, people will say that's a crazy law and i'm not going to follow it. we have to hit a sweet spot between laws that command our respect and can be follow, and also meet the demand of the
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people who are already here legally that we get our pound of flesh that something inherit in the law says i'm sorry i broke your lawings. that's a terribly tricky balancing act. i think we understate how difficult it is. >> i would love to continue this conversation. we began by saying promising a fascinating conversation with a fascinating person and a fascinating topic. i think we met those very high standards. for those of you who have interested and i suspect and hope you are. copies of the book are available in the front. i have read it. it's a very good read. i highly recommend it. for those watching as well. make sure you get your own copies. but -- >> can i say one thing? here is an example where we're going. many, many general market books that have some interest among the 35 million americans who speak spanish. come out in english and some date in the future.
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90 days, 120 days the following year come out in the spanish translation. penguin brought the two books out on the same publication date. they see something in the future about the future that made the simultaneous dates not only symbolically important but commercially important too. >> so. >> well, please join me in congratulating him. [applause] [inaudible conversations]
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>> sixth on "the wall street journal" bestsellers' list, the bully pulpit written by doris kerns goodwin focusing on
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presidents theodore roosevelt and william howard taft. be number seven is "soul-healing miracles," advice for spiritual healing. guinness world records released guinness world records 2014. malcolm gladwell's "david and goliath, and finally at number ten, sara alin's good -- sarah palin's "good tidings and great joy." these are some of the current best selling upon the fiction books according to the -- nonfiction books according to "the wall street journal." >> victoria sweet is next on booktv. she talked about her book, "god's hotel: a doctor, a hospital and a pilgrimage to the heart of medicine" in which he chronicles the history of the last alpshouse in the dun
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concern almshouse in the country. >> lynn tuchman, i want to thank humanities tennessee and the robert penn warren center for sponsoring this talk today and, in fact, for sponsoring a series of sessions taking place the rest of today and tomorrow entitled "taking our pulse: promises and pitfalls of modern medicine." and we have some pamphlets up here if you're interested in any of the other talks in this series. please, feel free to come take one. i am delighted to introduce dr. victoria sweet who is an associate clinical professor of medicine at the university of california san francisco and a prize-winning historian with a ph.d. in history. she practiced medicine for 20 years at laguna honda hospital in san francisco, a chronic care
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hospital founded in 1867 for the care of the city's destitute and ill. and that's where she began writing her recent book, "god's hotel: a doctor, a hospital and a pilgrimage to the heart of medicine." it won the penn award for nonfiction, and this is the book she will be telling us about today. i can't agree enough with a line from a review in "the new york times" that claimed it's compulsively readable chapters go down like a restorative sips of cool water, and its hard core subversion cheers like a shot of gin. i love this book so much that i assigned it last year to a class of 60 undergraduates, almost all of whom planned to go into health care. they were inspired by dr. sweet's criticism of the modern form of health care
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delivery with its pursuit of efficiency, and they were cheered by her advocacy of what she calls slow meld sin, a kind -- medicine, a kind of medicine that is personal and face to face and that gives doctors and their patients enough time to talk and to think. what's most provocative about dr. sweet's argument is her assertion that this way of practicing medicine is not only far more humane, it's not only filled with far more dignity for those who are vulnerable, but because it is better at determining the right diagnosis and the right treatment, it is also far more efficient. and i give you dr. sweet. [applause] >> i've got to pay attention to this, don't i? how's that, yeah? is this the one? well, good.
