The New Yorker Radio Hour - Politics at the Oscars, and a Doctor’s-Eye View of Trump

Episode Date: February 3, 2017

Two doctors describe how Trump’s policies may affect patient care, and a brief history of entertainers making political statements on Oscar night. New Yorker Radio Hour listeners, we want to hear from you.  We have a few questions about the show and how you listen to it. The survey takes about twenty minutes, and your feedback will help us make our podcast better.  Take the survey here.

This is the New Yorker Radio Hour. I'm David Remnick. Today we're going to get a doctor's eye view of the Trump administration. Actually, two doctors. One works in a hospital where the majority of the patients are white Trump voters. And the majority of the doctors are immigrants, many from the countries that Donald Trump has just banned. And I'll talk with Atul Gawande, a surgeon, and an extraordinary journalist about what a repeal of Obamacare might look like. But we're going to start. Right here.

Thank you. Thank you. This is a moment of joy. And I want to kiss everybody because you are the image of the joy. And he who kisses the joy as it flies and lives in eternity sunrise, that said the poet. And this is wonderful to be here. Wonderful. I feel like now really to dive in this ocean of gratitude. This is too much.

General, this is Anna, how do you say? You and Derey? Wow, what a flashback. What am I listening to here? Well, this is an iconic Oscar moment. It's Roberto Benini.

Winning his Oscar for Life is Beautiful in 1999, right after he jumps over all the chairs to get to the stage. I'll never forget it. Michael Shulman, you're a contributor here at the magazine, and you're working on a big story about the Oscars now, and you're kind of a Hollywood acceptance speech connoisseau.

You could say that. How come you're so into acceptance speeches? Well, acceptance speeches at award shows. They're kind of like this genre of dramatic monologue where you get a celebrity who has a very short amount of time to kind of be themselves and express themselves with a countdown clock, usually under very heightened emotions because they've just won an award. So a lot of weird and crazy things can happen. You know, these are people who live rarefied lives and to see them step out in. be themselves for two minutes. Are they really themselves?

What are your all-time favorites? Okay, well, I have a couple of subsets that I really like. So there's the kind of over-the-top exuberance, which is where I'd put Roberta Benini, and Acuba Gooding Jr. falls into this category. So you have the excessively weepy ones like Hallie Berry and Gwyneth Paltrow. Another subset I like is that... But Halliberry's was really moving. I mean, that was an extraordinary moment. Oh, yeah, because it was an extraordinary moment.

Oh, yeah, because it was a major political moment as well. This moment is so much bigger than me. This moment is for Dorothy Dandridge, Lena Horn, Diane Carroll. It's for the women that stand beside me, Jada Pinkett, Angela Bassett, Vivica Fox, and it's for every nameless, woman of course. color that now has a chance because his door tonight has been opened. Another type I love is the passive aggressive or angry acceptance speech, like Shirley

McLean when she won for terms of endearment. First she talked about her past lives, and then she thanked Deborah Winger for her turbulent genius. Meaning they fought on the set a whole time? Well, that is not what you want a coworker to say about you. And then there's the genre I would call sort of the... the insight into blatant Hollywood ego run amok. Who's the tops at that? Well, you know, an early example is a kind of famous but often misquoted Oscar moment.

Maybe you can guess which this is. I owe a lot to my family for holding me together and loving me and having patience with this obsession of me. But I want to say thank you to you. I haven't had an orthodox career. and I've wanted more than anything to have your respect. The first time I didn't feel it, but this time I feel it, and I can't deny the fact that you like me right now.

You like me. It was very moving when Clark Gable won for the first time, wasn't it? No, that was Sally Field. But do you know what she was winning for? Norma Ray? Ah, no. It was her second Oscar for Places of the Heart. Ah, yes. And there's lots of things.

I've got that film entirely. things to love in that speech. So you can kind of see this sort of self-aware and sweet sort of, you know, version of the self-absorption that all these people have on some level. Now, earlier this year, Merrill Street made some headlines with a speech at the Golden Globes that was just all about politics, all about Donald Trump. And this instinct to humiliate when it's modeled by someone in the public platform, by someone powerful, it filters down into everybody's life, because it kind of gives permission. for other people to do the same thing.

Now, Donald Trump did not take kindly to that speech at all. Why do you think, Michael, that this captured the attention that it did? So in a nutshell, she has this self-awareness. She knows that she arrives on this pedestal of being the greatest living actress, and she has a sense of humor about it, where she can kind of knock herself down to size, that there was this great Emmy speech she gave once for Angels in America, where she said, there are some days I myself think I'm overrated,

but not today. So she's wonderful talking as herself, about herself, in this sort of sly way. But I think what made this Golden Globe speech so extraordinary is that this was really the first televised major award show after the election. And I think there was just this dark feeling that had been percolating. And what Merrill Streep did was come in and use her stature and the moment of getting this light time, Chiefs Award to, I think, give voice to something that a lot of people were feeling. And the stuff that she talked about, it wasn't partisan issues. She spoke about decency and empathy and things that shouldn't be partisan, but that a lot of people have just felt have vanished very suddenly from American life.

