Category: National

Be forewarned, this is one of those “in-my-day-things-were-different” columns. And, of course, “different” means better. And “my day,” undoubtedly, will seem like code for light years ago to some. It comes with having lived at another time and not having thrown away the minutes of previous meetings.

Anyway, such musing was prompted by a movement earlier this year in support of an amendment to Florida’s constitution that would require smaller classes for students in public schools. For example, the limit for grades 4 through 8 would be 20 students per teacher. The current average is roughly between 23 and 27.

As a former secondary teacher in Philadelphia and Tampa, I know the import and impact of student-to-teacher ratios. The lower, the better, whether physics or phys ed. But as a former student, I’m still tempted to shake my head incredulously over having survived elementary classes where the ratio sometimes hit 70-1. That’s not a typo.

I take you back to yesteryear, in this case the late ’50s, to St. Timothy’s, a blocky, stone-gray Catholic school in a working-class, row-house section of Philadelphia called Mayfair. We were the sons and daughters of WWII-vet families who couldn’t afford Levittown, but were upwardly mobile enough to escape the temporary, post-war project housing that dotted the city.

The intra-city migration was sometimes referred to as “Welfare to Mayfair,” which was much more a function of self-conscious, self-deprecating humor than accuracy. That’s because all fathers worked — mine was a city bus driver — and all moms stayed home raising ever-burgeoning families.

In my case, three brothers and a sister. And, yes, all parents came in pairs.

For demographic diversity there were variations on a Caucasian Catholic theme: Irish, Italians and Poles. Tolerance was shown in acceptance of the odd Protestant family — incongruously nice folks for infidels, we thought.

We all walked to school and came home for a lunch of baloney sandwiches while watching “Tic Tac Dough.” Whenever we left the building — lunch or dismissal — it was always in well-disciplined lines till we crossed the big streets that abutted the school.

The crossing guards were like extended family. The nuns, with stentorian voices, meat-hook hands and martinet manners, were the enforcers. (Even for fire drills. Never know when you would need to walk in straight lines — at a prudent pace — from a burning building.)

Our eighth-grade class was 35 school-tied boys and 35 uniformed girls. Boys on the left, eight or nine to a runnered row of desks; girls on the right. Some, undoubtedly, with all kinds of undiagnosed learning disabilities.

The Ten Commandments were posted prominently to remind us that there was yet another layer of authority beyond our parents and teachers.

Sister Charles Mary of the Order of St. Joseph arranged us according to academic average — if you can believe such pedagogic heresy. I was a fixture in the first row, periodically switching places with James Krawczyk for the highly sought first desk, which meant that you also doubled as the doorman who personally granted entrance to the Monsignor at report-card time.

Sister or “‘Stir” — as in “No, ‘Stir, I didn’t do it; in fact, ‘Stir, I didn’t even know it was a sin.” — presided as only a stocky, tough-love nun could. Doubt if she had a college degree, let alone a teaching certificate emblematic of a dozen courses in educational psychology. She taught everything — religion to math. All day long. No time off for our good behavior. She gave a lot of homework and never failed to collect it and promptly return it with some sort of comment.

She was the first, last and loudest word on all subjects — from what made a sin mortal to what made a rhombus relevant. You memorized; you recited; you applied; you learned. That was your job.

Amazingly, even David Massucci learned. David had been left back one year and struggled more than most. He anchored the class from the last desk on the boys’ side.

Years later we met up and he was married, the father of two, owned a house and made a good living as a General Motors salesman in Cherry Hill, NJ.

As you might infer, corporal punishment was more than permitted. More than condoned. It was mandated. No parental permission necessary. No Polaroids of black-and-blue butts. Your parents were on the same side as the teacher. And they hit you at home, because they knew what you were like. So parents couldn’t be used for intercession, let alone leverage, against ‘Stir.

Another form of punishment was staying after school. It meant, however, more than heel cooling. You had to do windows, clap erasers and clean the room, including inside and under every desk while ‘Stir checked homework and your buddies played audibly in the adjacent schoolyard. For those deserving hard time, there was heavy lifting at the convent next door.

‘Stir had a ruddy face and fleshy hands. Otherwise, she was all black robes, white habit and rosary beads that made an ominous swishing sound when she bustled down an aisle with hands-on discipline topping her agenda. She was probably about 40 years old, give or take 30 years. Just couldn’t tell with nuns. Most days we were convinced her assignment on earth was to make us learn — whether we hated it or just disliked it. Or her.

Of course, much has changed since that class of 70. The meltdown of the nuclear family, erosion of discipline, drugs, guns, an Eminemed culture and curricula that treat self-esteem as a goal rather than a by-product of learning.That eighth grade year at St. Timothy’s, frankly, was no fun. Thanks, ‘Stir.

HAVANA — For Americans, there’s no place like Cuba.

And it has nothing to do, of course, with pineapple farms, banana groves, banyon trees or thickets of majestic royal palms and sugar cane fields forever. Neither does it have anything to do with remnants of magnificent, neo-colonial architecture, world class baseball without commercial interruption and obscene salaries; spandex-clad young (and not so young) women; infectious music; and the absence of cell phoniness.

It has, however, everything to do with Fidel Castro.

As in nationalization, expropriation, Bay of Pigs, missiles of October and exiles of South Florida. As in embargo, revenge, assassination plots, the mob, and ego. As in Alpha 66, Brothers to the Rescue, Elian and political pandering.

We rebuilt the Axis powers of World War II and normalized relations with the Soviet Union of Stalin and the China of Mao. We’ve kissed up to Vietnam and cut deals with North Korea.

But Cuba is different; it’s the Cold War relic that won’t go away.

It’s also safe, must-see history still in the making.This much we think we know regarding Cuba: at some point America’s unilateral, counterproductive embargo against it will end. And the impetus likely will come courtesy of the “biological solution.” That’s mordant, euphemistic, Cuban shorthand for the mortality of the 74-year-old Castro.

This much, however, we do know. Cubans will retain their characteristic, coping-device sense of humor — and remain among the world’s most resourceful people. In addition, the compromises made to keep the Cuban economy afloat via tourism will continue to mock and erode a failed socialist experiment — like so many “Patria o Muerte” (“Country or Death”) signs incongruously proximate to dilapidated buildings and trash-strewn lots.

This was ever more apparent in a recent visit, this one legal — and the second in two years. This was under the auspices of the Friendship Force, an Atlanta-based organization that promotes private citizen exchanges worldwide. The reciprocal organization was the Cuban Council of Churches, which arranged home stays in Havana and Santa Cruz del Norte, about 100 miles east of Havana.

Revolution in defeat — not transition

Whether the venue was a public housing-ambienced apartment in Havana or a small, plumbing-challenged, adobe-like row house in a small town, this much was clear: Cuba appears increasingly as a revolution in defeat, not transition. Its people deserve better than grim lives offset by hustling for the table scraps from tourism.

There is no more fitting metaphor for Cuban ingenuity, of course, than its stock of well-maintained, vintage American cars. It’s the first thing you notice in Havana after faded facades and laundry-bedecked balconies.

The ’50s fins are still there, but the Cubans have typically removed the gas-guzzling engines and replaced them with Romanian or Russian diesels. These are not museum pieces; they are transportation, many of them private cabs relegated to local peso-paying fares. With gas at more than $3.50 a gallon, siphoning hoses are as necessary as jumper cables.