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thank you very much for that, arlene. actually, she covered all my main points, and we could really just stop there. i will say that was one of my favorite reviews, because i love gin. water's pretty good, but the gin part was really nice. so what i'd like to do, arlene suggested and i thought it was a good idea for me to spend be about 30 minutes talking about the book. everybody can hear me okay? good. talking about the book. i'm going to kind of condense it for you and give you the pain points, give you sort of a general feeling. i'll read a page or so at the end of the 30 be minutes to get a sense of the writing, and then i'll throw it open for any questions or comments. and aye organized it -- i've organized it as -- first, what i'm going to do is talk a little bit about myself. that's the doctor part. then about the unusual hospital where i practiced medicine, as you heard, for 20 years in san francisco, that's the on the part. ask last ill tell you -- i'll
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tell you about the pilgrimage i took across europe. so first let me say that i never thought of myself as a natural doctor. a natural-born doctor. ask by that i mean -- and by that i mean growing up i never watched doctor shows on television, i never volunteered at hospitals, i didn't want to hear about or see sick bodies. and when my family told -- when i told my family i was going to medical school, they were absolutely shocked. what had happened was that i had discovered the writings of carl jung, the psychiatrist k and i loved them. i loved the meaning and depth he brought to his life, and i particularly liked the way he'd set up his life as a psychiatrist living on lake in zurich and seeing well-paying, articulate patients in the morning and illuminating manuscripts and studying alchemy
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in the afternoons. i decided that's what i wanted to be when i grew up, and that's why i went to medical school. but it turned out i liked medical school a lot more than i thought i would, especially those last two years when you first get to see patients. i loved the history where you talk to patients and you listen to what they say and what they don't say. i found there was a lot of psychology to that. and it turned out i loved the physical examination in part because i thought it was amazing that just by touching and examining a patient i could often figure out what the diagnosis was. and then the work-up, the figuring out what labs to get and what x-rays, putting it all together in the differential diagnosis and a plan. i thought it was brill yafnlt but i still -- brilliant. but i still carried on and started my psychiatric residency which it turned out was in the only locked ward in the whole
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county. and its patients were not jung's well-paying, articulate patients. they were severely psychotic. and i found that they responded much better to the antipsychotic medicine i used than they did to the talk therapy we tried. so after i got my medical license, i just left the residency, and i went out, and i practiced medicine in a community clinic for several years. and that was a wonderful place to practice because community clinics you end up seeing everybody. and every time, particularly immigrants. so every time there was a war or a rumor of war, we would get a wave of immigrants coming to the clinic with their different diseases and ask tear different cultures -- and their different cultures and their different ways of looking at their illness. i saw incredible -- i saw everything there. i saw all the parasites. i saw three cases of leprosy. i saw very unusual cancers and, you know, it was a very
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fascinating place to practice, but it also got me thinking about the ways different people have of looking at disease. i found after practicing medicine for several years i was more and or impressed by modern -- more and more impressed by modern medicine, but its logical, scientific way of arriving at a diagnosis. but i was also more and more impressed by what modern medicine left out. naturally, anything that wasn't logical. and i began looking at alternative medicines. i looked at homeopathy ask i looked at chinese and finish. [inaudible] medicine both of which i particularly found fascinating systems. and i thought for a while about learning chinese or learning sanskrit so that i could really understand these systems from the inside, but finally i realized that even if i did learn chinese or sanskrit, i still wouldn't really be able to understand them. they were just too different from my own culture. and it was at this discouraging
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moment that i ran into a book, another book, actually, that surprised and intrigued me, and that was "medicine." hild guard was a 12th century nun. she was also a mystic, a composer, a theologian and, it had turned out, a medical practitioner. and she'd written a book about her medicine. and it wasn't the eye of newt, toe of frog medicine i'd expected from a medieval medical text. it was a real medicine for real patients with real diseases that i could recognize. but it was based on a completely different model of the body from our mechanical model. i didn't really quite understand what she was trying to get at. it was her like chinese medicine, but i decided at that moment that i was going to go
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back to school and get a ph.d. in pre-modern medicine, the history of medicine, and use hild guard bingham's medicine as my source. i didn't want to stop practicing medicine, so i looked around for a while for a part-time job, and the only place that would offer me a part-time job at the time was laguna honda hospital in san francisco. so i went over for my interview. and when i saw it for the first time, i was absolutely shocked because it looked like a medieval 12th century monastery. it was high on a hill, it had cream-colored walls and a red-tiled roof and turrets and a bell tower. so i went for my interview, and then the medical director took me around. well, the lace was enormous. it was on 62 acres of land in the middle of the city, it had almost 1200 patients who were taken care of on those