When did this all start? Merrill Streep's not the first to use a Hollywood's award ceremony as a political forum in a way. When did this become a thing? Well, for the first couple decades, Oscar speeches were really short and political. light and you'd have Elizabeth Taylor come up and just say, thank you so much and then leave. I think it was really the 70s that they evolved into something more interesting. The most famous and the one I think will never be topped being when Marlon Brando won the Oscar for The Godfather in 1973 and in his place sent a Native American activist named Sashi

Lettle Feather to decline the award. I'm representing Marlon Brando this evening, and he has asked me to tell you in a very long speech, which I cannot share with you presently because of time, but I will be glad to share with the press afterwards, that he very regretfully cannot accept this very generous award. And the reasons for this being are the treatment of American Indians today by the film industry, excuse me, and on television in movie reruns and also with recent happenings at Wounded Knee. I beg at this time that I have not intruded upon this evening and that we will, in the future, our hearts and our understandings will meet with love and generosity.

Thank you on behalf of Marlon Brando. It's kind of a touching speech, isn't it? It is. And much made fun of at the time. Yeah, and I think looking back, we can probably credit it as being completely punk. It's a brilliant stroke of political dada-a-ist theater. But the 70s also had a number of political speeches that were also divisive. In 1975, the documentary producer, Bert Schneider, read a letter on behalf of the North Vietnamese, thanking the anti-war movement.

And then Frank Sinatra had to come out moments later. and apologize. That was for the film Hearts and Mind. Yeah. And Vanessa Redgrave in 1978, talking about the Zionist hoodlums, which she was also booed. Jane Fonda,

the next year, doing her speech in sign language for coming home. So you get the kind of evolution of the speeches that have causes attached to them or speak to the current political moment. Skipping ahead to the current century,

I think the really defining political Oscar speech was in 2013. when Michael Moore won the Oscar for Bowling for Columbine, and this was March 2003. So the Iraq War was starting. The drumbeats were playing, and he got up there, and he talked about

how we have a fictional election that gave us a fictional president, going to war for fictional reasons. We are against this war, Mr. Bush. Shame on you, Mr. Bush. Shame on you. And any time you've got the Pope and the Dixie... You know what's amazing there, Michael?

It's supposedly all of liberal Hollywood is gathered in the auditorium, and what you're hearing is a lot of booing and a lot of derision coming from the seats. Yeah. I mean, it seems so quaint now to boo someone for object to the Iraq War. A more recent one that I thought was really moving was two years ago, 2015. This was the first year of the Oscars so white controversy because all of the acting nominees for the first of two years in a row were white.

And the movie Selma, which is, of course, about the Civil War. Rights March in Selma was only nominated for Best Picture and Best Song. Its director, Eva DuVerni, was snubbed and its actors were not nominated. But it won Best Song, and John Legend and Common got up. And what was incredible about the speech is that it was really up to them to represent the movie and also to represent not only this racial tension that was going on, you know, in the subtext of the ceremony, but also that was going on throughout America. We wrote this song for a film that was based on events that were 50 years ago, but we say that Selma is now because the struggle for justice is right now.

We know that the voting rights that act that they fought for 50 years ago is being compromised right now in this country today. And now President Trump has decided to investigate voter fraud, but with quite a different accent, quite a different motivation, obviously. What might we expect from this year's Oscar speeches? What are you looking for when you turn on your TV that night? Well, I sort of hope that this year's Oscars has some kind of political moment of catharsis. I mean, these are the first Oscars of the Trump era.

And what's so weird is that the people who win and who are up there presenting or speaking must know that they are in some sense speaking directly to the president. I mean, President Trump could easily have his feelings hurt and take to Twitter. And then there's a whole army of, you know, trolls and people with, you know, Pepe the Frog avatars who come after you. So I'll be really interested to see what, you know, if there's someone who gets up and really speaks from the heart in the way that Merrill Streep did. But I do think that the Academy Awards will need that on some level because like so many things in American life right now, I think, Words shows have to figure out what their role is in this, you know, horrible Twilight Zone episode that we're in. What makes it especially odd this year is that the main movie that is storming the Academy

Awards is completely apolitical, which is La La Land. Escapism to the nth degree. Yeah, and a lot of people have credited its success to the fact that it's escapist, that it's take you away from your trouble sort of movie and dance and sing. You know, I think it won't win everything. You know, for one thing, it has two best song. comedies against each other. So we're down to 14.

