The RW Interview
Dr. Tolbert Small: Journey of a People’s Doctor
Revolutionary Worker #1139, February 17, 2002
Posted at http://rwor.org
The RW Interview is a special feature to acquaint our readers with the views of significant figures in art, theater, music, literature, science, sports and politics. The views expressed by those we interview are, of course, their own, and they are not responsible for the views expressed elsewhere in the Revolutionary Worker and on this website.
Dr. Tolbert Small runs the Harriet Tubman Medical Clinic in East Oakland. The Clinic is located in an old Victorian in the middle of a low-income residential neighborhood. On the walls in the clinic are pictures of Frederick Douglass and Harriet Tubman, African American art, posters from the civil rights and Black liberation movements. In the waiting room, medical magazines and information share the tables with radical literature. On the walls are also some old signs from the days of Jim Crow. “Colored waiting room” one sign reads, a reminder of the overt racism of that time. Most of the patients in the waiting room are African Americans and know that racism is not a thing of the past but confronts them in every aspect of their lives, including health care.
Dr. Small went to college and medical school at a time when Northern medical schools would only admit one token Black student while the Southern schools were “white only.” It was a time when hospitals had quotas on the number of Black patients, and pregnant women were turned away from hospitals with empty beds if the quota was full. “I was a very good student in school. I would usually score the highest mark in the classroom,” Dr. Small remembered. “The teachers would stand behind me and watch me when I took every exam because Black folks weren’t supposed to be smart. I used to jokingly say to myself, ‘Who the hell can I be copying from? I’m scoring the highest damned mark in the room.'”
RW: Why did you decide to become a physician?
Dr. Small: When I was an undergraduate student in college, it was in the early ’60s, and I was involved with SNCC–the Student Non-violent Coordinating Committee. We were interested in developing our skills to either take to some other country that was more interested in providing the things necessary for survival for its citizens, like education and health care, or using it in this country. And so I went into medicine, because I thought it would be a useful skill to have, not only to bring a service that served the needs of the people of our community, but also because our government has a long history of neglecting the health care of its citizens. We spend more money than any other country in the world on health care. We spend 16% of our gross national product on health care. But, when the World Health Organization ranked us [for health care] we were ranked number 37.
RW: How did you come to set up the clinic?
Dr. Small: I came to Oakland in 1968. And I did a lot of different things before I finally opened up an office. I ran a free clinic for the Panther Party for three years. I was their physician for four years. I worked at the West Oakland Health Center for three years. I did emergency room work for nine years. I was doing house calls in West Oakland in the early ’70s, and in North Oakland.
“Healthcare” for Profit
RW: What do you think about the health care system in this country?
Dr. Small: The basic problem is when you hand people a lot of money and you tell them “If you deny care you’ll make money,” they deny care… The head of one HMO sold his interest in the company for $1 billion. In 1995 the government spent, public and private, $1.4 billion on AIDS research. But the top six CEOs of insurance companies–they made $2.4 billion. So it was more than the entire government spent on AIDS research.
RW: How does all this affect your patients? I understand that you used to run a blood-drawing lab here, and you had to close that because you couldn’t get the HMOs or the government to reimburse you.
Dr. Small: If I have someone who has weakness in their legs, back pain, numbness radiating down their leg, obviously they need an MRI to rule out a herniated disk. If I order an MRI, the HMO will not allow me to order it. The radiologists are paid, capitated. Capitation is where they will pay them so many dollars for each patient that signed up whether they are treated or not. So the radiologists don’t want the primary care doctors to be able to order MRIs, because they’ll order “too many” appropriate MRIs. So I have to refer the patient to a neurologist, to a neurosurgeon, orthopedic specialist so they will order MRIs so the insurance company will pay for it.
Inspired by Revolutionary China
RW: You showed me some of the pictures from when you went to China in 1972 with the Black Panther Party–back when China was a socialist country under Mao Tsetung. And I also read a poem you wrote that was printed in the Black Panther Party newspaper titled “Serve the People.”
Dr. Small: I wrote that in China. Yeah. What happened was Huey [Newton] went to China and met Chou En-lai, and Huey suggested that the BPP send a delegation to China and Chou agreed. We were actually supposed to be over there right before Nixon left. But the CIA didn’t want us over there at the same time. When Kissinger was arranging Nixon’s trip, he told Chou En-lai that he wanted the Chinese to leave the American leftists alone. Masai Hewitt and Elaine Brown went to Canada to get our visas. There was no Chinese embassy, of course, in the United States. The Canadian government wouldn’t let them into Canada until after Nixon had come back.
RW: After Mao’s death, capitalism was restored in China and today, the health care system in China, like in the U.S., puts profit above meeting the needs of the people. But you actually saw how under socialism the health care system is run in order to serve the people.
Dr. Small: Well, you know, China in 1972 was a different country than China in 2001. But at that time they were sending “Barefoot Doctors” — they had over a million Barefoot Doctors who were going into the community, providing health care. Whereas in this country, the first thing they ask you when you go into the emergency room is “Do you have insurance?” Medicine in this country is not to provide a service for its citizens, but it’s used for insurance companies and HMO directors to make money, whereas in China in 1972 medicine was supposed to be of service to the people, you know; if you’re a citizen of the country we’ll provide you with an education, we’ll provide health care, we’ll provide all the things necessary for life.
RW: At the time acupuncture was illegal in the U.S. and was not considered “legitimate medicine”–but you learned acupuncture in China and then came back to the U.S. and continued to practice it.
Serving the People
Dr. Small: I had been working with SNCC and the Mississippi Freedom Democratic Party (MFDP) while I was in medical school and when I came out here to intern at Highland Hospital in 1968, I did some work with the Oakland Direct Action Group.
RW: How did you set up and run the free clinics in the community? I know they didn’t get a lot of government funding.
Dr. Small: Well, we relied tremendously on volunteers. When I originally set up the clinic, I was working there Monday, Wednesday and Friday, and I’d get other doctors to volunteer on the other days. We would get volunteers from the community.
RW: The last question I wanted to ask is, what keeps you going? After 30 years, with the government going after you, trying to prevent you from doing your work, going after you financially, working like 12-hour days, 7 days a week. What is it that motivates you and keeps you going?
Dr. Small: When I was younger, I think it was anger that motivated me. I think that people who oppose racism and oppression, it’s psychologically uplifting for them to oppose it. And I think as you develop principles in life where you want to serve the needs of your community, that you can also get your satisfaction and your energy off of the positive things you see in life… Even though you work long hours, you can get some energy out of the positive things that you do in society. You know, I’m almost 60 now and so I’m not quite yet ready to give up!
# # #
Dr. Tolbert Small: Journey of a Peoples Doctorrecmask2019-02-07T04:29:50+00:00