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In Memorium: Linda Farley

By John Nichols, writing in Madison's Capital Times:

Dr. Linda Farley did not live to see her dream -- the establishment of a universal health care plan that would provide quality care to all Americans -- come to fruition.

But the Verona physician who sought to heal a broken health care system survived long enough to see the first outlines of what she hoped would be a fundamental reform take shape.

Farley died Tuesday morning, on the very day that press reports indicated President Barack Obama would demand that Congress enact sweeping changes in the health care system before the end of the year, changes that reportedly will include a public option that reformers hope will lead to the establishment of a national health care plan like those now operating in most developed nations.

Farley, an ardent champion of a single-payer health care system run by the government as a public good rather than by for-profit insurers, would have loved to have been a part of the coming debate.

And she would have joined it as she did all others -- for peace, for economic and social justice, for civil liberties, for the environment -- with a rare and remarkable combination of urgency, warmth and good humor.

"I know we have a lot of work to do, so many barriers, so many challenges, so many powerful foes," she told me a few weeks ago, at another rally on another night when a woman of 80 who was battling cancer might have been excused for staying home. "But we've got to do it, so what's the point of getting frustrated. After all, we're right."

Farley, almost always in tandem with her husband and fellow physician, Dr. Eugene Farley, redefined health care activism in Madison and Wisconsin over the past several decades. Bringing lifetimes of medical experience and the calm, cheerful demeanors of the family physicians of another era -- when doctors had the time and the wherewithal to get to know, and love, their patients -- the Farleys made the case for fundamental reform in human terms.

At community forums, in church basements and union halls, on the stage before thousands at BobFest, the Farleys created a constituency for single-payer health care, and they changed the politics of the region. After Gene Farley toyed with a congressional run in 1996 on a health-care reform platform, a young state representative named Tammy Baldwin took up the mantle in 1998 and got elected in large part because she championed single-payer.

Baldwin adored the Farleys, and they her. A few years ago, the congresswoman nominated Linda Farley to be honored as part of the National Library of Medicine's "Local Legends" program. Baldwin, who is no slouch in this department, hailed her nominee as Wisconsin's "passionate crusader for health care reform."

But that didn't stop the intrepid Farley from lobbying the congresswoman, as she did every other official. And when the politicians fell a little short, she kindly -- but firmly -- prodded them. And they listened.

They listened because Farley knew of what she spoke.

Inspired as a teenager growing up in a blue-collar neighborhood in Rochester, N.Y., by novels about doctors who cared for the rural poor in Appalachia, she decided to become a physician.

Farley put herself through college and medical school working as a nurse's aide.

It was tough, but she was smart and determined. And she was cheered on by a fellow student, a young fellow named Gene Farley, who eventually convinced her that he shared her dedication to serving those who most needed, but could least afford, care.

Together, they worked at great teaching hospitals and inner-city clinics, on their own rural practice and in neighborhood health centers in big cities. They trained nurses in Jamaica and doctors in Madison. And when she retired, Linda Farley kept on caring for folks for free, making the rounds of local clinics and donating her services.

Farley "credited her two years in the mid-1950s on the northeastern Arizona Navajo Reservation as transforming her attitude and approach to medicine," recalls her biography at the National Library of Medicine. "Fifty miles from the nearest paved road, she and Gene lived in a small trailer and ran an outpatient clinic, providing medical care to the surrounding Navajo community, and also evaluating ambulatory treatment of tuberculosis using a then-new drug."

The experience on the reservation was a powerful one for the Farleys. In fact, several weeks ago, to celebrate her 80th birthday, Farley returned with Gene and her children and grandchildren to Many Farms, Ariz., which is on the reservation. Gene said Linda delighted spending time with patients she had cared for more than 50 years ago.

Another major influence for the couple was their work at Meharry Medical School in Nashville, Tenn., -- the country's largest private, comprehensive historically black institution for educating health professionals and scientists -- where they established a faculty development program.

At the University of Wisconsin Medical School, Linda Farley served as an assistant professor of Family Medicine, and it was in this role that she received a great deal of regional and national recognition, earning the Society of Teachers of Family Medicine Task Force Appreciation Award in 1993, the Wisconsin State Medical Society Physician Citizen of the Year in 1995 and the American Academy of Family Physicians Presidents Award in 2001.

But the awards and honors were never more than cause for an awkward smile from an instinctively modest woman. Her many friends saw that smile once more this spring, when the Democratic Party of Wisconsin -- of which she was a loyal if frequently prodding member -- honored her and her dear friend, former state Rep. Midge Miller, for their decades of leadership and activism. Democratic Party of Wisconsin Chair Joe Wineke got it right Tuesday when he said that "Linda Farley was a beloved member of the Democratic Party who embodied our commitment to health care reform. Linda devoted her career in medicine and politics to helping the medically underserved and advocating for real health care reform."

While she accepted the honors -- especially if they helped advance the cause of health-care reform -- Farley got excited about caring for people, especially when she was volunteering at the South Madison Health & Family Center-Harambee and other free and low cost clinics.

She delighted in her children and grandchildren, and in her husband, Gene, who survives her. She enjoyed the Madison Quaker Meeting, and the hundreds of friendships and projects that came from it and her involvement with local peace and justice groups.

