In a lecture given at Harvard Medical School’s “Diversity Awards Ceremony”, Pedro Greer, who was “invited to be the … visiting lecturer in recognition of his commitment to health equity and social justice”, “called on physicians and medical educators to address the lack of social justice that he said causes increased morbidity, suffering and mortality in impoverished neighborhoods in the United States” in a lecture named after the first three Blacks to graduate from the school in the mid-1800s.

While the policies he advanced—organizing transportation-sharing through local churches to allow people without cars to more easily pick up prescriptions in areas with no public transportation, for example—sound reasonable, the language surrounding them is curious. If the policies are worth implementing, one would think that their merit alone would be a good enough argument for implementing them.

But today, everything is political. Just like in the infamous regimes of the 20th century—which one must hope will go down in history as an age of supremely bad governance (since if it doesn’t, nothing will have improved after it)—there is one Official Idea in America today, and to succeed, one must reference the Official Idea, speak its language and use its buzzwords. The Official Idea shows up everywhere, from federal preferences to ‘minority-owned’ businesses to affirmative action programs in colleges to Google doodles of obscure progressives to diversity initiatives in medicine—and beyond: opponents of gay marriage, not the sorts one would expect to fall in with the progressive camp, appeal to “diversity in parenting”.

For that matter, when David Duke argues against affirmative action, he calls it ‘racist’. A former Grand Wizard of the Ku Klux Klan speaks progressive—accepts, at least rhetorically, some part of the Official Idea. So it’s no surprise that Harvard does: how could they not?

While the presence of an Official Idea is worrying in and of itself, its presence in medicine is even more so. The language the Idea demands is dangerous. The last time it was prominently used was in the creation of the quota system at the University of California Davis School of Medicine, later overturned by the Supreme Court in the Bakke case.

Quota systems were popular in the aftermath of the ’60s, but the one at UC Davis is notable for reasons beyond the Court case alone: one of the students admitted in Allan Bakke’s place under the quota system, Patrick Chavis, was later referenced by many progressives as a success story for the quotas. Massachusetts Senator Ted Kennedy called Chavis a “perfect example” of the “enormous dividends” paid by racial quotas, saying he was “serving a disadvantaged community and making a difference in the lives of scores of poor families”; Tom Hayden wrote in the Nation that “Bakke’s scores were higher, but who made the most of his medical school education? From whom did California taxpayers benefit more?”; the progressive magazine In These Times, founded by the socialist James Weinstein with help from Herbert Marcuse and Noam Chomsky, wrote that Chavis was an example of the success of affirmative action because he, “now an obstetrician-gynecologist, has built up a large practice in Compton, Calif., a predominantly black and Hispanic city”, whereas Bakke was merely an anestheologist in Minnesota; and Nicholas Lemann—the same Nicholas Lemann who, as president of the Harvard Crimson, led the paper to endorse the Khmer Rouge—wrote a ten-page cover article in the New York Times Magazine contrasting Bakke, who, he wrote, “does not appear to have set the world on fire as a doctor”, with Chavis, a “poor-folks’ doctor” who “seems to assume a superiority over his white medical-school classmates … says he works harder than they do and in tougher conditions.”

A year after Lemann’s article went to press, Patrick Chavis botched a liposuction, a practice which he had taken up after only a four-day training course and which he habitually carried out without an anesthesiologist, and killed a patient.

This was not unpredictable; Chavis had shown warning signs of incompetence throughout his career.

Cathy Chavis, one of his former wives and who worked in his office for nine years, has testified to the state medical board that the doctor was “wrong a number of times,” about the age of a fetus. In one case, she said, after Chavis removed the arm of a fetus, the patient was determined to be eight months pregnant. The patient was then taken to the hospital to deliver the baby. According to Cathy, Chavis would keep the fetus in formaldehyde for up to 30 days. She never knew what he did with remains but said that one day the sink in the office backed up and she saw “pieces of bone and fingers.”

