At the Charity Hospital

Just recently I used the word “charity” while trying to write about “welfare” and as I was doing that I felt another discussion going on in the back of my mind; it seemed worth listening to but I couldn’t make it out so I just wrote on in the groove I had laid out for myself. Later, like just a few minutes ago, I tapped into that discussion I was having with “myself” while my other “myself” was writing away. Here it is.


In the mid-1950s, the State of Louisiana ran a big hospital in Shreveport, where I lived. It was officially named “The Confederate Memorial Medical Center” but it was more usually referred to as “the charity hospital” and, in certain circles, “the nigger hospital.” The state had operated “charity” hospitals since the 1870s but a modern state-wide, state-financed hospital system was the creation of Huey Long’s administration between 1932-1936. That system was expanded after WWII from six to eight medical centers in which half of the beds were reserved for whites and half for African Americans. These hospitals were rigidly segregated in terms of beds and services.

 The hospitals were supposed to provide medical care to the working poor and although early on whites used the hospitals as often as blacks, white Louisianans assumed, or pretended to assume, that only African Americans used the hospitals. In the immediate post-war years, black admissions outnumbered  those of whites in the state centers  but, statisticians said, whites stayed in hospital longer so “usage” was nearly equivalent. In fact, in the late 1940s, while black children were admitted at a rate of about 42 per thousand population (by race), white children were admitted at a rate of 70 per thousand (by race). This suggests that white adults would not use the services but they would take their children there.

In the summer of 1957, when I was 16, a nurse my mother knew got me a job as a ward orderly at the charity hospital. In 1953 the hospital had moved into a new, $10,000,000 building and had, for the first time, hired a black doctor. By the time I got there, some black doctors and nurses staffed the African American wards and services, but in smaller numbers than their white colleagues. At the same time, African American patients far outnumbered white patients, from what I could see on a day-to-day basis. The existence of Jim Crow wards meant that black patients could not be given beds on white wards, and vice versa. In practice, Jim Crow wards meant that the greater number of black patients outstripped the number of beds available in black wards and so, rather than placing the overtally in empty beds (of which there were many, given white folks reluctance to use the “nigger” hospital) on white wards, we made pallets on the floors and in the hallways for the black patients.

I say “we” because I was assigned to the black cancer and orthopedic wards as an orderly, the only white orderly on the African American “side” of the hospital. (The hospital was divided by a yellow line that bisected the central tower in which the in-patient wards were located; clinics, also Jim Crowed, were in opposing wings on either side of the central tower. One was not allowed to take a patient of the inappropriate color across the yellow line, not did the nursing or orderly staff usually cross over for service; certainly no black doctor treated a white patient.) How or why my assignment happened I never knew but I took no exception to it and, in fact, for reasons I’ll write about another time, was glad of it.

In the next installment: some stories about medical care in a segregated hospital in the 1950s and some reflections on them, by a man trying to remember the boy he was.


Oligarchies, Inequalities, and What’s Coming Down the Road

I’m going to get all wonky on you this time around.

 I’ve been noticing the waves of rhetoric sweeping over the inequality divide in this country and it strikes me that no one yet wants to admit that the folks at #occupyWallStreet were ahead of the curve. The recent spate of books and articles by Piketty, Krugman, the Princeton researchers on oligarchy, and the rest are actually later, and obviously more analytically rigorous, iterations of the #occupyWallStreet phenomenon: –reaction to the increasingly visible contradictions inherent in late stages of capitalism.

 As a “good” Marxian, I have always admired capitalism in its early stages as a far more efficient system for the allocation of resources and wealth at the time of its appearance than those of late feudalism. But without some controls, internal or external, capitalism inevitably becomes less efficient in the distribution of the value produced by its activity. That is, advanced capitalist economies begin to suffer more and wilder and unequal swings of productivity and profitability in local markets and reward an ever-shrinking pool of very large capitalists while maldistributing the surplus value of productivity among other sectors of the  population. One response by governments is to try to reconcile these contradictions by regulating the practices of the generators of the energy that drives capital markets. This is done to help preserve capitalism because, as both Marx and Roosevelt understood, once the contradictions become inevitably visible and permanently on display, non-capital-intensive portions of the society (workers) will demand direct redress, i.e., will take to the streets seeking it, even if that means a different system for the distribution of the means of production, more specifically, a change in the ownership of those means.

 Thus, #occupyWallStreet, which seemed inchoate because it was genuinely populist; that is, was a response to contradictions by the population most affected by those contradictions; Occupy was not an analysis of those contradictions nor could it produce a “program.” “It” only wanted relief from the cognitive, fiscal, and physical contradictions between capitalism’s promise and its performance in their lives.

