Let’s Learn Our Policy Lessons From Television.

I like the newer medical shows on TV: Chicago Med, The Resident and the latest, New Amsterdam, even though it’s also the most political. Notice the absence of Grays Anatomy, which I consider a hookup show in a medical setting. All of my faves do a good job addressing issues in medicine and healthcare policy, and feature a fair amount of depth and complexity in human relations. New Amsterdam takes place in America’s oldest public hospital, inspired by the actual Bellevue Hospital in New York City, the only one in the world capable of treating Ebola patients, prisoners from Rikers Island and the president of the United States all under one roof. In such a setting, the temptation to be political is irresistible.

In the latest episode, the staff is dealing with a “chain transplant”. No, they aren’t transplanting a chain. When a patient needs a transplant, and the organs in question are not available, either from compatible family members or the national transplant registry, it is possible to set up a chain of transplants. In this case, patient #0 needed a liver transplant, and the sister of another transplant patient who was compatible volunteered to donate a part of her liver in exchange for her brother–patient #1–getting a kidney from a compatible donor who needed a part of a lung from the husband of patient 0. In other words, transplant by quid pro quo. The chain was actually six people, half donors and half patients. If any donor backed out, the chain would collapse. Needless to say, because we have an hour to kill, that happened.

Guess who saved the day? Jorge, an illegal, er unauthorized alien migrant from none other than Guatemala, the country that figures prominently in the migrant caravan so much in the news. Coincidence and timing aside, if no lesson were intended, the savior would have been from Mexico, which supplies the majority of unauthorized migrants to the United States. If it were up to me, I would love for someone like Jorge to get citizenship here. He says he was a policeman in Guatemala who was threatened because he stood up to the gangs and drug cartels, and fled for his life with his 12 year old daughter, who was suffering from lung disease, carrying her much of the way. Finally, he’s in NYC, and she needs a new lung. After the critical donor backed out of donating a kidney to her brother no less (they were estranged), the medical director of New Amsterdam approached the husband of patient 0, asking if he would still donate to the next person in the chain, with a promise they would try very hard to find a new donor for his wife. Without a guaranteed quid pro quo, he backs out too, but it turns out Jorge is a compatible donor to patient 0 for a part of his liver. There’s no quid pro quo for his daughter, since as an unauthorized migrant she isn’t eligible for a donor from the registry. As Jorge is mulling this over, the hospital director calls for volunteers from the public to donate a lung to Jorge’s daughter. Twelve complete strangers volunteer for compatibility testing. Jorge is so moved, he volunteers to donate part of his liver to patient 0, despite there being no guarantee that any of the volunteers will be compatible, or will not follow through.

Contrast the selfless, courageous Jorge with the selfish Americans who backed out of their commitment. The American donor for patient 0 was black, which will no doubt elicit a mega mea culpa from the show once BLM gets wind, or is that breaks wind. Okay, lesson received. As I said, I would love to see Jorge become a citizen. He’s my kind of guy, other than being…you know, unauthorized or undocumented or illegal. I want to offer a proposal: If a foolproof method of determining a person’s character is ever invented, we should give automatic asylum to everyone from any country who gets a high enough score, whatever that turns out to be. We want high character people here. Line up at the border, put the magic helmet on your head, if the light flashes green you’re in, if it flashes red, you’re out. Democrats like that, except make the green light blue.

I wrote a post many months ago about criteria for accepting immigrants into the United States, and nothing I have seen since has weakened my argument. So let me reiterate the principles of sensible, pragmatic membership policy: 1. Whenever a jurisdiction, be it a nation, country club or college, has a huge flow discrepancy, with scads more people wanting in than want out, there must be entrance requirements; 2. That sort of jurisdiction is obviously more of a privilege than one, say like North Korea, which would have a huge flow discrepancy in the opposite direction were it not for exit requirements (the ability to outrun a bullet); 3. The members or citizens of the privileged jurisdiction, not the supplicants, get to set entrance requirements; 4. Such requirements are always designed to enhance the desirability of the jurisdiction; 5. Therefore, no one has a right to be admitted without passing the entrance requirements; 6. Anyone who insists they have a right to be admitted, entrance requirements be damned, is the kind of person who will make the jurisdiction less desirable in the future, and is therefore violating principle #4. They are, in the immortal words of Groucho Marx, the kind of person who should never be in a club that would have them as a member. Need I add that #6 is a valid reason to keep that person out? No one could verify Jorge’s story, he might have been a cartel honcho fleeing other cartel honchos. Also left out is all the violations of US law he had to have committed knowingly in order to get from the Mexican border to NYC.

Ah, I lack compassion? Is it compassionate to destroy the quality of a desirable destination over time by allowing those fleeing a bad situation to import into the new destination problems which made the old situation a mess? I refer to the foundational problems of all failed states, corruption and larceny of the heart. Corruption is the lust for power over others and larceny is the desire to have without earning. While many of the migrants are seeking a better life, the seeking of which is a right, they don’t necessarily have the right to seek it in contravention of the laws of their country of choice. If there was an effective way to weed out the carriers of corruption and larceny, I would applaud using it. Since there isn’t, my emphasis is protecting that which makes us desirable. You may say, “you didn’t earn your American citizenship.” True, nor did I have to, and yes, it is an undeserved privilege, for which I praise God. So what?