In all, there are an estimated 150,000 cars, including barely-within-memory Ramblers, Studebakers and Edsels, that are older than the Revolution itself.

There are also the much-maligned Russian cars, notably boxy Ladas and the more recent, less reliable Moskviches. The latter has become the familiar butt of a Cuban joke that has been making the self-deprecating rounds: “Who’s the most deluded person in Cuba? Answer: The owner of a Moskvich; he thinks he owns a car.”

But most urban Cubans still get around on over-loaded, exhaust-spewing buses, bicycles, motor bikes and side-car-affixed motorcycles. In the provinces, animal-drawn transportation remains much in evidence.

Those without transportation can always hitchhike.

Government vehicles, from jeeps to flatbed trucks, routinely stop for those in need who queue up along main roads. It’s not at all unusual to see well-dressed women and girls in school uniforms, called botelleras, flagging down rides with impunity. It’s part of the make-do mentality brought on by the economic hardships of the “Special Period” — as the post-Soviet and Eastern Bloc-subsidy epoch is known.

Make-do mentality

For a number of Cubans and their children it also means living with the occasional rolling blackout and without hot water and reliable toilets. Wood scraps with ill-matched wheels become ad hoc scooters. There is always somebody who knows somebody who can tap into a TV satellite– and see what foreigners see, including CNN and HBO, at the tourist-only hotels. Ditto for those needing an E-mail address to communicate with the outside world. Currently, there are an estimated 60,000 Cubans with E-mail accounts, mostly through universities, workplaces or computer clubs.

Official Cuban television (two stations) is used effectively in the service of the state — furthering such government priorities as public health campaigns and English language instruction.

That resolviendo (making do somehow) mentality is notably evident in moonlighting, Cuban style. With the tourism-inspired influx of visitors — and the legal tender status of the dollar since 1993 — many physicians, attorneys, engineers and teachers can be found working for tips as waiters, bartenders, tour guides and cab drivers. To paraphrase Willie Sutton: That’s where the dollars are. Especially if you’re not fortunate enough to have cash-wiring family in Miami.

Without access to dollars, the professionally educated can’t expect to make much more than about 400 pesos ($20) per month. Plus, anyone who owes his education to the government — which is virtually everyone — is forbidden from seeing patients or clients privately. Those with lesser state jobs average half what professionals make. Pensioners receive $3-4 monthly.

The “internal” embargo

Even those in business for themselves, such as it is, find themselves governmentally hamstrung by what is cynically called, by Cubans, the “internal embargo.” That is the incentive-stifling system of surprise inspections and relatively stiff fees and taxes for small, private restaurant (paladar) owners or venders.

For example, Ofelia, a middle-aged artisan, pays $15 a day for enough room to set up a small rack for her inexpensive, hand-made sweaters near the resort beaches of Varadero in North Cuba. That’s whether she sells anything or not. By decree, she works half the month: a pattern of two consecutive days on, then two days off. She also had to pass a rigorous exam after two years of studying Cuban folk art and prove to the government that she was, indeed, the artisan — not some capitalistic hireling.

Ration-card subsidies, which range from modest rice, beans and bread allotments to cigars, cigarettes and matches, will typically need supplementing from the parallel markets, Cubans tell you, at four times the price.

Increasingly, churches are playing a supplementary role to the erstwhile atheist — now “secular” — government by helping get food and clothing to the most needy. It’s hardly a windfall, but the modest aid is the quid pro quo Castro exacts for having eased off religious oppression.

In Old Havana there are scores of mostly benign hustlers making the rounds. The crackdown on prostitutes has been effective.

Some hustlers, called jineteros (“jockeys”) impassively inquire about your taste in cigars or whether they can direct you to a paladar, which are literally part of a family residence, seat no more than 12, and employ no one outside the family.

Others ask, on average, for a dollar “to practice” their English. The rate is the same for those crooning “Guantanamera” or posing for photos in Colonial garb.

Dollar dichotomy

Thanks to tourism (nearly 2 million visitors — predominantly from Europe and Canada — that now generates (at $1
.3 billion) more than half of the country’s revenue, and joint-ventures, Cuba’s gross domestic product is expanding in the 5% range. It was contracting severely in the early ’90s.

Castro, for example, has sold half of Cuba’s cigar export monopoly to the Spanish. Canada is buying into the nickel sector and Europeans into oil. Israel has a citrus export agreement. Sol Melia, an international Spanish hotel chain, is building its 14th Cuban resort. UNESCO underwrites some historic restorations.

But the down side of an economy that is barely off life-support is a societal issue no less threatening — if you think about what causes revolutions in the first place.

Cuba, Marxist ideology notwithstanding, now sports three blatantly distinct classes. High-profile foreigners, both tourists and joint-venturing investors, who have dollars; Cubans who have access to dollars; and Cubans who don’t. It’s an incongruously complicating position for a country grounded in command-economy principles and egalitarian tenets.

The juxtaposition of average habaneros — typically crammed into aging, tiny apartments within large, crumbling neoclassical structures — with affluent Canadians and Europeans coursing around town in Mercedes cabs could, one would think, foment frustration, disillusionment and bitterness.

Ruben, a 40-something Havana friend with four children, two jobs, a wife and a 15-year-old Moskvich, wouldn’t argue the point. He’s already been turned down for a visa to the U.S., and he knows he has no future in Cuba.

“Do you know what it’s like to live your life under socialism?” he asked. “To see those ‘Socialism or death’ banners every day. Ughhh

There was an overseas ceremony recently that should give all Americans cause for pause and reflection, if not an irony fix for the ages.

Secretary of State Madeleine Albright formally dedicated a new U.S. consulate building in Ho Chi Minh City, Vietnam. The new American consulate reestablishes a diplomatic foothold in the erstwhile Saigon for the first time since 1975. That’s when U.S. diplomats fled the advancing North Vietnamese forces that overran the American-backed South Vietnamese army in the last stage of that tragic American misadventure.

In her prepared remarks, America’s Iron Lady said, “The United States and Vietnam will forever be linked by history. But by continuing to work together to transcend that tragic legacy, we can add to our shared history bright new chapters of hope and mutual prosperity.”

That shared history, of course, includes more than 50,000 dead GIs and another 2,000 service personnel still listed as missing in action a generation later. It even brought down a president.

Meanwhile in Washington, House and Senate negotiators are still trying to wrangle a compromise that would at least permit an easing of the embargo on sales of food and medical supplies to Cuba. Through four decades and nine presidents, beginning with President Dwight Eisenhower in 1960, Americans have been banned from selling much of anything to Cuba. To those who have questioned presidential guts in dealing with the South Florida Cuban-American lobby, the Administrations’ responses have been, in effect: “That’s the way it embargoes. We don’t want to be known as the Administration that ‘gave in’ to Castro.”

Because Fidel Castro has refused to die off, the embargo lives on. Its impact, especially in the aftermath of the Soviet Union’s implosion, hurts nobody but American business interests and the Cuban people who, like people everywhere, are hardly responsible for the government they’re saddled with.

We’ve never been to war with Cuba, and the island was never a killing field for American soldiers. The embargo is a counterproductive, foreign-policy incongruity that induces global alienation and ridicule — and that’s from our allies.