We're done to 13. Yeah, 13 at most. But I do hope we see some love for other movies like Moonlight and Fences. There's just a great slate of movies out there. Michael, thank you so much. Thank you. Michael Shulman is reporting for the New Yorker on the Oscars So White Controversy. The Oscars are broadcast later this month, Sunday the 26th. Atoll Gawanda is a practicing surgeon who also writes about medicine for the

Yorker. And his articles have legs. A 2009 piece he wrote about the out-of-control cost of health care was cited by President Obama while he was making the push for the ACA and passed around the West Wing. So, Atul is concerned about the repeal of the law, and in particular, what happens if insurers can once again deny coverage of pre-existing conditions? He wrote about that recently in a piece called The Heroism of Incremental Care. You grew up in a fan. You grew up in a fan. family of doctors. Your parents were specialists, a pediatrician and a urologist, and you grew up with this all around you. And you yourself became a surgeon. I'd love to know why. Since this piece kind of valorizes primary care doctors, I wonder why you decided to become a surgeon,

and your parents were specialists, of course. Well, it was, there were a couple of reasons. Number one was, I think it suits my personality. I like problems you can solve in three or four hours, not in a lifetime. When you were coming up as a doctor, was primary care considered kind of a dull thing, an ineffective thing? Oh, yeah. Like, you know, all of the pressure was, you know, if you're smart, you know, how could you go into primary care? And at the time I was, you know, going through medical school, was so easy to see what the impact was of surgery. Like, you go in an operating room, you see people save a life, and you said, wow, I want to be part of that. So when was the inflection point? When was the moment at which primary care became something absolutely

essential? You call it the heroism of incremental care, but was there a moment in time when things flipped? Well, I would say we're kind of in the middle of that time now. It's only been in the last decade or so, that it's been demonstrated that having a regular source of care from a clinician who knows you added years to your life and health in a way that simply seeing the best possible specialist you could find was not generating that. My son is an example. I tell the story of Walker who has a congenital heart disease, a complex congenital heart disease. And the critical person in his life is his cardiologist. You know, he was saved by heroic rescue medicine when he, in 11 days of life, went into congestive heart failure. We didn't know why. And it was... How old is he now,

and now he's 21 years old? Yeah. Amazing. And he was rescued and saved on that in those first two weeks from complete organ shutdown. Artificial Archivis aorta reconstructed and open heart surgery. But then the next 21 years has been all about... controlling his blood pressure, being able to address some learning issues that come along with this condition, being able to monitor and catch when the repair now was becoming too small for his six foot one inch tall body. And, you know, his cardiologist and the physician assistant who works with her have been paid a fraction of what that cardiac team who worked for a few days to save his life. But they have been equally important in many ways. is absolutely essential to his realizing the value of all of that heroic work done at 11 days of age. So I'm lucky. I have a doctor. I see once a year, if not more often, have all the normal tests, EKG and all the pleasant and unpleasant tests that come with it. And then afterwards, he takes me into the office and we go through all the major things that can go wrong. And he sort of assures me

I thought I'm doing the right thing with terms of exercise or a statin or whatever it is all through the list. And if I'm lucky, I leave the office singing a happy tune. But I know in my heart in this very big country that very, very few people have a doctor like that or a medical circumstance like that. What is the range of circumstances out there in the country in terms of people seeing their doctors, not having access to doctors, costs? What are the big things that are the barriers to the circumstances that you're hoping for in your article and beyond? Well, this is where I think it's so important because most people do not have a regular source of care from someone who knows them. And there are a variety of reasons for that. One of them has to do with the very issues we're debating right now around our national health care debate.

You know, we have 19 states where the Affordable Care Act was not accepted by those states, by conservative states. And so you have 15, 20, 25 percent of the population there who do not have regular access to care. And one of the first things that people drop when they're short of money is having your regular clinician appointments and a routine relationship with a clinician. goes out the window. You wait until the very last minute, until it's an absolute emergency until you can't avoid it. And that's when things are often out of control. And then that's where you have, you know, major reduction in life expectancy and in health. Now, I think we've been very disciplined and we haven't mentioned the name Donald Trump, not once in this conversation yet, but that's about to end. Right now, the president, President Trump, declared that he was going to make good on his promise to

repeal and replace. What were the flaws in your view of Obamacare and what is your concern about what's happening now in Congress in the White House? Well, the flaws and the Republicans have hit on it and they're not wrong about these flaws. Mitch McConnell pointed out, well, for all the 30 million who gained coverage, there's still 25 million who still don't have health care coverage. Number two, 43% of people who got a health plan on the exchanges under Obamacare have a $2,500 deductible or more and often can't afford to pay that deductible. So the subsidies aren't that generous. And so they're not wrong about those criticisms. The problem is the conservatives in the negotiations with the Democrats pushed hard to keep those subsidies low. it was conservative states to refuse to accept