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old-fashioned open wards, the nightingale wards. it had a live-in priest, a resident nun. it had a chapel where looked like -- which looked like a church really as she showed it to me, you know? it had stained glass windows and solid wooden pews. and very politically incorrect stations of the cross along the walls. we're walking around, and then we went out to see the gardens. because there were extensive gardens. and the medical director showed he the aviary, the greenhouse and and even the barnyard. they were there so that patients could pot plants, watch with chickens hatch from eggs and even see animals even if they were bed-bound. well, then we walked back to her office x be she offered -- and she offered me the job. i didn't know. i wasn't sure. laguna honda was like no
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hospital i had ever seen or even imagined, but it was the only place that offered me attar-time job, so i told her i would come for two months, and i ended up staying for more than 20 years. because it turned out to be a wonderful place to practice medicine. originally, it had been the san francisco be almshouse. this is not what it looked like when i got there. it looked like the medieval monastery, but this was the original almshouse built in the same place in the late 1860s, as arlene said. and the almshouse is how we used to take care of the sick poor before there was health insurance. lo and behold, we did have a system as some of you probably remember. the system was a simple system. there would be a free county hospital for the acutely ill, and then there would be a almshouse for everybody else. so the chronically ill, people who needed rehab, people who had no place to go, the lazy, the
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craze i, anybody you didn't know what to do with you could send to the almshouse. and be laguna honda, it's how i got the title for the book because in french the almsst -- almshouse is called the hotel dieu, god's house. and that's how i got the name for the book. and what happened at laguna honda is they would take care of bottom 1%, really the bottom one-tenth of 1%. so everybody who fell through the holes this the safety net. and what i found was my patients were -- they had nothing in common with each other really except they were all standard deviations from the means. so they were the tallest and the shortest and the fattest and the thinnest and the oldest and the youngest and the nicest and the meanest of any patient i ever
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had. they had almost every disease in the world, because if something was 1 in 100,000 patients, i'd see two or three cases. so it was a fascinating place to practice medicine. it took me quite a while to realize though how much i was learning about real medicine. and when i first started thinking about talking about the book, i asked myself how would i summarize everything i learned if i had one with sentence? and i decided that the i had to summarize -- that if i had to summarize it in one sentence, it would be that medicine is personal, not personalized. whatever that means. medicine is personal. and that what i learned at laguna honda is when it's personal, it works. and what i mean by works is that the patient is happy, the doctor is happy, we have the right diagnosis, the right treatment and all for the least amount of
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money. now, this gelled for me the day that i met my good friend dr. curtis. and's coming back from outside the -- and he was coming back from outside the hallway. outside the hospital. i asked him where he was going. he said he was going back to see a patient who'd within -- who'd been at laguna honda for months ready for damager, but every time he saw him on rounds, there he was still zipping around in his wheelchair, still going to therapy. so i asked him why he was still there since he could walk. in shoes, doc -- no shoes, doc. i need special shoe, and they've ordered them from medicaid, and they're waiting for medicaid to approve them. how long have they been waiting, dr. curtis asked him. three months. so dr. curtis thought about that for a little bit, and then he said to him, well, what size shoe do you wear?
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size 9. dr. curtis told me he thought about all the things he had to do, all the forms he had to write, and then he just got in his car and went over to walmart and bought a pair of size 9 running shoes for $16.99, and now he was coming back to put them on the patient himself and write the order of discharge. and as i watched him hurry off, i realized he reminded me of an after prison m -- aphorism i'd always loved but had never understood, the secret this the care of the patient is in caring for the patient. now be, i'd always thought that meant caring about the patient, you know? loving the patient or at least liking them. but when i watched dr. curtis rush off to put shoes on a patient he barely knew, i thought there must be more to it than that. so i looked it up, and i found it in a talk by with dr. francis
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peabody to the graduating medical class of harvard in 1927. turned out that what dr. peabody really said, really meant, actually, was not that the secret of the caring patient was caring about a patient, but in caring for a patient. which, he said, meant doing the little things, the little, personal things that nurses usually do; tucking in bed clothes or giving them sips of water with. it wasn't the most efficient way for doctors to take care of patients perhaps, but it is what created the personal relationship between doctor and patient. and that relationship is the secret of healing. so that was very ironic, because particularly ironic because right around this time laguna honda had been discovered by health care efficiency experts, and they were going through the hospital, and they were finding all sorts of inefficiencies.