Yet, inexplicably, a new chapter of “hope and mutual prosperity” applies only to Vietnam, not Cuba. Explained Albright: “It will help us better serve the American business community, which is concentrated here in the south (of Vietnam).” That eclectic business community, it should be noted, even includes the J. Walter Thompson ad agency. Perhaps JWT should pitch the Cuba account.

But back in the states, farm groups and agribusinesses continue to clamor for their piece of “mutual prosperity” and permission to move a glut of grain that has been depressing commodity prices. Such beseeching is belittling when the rationales of humanitarian aid, enlightened self-interest and common sense should be carrying the day.

So, while American officials in Vietnam say they now expect to receive up to 25,000 requests each year for permission to live permanently in the United States, Cuban smugglers continue to traffick in those fleeing from the deprivations ensured by the U.S. embargo.

Isn’t it, after forty years of failed policy, time to “transcend that tragic legacy”?

This summer’s pro-democracy protests in Iran took much of the West by surprise. It did so because we know so little of that country beyond its image as a terrorist state that sanctioned the taking of American hostages.

Its most recognizable images are anti-American demonstrators, androgynous, chador-shrouded women and grim-looking clerics — all seemingly trying to repeal the 20th century.

What most Americans don’t know is that most Iranians weren’t around for the Revolution of 1979. In fact, two thirds of its 64 million people are under age 25. Its youth, who can start voting at age 15, are the most educated generation in Iran’s history. From 1979 to 1999, literacy went from 58% to 82%. Not surprisingly, they want what most people want — a better life.

This generation knows the revolution unshackled Iranians from an authoritarian dynasty, and that Islam was the vehicle. What many of them also know is that the revolution against a dictatorship was hijacked by the most conservative clerics.

These reactionary mullahs, in turn, crafted a constitution delegating ultimate power to a supreme religious leader — Ayatollah Ruhollah Khomeini and his 10-year successor, Ayatollah Seyyed Ali Khamenei. Purges, opposition bashing and rigid social restrictions have followed.

When the opportunity came, however, to popularly elect a president in 1997, a mandate for the reformist Mohammad Khatami resulted. Khatami, who favored an opening to the West and democratic reforms at home, won 70% of the youth-skewed vote in a four-way contest. He’ll likely be re-elected next year as well.

While the students respect Khatami, they’ve grown restless for rapid results. They want more republic and less theocracy in the Islamic Republic. And that’s what Khatami, ever mindful that his hard-line opposition ultimately controls the police, the judiciary and the media, can’t deliver at more than a prudent pace. This uneasy state of discontent was shattered when police and vigilante-type activists stormed a Tehran University dormitory and set in motion a series of demonstrations and riotous behavior in a number of Iranian cities.

Journalist Joe O’Neill was traveling in Iran prior to the outbreaks, and he reports on a populace that, for all its recent history and alien Islamic ways, has more in common than conflict with Americans. He was also privy to some of the frustrations simmering among Iranian students.

TEHRAN– “Some places you have to see for yourself.” That was my stock, terse-to-a-fault answer, and I stuck with it when queried about plans to spend some time recently in Iran.

THAT Iran.

Of American hostage-taking fame. Of “Death-to-the-Great Satan” renown. Of state-sponsorship-of-terrorism repute. Of Satanic Verses hitmen. Of teenage “martyrs.” Of dyspeptic, stern-visaged mullahs. Of sepulchral, chador-shrouded women. Of Luddite license toward the Internet. Of Koranic cops. Of heavy-handed censorship. Of institutionalized anti-Semiticism. Of public executions. Of earthquakes. Of awful television. Of squat toilets. Of no beer.

What’s not to dislike except for world-class worry beads and nickel-a-liter gas?

“You are American, yes? I’ve been to Kansas City. America is a great country. Americans are great people. These are my children.”

The longer answer says that too much that matters to America — and the rest of the world — has happened here. The fall of the Shah and the rise of the Ayatollah Khomeini made us examine our culture as well as our foreign policy.

The short list of America’s favorite autocrats was subsequently downsized. It also forced us to acknowledge Islam beyond knowing it has something to do with Muhammad Ali, Louis Farrakhan and a bunch of black bouncers in bow ties.

To know a country and a people only through the filtered lens of the American media is to court collective ignorance. Arguably, too many Americans are already there on matters historical and geographical.

“Mister — you American? Welcome. You-like-Iranian-people-we-like Americans.”

A civilization — Persian –that has been around for 2,500 years and weathered invasions by Greeks, Arabs, Mongols and McDonalds has some kind of staying power. It is the only country — Persia officially became Iran in 1935 — invaded by Arabs that retained its language — Farsi — and culture.

Its 64 million people — from Third World, desert-dwelling nomads to first-among-equals nabobs in the gated communities of North Tehran — are as proud as they are stubborn. They are also young. Half the country’s population wasn’t around for the Khomeini-led revolution of 1979.

Although 20 years removed from the Islamic Revolution and the takeover of the U.S. Embassy, the 444-day, hostage ordeal understandably remains — for many Americans — a defining, viscerally humiliating and enraging image in the demonizing of America. For many in the West — especially the U.S. — Islam has replaced communism as the Cold War villain. And nobody among the one-fifth of the planet who practice Islam has been more villainous than the theocracy from hell, the Islamic Republic of Iran.

But a funny thing happened on the way to reinforcing an unflattering stereotype of the country so many Americans love to hate. The Iranian people wouldn’t cooperate.

“HELLL-o, HELLL-o. Sorry for my English not so good. Good bye and welcome.”

Not in Tehran, a noisy, nondescript, motorcycle-and-car-clogged city of more than 10 million people — most of whom appear to be crossing the street at any given time — and hundreds of abandoned construction projects. Nor in the sprawling, time-warp bazaars of Shiraz and Isfahan, the latter an oasis of beauty in an ancient ruins, desolation-dominated countryside. Not in scores of produce and spice shops; not in mosques; not at newsstands; not near universities; and not by ad hoc soccer fields.

The Iranian people were uniformly open, gracious and typically taken aback. Some NATO allies wouldn’t have been so hospitable. Old and (especially) young, male and (even) female; civilians, clerics, cops. And yes, there are mild-mannered mullahs and disarmingly friendly soldiers.

Iraqis, afterall, are the real, eight-years-worth-of-devastating-war enemy in Iran. And if Iranians just want to feel superior, there’s always the lowly Afghanis, currently straining resources as refugees from Taliban barbarities.

“Welcome to Yazd. We like Americans. Do you like futbol? World Cup? Iran 2, USA, 1. But America is good team too.”

Americans, however, seem viewed more as intriguing curiosity pieces, unwitting hostages, so to speak, of Middle Eastern stereotypes and a government still officially inimical to their own. Erstwhile support for the Shah is more a colonial footnote than a reason to dislike Americans now. And it’s been 11 years since the USS Vincennes downed a commercial Iranian airliner.

It’s as if a decade removed from the death of ultimate zealot Khomeini, there’s a sense that so much of what impacts Iranian lives today — U.S. trade sanctions notwithstanding — has increasingly little to do with America and nothing to do with Americans. It has much more to do with depressed oil prices, refugee problems, a population explosion, xenophobic attitudes and governmental meddling in the economy.

“Mister. Can we speak English to you? We-like-Americans-do-you-like-President-Khatami?”