Obamacare and now we've come out on the other side I think it would be it would clearly be a fantastic thing for the health of the country that we repair and supplement what's there

I can see readjusting you can't get there and also reduce taxes on everyone which is the vow that Trump is making he wants he's promising everybody a magic bullet and there are tradeoff

here, and in a grown-up world, we work our way through figuring out the trade-offs that we're willing to make and not willing to make. And this is so crucially important because if they repeal without replacing or promising that the replacement will come, the danger is that the insurance market that we've got or the subsidies that we have for people could collapse. Well, how is that not political suicide? I think it is political suicide. and that the expectation of people, whether it's focus group, polls, or just talking to people back in my hometown in Ohio, the expectation is Trump wouldn't do that.

Trump would not make my situation worse. Why can't we get this right? This is just an enormous problem. I don't imagine that conservatives don't share the value of having people be healthy in the country. Where is the great disconnect and why can't this be fixed? more easily. It's in a matter of values, politics? What is it? I think it's politics less than values. The political battle is over who's going to pay for it and how. And Obamacare at the end of of the day was a tax increase. It was a significant tax increase on the wealthiest part of the spectrum in order to pay for health care that ended up guaranteeing coverage and providing

coverage for 30 million people. And that was a major political tradeoff. There were winners and losers. The winners were not only the 30 million people who got coverage, but everybody who might have a preexisting condition in their future that they had a system that they could turn to for care. But on the whole, those were the winners. And the losers were the people who paid the increased taxes, although they themselves were protected by this insurance. But you make the point that All of us, all of us, in a sense, have a pre-existing condition. It's called being alive. It's called facing mortality, if we can refer to one of your great books.

And the conservatives have come up with this idea of risk pools. How does this work or not? Right. So one of the things that you see conservatives trying to generate are alternatives to the ways that the current system that Obamacare has works for covering the people who have preexisting conditions. And you're absolutely right. That is increasingly all of us because between genomics and new kinds of data, we can predict more and more who is going to have what kind of condition. The risk pool approach is to say, you know what, let's not require that insurers cover preexisting conditions and have an individual mandate. But instead say, look, if you keep your insurance coverage continually, then insurers have to cover your preexisting.

existing conditions, but if you have a gap in your coverage and you can't afford now the coverage of insurers who may raise your rates if you had a health care problem during that time, will create risk pools that'll pay for you. It's basically saying the government will take care of some of the sickest people in the system. And I don't think there's anything wrong with that. You know, 5% of the population accounts for 50% of the health care costs. And if you took the people who are chronically ill that the insurers are reluctant, to cover and said, let's cover them through a government insurance pool. I think that's actually could be a good thing. It would lower the insurance costs for other people. Here's where it goes wrong

is that the risk pools that we've had at the state level have been ones that often have a six-month period of pre-existing condition exclusions themselves. They have caps as low as $75,000 total. They have very steep premiums, usually up to 250 percent of what the rest. regular costs are for anybody else. And so the result is people didn't often sign up for the coverage. Now, imagine if we said, look, let's take these people who are high risk that are uninsurable in some sense, put them in Medicaid or Medicare. Right. That would be a way of putting them in a risk pool and why create a whole new program when we have these other places to put them. Do you have any optimism when it comes to health care and the Trump administration?

Well, two things. To me, Trump is so unpredictable. Basically, the existence of Trump as a decision maker is just it's widened the range of possible outcomes, outcomes that could have tremendous damage and really roll back gains that have appeared. On the other hand, if there were a plan that passed that was a quote unquote repeal, but it won't. take action until we've replaced Obamacare and put that date off into the future. You know, I could see that that could get passed. And the reality is there's no agreement among conservatives about what replacement is. And so in the meantime, they'll sign lots of waivers to allow the 19 states with conservative governors who didn't take Obamacare to now accept the program. And you could ironically be in a situation where I said, again, there's a government. is a wide range of potential outcomes. One of those outcomes could weirdly enough be that there is an