And Farley positively glowed when she was campaigning for single-payer health care, as a member of Physicians for a National Health Program, the activist group that she helped build into an organization with more than 16,000 physician members. "It's my passion," she would say.

Farley once said that "I'd like to be remembered as a good family doctor who really cared for people."

But she always added that "really caring" required doctors to do more than just give shots and write prescriptions. "We have to be active," she said. "We have to take our experience, our knowledge, and use it to shape a better health care system."

And so she did.

Gene and Linda are two of the loveliest people I have ever had the privilege of knowing. It seems to me that a fitting tribute to Linda would be to put single-payer health care at the forefront of the struggle for social justice, and make her dream a reality.

Book review: Monique and the Mango Rains by Kris Holloway

Monique and the Mango Rains: Two Years with a Midwife in Mali chronicles Kris Holloway's two years as a Peace Corps volunteer in Mali, Africa and also tells the story of a remarkable young woman, Monique Dembele.

Kris Holloway was 21 years old and just out of college when she was assigned to the village of Nampossela, Mali. Her host in the village was 25-year old Monique Dembele, the midwife and general health care provider for the area. Monique had been born in the nearby city of Koutiala, and as is traditional, came to her husband's village to live after her marriage. Because she was fluent in French as well as the local language, she was selected by the village leaders to receive training as a health care worker. This work became Monique's passion.

One of the things that really struck me about Monique Dembele was that, although she had very little formal education and was relatively isolated from many of the ideas that women growing up in the Western world take for granted, she had an amazing feminist sensibility about her. To me it is the essence of feminism to be concerned about what's best for women and children. Monique knew from her health work that multiple successive pregnancies were often deadly for women, as was too-early weaning of babies, so she worked to make birth control pills available in her village.

Another example of this (and a very touching part of the book) was when Kris became aware of and was shocked by the Malian practice of female circumcision. Monique was equally shocked by the revelation that it was not universal practice, that women in the United States are not cut, and can actually enjoy sexual intercourse as much as men. This set Monique on the road of thinking about her younger, pre-pubescent sister, as well as her young daughter.

Over the two years that Kris lived in Nampossela and worked with Monique, the two women became fast friends, a friendship that endured after Kris returned to the United States. Monique visited the United States for a month in 1993. The two women corresponded, sharing their joys and sorrows. More than anything else, this book is a beautiful tribute to a friendship.

Holloway wrote the book after Monique's tragic death in childbirth with her fifth child. (This is not a spoiler. It is included in the book's introduction.) Kris returned to Mali in 1999 to try to understand her friend's death and to advocate for the education of Monique's three living children. The proceeds from Monique and the Mango Rains are directly benefiting her children, as well as helping to fund Clinique Monique outside of Nampossela, a medical clinic founded and run by Monique's cousin. Monique's younger sister Angelé followed in her sister's footsteps by becoming a midwife, and works at the clinic.

I highly recommend this book.

Sobering

HuffPo linked to this article from ABC News. It discusses why rising unemployment will lead to a potentially catastrophic situation with health care in the U.S. In short, we are screwed, whether we've been laid off or we have jobs that provide health insurance. The article predicts that soon the American Hospital Association will be in Washington looking to be bailed out.

"There is a huge, looming problem about what to do with people who are unemployed," said Dr. David Nash, dean of the Jefferson School of Health Policy and Population Health in Philadelphia. "The short answer, regretfully, is that there is no good answer for these people."

I have an answer. It seems to me that was has been happening in the arena of health care for so long, with insurance companies getting fat off of the suffering of ordinary people, is analogous to war profiteering. I may be naive, but I say, take them over. Nationalize health care.

I actually resent these further comments from Dr. David Nash.

"As someone who grew up in Germany and lived for some years in Canada and got used to portable, life-cycle health insurance, I have always been amazed that Americans preferred the ephemeral health insurance that comes with the job at a particular firm and is lost with losing that job." Reinhardt said. "Now, the foolishness of that preference is becoming clear to many middle-class Americans who spent their life denigrating 'government' health insurance.

"Frankly, I find it hard to muster much sympathy for people who are waking up only now."

"There is not a silver lining," Nash said. "What's coming home to roost here is the historical accident of having private health care insurance tied to the place of employment. There is no way out if it is tied to the source of where you work."

Thanks, Dr. Nash, for blaming the victims. Middle-class Americans have been duped by a Congress who allowed health care to become a commodity instead of a right.

The only people I hear denigrating "government" health insurance are Republicans and wealthy people.

Americans have been asking for health care reform for years, and we keep getting "solutions" shoved down our throats that benefit the insurance companies. Unlike members of Congress who have what amounts to a socialized health plan (paid for by us, the People,) the average American has been forced to choose between mediocre or downright bad health plans. There has been no meaningful health care reform. I still seethe when I think about the "blue ribbon panel" that Hillary Clinton chaired, on which sat CEOs from several of the major health insurance companies. Oh yeah, they were really going to come up with a plan that benefited us.

We are living in scary times, and I don't know what it is going to take to make the powers that be change their course and do what's right for the people who really make this country run.