Sure, the Iranian government is restrictive and paranoid, but who can explain governments anyhow, including our own? And yes, the name Monica Lewinsky, embarrassingly enough, did surface but only to buttress the contention that government leaders are rarely worthy of those they govern.

Right now Iran is undergoing serious, sometimes strident, internal debate on just how much to open up to the West and how much to ease up on its citizens without running afoul of Islamic guidelines. The personally popular president, Mohammad Khatami, does a high-wire act daily over the political mosh pit of religious hard liners and pragmatic reformers.

“I think what you have experienced in your travels is a true reflection of how Iranian people feel about Americans,” summarized Akbar Heshani, the owner of one of the myriad Persian carpet shops in the Isfahan bazaar. “You are admired as a people because of your many accomplishments and your country, of course, is the only super power,” he said. “The Iranian people are surprised and probably flattered you are here.

“All that’s happened in the past is between governments,” he added. “We are different, but we can still be friends.”For now, that will have to do.

There are no official diplomatic relations between the U.S. and Iran. Only recently has the U.S. government backed off its embargo on all trade with what is still considered a pariah state that supports terrorism and fancies weapons of mass destruction. Sanctions are being waived on a case-by-case basis on the export of food and medicine.

As for Iran, although President Khatami has called for better relations with the U.S., he has stopped short of endorsing an official dialogue. But the good news is the reminder that individuals will always have more in common than in conflict.

What’s amazing, however, is that we have to keep relearning that basic lesson in human nature. People not caught up in governmental power politics tend to get along.

Which means that diplomatically, a friendly “salaam,” a courteous smile and an extended hand will just have to do — nicely as it turns out.

Let the (Friendship) Force be with you

The U.S. State Department officially — and euphemistically — warns all U.S. citizens to “defer” travel to Iran. There are no formal diplomatic or consular relations between the U.S. and Iran, although the Swiss government, through its embassy in Tehran, serves as protecting power for U.S. interests there.

But nobody pretends a surrogate government can “protect” an American the way an American Embassy can — provided, of course, no one swarms its grounds, scales its walls and takes its citizens hostage.

The Iranian government, however, does grant visas to American citizens and operates an Interests Section in Washington. Application can be made there — and a visa granted subject to review by Iran’s Foreign Ministry. The understandably few Americans interested in traveling to Iran are advised to allow at lea
st several months for the visa process to run its bureaucratic course.

In my case, there was also the travel vehicle of the Friendship Force, a non-political organization that fosters friendship among private citizens worldwide. I traveled with a contingent of 24 other Friendship Force “ambassadors.” The Friendship Force expedited the visa paperwork by utilizing the good offices of Canada, which often intercedes for the officially estranged countries.

Co-founded more than 20 years ago by former President Jimmy Carter, the FF is based on the premise that friendship — facilitated by direct people-to-people contact — can be a catalyst for improved world relations. Atlanta-based Friendship Force International now includes clubs in more than 350 communities around the world — from Brazil to Belarus.

Additional information on The Friendship Force is available at (404) 522-9490.

Land of contrasts, country in transition

Some things you can’t blame on an all day, all-night, twitchy-limbed, bleary-eyed flight from Tampa to Tehran via New York and Frankfurt.

For instance, upon the approach to Tehran there was an abrupt morphing of all the women aboard Lufthansa flight 405 into a sea of cloaked, scarfed specters. No manner of eye-rubbing and double-taking could change it.

One moment you’re next to a woman; the next moment you’re beside a speed bump. For some, make-up became even less prominent. Whether Westernized Iranians returning from overseas or non-Islamic Republic visitors, they were all gearing up to cover up.

Since 1983, public “veiling” has been mandatory for all women in Iran. And there are no summer-color loopholes. Earth tones rule.

Then there’s the Customs Declaration for Arriving Passengers. “In The Name of God” is emblazoned at the top of the form to remind all that the Deity is also the Ultimate Bureaucrat in Iran.

Anyhow, you’re asked to declare that not only are you not bringing guns, ammunition, drugs, alcoholic beverages and glossies of the late Shah into Iran, but you’re also not toting cassettes, CDs, books, magazines and films that are “in violation of public order and decency and national and religious values of the country.”

Party on.

After a two-hour airport welcome — disguised as a paranoia attack by officials at the sight of 25 Americans — it’s on to an official briefing. To quote a government tour guide: “You must remember that there is no alcohol available here. It is forbidden. Not in the hotel. Not in restaurants

Just when it appeared that Gov. George W. Bush and Sen. John McCain might both self-destruct in a demolition derby of character assassination, along came the Al Gore-Bill Bradley debate. The high decibel, raucous, celebrity-dotted one at the Apollo Theatre in Harlem sponsored by CNN, Time and the WWF. Call it “Pandermania I.”

This exercise in recrimination, revisionism and rank rejoinders was enough to get Michael Dukakis, Walter Mondale and George McGovern looking for their running shoes again. Gore and Bradley forensically flogged each other and tripped over the truth in blatantly pandering to America’s black voters — especially when it came to who was more opposed to racial profiling and more in favor of affirmative action. Neither, however, thought much of Bob Jones University, which doesn’t even have a basketball team.

Bradley won on points if extra credit is given for “white skin privilege” references (4) and sheer persistence of stagecraft. The former New Jersey senator tried repeatedly to reacquaint Gore with the documentation of his five senate votes between 1979 and 1981 to preserve tax-exempt status for colleges that racially discriminate.

It was somehow fitting that the Rev. Al Sharpton was accorded the evening’s leadoff question. It was on racial profiling and police brutality and was framed in the perception that “Many in our community have to live in fear of both the cops and the robbers.”

Too bad that neither candidate had the guts — and indifference to Democratic Party sacrilege and political suicide — to frame the first answer this way: “Many in your community also have to live in fear of professional race baiters who feed off and foment fears, stereotypes and rumors to advance their own agendas.”

Little Richard, where were you when we needed you?

The occasion of Great Britain’s recent decision to suspend Northern Ireland’s fledgling, power-sharing, Protestant-Catholic government had me re-reading my notes from Gerry Adams’ barnstorming American tour last year. Florida was on the itinerary, and I listened to the Sinn Fein leader at the University of Tampa and at Colin Breen’s Four Green Fields Irish Pub near downtown Tampa.

Adams — who’s no Lucky Charms cut-up — can be pleasant and polite. But the tenor of his comments, in the context of the precarious state of the Good Friday Agreement, was as disarming as it was illuminating. Adams is brinkmanship incarnate.

The current deal-breaker, of course, is the IRA’s reluctance to turn over weapons — “decommissioning” as it’s called in the argot of disarmament. And to do it with enough specificity of detail to assure all parties of Sinn Fein’s commitment to non-violence and the 72-day-old, now suspended, Belfast government. As of now, talks remain broken off with the official disarmament panel of Gen. John de Chastelain of Canada. Secure Semtex supplies and caches of automatic weapons are reminders that the IRA is still armed and not ready for the alternative.

In his Tampa appearance, Adams made clear that the Good Friday peace accord and what was to become the shared-power experiment in self-government was merely a “short term, strategic goal.” Unification with the Republic of Ireland remained, unwaveringly, the long-term goal. And, according to Adams, “long term” is not all that “long” as demographic patterns continue to favor Northern Ireland’s Catholic population. More like “15-25 years out,” he said. In other words, a favorable self-determination scenario looms large.