increase in coverage because conservative governors start opening the gates to letting people have coverage paid for by the federal government. Atul, thank you so much. Thank you. This is fun, as much as it is painful. All the best. Atul Gawande practices surgery at the Brigham and Women's Hospital in Boston, and he's a staff writer for the New Yorker. We're going to continue in a minute with a look at how the executive order banning immigrants from seven countries plays out in a small hospital in the state of Georgia. It's the New Yorker Radio Hour. Stick around. This is the New Yorker Radio Hour. I'm David Remnick. Donald Trump's ban on immigrants from seven countries, Muslim majority countries, was met with protests in major U.S. airports and in cities

around the world. But that ban is going to be felt specifically around this country and not just in the immigrant enclaves you might think of, but also, for example, in rural hospitals. Rural areas in our country have a real shortage of doctors, and the physicians who take jobs in those hospitals often tend to be immigrants. Ali Fadil is an internist working at two hospitals in northern Georgia. He's originally from Iraq, and we know him from his work as a translator and as a reporter during the Iraq war. Dr. Fidel spoke with the New Yorkers Dorothy Wickeden a few days after the executive order. I want to go back many years now because I remember first hearing about you from my colleague, George Packer, during the Iraq war,

when you were working with him as a translator and fixer in Iraq. Yeah, that's true. Yeah, he sends his regards, by the way. You know, I think the reason I remember is because he said, at the time that his life depended on you. I don't remember where it was, but you were in a particularly diciest situation. Do you remember that incident? That's true. I remember that very well. I mean, I'm smiling right now. I just remembering all of that. It was in a house of one of the Sunni tribes there in Kirkuk. Basically, when we were talking to them, usually these guys are very, very nice people and they like guests and they protect guests very well. But for some reason, guys we were interviewing in that house, that particular house in the

living room, suddenly they were talking among themselves about how much George Packer worth in terms of dollar money. And that was for me. Yeah, that was for me. That was it. So it's basically they were thinking about ransom and stuff like that. At that time, it was the hype of the kidnapping and all these things. All the bad things started.

And, yeah, I decided this is getting dangerous, specifically because they were whispering. They weren't really, frankly honest with us. And, yeah, I decided to cut the interview short and get out of there. I remember George was really mad at me. So, but this was really, this was very dangerous work for you, too. And you had a young family at the time. Did you not? At what point did you decide this was getting too dangerous and you had to leave?

Well, until 2008, when I finally said, okay, that's it. I need to focus more on my family. Even when I came to the United States, I kept going back to Iraq, working on documentaries for HBO and others. But in 2008, I decided, okay, it's time for my family. Iraq at that time was just not doing any better. and things were just getting worse and worse. Now you're practicing as a doctor again in a small town in Georgia. Tell us a little bit about your practice.

You're in a hospital, but you're a primary care doctor there. Are you able to develop relationships with your patients? Well, we see patients coming through the ER and their worst shapes and all kinds of conditions. I do develop relationship with my patients. I keep calling them back over the phone, even after they leave the hospital, make sure that they're doing all right, especially the ones who are really sick. And what are your relationships with the nurses, the staff members, other doctors you work

with? Are there other immigrant doctors? Oh, mostly, actually, the hospital's group, which is the internal medicine section of the hospital, is mostly immigrants. I would say about 85%, 90% are immigrants. They're either Indians, Sudanese, Iraqis, Ethiopians, all the kind of nationalities. So we're like, I think, 96 physicians. The majority of us are immigrants. Well, that is really interesting. And what are your interactions with your patients like, given that?

Do you talk politics with them? This has been a rather tumultuous time in American politics? Well, not until recently. So with the primary, the Republican primary, that's when things started getting, well, I would guess, more interesting. And of course, the majority here are white Republican voters. So, yeah, we talk about Trump. We talk about various issues, including immigration and other issues. And is there any tension in these conversations?

I mean, I don't know how much you get. Obviously, they know that you are an immigrant. We've just had this enormous eruption with accompanying Donald Trump's executive order. How does that play out in your work? So after the Muslim ban, I have not gone back to the hospital yet. It's my week off. But before then, when we were talking about immigration and when they say, aren't you happy Trump is president,

I usually reply with no I'm not. I voted against him. And they would say why, and I explained to them my concerns that he does not want people like me in this country. And they would say, no, don't listen to what he says. This is usually just a political talking point. It's not something that he really is going to do. Actually, one of my colleagues, physician with me,

he happened to be American and born here. He said that Muslim bands will never happen. Don't listen to this. This is just politics. It was amazing when this happened Saturday. It wasn't so reassuring. And what about the other immigrant doctors? Presumably you have had many conversations with them in the past year

trying to figure out how all of this was going to play out. I've had phone calls from Iraq, even from Sudan. some of my colleagues whom we trained with together during residency actually the entire residency they're all made of immigrants because usually in turn of medicine not many Americans want to go into it

it's a not that well paid it's overworked profession so usually immigrants coming from mostly from these seven countries I would say come into these programs So, for example, I was talking to my friend Muhammad al-Termizzi.

