Until recently, Patrick Chavis's claim to fame was that he was admitted to the University of California at Davis Medical School as an affirmative-action student in 1973--the year Allan Bakke was rejected. Because of Chavis's outspoken advocacy of racial preferences, the media sometimes referred to him as "the" student admitted in Bakke's place--although, strictly speaking, he was one of several possibilities.
Chavis went on to become an obstetrician/gynecologist in Compton, California, a mostly minority suburb of Los Angeles. Chavis also became a much-celebrated symbol of racial preferences. When the New York Times Magazine published Nicholas Lemann's ten-page paean to affirmative action in 1995, Dr. Chavis' spicture graced the cover. Inside was a full-page photograph of him cradling a newborn.
During the Proposition 209 campaign, his name was difficult to escape. Senator Edward Kennedy (D., Mass) called him a "perfect example" of the enormous dividends affirmative action has paid. Tom Hayden and Connie Rice argued that by practicing medicine in Compton, Dr. Chavis had contributed more to society than Dr. Bakke had: "Bakke's scores were higher, but who made the most of his medical-school education? From whom did California taxpayers benefit more?"
Then came the fall from grace. Two months ago, citing his "inability to perform some of the most basic duties required of a physician," Judge Samuel Reyes ordered Dr. Chavis' license suspended. His "gross negligence" and "incompetence" had led to the death of one patient and near-fatal injuries to others. Allowing Chavis to continue practicing medicine, the judge wrote, would "endanger the public health, safety, and welfare."
It turns out that Chavis--no stranger to disciplinary actions even before his suspension--was in the liposuction business. He learned the procedure at a four-day seminar at the Liposuction Institute of Beverly Hills; he never bothered with the program's second half. For $2,580, Dr. Chavis would send a limousine to whisk you away to his office; he would have you back home before dinner, thinner and lovelier.
That's how it was supposed to work. Yolanda Mukhalian had a very different experience. Hours after her surgery, she was vomiting, incontinent, and unable to stand without assistance. Blood poured down her legs. Instead of getting her to the hospital, however, or even checking her vital signs, Dr. Chavis took her to his home. There she lay for forty hours, with shockingly little supervision, her blood soaking the towels and sheets. During her last twenty-four hours there, neither Chavis nor his nurse even looked in on her.
Afterward, Miss Mukhalian repeatedly sought Dr. Chavis's help for bleeding, pain, and delirium. He prescribed heat packs and massage, again without examining her. When she finally went to a hospital, she was found to be suffering from serious infection. She had lost seventy percent of her blood. The medical board filed ten separate charges of gross negligence against Chavis on account of her treatment.
But she at least survived, as did another liposuction patient who had a similar experience. Tammaria Cotton was less fortunate. She died despite desperate attempts by emergency-room doctors to revive her.
This tragedy obviously does not prove that most doctors who received preferences are incompetent, just as the original story did not prove they are all saints. It is a counter-anecdote neutralizing the original story's rhetorical effect. As such, its use is fair; live by the anecdote, die by the anecdote.
More importantly, the story is a reminder that medicine is too serious to be driven by ideology or political pork, with qualifications overridden when some group does not get its "fair share" of slots. Bakke's college GPA was 3.46; his scores on the verbal, quantitative, science, and general-information portions of the MCAT were in the 96th, 94th, 97th and 72nd percentiles, respectively. The average student admitted through the diversity program had a GPA of 2.88 and MCATs in the 46th, 24th, 35th and 33rd percentiles [also, respectively]. Entering credentials matter.
A study published in the Journal of the American Medical Association in 1994 reports that failure rates for the National Board of Medical Examiners Part I exam--which measures minimum competence in the scientific core of modern medicine, including basic anatomy, pharmacology, and pathology--were 51.1 percent for African-American medical students, compared to 12.3 percent for their white counterparts. Preferences were almost wholly to blame for this gap, which mostly disappears when MCAT scores and undergraduate GPAs are taken into account.
While they undermine the quality of medical practice, racial preferences do not much improve inner-city access to medicine. The average minority medical student is only somewhat more likely than other students to open a practice in the inner city. If the University of California were really interested in that goal, a loan-forgiveness program for doctors who practice in under-served areas, regardless of skin color, would be vastly more effective than racial preferences.
The number of minority students at UC medical schools will probably decrease this fall. When you stop rigging the numbers, the numbers change. What is more important is that standards will have gone up--something for which patients of all shades can be thankful.
Heriot, Gail. 1997. "First Do No Harm." National Review, October 13, 1997:58.