“Irish unity will manifest itself in whatever society people want,” he stated a year ago. “Peace is not just the absence of violence. It’s also justice

Time was when South Florida’s Cuban exiles and pandering politicians were satisfied with holding veto power over United States’ policy toward Havana. Until Fidel Castro dies off, went their mantra, the embargo lives on. End of discussion — unless anti-embargo voices actually enjoyed the irony of being shouted down by undemocratic demagogues draped in the American flag.

That such lethal leverage, made possible by political expedience and cowardice in Washington, was not in the best interests of the Cuban people or American businesses was incidental. That it was inimical to U.S. foreign-policy credibility was irrelevant. That it was numbskull dumb and perversely unpatriotic was ignored.

The anti-Castro vendetta that masquerades as principled policy toward Cuba, however, has reached a new low with the custody crucible of the shipwrecked Elian Gonzalez. The six year old was found lashed to an inner tube off the coast of Ft. Lauderdale on Thanksgiving morning, after his mother, her boyfriend and nine others had drowned. Now it’s the best interests of a traumatized child that are being sacrificed by the exploitative exile community.

The usual suspects, led by the reactionary likes of South Florida Congressman Lincoln Diaz-Balart and Congresswoman Ileana Ros-Lehtinen, became human velcro in attaching themselves to Elian. They cast him as a victim of Communism in a cold war custody battle between his Miami relatives and his father and two sets of grandparents in Cuba, who have played major roles in his upbringing.

In reality, he was more a victim of reckless endangerment, as his mother’s boyfriend jammed too many smuggled passengers — at $1,000 a pop — into his small aluminum motorboat.

Amid the propaganda firestorm of jingoistic rhetoric and a backdrop of intimidating demonstrations, Judge Rosa Rodriguez of the Miami-Dade Circuit Court has granted temporary custody of Elian to relatives in Miami. Interestingly enough, the consultant who ran her election campaign is also a spokesman for the custody-battling Miami Gonzalezes.

Just days before Judge Rodriguez’s non-conflict-of-interest decision, the Immigration and Naturalization Service had ruled that Elian’s father, Juan Miguel Gonzalez, was the only person it recognized as representing the child’s best interest and should expect him home in Cardenas, Cuba by January 14.

For a state court to blindside the federal government — in the form of an INS order — is a bizarre delaying tactic, likely not legal and a mockery of expeditious justice. But it could work. Although Attorney General Janet Reno says the Rodriguez order has “no force or effect,” the Clinton Administration may, in effect, not want to continue to play the heavy to influential, South Florida fanatics in an election year. A full evidentiary hearing isn’t scheduled until March 6. That’s two more bribery-filled months of ice cream utopia, video games, Nike sportswear, Disney World visits, Universal Studios tours, cell phones, Gap Kids duds and skewed views of daily life in America.

Legally and morally, this is equal parts sham and shame.

Under U.S. law, when one parent dies, custody of a child belongs to the other parent — absent evidence, such as neglect or abuse, that the surviving parent is unfit. Being a card-carrying Communist living in Cuba does not disqualify Juan Miguel Rodriguez from custody of his son. Even if he has a framed glossy of Che and a velvet Fidel in his home. There is no exemption from doing the right thing because Cuba is involved.

What Elian Gonzalez has needed once he had recovered from his ordeal at sea, was the love and security of family members who had raised him — not status as a tug-of-war trophy. He’s at the epicenter of an anti-Castro circus, a pawn between propagandists on both sides of the Florida Straits. He belongs, not to an ideology, but to a family and a father. He is a little boy, not a geopolitical icon.

To date, the irrational, intolerant, Cuban exile community is winning the war of words and warnings. It is inimitably aided by the political ploys of North Carolina Senator Jesse Helms, Florida Senator Connie Mack and Indiana Representative Dan Burton. It is further fortified by the anti-Castro forensics of the Republican Six and the laissez faire-weather approach of the Administration and the men who would be the next Democrat elected president.

Oh, and Castro also wins. The Elian affair is propaganda manna for a dictator. He gets another welcome diversion to rally his island against the Yanqui bully that hypocritically equates material goods with family values.

When he was pulled from the sea, Elian had no idea he would later be thrown to the sharks.

HAVANA — Amid the mix of vintage Chevrolets, Oldsmobiles and Pontiacs, several Mercedes cabs, a few dowdy, Soviet-era Lada compacts, and the omnipresent, sidecar-affixed motorcycles, there was no missing the military truck. Towering over the traffic, it had showed some serious acceleration until it abruptly stopped in front of Parque de la Fraternidad near downtown Havana. Then out jumped two armed, sternly-visaged soldiers.

A dissident sweep, perhaps? Overkill in the war against street-corner speculators? The ultimate, strong-arm strategy in the inchoate, frustrating fight against pickpockets and prostitutes?

Hardly.

The two soldiers immediately hustled to the rear of the truck, where they opened the canvas flap. A frail woman, likely in her 70s, was then helped down by the soldiers. Next came a youth of maybe 10; then his bicycle. Then another two dozen civilians.

This was hitchhiking, Cuban style, a microcosm of the island’s indefatigable, make-do mentality. Outside Havana and other cities there are yellow-suited officials called amarillos who queue up hordes of hitchhikers and wave down state vehicles, which are required to stop and give a lift to a companero — or comrade.

It was a graphic reminder that Cuba is still very much in its “Special Period,” as the post-Eastern Bloc-subsidy epoch is known. In effect, in means “tough it out some more” while Cuba, a country reborn of revolutionary rhetoric and raised on ration cards, recovers from near economic collapse with a diet of dollars and a rapid-growth tourism strategy.

Cuba and its 12 million people have learned to live with the punitive U.S. embargo — called a blockade by all Cubans — and, indeed, Fidel Castro has been able to use it for his own anti-imperialist, scapegoating purposes. But it’s the dollars, legal tender since 1993, and the (mostly) European, Canadian and Mexican tourists that have morphed Castro’s socialist dream into some kind of perverse practical joke.

While the country formally celebrates the 40th anniversary of its revolution this year, the requisite, long-winded speeches — not the least of which, of course, are still by Castro — are now muted with caveats against crime and decadence. Both are directly linked to free-market reforms — such as limited free enterprise and legalized self-employment — and tourism. Especially tourism.

Recently Otto Rivero, the president of the Union of Young Communists, laced his revolutionary boilerplate with dire warnings about “…delinquency, economic crimes against state property, prostitution and its effects, consumption of drugs and the proliferation of children begging from tourists…”

While a pretty fair argument can be mustered for any kind of revolution that would have ousted the corrupt Batista regime in 1959 and introduced free medical care, education and food rations, it’s beyond irony that the seeds are seemingly being resown for the next revolution.

Castro himself warned of as much in a speech to police earlier this year urging a further crackdown on crime, which he compared to a “fifth column” of enemies attacking the socialist revolution from within.

“On you depends internal order, and if we lose the battle for internal order, then we lose everything,” said Castro, who, nonetheless, realizes he can’t woo free-spending tourists to a police state. Club Dread would be a hard sell.