He's in Sudan. He was taking off the airplane in Doha and his way coming here to the United States to Atlanta. He was accepted as a physician and as a hospitalist in a hospital south of Atlanta, about 100 miles south of Atlanta. And it happened that I worked in that hospital in the past. It's in a very rural area. And it's mostly white voters, mostly Republican voters. these people will be affected because no one wants to work there.

It's far away from any big city. And he signed a contract with them to work for four years in that area on an H-1B visa, but he was denied entry into the United States. Other colleagues, a friend of mine in Austin, Texas, who works there right now, he was about to leave the country to see his mother. He hasn't seen her for eight years. But shortly before he, he was. he leave, this band came in and he was really mad about this. He has a green card and he doesn't

know if it's really wise to leave the country, whether he's going to be able to come back in or not and leave his life here behind. It's just difficult. And lots and lots of other examples. It also shows the unintended consequences of what the Trump administration is trying to do. Didn't Trump repeatedly say during the campaign that he wanted good immigrants, not bad immigrants, which is the way he put it, meaning immigrants in professions like rural health care. Well, you know, this is ironic because the residency I come from Atlanta Medical Center, mostly uninsured people, very poor people coming in their end-stage diseases. This is where I trained with, I would say, 28 other residents.

Most of them are immigrants. Usually this time of the year is when the residency, system is already the interview is already done and they go through the matching and placing people through the roster for the match. The problem is I was just talking to my program director this morning and basically it's they don't know what to do because a lot of these people they interview they're from Iraq from Sudan she I mean she literally said about 30% of people from Sudan 30 from Iraq is just there's a lot of people coming from these countries and they have to go through this whole

process. The problem with the H1B visa, you have to leave the country and get the visa issued in the country of origin. So they have to leave back to Iraq to get the H1B visa, and that's never going to happen. So meaning these residents who are responsible for so many patients on daily basis, these programs will be affected. A lot of these jobs will be empty, vacant, and I don't know how they're going to fill these jobs. It's going to be difficult without immigrant people from these countries or even other countries. It'll be very difficult. And do your patients understand the ramifications of some of this,

that they may come to the clinic and not have the doctors they need to take care of the conditions they're suffering from, and that when Obamacare vanishes or is whatever, they are going to be consequences for themselves and their families? So ironically, even the patients who have Obama-Kare, care. When they come to the clinic, they are furious about President Obama. I keep explaining to them that for us as doctors, it's probably better financially for the Obamacare to go away.

But for you patients, you're going to be affected more. You're going to come to us with more terminal illness. I've seen it in Atlanta, where I've seen people uninsured. Come with end-stage cancers, end-stage all kinds of diseases, even though these are somewhat treatable at earlier stages. But they don't have insurance. They can't come to the hospital. They can come to the primary care physician where all these screenings should be done. So they end up going to the ER. The emergency department becomes over flooded and of course the emergency department costs way more, probably 300%, 400% more than actually even more than a primary care visit. Compare $7,000 to $250 in a primary care. The ER costs at least $7,000.

So they don't understand the ramification of all of this. And I don't know how they're going to survive without Obamacare, without something alternative to it. It's going to be difficult for them. I feel sorry for them, even though they don't understand it. They don't fathom the idea yet. But I'm pretty sure they're going to feel it pretty soon. So I want to go back and ask you a little bit more about your own situation and your family.

I understand you're leaving Georgia. So that's correct. Back in late 2015, early 2016, when Trump was in the picture and when the Republican primary was at its ugliest moments, things started to change here at home in Swanee in my area. My kids started hearing things about Muslims, about ISIS and stuff. like that. I have two kids, Sarah, she's 13 and Adam 11, and both in middle school. And so a lot of ugly things happened to them at school. So Sarah, his nickname became Sarah Isis. And Adam,

they were asking him about his relation to ISIS and if he's a relative of ISIS and so on and so on. So they come back home. They're furious from the bus. Sarah would be ranting as soon as you get at home. She says, this girl behind me in the bus, she keeps me. playing the same song every day behind my ear. And when I ask her what the song is about, she says the song is about how Arabs made with camels and stuff like that, very vulgar songs. And they hadn't experienced anything like this before? No, really, no.

Before we used to, I mean, even here in Swanee, we didn't feel anything like that. Back in Atlanta, we didn't feel anything like that when we used to live there a couple of years, three years ago. So we never felt this before the primaries, before the election. But when Trump came in power, I mean, when he won the primaries, as soon as this new year, new school year started, things really escalated. This became a regular thing. I complained to school.

