Free Movement of People and Ideas Contributes to the Progress of American Medicine

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A story is told about Henry David Thoreau (1817–1862), the great American naturalist and philosopher, who went off to live in the woods near Walden Pond in Massachusetts. Thoreau stopped reading the newspapers during his sojourn in the woods. An acquaintance heard that, after a few years, Thoreau had resumed reading the newspaper.

“What have you learned by reading the newspapers again?” the friend asked. Thoreau replied, “The verbs are all the same as they were a few years ago. Only the nouns have changed.”

As a medical historian interested in the history of racial, religious, and gender discrimination in medicine, I note that time is circular. We just keep repeating history. The nouns are different from what they were in the past, but the verbs are the same.

During the administration of Democratic President Woodrow Wilson from 1913 to 1921, congressional Republicans tried to pass several anti-immigration bills. Wilson blocked them, saying they targeted Eastern European Jews. Previously, as governor of New Jersey, Wilson had taken the unprecedented step of appointing a Jew to the New Jersey Supreme Court. As president, he appointed the first Jewish member of the U.S. Supreme Court, Louis D. Brandeis, a child of German immigrants. Wilson, like President Barack Obama, was criticized for being a moralist, an Ivy League intellectual, and aloof and for having held elective office for only a limited period of time before becoming president.

“Science, art, and philosophy are all universal to humankind and not confined by national boundaries. At least 25% of practicing physicians in the United States were born in another country. These immigrant physicians contribute to the cultural diversity of the physician workforce and its ability to respond to health care disparities.”

Wilson suffered a stroke, and in the waning days of his term his Attorney General A. Mitchel Palmer launched roundups and deportations of alleged Bolsheviks in the Red Scare of 1919 and 1920. In 1921, Wilson was succeeded by the intellectually incurious Republican President Warren G. Harding and Vice President Calvin Coolidge. Harding was elected on a platform of making America great again by returning the country to “normalcy.” Once again the Republican-controlled Congress approved anti-immigration legislation, but this time Harding signed the bill. Americans were told that the legislation would “bar our borders from radicals and terrorists.”

Unlike today, leaders of America's medical schools in the 1920s generally endorsed immigration restrictions. They thought U.S. medical education had a “Jewish problem” and that these immigrants and their children should be kept out of medical school by restrictive quotas called numerous clausus. In 2017, it is far more common for leaders in academic medicine to recognize the benefits diversity brings to medicine. Science, art, and philosophy are all universal to humankind and not confined by national boundaries. At least 25% of practicing physicians in the United States were born in another country. These immigrant physicians contribute to the cultural diversity of the physician workforce and its ability to respond to health care disparities.

We are more likely today to acknowledge that this is a country of immigrants and to support the inscription on the base of the Statue of Liberty, particularly the following words:

“Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore.
Send these, the homeless, tempest-tost to me,
I lift my lamp beside the golden door!”


In the 1930s, most American medical schools closed their doors to the children of Jewish immigrants. A small, but committed, group of medical schools and their leaders opposed the quota system and served as bastions against bigotry in medical education. The free movement of people and ideas fosters progress in medicine. We now recognize that a large proportion of American winners of the Nobel Prize in physiology or medicine were immigrants or the children of recent immigrants. We can thank those who opened the doors of education to these immigrants. More important, we can thank the immigrants themselves for antibiotics, the polio vaccine, vascular surgery, and much of our progress in the war against disease and disability.

My grandparents, fortunately, reached America's shores before the restriction of immigration in the 1920s. Other members of my family were consigned to Nazi concentration camps because the doors to immigration were blocked. My personal history makes me even more aware of the deference we must show to the role of freedom in fostering medical progress. Those of us engaged in the generation, conservation, and dissemination of knowledge about the causes, prevention, and treatment of human diseases and disabilities must stand where we have always stood. We shall not be moved.