Moreover, all such ideological skirmishes are fought in the context of a tinderbox economy. Cuban peso salaries, including those of professionals, currently average about $15 a month. Pensioners draw an average of $3 monthly. The juxtaposition of such Cubans — typically crammed into aging, tiny apartments within large, crumbling neoclassical structures — with affluent tourists coursing around town can foment frustration, disillusionment and jealousy.

The best stores, goods, accommodations, taxis and even hospital facilities are not for local consumption. Pesos are redeemable for only a half bottle of cooking oil, 5 pounds of rice and four eggs per month, when available. They’ll also pay for a baseball game, and a few centavos will also get you aboard one of the ugly, jam-packed, troop train-like buses called camellos (camels). Virtually nothing worth having, let alone luxury items, is available without dollars — often a lot of them.

No revolution yet known to man has been able, ultimately, to negate human nature. People have wants not satisfied by revolutionary slogans. No revolution has ever been able to justify a sense of low self-worth and second-class status in one’s own country. It’s why revolutions are fought in the first place.

No wonder, then, that an all-too-typical street scene in Old Havana includes an eclectic mix of sleek cabs, bicycle-driven rickshaws and fancy tour buses wending around European tourists, cigar hustlers, generic beggars, young hookers and restaurant touts. And it’s not just the Italians, Brits, Spaniards and Canadians who sport the occasional Tommy Hilfiger shirt, New York Yanqui cap and bad Nike knock-off. And audible somehow, somewhere over the street noise are the inevitable strains of “Guantanamera,” now a siren song for foreign tourists.

Literally overlooking such ticklish tableaus are locals peering impassively down from their laundry-bedecked balconies. What might be on their minds might be Castro’s worst nightmare.

“Castro’s done what he’s had to in order to weather the toughest of times,” says Harry Vanden, a professor of government and international affairs at the University of South Florida and an expert on Latin America. “But he’s had to take some pretty extreme measures to pull it off. They can get away with what they’re doing for a few years, but how long does a ‘Special Period’ last?”

As recently as 1990, Cuba hosted only 100,000 tourists; in 1998, it welcomed 1.5 million. The government, largely reliant on European and Canadian joint-ventures for its boom in hotel construction and renovation, projects 7 million tourists by 2010 — even if the bloqueo remains. (Total joint ventures between Cuba and foreign investors now number approximately 340. There were 50 in 1992. Moreover, total foreign investment, including telecommunications and oil and gas exploration, amounted to $550 million last year. As recently as 1995, it was a mere $80 million.)

“Special Period” concessions that have resulted in an influx of tourists, investors and media — and an infusion of hard currency — have turned doctors, attorneys, engineers and teachers into maids, waiters, bartenders, bellboys and cab drivers. Many moonlight; many more have simply forsaken their formal training altogether. Cuban law prohibits individuals from moonlighting in their professional areas, so doctors, for example, cannot see patients on the side. But there’s no proscription against, say, M.D. maitre d’s or cabbie-neurosurgeons, for that matter.

There have now evolved three classes of people in Cuba: Cubans with dollars; Cubans who can’t get them; and foreigners, mostly tourists, with plenty of them. It’s an increasingly volatile mix.

Besides panhandling, drug-dealing and flesh-peddling, the illegal or “anti-social” means of obtaining dollars are unauthorized rooms to let, unlicensed taxi drivers and a myriad of anti-government scams. These range from fishermen skimming a portion of their catch to sell to restaurants to government cigar rollers selling smuggled, contraband smokes.

Except for those with dollar-dispatching relatives and now friends in America, Cubans’ best chances of legally tapping into the dollar economy are through flea-market vending, farmers’ markets, small (maximum 12 seats), private, in-home restaurants (called paladares) and tourism-related positions that are top heavy in tips. (Merely working for a foreign employer isn’t enough, for the government directly collects Cubans’ salaries in dollars and, in turn, pays the workers in devalued pesos.)

“Some of these (nose-in-the-air gesture) tourists treat us as if we were just (ignorant, lower-caste) brutas,” noted Maria, a pretty and pleasant maid in the histo
ric Hotel Nacional de Cuba in the Vedado section of Havana. “I understand it’s that way in other cultures. But we are not brutas. We just have families to support.”

She was by training, she pointed out, an attorney — and bruta connotation notwithstanding — one of the luckier ones.And then there was Arsenio, a cab driver in his 50s who had been educated as an engineer. He had a prime spot in front of the Nacional — as well as a late model Mercedes. He had a track record for being “honest and punctual” he explained, and that qualified him to bid for the luxury cab, which, in turn, enabled him to work the better hotels.

Arsenio was a veritable tour guide and his insights ranged from the early Soviet years to the current “Special Period.”

The Cuban people, he said, were on to the Russians’ agenda from the start. “They arrived wearing sandals,” he said. “We knew why they were really here.”While he was quite capable of working himself into a geo-political lather over the American embargo, he opined that “Either extreme was not good” meaning the worst of capitalism and the worst of socialism. He chuckled in agreement that both Louis XIV and Robespierre had their failings.

But there was little room for levity in referencing the “Special Period.” His anecdotal accounts included the increased incidence of grave robbings (of older generation Cubans who were customarily buried with their jewelry) to the “apathy” of Cuban youth, who have no memory of the Revolution and are less enamored of Castro than older generations.

“They don’t want to go to school; they want what they see on TV,” said Arsenio. They also see an austere life in the midst of plenty as well as a bleak future continually mocked by socialist slogans and revolutionary rhetoric.

For Castro, the epitome of charisma and emblematic of all that is Communist Cuba, such alienation — not embargoes, CIA plots and the Soviet implosion — is his most formidable challenge in years, maybe ever.

It’s undoubtedly too late to rebottle the genie of tourism, and definitely too late for Castro to change. He made that clear enough late last month when he wrapped up an international economics forum in Havana with a declaration that the current global economy will eventually cease to function. He then predicted that the new world order would be “socialist, communist or whatever you want to call it.”

Some would certainly call it unrealistic as well as the philosophic rantings of one scrambling pragmatically to survive the loss of $6 billion in annual Soviet subsidies.

Too bad Castro never heeded the wisdom of Winston Churchill, whose words more than 40 years ago ring no less true today. “The vice of capitalism is that it stands for the unequal distribution of goods and services,” said Churchill. “The virtue of socialism is that it stands for the equal distribution of misery.”

Unless, of course, you have dollars.

D ANVILLE, PA — In piecemeal fashion, the doctors shuffled into Hemelright Auditorium. Most remained garbed in their lab coats; some still sported surgical caps and foot covers. Light banter was a no show; physicians wore the grim-visaged game faces of modern medicine.

These Geisinger Medical Center doctors — some 60 in number, including oncologists, nephrologists, cardiologists, radiologists and dermatologists — had not gathered on this September evening to hear about medical protocols, research findings or surgical procedures. They had assembled to hear about forming a union.

This is hardly what Abigail Geisinger could have envisioned in 1915 — nor what anyone who has ever taken the Hippocratic oath ever had in mind. Then again, Hippocrates never had to sweat the details of “downsizing” or reimbursement.

Welcome to the brave new world of managed care, where big medicine is very much big business. And that big, landmark campus on the hill — now a component partner in the merged entity known as Penn State Geisinger Health System — is hardly immune.