The kids went to their counselor, and nothing really happened. My daughter started wearing a, what would Jesus do, bracelets, I'm sorry, just so that she can, she says, if I wear this, nobody's going to ask me this way. it'll be easier for me. They will be easier. So that's what they're doing right now. Has it changed their... I'm interested in them as American children.

At least that's how they, presumably, they saw themselves until the past six to nine months. Talk a little bit about that and whether this has changed their feelings about their country. Well, I started hearing a lot of bad words here at home, like rednecks and stuff like that. So I, to be honest with you, myself, I didn't do a good job initially with the hype of the election.

I myself became so polarized. So I agreed with them in these terms. But once the election happened and the morning after, I felt that we made a big mistake. Yes. So we decided at home not to ever use the word the terms rednecks, white supremacist or racist and all these things. Just to say that these people are ignorant, that's basically why they're saying this. and they need to understand better. Meanwhile, when Trump won the elections, the primaries,

I immediately said to my wife, Zena, we have to search for a job in California. This guy is going to win. There's a big possibility. You thought he was going to win? Oh, yeah. Against the odds of my friends, against the odds of my wife was saying, you're crazy. This is never going to happen.

Why did you think that? Because he was just using a language very similar to the language of our politicians. back home. He is radical in terms of not the religion, but in terms of politics. In Iraq, the politicians who usually win, they use radical religious terms. So the extremists, the extremists of the extremist Shiets, they are the ones who win the election. The extremists of the extremist Sunnis are the ones who win the election. But did you feel that it was comparable in the United States? We were, obviously the media, mainstream media got this completely wrong. But, you know, plays pluralist America, people thought that this was just beyond the pale, and then when it came

down to it, people simply would not stand for this. Well, I did not think that he's going to win the election before the primaries. When he won the primaries, it was very obvious. My suspicions were in place. I'll tell you why, because when you work in a hospital, you usually see people at their worst conditions. And usually they speak their mind, their heart. And when I see it here in my hospital, even in my wife, she works in the same hospital,

in a different campus, but the same hospital. We both saw it. Our patients come in and it's Trump, Trump, and I knew that in this area, in the suburbs, Trump is winning. And whether he lost the election or not, at the end, this area is just not a place for me to live. So where are you going? So right now we're going to California. I'm incurring a huge financial loss by moving to California.

We thought about the options between California and the northeast coast because these are the places that we know we are going to melt with the rest of the population easily. Nobody is going to differentiate. So are the kids on board with the move? Believe it or not, they're really excited about it. They're tired about all of this for them, seeing Trump on the TV.

and connecting this with what they're saying in school is just too much. It's a daily psychologically tormenting issue for them, especially my daughter, Sarah. She's very active politically. What does she want to do? Does she know yet when she grows up? She does. She want to be super rich and go to Hawaii and live in Hawaii.

Good for her. Well, I wish you, I wish you, all the best of luck. Thank you so much. Thank you very much for coming on. Dr. Ali Fidel talking with Dorothy Wickeden. Dorothy is executive editor of the New Yorker, and she hosts our podcast, Politics and More, with conversations about what's happening in Washington and in foreign affairs. This is the New Yorker Radio Hour. Stick around. Welcome back to the New Yorker Radio Hour. I'm David Remnick. Next week on the show, I'll talk with chef turned documentarian Anthony Bourdain.

Bordane's TV show No Reservations explores street food and food culture and politics all around the world. And the strange thing is that Bordane ends up reporting from some dangerous and difficult to reach countries where even network news tends to steer clear. That's next week. And one more story this week before we go. With a few great exceptions, Acapella Singing has been a pretty insular world for a long time. But these are banner days for acapella.

The vocal group Pentatonics has won two Grammys and is nominated for a third at next month's awards. The comedy, pitch-perfect, about a college acapella group was a hit with a couple of sequels. And there's a musical on Broadway right now written by Kristen Anderson Lopez that's sung entirely by the cast without any instruments at all. That's a first. Acapella never went away exactly, but it's definitely having some sort of comeback. and the New Yorker's Giatollantino recently spent an afternoon trying to find out just why. So Kristen Anderson-Lopez co-wrote the music for Frozen.

You know Let It Go, which is the song that she and her husband won Academy Award for. It is a hard song. It is a very, very hard song. She has a ton of stuff going on. She is currently working on Frozen 2, the sequel, adapting Frozen for Broadway. But she also recently wrote a musical called In Transit. which takes place entirely on the New York City subway. The reason we put it in the subway is it started as a bunch of songs about what it was like to live in New York and struggle in New York.