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and i'm sure if they'd known about dr. curtis and those shoes, they would have thought it very inefficient. very costly. of the time of a highly-trained physician. but when you think about it, it was really a very efficient thing for him to have done. it, after all, he got the right diagnosis -- no shoes -- he got the right treatment -- shoes. and all for the least amount of money, $16.99. so i started calling this for piets the efficiency -- for myself the efficiency of unefficiency. so in the meantime, of course, i had gone back to school, and i was pursuing my studies in premodern medicine, so i took a lot of classes, and i learned -- i wanted to learn in the originals which she wrote in latin and medieval german, and
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then i realize she actually works right? and i wanted to look at the real text, so i took pail yoking my, it was a lot of fun actually. really, it wasn't that much work. and i even experimented with some of her recipes because i wanted that sort of practical stuff. so i planted a medieval me dipsal garden, i grewed up some of her potions, i made her medicinal beers, and i even baked her anti-depressant cookies. [laughter] and gradually i began to understand what was different about her medicine and my medicine and the way we looked at things. we look at things as if the body was a machine. that's our fundamental metaphor. and this is a wonderful -- i love this. this is a poster done in the early '20s by this guy called fritz khan, and we think of the brain as a computer, and the heart's a push, and the kidneys
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are filters u and the lungs are -- and the lungs are bellows. and the doctor, consequently, is a mechanic. i'd guard's model was very different, i finally realized. it was much more of a body as a plant and the doctor as a gardener. what's the difference? the difference is that someone has to fix the broken machine, right? but a plant can heal itself. hild guard called the power of a plant to heal itself its greening power. and she believed that humans had their own veriditas and that the role of a doctor was to step back is and remove whatever was in the way of that natural
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healing power and then to fortify it with basics; good food, sleep, rest, tough like that. stuff like that. i sort of grasped this idea theoretically, but it wasn't until my patient, terry becker, that i really understood what she was talking about. terry was homeless, and she lived on the streets with her boyfriend mike. and they smoked, they drank, and they took drugs. and then one day terry woke up x she was paralyzed -- and she was paralyzed from the neck down. so mike tooker over to county hospital, and she got admitted, and she got worked up, and they got the diagnosis which was transverse my lites which is a very rare viral disease that attacks the spinal cord, causes paralysis. it has no treatment, but it usually gets better over time, so they sent her over to laguna
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honda, and she was hi patient. and she did get better. over those first few weeks. but then the first of the month came around, and mike showed up, her boyfriend. be can mike said he was going to take her out -- he didn't say this, but the first of the month is when in san francisco the homeless get their welfare cash from city hall. so mike was showing up just to take her out for a few hours and, of course, he took her out, and they disappeared for about a year. of and i didn't hear from her for about a year. but it turned out over the course of that year living on the streets, terry had been at the emergency room 28 times, she'd developed a huge bed sore for sitting in her wheelchair all day and had had it grafted, three different month-long hospitalizations but every time the first of the month rolled around, mike took her out. mike even beat her up, took a
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2x4 to her, broke her skull can, broke her leg, robbed her and abandoned her in a wheelchair on the streets of the city. finally that bed sore was just too big to operate on, it was too big to treat, so the surgeons at the general hospital sent her back to laguna honda, and she was my patient again. and when i saw terry for the first time -- for the second time, really, i was really shocked. and when i saw the -- was she looked so much older, so tired, so depleted. and when i looked at that bed sore, i was shocked. it was the biggest open wound i'd ever seen on anybody. it went from the middle of her back all the way down to her tailbone, and it spanned her entire back. and it was so deep that i could see bone, i could see terry's spine at the bottom. and in the middle of it was all the this decayed ask decaying -- and decaying tissue from all
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those failed skin grafts. you know, it really was too big to graft. it would take years, i thought to myself as i was looking at it, for that to heal on its own. and in the meantime, what would stop terry from having an overwhelming infection that would kill her? it doesn't work to give antibiotics pro lackically, you'll just get immune and get an infection anyway, so i had nothing leavitt in my -- left in my little black bag. so i walked back to my office, and i sat down because i didn't know what to do. and i found myself staring at a atlanta that a patient had given to me many years before, and by this time it had grown all over the wall of my office. and i thought, you know, terry's going to die of this, you know? she's going to die of this untreatable, essentially medieval disease. and that got me thinking, and i asked myself, you know, how would hildebgard have seen this open wound if --?