Sure, Geisinger, which began offering its own health-care plan to its employees in 1984 and is now the largest rural HMO in the country, is still known nationally as a near utopian sanctuary for the practice of big-time medicine in small-town America. But no less sure is that as hub of the PSGHS’s Central Region, it must deal with a current budget shortfall of $18 million. And for all its national acclaim, it is plagued by a ’90s track record of layoffs, outsourcing and flat physician compensation — amid an uneasy environment of competitive pressures and pricey technology.

Geisinger’s growing pains are largely a function of being paid less by the government as well as by insurance companies. Health plan premiums have been flat for three years — and that money represents $3 out of every $5 Geisinger takes in. And being relatively top-heavy in Medicare patients hardly helps.

Such fiscal concerns, however, are compounded, say many clinicians, by morale-sapping perceptions — from the humanistic to the strategic. Communication from the top down, for example, is often seen as arrogant and nominal. Various communication teams — strategic elements in the Geisinger 2000 master plan for change — include clinician input but are often viewed as window-dressing.

Some point to the new Women’s Center as Exhibit A for skewed priorities at a time when other services, such as the Geisinger Pain Clinic, are being pared back. Even casual observers note the juxtaposition of the Women’s Center construction to the nearby, 3-year-old Janet Weis Children’s Hospital — where one whole floor is closed and wards periodically are shut down. Then add worries about a “brain drain” and identity anxiety that Hershey, where PSU’s College of Medicine is quartered, will increasingly supplant the Danville-based Geisinger Medical Center as provider of first resort for most specialties.

It may not be paradise lost, but there is a sense of professional angst, voiced Cassandra-like by some physicians, that Geisinger could eventually become little more than a “very good community hospital” with helicopters.

<"Everyone expects some turnover, and ours may well fall within national figures," acknowledged another surgeon. "But that is just a number. What it doesn't show is the quality of people we're losing. Doctors on the high end, doctors who have started programs, built careers, who are the reason Geisinger has the reputation it does."

<"The compensation plan changes every year, " complained another physician. "We have no idea what the health plans are paying us. We don't have our own accountant. We just don't have enough information to galvanize us to fight this kind of problem."

<"We have nobody (rank-and-file physicians) on the (PSGHS) board; it's always denied," noted another doctor.

<"Morale is at an all-time low," pointed out another surgeon. "We're like sheep being prodded along with stun guns to keep us moving. We feel disenfranchised, devalued and seriously compromised."

And so it went, the rhetoric less of revolution than raw resentment. Some physicians, however, were clearly beyond venting.

“I’m at the end of my rope,” acknowledged a physician especially disturbed over a decline in available anesthesiologists. “I can’t keep working here like this. I’m very concerned about making mistakes. It’s only gotten worse.”

One “mistake” this doctor, who has been at Geisinger for more than a decade, was not about to make, however, was to “burn bridges” by allowing direct quotation.

“Look, I met my (spouse) here; we live on a farm. We have two kids. I love this area. They could make life miserable.”

A Hospital’s “Pilot Test Case”

The gathering was under the auspices of the Assembly of Geisinger Clinicians, the organization recognized by the administration as the collective voice of the more than 270 physicians on staff.

Adding some bite to the bark of the exasperated AGC is the restive, dues-collecting sub-group, the Geisinger Clinicians Group. The approximately 150-member GCG was formed two years ago, with each founding physician putting up $300 toward a legal fund.

At its inception in 1996, a GCG spokesman, Pediatric Surgeon Charles McGill, offered this rationale:

“…Geisinger has been a physician-led organization since its beginning. The clinicians recognize the complex nature of the decisions the business side of medicine must make to meet this challenge. The recent activities of the GCG have to do with the responsibility to be the patients’ advocates. The clinicians want to assure that significant input from the practicing physicians remain in the decision-making process at Geisinger. We feel that is essential as we seek to provide cost effective, quality care with compassion. This is what we feel our patients expect from us and what we expect of ourselves.”

To those ends, the GCG hired a Philadelphia-area law firm to help it address what it now considers its increasing sense of estrangement from, frustration with and even intimidation by the Geisinger administration.

As one key member of the GCG explained, “People are afraid to speak out, whether it’s about a ‘brain drain’ (of high-caliber, senior clinicians), lack of support staff, poor communication, compensation or whatever. People are tired of rumors and scared of reprisals, from subtle forms of harassment to being forced out…But ultimately people will have to put their money where their mouth is.”

For now, however, this surgeon does not want the words out of his mouth attached to his name — or even his speciality.

The GCG’s retained law firm, Beautyman Associates, represents doctors, medical staffs and health care providers in more than a dozen states. Recent clients include the medical staff of the Medical College of Pennsylvania (a beleaguered, Allegheny Health System constituent) and Community Hospital in Reading.

On hand to speak to the assemblage of physicians was Michael Beautyman, who had been brought in initially to either negotiate physician contracts with Geisinger or assist doctors in departing. His primary charge now was to help the physicians navigate the tricky — and possibly expensive — shoals en route to a collective bargaining unit — or CBU.

In addition, Roger Mecum, executive vice president of the Pennsylvania Medical Society, also addressed the group. The PMS, which has seen its membership, including that at Geisinger, erode in the last decade, is interested in lending support to the AGC as a quid pro quo for regaining dues-paying members. Geisinger could become a “pilot test case” for the PMS.

“We are not like we used to be,” acknowledged Mecum. “Physician needs have changed so much.”

In other words, socio-economic issues are now a priority for the PMS. Indeed, the organization even has a sub-division devoted to collec
tive bargaining.

But the PMS is hardly a rush-to-unionize proponent. Mecum used the metaphor of “guerrilla warfare,” which could entail, among other strategies, going public with physician grievances and even holding news conferences.

CBU in September?

Beautyman’s focus was the CBU and some of the legal challenges that would assuredly ensue. He also apprised his audience of results of a recent ballot that asked them to endorse the development of a CBU for Geisinger Clinicians. They were informed that 81% of those (148) responding supported the formation of a CBU and 96% of GCG members authorized legal counsel to contact the Board of Trustees.

“You are all employees of the same health care system,” pointed out Beautyman. “You fit into the parameters of the National Labor Relations Act.”

He also discussed who would be ineligible to vote — supervisors and managers — and assured all present that “No action can be taken (by the administration) for filling out a (union) authorization card.” To do otherwise, he emphasized, would be a violation of federal law.

Although Beautyman fast-tracked his audience through the CBU process up to the secret-ballot election conducted by the National Labor Relations Board, he had the less-than-favorable connotations of physician unions to contend with.Nationally, the number of physicians and dentists in unions has increased from approximately 20,000 to 44,000 in the last decade. Not coincidentally, the proportion of physicians with managed-care contracts rose from 61% in 1990 to 83% in 1995. No one thinks the numbers have gone anywhere but up in the last three years.

However, to many Geisinger physicians — a nationally respected group that is arguably as idealistic about medicine as it is naive about business– “First do no harm” is antithetical to the withholding of any service as bargaining leverage. And that could include a slowdown of paperwork as well as a halt in elective surgery.

“I don’t think collective bargaining will occur here,” flatly stated one physician familiar with speaking in the first person plural. “I don’t think there’s a fire in the belly.”

Perhaps, then, that fire is more like heartburn when doctors size up their perplexing situation on the Danville campus. For most, unions still conjure images of Jimmy Hoffa — not Albert Schweitzer.