And very quickly we realize we're all connected by a subway, but we're all also really fighting similar obstacles. And the subway was a perfect metaphor for those obstacles. In Transit is the first Broadway musical to be performed completely without instruments. it's all acapella, which is something that I have a secret and shameful treasure trove of knowledge about. Kristen wrote in transit with three of her old friends. We started as an acapella group. We were put together as an acapelle group. What was its name?

Oh, it was called Bob Ross Juice Box because we were drinking beer, and we were all talking about, like, what are things that we love that have gone away? And Bob Ross was one of them. We all really connected with watching Bob Ross paint happy little trees. You know who Bob Ross is, the big hair, the blue shirt, the easel. Bob Ross juicebox is squarely within the a cappella name genre in which the more wordplay you have, the better. Des can't be happening. Oh, yeah.

So good. There was one of my college called Who's in Treble. I liked unaccompanied minors. That's really good. For kids who were in high school. That was a fun one. So part of my attraction to in transit was me trying to re-examined. visit my past as a college

a cappella singer and devotee. And I've been trying to figure out the nature of my you know, it's so cheesy. It's so fun. It's so, it's such a strange pastime. But anyway, I think a lot of people come out of college

acapella, you know, with conflicting feelings about it. Yeah. Yeah. Yeah. No, I mean, it's a, it, I think it has been, become a guilty pleasure. I think that's perfect tried to explore that in the first one, certainly. Actually, in all of them, it tries to say, tries to say, oh, we all know this is like, sometimes it is the worst of the worst of not only being incredibly cheesy and thinking

you're cool. That's the worst part, is that it's a bunch of people. When you're doing like, I'm just like, you can call me Al comes to mind right now. Like when you're like, ba-da-p-pa-ba-ba-ba-da-p-ba, and you think you're so cool up there, and you are as dorky as you can possibly be. And I think as the world becomes increasingly digital,

I think we are longing for something that is completely human and in the moment. And if I had to say, why now? It's that our music is more and more produced. So to experience just human voices in a room making music, I mean, I might go even as far as to say there's something built into humans that needs singing. And the little bit of drum is the beatbox. Yeah. Can you beatbox?

I'm horrible. I'm awesome. I'm like, bt's tkats. That's it. That's all I got. So part of the defining element, I think, of singing with people in an a cappella group is that you get really bonded to them in a way that is hard to explain. and it's cathartic in a way that I think it, like it's... I read an article about this.

There's neuroscience behind that. It turns out that if you are in a room singing harmony, we release the neurotransmitters, serotonin, and oxytocin, which are responsible for happiness, elevated mood levels, and bonding. Oxytocin is what you release when you are nurse. a baby and you as humans like humans have this release of these neurotransmitters and you're creating something I think that it's the anti-irony and in a time that's increasingly ironic um aquaels the anti irony is is true that's so true yeah what was your favorite solo you ever

sung um I my signature solo was bohemian rhapsody whoa yeah and that was fun that was that was um um um That was, it had just the right range for me. Do you want me to do it? Like, okay, I got to, so you think you can love me and then it's my eye. So you think you can hunt and leave me to die. That part rules. Yeah. Oh, baby.

Yeah, and of course, I mean, dork, a dork singing this. This is not Freddie Mercury. But it was fun. What was your story? signature solo? Oh, man. I sang, so I'm like, how can I evaporate

before I have to do this? I sang that Regina Spector's song, Fidelity, which is so embarrassing. How does it go? I can't recall it. I can't sing it ready. Yes, you can. And you should.

And you will. It's the one that goes, I never love nobody fully. Always one foot on the ground You sound great So I can't believe I just sang in front of the woman who wrote Let It Go But she had just sung for me Bohemian Rhapsody of all songs And really committed to it

And when somebody is singing Acapella And there are no instruments to hide behind And they're just singing in front of you face to face And they ask you to join in I guess you have to There's a vulnerability to the whole project that I'd kind of forgotten about a vulnerability that doesn't come up too often in your normal life in New York City.

I never love nobody fully. Always one foot on the ground. And by protecting my heart truly, I got lost in the sound. I hear in my mind all of these voices. I hear in my mind. All of these words I hear in my mind. All of this music.

And it breaks my heart. And it breaks my heart. And it breaks my heart. Oh, I can't do it anywhere. When it breaks my heart. I can't do it. The New Yorker's Gia Tolentino singing along with Regina Specter. Thanks so much for joining us this week.

Hope you enjoyed the show. let us know on Twitter at New Yorker Radio. I'm David Remnick. See you next week. The New Yorker Radio Hour is a co-production of WNYC Studios and The New Yorker. Our theme music was composed and performed by Merrill Garbus of Tune Yards with additional music by Alexis Quadrado. The New Yorker Radio Hour is supported in part by the Cherina Endowment Fund.