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what would she have done? i thought about the idea that coarsing through terry's body was this natural power of health and healing. and i thought maybe hildegard wouldn't have done anything at all, maybe she would have just removed what's in the way. and then i asked myself, well, what's in its way? well, all the dead tissue was in its way. it had to be removed. any medications that terry didn't absolutely need, i would take way. fig that caught her attention -- anything that caught her attention, so uncomfortable mattress. fear, uncertainty, hopelessness. then i thought, then hildegard would fortify terry's veridi, the as with food and deep sleep and rest. so that's what i did. and it was amazing to see how
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was the prescription began to work. then the first of the month rolled around, and mike showed up. and he was still pretty cute. he was still wearing his little levis and still walking with his little strut, and the nurses and i, we stood there, and we made him wait in the waiting room, and we told terry and watched terry wheel herself on her gurney the whole length of the ward and go in to see him. they were this there a long time -- in there a long time. finally, the door opened, and mike came out alone and left. terry had thrown him out. she told him never to come back. then she stopped smoking. her appetite came back, she started to to eat. and that hole in her back side began to fill in. and since i only saw it about once a week with, its healing seemed as miraculous to me as
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those time lapse movies you see, we used to see in school when you'd watch a plant grow from a seed in just a few minutes? that's the way ter arely's bed sore -- terry's bed sore seemed to heal. first there was a little glistening at the base, then there was muscle, and then skin began to crawl in from the sides, and it began to get smaller and smaller and shallower and shallower until finally it looked like just a big scab on her back. and then the scam flaked off -- scab flaked off, and there was pink, new terry becker skin. it took a long time. it took two and a half years. but we were in no hurry, and neither was she, and at the end of those two and a half years, the social worker located her family in the midwest who wanted her to come live with them. we flew her back, he lived with them, she never went back on the streets and lived, as far as i
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know, for many years. so watching terry's bed sore heal changed the way i practiced medicine. ever since terry, i not only look at my patient with the idea of the modern doctor and ask myself what's wrong and how can i fix it, i also step back and look at my patient in the context of their environment and ask myself what's in the way of veriditas, and what can i do to sport -- support it. and i've begun to think of these two ways as slow medicine and fast medicine, p kind of the same way we have slow food and fast food, right? it turned out that hildegard's way works best on people with slow diseases, people with diseases that are slow in coming op or don't have a treatment. and what i found was though it's easy to put slow medicine and fast medicine in opposition, they really work both best
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together. kind of the way our two eyes work to give us a three-dimensional view. in oppot they work best together like a three-dimensional view. by this time i had finished my ph.d. in as a present to myself i decided to go on a medieval pilgrimage. there has been a little more press for those across variance but why did i want to go? the word actually comes means moving through the territory. uphold to leave your home to
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journey through only and is not yours. the medieval thought we were all pilgrims leaving home at burst traveling through life to reach the spiritual cool of death and in the middle ages in a telegram that was a big deal there was one to rolled and jerusalem and santiago this one here was the most exotic it started in the ninth century with the body of st. james the apostle was miraculously discovered in a stolen boat at the tip of spain and the church was built around it and people began to walk all across europe to visit st. james but hildegarde's time there were hundreds of thousands of people every
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year while keeping to a santiago then it became it fell into disuse and was rediscovered in the 1980's when i found you could still walk this i wanted to do it i went in four sections and with a friend and we did 300 miles every year dash ago back where we started every time and those four years in pieces really changed my perspective and my life and to give you a sense i will keep you a sense what i learned from the first section of the pilgrimage. >> there were many stunning moments on the first section but the one that they carried back was the date was pouring rain.
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we were a long way from the shelter and we would be walking in the rain for a long time. it was cold and i was soaking wet and roslyn and i were trying to keep warm. medfield's in of rain and i was chilled to the bow of the yet i did not want to be anywhere else than to walk in their brain or be anything else to arrive at the warm and comfortable destination i did not want the rain to stop with this field to stop the muddy for to be one step farther along or back i want to be just where i was because only by being there could i experience when i was experiencing so as i walked through the field i thought about how much of my life i
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would never be in the place out in the cold, homeless without shelter. i thought about my patients is left in the doorway to drink vodka. our guest the patient who is eager to get discharged what was the attraction of life? care what she told me was freedom of responsibility or work toward to be but that day i wondered homeless kohl's in shelter she but the feeling i had that day. i was happy and i knew i was the happiest i had never been. not angels coming at of the clouds that as if in the a feeling of great pleasure or contentment of mind rising from satisfaction.