There were also problems with deliveries. At Long Beach Memorial Hospital, Chavis used forceps to pull a baby out of a woman not sufficiently dilated. In that situation, hospital policy called for a cesarean and administrators, always wary of lawsuits, had Chavis monitored. He charged that he had been singled out for discipline not given to whites and filed a discrimination suit. The hospital said it was simply a question of substandard medical practices. Chavis was offered $750,000 out of court but turned it down. The court awarded him $1.1 million but this was overturned on appeal and he got nothing. Chavis also maintained a running conflict with St. Francis Hospital, just down the street from his Lynwood office, charging that administrators there discriminated racially against nurses and practiced unfair competition against Martin Luther King Hospital. St. Francis has since suspended his surgery privileges there, which he attributes both to race prejudice and the Catholic hospital’s animosity against him for performing abortions. …

On May 11, 1996, Chavis performed a general anesthetic liposuction on Yolanda Mukhalian at the Westwood Surgery Center. In a written declaration to the medical board, Mukhalian said they agreed to do only her abdomen but Chavis also removed fat from her buttocks, hips, and thighs. Afterward she was sweating and her heart began racing. When Chavis was driving her back to her hotel, fluid was gushing down her legs.

“Fuck it,” he said. “I’ll just take you to my house.”

Despite subsequent ministrations by Chavis at his home and office, her condition worsened. She was admitted to hospital on June 8, 1996, with acute abdominal pain, weakness, nausea, and an astonishing 70 percent blood loss. She also suffered abdominal scarring and the shape of her thighs remained irregular. …

Personnel in the adjoining medical office, where Chavis used to work, made four tapes of “horrific screaming” by patients, with Chavis telling them, “Don’t talk to the doctor while he is working” and “Liar, liar, pants on fire.” In one case a patient screamed “stop,” and a voice could be heard asking another doctor for advice on a patient who was experiencing trouble. …

On June 21, 1996, Chavis used [the liposuction] machine to suction 2,200 cubic centimeters of fat from Valarie Lawrence, who lost 300 ccs of blood during the procedure and fainted three hours after discharge. She made her way to the hospital but Chavis discharged her with a Foley catheter and IV tubes still in place, then took her home, did not take her vital signs, and did not monitor her condition. The next day Chavis left her in the care of his 18-year-old niece and went to perform liposuction on Tammaria Cotton.

Chavis removed 3,500 ccs of fat through 11 incisions in Mrs. Cotton, who moaned and complained of pain during the procedure. At one point she complained she couldn’t breathe, to which Chavis replied, “If you can talk you can breathe.” Her husband, Jimmy, who stayed with her throughout, was alarmed at her drop in blood pressure and the “red fluid” pooling on the floor.

Chavis left the office to attend to Lawrence, who was still at his Compton home, and made no arrangements for another physician to monitor Mrs. Cotton. … By 5:30 Mrs. Cotton’s pulse was faint and Allen called 911. “There was a lot of blood on the floor, on the exam table itself, and on her and her clothing,” testified a firefighter paramedic, who believed Mrs. Cotton was dead when they arrived. She was pronounced dead later that evening at St. Francis Hospital, with “immediate cause” on the death certificate reading: “Hypothermia and fluid overload. Tumescent anesthesia for liposuction.”

“It was only liposuction,” said a horrified Jimmy Cotton, who was told by nurse Allen that at least he would get his money back. Chavis, who maintains he did nothing wrong, blamed Jimmy Cotton, who in the doctor’s absence had attempted to put his wife in a wheelchair. “Mr. Cotton, if he didn’t commit murder, it would have been at least second-degree murder because you don’t just do that. You don’t take things if you don’t know what you are doing,” Chavis told me. He told the Los Angeles Times that Mr. Cotton should be accused of “second-degree murder, if not first-degree murder.”

The death of a patient in any case is a serious matter and a death following a normally safe procedure can bring swift sanctions. For example, a patient died after liposuction by W. Earle Matory Jr., a board-certified plastic surgeon in Orange County. Within two months, the state medical board suspended his license. But Chavis, who is not board-certified, was allowed to continue practicing for more than a year.

This is the man who Ted Kennedy called a “perfect example” of the “enormous dividends” paid by the application of the Official Idea to medicine. Thus we see the danger of that application. If the Official Idea ever conflicts with being effective at medicine, as all Official Ideas do, it will win out (that’s what makes it Official) — and effectiveness at medicine will lose.

The purpose of medicine is not politics, but medicine. If there is something that stands in the way of effectively realizing this purpose, if there is some inefficiency in the system, then that inefficiency should be addressed, as it appears Greer is trying to do — but it should be addressed as an inefficiency, not as a lack of realization of any Official Idea.

When all institutions are told to serve the same agenda, they will fail at the many separate agendas they were designed to fulfill.