Witness the following exchange:

First Doctor: “What is the difference between a union and a collective bargaining unit?”

Attorney Beautyman: “None.”

First Doctor: “Oh.”

Attorney Beautyman: “But one is more palatable. On campus you can call yourself anything you want.”

First Doctor: “I see.”

Second Doctor: “How about consortium?”

Attorney Beautyman: “Yes, consortium is fine.”

Among the myriad physicians uncomfortable with unionization is Danville-based Robert Haddad, M.D., senior vice president clinical operations/Central Region.

Haddad, who still stays active in the practice of internal medicine, said he is “disappointed that a group has elected to pursue that (course). Unions have no place in medicine. It’s not compatible with this culture.”

Echoing those sentiments is Stuart Heydt, M.D., CEO of PSGHS, who began as a Geisinger clinician 25 years ago. Heydt, who last year relocated to Hershey and recently sold his Danville home, termed physician unions “incongruous organizationally and professionally. It’s not constructive to head to a bargaining unit. There’s ample opportunity for those in the system to express their point of view.

“The idea that you can create a bargaining unit that will hunker down and set certain unequivocal demands in order to provide service is antithetical to what we’re about,” stressed Heydt. “I understand that people say they have a perspective and it’s not being heard. But people can influence decision-making if they go about it in an honest and constructive way. They also need to understand we’re at a time when we have to be creative and responsive to the fact that our resources are not infinite.”

Nor, apparently, is the supply of patience.

Whether it results in a CBU or not, the organizing process, which could conceivably include complementary roles for both Beautyman and the PMS, is moving apace. Beautyman has been authorized to send a letter to the PSGHS board putting it on official notice that Geisinger clinicians are heading, maybe inexorably, toward forming a more perfect union if their concerns are not addressed.

That letter, which reportedly was akin to a heat-seeking epistle in its initial draft, will still be packed with anecdotal reports that will not reflect well on administrative deportment or ethics.

There are accounts of physicians verbally agreeing to compensation compromises in order to retain support personnel, only to see those key staffers laid off six months later. Examples of errant communication skills feature the likes of a private E-Mail query responded to with an insulting, intimidating letter — copied to others.

“The tragic flaw here is hubris,” Beautyman said. “You’ve got to know when to compromise. Things haven’t gone well with the HMO. They need to reduce costs. There’s always unhappiness with downsizing.”

His characterization of the PSGHS’s overall manner of operations is that of a “Harvard Business School case study of how not to do it. You should be bringing people into the fold, the malcontents, if you will. But they’re not flexible; they stay in denial.”

Keeping It Personal

According to a number of physicians, there’s no denying that the dynamics at Geisinger have become entirely too personal.

Some overall, negative fallout was inevitable given the onset of managed care restraints that were already apparent when Heydt took over as CEO in 1991. But Heydt’s predecessor, neurosurgeon Henry Hood, was country-doctor friendly, charismatic and a veritable guardian angel of the Abigail Geisinger legacy. Indeed, he would begin all his formal meetings with a brief reflection on the Geisinger mission and a solemn reiteration that headquarters would never leave Danville.

Now, neither Hood nor headquarters are where they used to be. Hood is retired and relegated to nostalgic icon status, and headquarters — along with Heydt — is in Hershey.

“Stu Heydt is making unpopular moves and has the personality of a parson’s table,” assessed Ollie Bates, M.D., a recently retired Geisinger nephrologist. “But the administration has done nothing illegal. Personality, I think, is a major stumbling block. Dr. Hood was a profoundly charismatic individual.”

Heydt, a hard-driving executive given to “tough love” approaches with employees, is mindful — and even understanding — of the perception of administrative arrogance. He underscored “perception.”

“We’re not arrogant,” explained Heydt. “We are sensitive to needs. But it doesn’t surprise me a bit. It’s a translation from, ‘Hey, I’m frightened and anxious and need reassurance, and you don’t seem to be listening to me. You’re not accessible. I want you to look me in the eye and tell me I have job security and all the resources I want.’ When that doesn’t happen, you’re perceived as uppity, arrogant, standoff-ish…But I don’t believe for a minute that any member of our management team is aloof or uncaring.”

Perception, of course, is its own reality. And at Geisinger, reality now means serious talk about the National Labor Relations Act.

“The personal factor may be the biggest factor,” summarized Bates, the former Geisinger clinician. “And that’s a shame. Central Pennsylvania must have a Geisinger.”

Will Union Suit Docs’ Needs?

As Geisinger clinicians plot strategies to buttress their negotiation leverage, they have plenty to ponder regarding the ultimate move — the formation of a union. Since physicians who are employees of hospitals, clinics or HMOs are free to form unions, this is, indeed, a viable option for the Geisinger clinicians.

The American Medical Association estimates that between 14,000 and 20,000 physicians are members of a
union. While this is more than at any time since such unions came into existence in the 1930s, it still only represents an estimated 3% of physicians — and most of these are interns and residents. Among the unions (and their founding years) representing physicians are: The Committee of Interns and Residents, 1957; The Union of American Physicians and Dentists, 1972; and The Federation of Physicians and Dentists, 1981.

Always among the issues is the question of whether a given physician or group of physicians are “managers” or “supervisors.” Only “employees” qualify for an anti-trust exemption and the right to bargain collectively under the NLRA.

These are some other questions — and answers — regarding the CBU process that were presented to the Geisinger clinicians.

Q: Why do we need to form a CBU?

A: A CBU will provide us with the legal ability to require Geisinger management to engage in collective bargaining.

Q: Why is a CBU any different than the AGC or the GCG?

A: The AGC and the GCG are only informal associations that do not receive any protections from the federal government, whereas a CBU is legally recognized to engage in negotiations with management.

Q: What protections or advantages does a CBU have?

A: When properly formed, a CBU enjoys the protections enunciated under the National Labor Relations Act, which requires employers to negotiate in “good faith” with a CBU. Management is under no such obligation to negotiate with the Assembly of Geisinger Clinicians or the Geisinger Clinicians Group.

Q: Can Geisinger take any punitive measures against us?

A: No. The NLRA specifically prohibits management from singling out CBU organizers for termination. Any actions taken in violation of such a prohibition are punishable by law.

Q: How will the CBU be structured?

A: The CBU can be structured in several ways. The CBU could consist of all physicians on staff, or it may be broken down by smaller groups. For example, we may form a CBU for each Geisinger campus.

Q: Who would lead the CBU?

A: The leadership of any CBU is decided by a vote of its constituency. After the CBU is formed, its members would then elect the officers.

Q: How do we form a CBU?

A: Have at least 30% of all eligible employees sign authorization cards or a petition; an election petition is then filed; management can then challenge the petition; an election campaign is commenced; an election is held; certification of CBU if the majority of those voting approves.

Q: What actions can a CBU take?

A: A CBU is authorized to negotiate on behalf of its constituency as to terms of employment.

Q: What is the cost of a CBU?

A: Costs inherent with organizing a CBU depend upon management’s response. The process can be lengthy and involve numerous legal challenges. Therefore, your commitment to the process is required. Once formed, it is the decision of the CBU leadership to determine what annual dues its members will pay.

Q: Could Geisinger management choose to negotiate physician contracts with the GCG and without a CBU?

A: Yes.