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as things what they turned out to be. when i got home that year put away my things my stick and shell and clothes and would not take the mound again for one year but i did not stop feeling like of pilgrim as i would walk down the wide corridor my footsteps would remind me i would be across the field happy with the things as they were. perhaps that is why my relationship began to deepen. that has everything to do with the doctor not excepting as they are i did not stop doctoring but there was a way out is appreciating who they were. >> that was a good think about that time things began to change at the hospital. they were discovered by the
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department of justice and that is where i will stop talking. thank you very much. [applause] >> we have time for questions and answers just please go to the microphone. >> that is a different
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story. the students are fantastic 87 how to examine patients physically because that is though one skill they really are losing. it is such the efficient skill as i can diagnose somebody by the smell alone. think how efficient that is. but yet that whole beautiful part of the physical exam is falling by the wayside in the medical students love it because it feels like a real doctor to examine the patient to talk about taking their pulse. they above it but it is
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discouraging because as soon as they get into the system especially a modern hospital is easier to press the button to get the ct scan pay and examine the patient of the that is more efficient i had a lot of time it was a lot more difficult but the students are wonderful. this generation the particular i want to congratulate the baby boomers to have done such a fabulous job with their kids. this generation is a fabulous generation did make some wonderful alliance because these kids our no fools they know what is going on there open and respectful with incredibly good values. one of the things i notice it is like fighting the last
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for a lot of educators and medicine still try to teach about diversity training this is a battle we have already won in california. it is fabulous that what they'd need is a direction and i think of values of what is really important. they kind of note that the health care isn't a commodity. they know that it has to be personal but even though there is a lot of melting it nobody demonstrates that. that is what i try to do for them as physically teaching them something to tell them what a wonderful profession medicine is and hopefully we can keep it that way. >> thank you for the message
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that medicine is personal but also not personalized. kidney talk more about those differences. >> that is the fun question. a number of you there are so many linguist personalize is the opposite of personal that means it is pretending to be personal he know when you get the wonderful hand written and throw away don't smile -- to of mail? it is personalized it is not personal it is the opposite but truth is lies personalized is not personal
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when the the other things that is pernicious is a virtual it does not mean virtue but it means the inner self. when you call something virtual you really mean it really is that thing and there is nothing left like the real thing than a virtual patient. or virtual ice cream that has no calories. [laughter] so that is what i would say about that i feel persons -- strongly about personal or personalize that is what a scary with medical education in particular to right an article that i love talked
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about a simulated patients he said they are simulated but they are not patience. [laughter] i thought that was good. >> talk about the medical students how well respected they are what about your peers and the medical community who are already out there practicing have they received it with such open arms as well? >> the medical field the and nursing field are all over. this book kind of surprised me because i have gotten thousands of letters now from doctors a and nurses. i did not realize the nurses have lost as much as doctors
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as we turn into health care providers to dispense a commodity called health care. nurses and medical students and their best like what do we do to reverse this? that is the real question like this is just common sense people's the doctor should have enough time to spend with patients to get the right diagnosis is a news flash? it is ridiculous but what do we do now? that is what i think a lot about i have come up with a number of different projects because the direction pushes us more and more personalized thank computerized with less time based on the incorrect assumption based on the idea
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that doctors are so expensive that anything you can do to decrease the time doctors spend with patients will save money but that is not true but i realized the doctor may be cost $200 an hour 20 minutes is like $80 but then i can get the right diagnosis and don't have to send you for the $1,500 test we are ahead of the game. i wanted to set up a project that would just demonstrate that there is one starting that i am consulting to just give them as much time as they needed to follow them for a couple years and compare care then show the economist the they are wrong
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penalities disaffected doctors are dropping out of the system to form the concierge and boutique practices. they are brilliant they are the intelligent way to start. last year 4,000 doctors dropped out to start these practices to say i cannot practice medicine this place will do it the way i want so i need x amount of money per year that means i can take care of this mini patients between 100 or 600 in depending on how many that is the figure how much they have to be paid per month about $10,200 per month did you have enough time and they are so happy and when i
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bring this up people say at all have to the dollar's i agree but but if we can use this to show that care is cheaper this seems to me the insurance company will want to do that very thing. . .