These or similar conditions are present in all the major western capitalist countries and some (but not by any means all) of their Asian clones. However, revolutionary change is not imminent. Capitalism will, sooner or later (probably later), be replaced by something like “socialism” but not until capital succeeds in transforming the latent feudal economic cultures of the rest of the world into more efficient market arrangements. Once the world’s labor force acquires the skills to function under capitalism and the intellectual and experiential “capital” to appreciate its (labor’s) own role in that system, will the inevitable contradictions we are experiencing be felt widely enough to shove capitalism down the road toward the next stage of economic history.

I know this might seem unlikely, but just  imagine yourself the Earl of Something-or-other in 14th century Britain or the Count de Whosis in 13th century France and discussion in your court tries to turn on the inevitable end of feudalism and its replacement by a capital-intense exchange economy fueled by the productivity of paid industrial labor. My, My!


(For fun, one could reread Mark Twain’s,

A Connecticut Yankee in King

Arthur’s Court.)

When Stranded….

When I was a young man in college, I was less bedeviled by the question of what I was doing than by that of “how” I was doing. Today I see all over the media people in education arguing among themselves about “what” students should be doing. The “Common Core” issue has got folks with kids in school riled up all around the nation and from colleges and universities come sounds of discord over the conflict between knowledge and training: can the study of philosophy get you a job?


I had, back in the day, a very interesting professor, Elsie Dean Hively. We called her “Sis,” mostly because she lived with her sister in a two-storey 19th-century house on the edge of the campus. Their mother was buried in the garden. Sis had been, in fact still was although they were separated, married to a pianist. Wells Hively had a minor reputation as a concert pianist but had made his name, such as it was, as the accompanist to the soprano, Lily Pons, a considerable figure between the world wars. As a young woman, Sis had followed Wells around the concert circuit, much of the time in Europe and when their relationship fell apart, she was more or less stranded in France, where she had a nervous breakdown. She was institutionalized there, for treatment, and eventually came home to America, to Kansas.


Sis Hively came away from her European life with two strict rules: 1) inasmuch as we are each flawed in our own way, it is incumbent on us to do the least harm possible to others; and 2) the act of listening to music must be an exercise of its own integrity, not an adjunct to some other activity and, as such, should be a matter of listening only to that which you and you alone have chosen for that exercise. Each of these rules hearkened back to Wells; the first a reflection of his failure to observe it and the second a consequence of her institutionalization.


That second rule needs a bit of explanation. Sis had been abandoned by her pianist husband and the abandonment had shattered her. In the hospital, the well-meaning doctors sought to soothe her as she healed. Unfortunately, they assumed that music therapy would be just the thing for her, as it was for so many other patients, so she was subjected daily to a background of classical piano recordings as she went about her therapeutic regimens. The doctors were at a loss to explain why she seemed to be getting worse, not better. I haven’t any idea how or when she convinced them otherwise, but I know that once away, she forbade the piano in her life.


Sis was an English professor when I came to know her in the late 1950s. She looked older than she was; her face was severely lined, perhaps from years of smoking French cigarettes. (Years later I thought I had come across her twin when I saw a photo of Lillian Hellman.) Sis had been at the college for many years by then and was somewhat legendary. She was irascible and strict, profane and worldly, edgy and wrapped in an aura of loss and regret, but clever and funny/witty still. She gave my first essay in Freshman English an “F” because, while technically flawless, it contained not one idea—only words.


But it was Sis Hively who explained to me what it was that we were about in college. The goal, she said, was to become educated for two purposes. One was so that, when you were abandoned in some difficult place, without a book to read or paper and pen, you could understand your situation, place it in its rightful context in the world’s affairs, and entertain yourself until help arrived, no matter how long that took. If, she said, you were lucky enough to escape abandonment and had a full life and made money, your education should be such NOT that you could do your own taxes every year, but that you could hire someone to do them AND know that they had done them correctly.


Those precepts became mine, along with keeping my weight on my elbows, which, as I have noted, I learned later in life. But for today, what can be said of a liberal arts education? The mystery of Malaysian Flight 370 notwithstanding, the likelihood of being stranded in some remote part of the world has become less and less assumed over time. Is there a contemporary equivalent of that first purpose Sis laid out for us? (The second makes even more sense today!)


I think so. I think the purpose of a liberal arts education, a “major” in history or literature or philosophy or some interdisciplinary mix of those should be this: come into the adult world possessed of the things you need so that when you find yourself, as you statistically are likely to, without a job, adrift in an economically horizonless sea of Wal-Mart/MickeyD/food stamp desperation, you can understand your situation, place it in its rightful context in the world’s affairs, and entertain yourself until help arrives, no matter how long that takes.


That help will arrive one day, perhaps not in the form you expect, but those same gifts the study of the humanities have given you are the gifts the world, despite itself, is waiting for and will wait for, long after the beans have been counted, the codes written, the bitcoins transferred. And those of your comrades stranded with you who have only data and charts and multiple choice answer sheets to sustain them at 3 in the morning when the Black Dog comes ‘round; well, we feel sorry for them; they should have taken more electives from Sis Hively.