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who suggested that we have a movement called occupied medicine, but i think we need a movement that is called reoccupy medicine because that is what happened is we used occupied medicine and when i say we i don't just mean doctor i mean the health care system. there's nothing but the doctors and the nurses and therapists and patience to yet i think that answer some of your questions, yes? >> can you comment about what you feel about the affordable care act and do you ever received single-payer in this country? >> okay that is a good question. i read the health care act about a year-and-a-half ago. i sent away for it. so i read it. it's actually 992 single spaced
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pages. i read ten pages a day for three months and i really studied it and it was fascinating and a was scary because there is so much in it. the idea is we would do something about the millions of people that don't have health care insurance. there was a good problem to solve. but along the way they solve all kinds of other problems and have created i think a whole bunch more problems that for the problem that they meant to solve they've set up these exchanges. now, i think and this goes back to the single-parent plan i don't think we will ever have the single payer plan. i don't want a single payer plan as a patient. 70% at least of americans are very happy with their private insurance. they do a very good job. but what we need is a solution for the people who don't have health insurance and the problem with exchanges is it's based on
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its very complicated for profit model. but i would like to do is add one thing to the current system and that is simply let people buy into medicare for what it costs the government to supply medicare. what are the costs of government to supply medicare if you take the medicaid budget and divided by the number of people it is about $802 a month. that is a huge amount of money. if we put medicare on the exchanges and let people buy into it we could give people the same subsidy. it's sort of already set up to do that, and that would be a way of letting the private insurance companies who believe that the government is an efficient to compete and we will see what happens, so that is how i sort of settled at the conundrum in my own head. i think it would be a good thing to do.
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>> how do you feel your book will affect the medical world like everywhere across the world now? >> well, there is a whole percolating thing happening and it's not just in medicine because one of the things about my book is it's not just about medicine that people recognize it is about style. whether we are teachers or lawyers or how we live and what is a value to us. you don't need very much to be happy and once you are happy you don't really care about all that stuff and the sense of exchange, of giving and receiving is gorgeous and it's beautiful and there's stuff happening all over the world.
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my book is part of it but if it was just my dhaka -- it's picking things up all over the place because we are all ready for a change. it's like we are ready for post modernity. what do i mean? i feel like the modern world at some level which came in and the 19th century fundamentally. and it was kind of like my god there's electricity to the we can figure things out. there is logic. we can do all these wonderful things and now we've done those things and now we get. these are kind of great tools, but we are ready. we've already i think moved to the next place we just haven't realized we've moved to the place where it's about connection and it's about community and it's about interchange. so what's happening is these things are popping up all over the place. i will give you one interesting example. when i think to myself what word would use to describe, and this
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was probably seven or eight years ago now i thought it's a lot like the slow food fast food. it's like slow madison. will it turned out what just as i was doing that, so far there's four other people in the world who came up with the same idea at the same time. there's one and is the leading lalinde and the united states and when that happened it's because these things are all percolating and popping up in different places. >> i think we have time for one more quick question. >> thank you so much for this great book and for what i think helps people get back to the things they were looking for when they chose medicine or other medical careers that we are dealing with all the electronic and medical records and community hospitals are so driven by the financial models. what do you do to stay alive and that seems to be what is on the top of the wind for almost every
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hospital, hospitals going bankrupt, doctors worried about financials and all of that. so how does laguna honda ek assist in this island or oasis? how do you interact with other hospitals in the community? because it seems to me that they would be trying to shift a lot of patience to you because your model is different but you obviously have a capacity and you can take care of everybody saw what is their relationship like? >> i could answer to this in many different ways but i will not be a politician. the last question is how does laguna honda do it? it came out and took care of the sick poor for the free in a monastery. that is where the health model that we have an obligation to take care of sick poor that comes out of matthew.
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so it was a religious and spiritual location. and then what happened was that when henry e3 formed the church in england and he shut down of the monasteries there was nobody to take care of the sick poor and then there was the first poor act which came to the united states that said the county would have to take care of the sick poor and that was the original basis of how we did this with the acute hospital. so the county of san francisco gives money to laguna honda and subsidizes what it gets from medicaid and medicare and private pay. and yes, we usually -- when i was there we had a waiting list of about 200 patients. [applause]
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>> visit to watch any of the programs you see here online. type the author or book title in the search bar on the upper left side of the page and click "search." you can also share anything you see on easily by clicking "share" on the upper left side of the page and selecting the format. booktv streams live online for 48 hours every weekend with top nonfiction books and authors. >> on many campuses, young well are taught that they live in a repressed society where girls are robbed of their self-esteem in adolescence and then channeled into low-paying fields. once in the workplace, they're cheated out of 25% of their salary, they face invisible barriers be can all sorts of forests that hold -- forces that hold them down and keep them out of the high echelons of power.
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now, this picture just doesn't fit reality. it's distorted. false claims that support it have been repeated so many times, they've taken on this aura of truth. >> her critiques of late 20th century feminism and feminism in contemporary american culture have led critics to label her as anti-feminist. sunday on "in depth," your questions for christina hoff somers. and join radio talk show host mark levin january 5th. booktv's "in depth" the first sunday of every month on c-span2. >> on your screen is a familiar face, ray suarez, former senior correspondent for pbs' "newshour" ask now withal jazeera. when did you make the move? >> just a couple of days ago. my first day on the air over there was november 11th and so
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far so good? >> host: why the move? >> guest: it was time. you've been at a place for a while, and you've done everything you can do there, and there were new opportunities and some great chances for advancement atal ya sear rah america, and it's a start-up with everything that implies, fresh, energetic, forward-looking. it's really, really fun, and my staff keeps me young because everybody's like 27 years old. >> host: this is booktv, so we want to talk to you about this, "500-year legacy that shaped the nation: latino americans." what smackerred you toly -- sparked you the write this? >> guest: the publishers approached me, and pbs was about to launch a big documentary series on the same subject, and today wanted something that would be a handbook that would both be for a general office, so americans who aren't latinos are kind of wondering what's the difference between a mexican and a puerto rican and a cuban and a
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dominican, and when did they come, and why are they here? what's the background? how is this changing the country? and then latinos aren't really taught their own history well if they go to public schools, so in the introduction to the book i say i haven't done my job if at least once a chapter you don't say i didn't know that. how comein -- how come i didn't know that? so i think i hit both assignments very well, for the general audience sort of giving them an idea how these one out of six of their fellow citizens came to be here, and for the latino audience, some after fir haitian, a little history they didn't know both proud and not so proud history and a leaning forward to the next 20, 30 be, 40 years when we're going to become an even bigger part of the american hold. >> host: why did you start 500 years ago? 1500?
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>> guest: well, the first european settlements in what became the united states was a column of soldiers, priests and settlers who came up from mexico city into what's now new mexico and settled santa fe. and i started there because, to me, that's where the united states is really born. before jamestown, before plymouth, before st. augustine, florida. these seem tried to make a way -- these people tried to make a way in the dry, scrubby southwest. they were looking for gold, they were looking for a place to raise cattle, and that's really where that entrepreneurial, her can tile, rest let's-moving united states -- restless-moving united states begins for me, so i started in new mexico in the 16th century. >> host: ray suarez, what's one thing that we're going to learn
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reading "latino america"? >> guest: that 23 states of the current united states were once all or part of the spanish be empire. -- spanish empire. all the way from vancouver ireland in what's now british columbia clear across to florida in this enormous crescent, that was all part of the spanish empire. and there were really three empires, the spanish, the french and the english, with their elbows out rubbing up against each other, pushing up against each other, so i'm suggesting you think of the united states not just as an english thing that starts on the east coast and moves to the pacific, but as a multi-empire thing that wrestles until we have of a winner, and that's the united states. that takes in people from everywhere and makes them americans. >> host: ray suarez of al-jazeera, the book is called "latino americans: the 500-year
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legacy that shaped a nation." you're watching booktv on c-span2. >> jessica alexander shares her experiences working for international aid agencies in rwanda, darfur and haiti. she talks about the corruption she found while in the field and the many inefficiencies she found with the way the u.n. and other ngost operate. this hourlong event is next on booktv. ..


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