November 13, 2019

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University Of Memphis Defies NCAA, Tests Enforcement Of Amateurism Rules

The University of Memphis is defying the NCAA and suiting up a star freshman who has been deemed “likely ineligible.” It’s a test of the NCAA’s power to enforce longstanding amateurism rules.



ARI SHAPIRO, HOST:

In men’s college basketball last night, an early season matchup between top 20 teams ended with Oregon beating Memphis in Portland. But the bigger story of the game was the presence of Memphis freshman star player James Wiseman. He is right in the middle of a legal battle with the NCAA. NPR’s Tom Goldman says Wiseman’s case is generating more anger about the NCAA’s strict rules on amateurism.

TOM GOLDMAN, BYLINE: It’s not often the mere act of putting a basketball player in a starting lineup is controversial.

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UNIDENTIFIED ANNOUNCER: Center, 7’1″, from Nashville, Tenn., number 32, James Wiseman.

GOLDMAN: But last night, as Memphis freshman center James Wiseman jogged onto the court in Portland for pregame introductions, it was indeed a moment of significant controversy – another act of defiance, says Michael McCann. He’s a legal analyst for Sports Illustrated.

MICHAEL MCCANN: It’s a university essentially telling the NCAA, we’re doing what we want, and we’re not afraid of you.

GOLDMAN: Last week, before Memphis’ season began, the NCAA indicated Wiseman would be ineligible to play. The NCAA believed Wiseman got an improper benefit from his current head coach, Penny Hardaway. In 2017, Hardaway was a high school coach in Memphis, and he paid Wiseman’s mom a little more than $11,000 to help her move her family to Memphis, where Wiseman played high school ball for Hardaway. Years before, Hardaway had donated a million dollars to the university, his alma mater. McCann says in the NCAA’s mind, that made Hardaway a booster for the university.

MCCANN: And because of that, Wiseman is ineligible or appears to be ineligible because a player can’t have expenses paid for by a booster.

GOLDMAN: Lawyers for Wiseman argue the NCAA knew about the Hardaway payment to Wiseman’s mom when it cleared Wiseman to play in May. The attorneys rushed to a Tennessee court last Friday and got a temporary restraining order. Wiseman has played all three of Memphis’ games with support from the university and most of Memphis.

REGGIE GLASPIE: I’m a hundred percent behind him.

GOLDMAN: Forty-six-year-old Memphis resident Reggie Glaspie made the trip to Portland for last night’s game.

GLASPIE: I think Penny, number one, has the best interests of the kids, and I think that he’s doing right by trying to just let the NCAA know that, hey, you can’t pick on us.

GOLDMAN: Anti-NCAA sentiment has been percolating nationwide since late September. That’s when California passed its law allowing college athletes to be compensated for the use of their name, image and likeness, a different case than the one in Memphis, says Daily Memphian sports columnist Geoff Calkins. But really, it’s all of the same piece.

GEOFF CALKINS: People are realizing that the fundamental rules that undergird all of this are based on a system of amateurism which makes no sense. And so, sure, were – was there a violation of rules that make no sense?

GOLDMAN: The NCAA said in a statement Memphis was notified Wiseman is likely ineligible. The university chose to play him, the statement continued, and ultimately is responsible for ensuring its student athletes are eligible to play. Possible NCAA punishment could include the school forfeiting games in which Wiseman played.

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UNIDENTIFIED ANNOUNCER: James Wiseman.

GOLDMAN: Wiseman only played about half of last night’s game because of early foul trouble. Still, he scored 14 points, had 12 rebounds and showed the agility and power that are expected to make him one of the top NBA draft picks next year. He didn’t talk to reporters afterwards. The university is guarding him closely. For now, his lawyers are doing the talking. There’s a hearing on his case scheduled for next Monday. Two days before, Memphis plays Alcorn State and, with James Wiseman in the starting lineup, will defy the NCAA once again.

Tom Goldman, NPR News, Portland.

(SOUNDBITE OF THE MOUNTAIN HOWL’S “MELT”)

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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Novelist Doctor Skewers Corporate Medicine In ‘Man’s 4th Best Hospital’

“The profession we love has been taken over,” psychiatrist and novelist Samuel Shem tells NPR, “with us sitting there in front of screens all day, doing data entry in a computer factory.”

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“Don’t read The House of God,” one of my professors told me in my first year of medical school.

He was talking about Samuel Shem’s 1978 novel about medical residency, an infamous book whose legacy still looms large in academic medicine. Shem — the pen name of psychiatrist Stephen Bergman — wrote it about his training at Harvard’s Beth Israel Hospital (which ultimately became Beth Israel Deaconess Medical Center) in Boston.

My professor told me not to read it, I imagine, because it’s a deeply cynical book and perhaps he hoped to preserve my idealism. Even though it has been more than 40 years since its publication, doctors today still debate whether it deserves its place in the canon of medical literature.

The novel follows Dr. Roy Basch, a fictional version of Shem, and his fellow residents during the first year of their medical training. They learn to deflect responsibility for challenging patients, put lies in their patients’ medical records and conduct romantic affairs with the nursing staff.

Basch’s friends even coin a term that is still in wide use in real hospitals today: Elderly patients with a long list of chronic conditions are still sometimes called “gomers,” which stands for “Get Out of My Emergency Room.”

Like any banned book, The House of God piqued my curiosity, and I finally read it this past year. I’m a family physician and a little over a year out of training, and I read it at the perfect time.

I got all the inside jokes about residency — and many were laugh-out-loud funny — but I am now far enough removed that the cynicism felt like satire rather than reality.

The House of God also felt dated. Basch and his cohort — who were, notably, all men, although not all white — didn’t have electronic medical records or hospital mergers to contend with. They wrote their notes about patients in paper charts. And it was almost quaint how much time the doctors spent chatting with patients in their hospital rooms.

It couldn’t be more different from my experience as a resident in the 21st century, which was deeply influenced by technology. There’s research to suggest that my cohort of medical residents spent about a third of our working hours looking at a computer — 112 of about 320 working hours a month.

In The House of God, set several decades before I set foot in a hospital, where were the smartphones? Where was the talk of RVUs — relative value units, a tool used by Medicare to pay for different medical services — or the push to squeeze more patients into each day?

That’s where Shem’s new book comes in. Man’s 4th Best Hospital is the fictional sequel to The House of God, and Basch and the gang are back together to fight against corporate medicine. This time the novel is set in a present-day academic medical center, and almost every doctor-patient interaction has been corrupted by greed and distracting technology.

Basch’s team has added a few more female physicians to its ranks, and together they battle a behemoth of an electronic medical record system. The hospital administrators in Shem’s latest book pressure the doctors to spend less time with every patient.

If The House of God is the great medical novel of the generation of physicians who came before me, perhaps Man’s 4th Best Hospital is the book for my cohort. It still has Shem’s zany brand of humor, but it also takes a hard look at forces that threaten the integrity of modern health care.

I spoke with Shem about Man’s 4th Best Hospital (which hit bookstores this week) and about his hopes for the future of medicine.

This interview has been edited for clarity and length.

The protagonist in Man’s 4th Best Hospital, Dr. Roy Basch, doesn’t have a smartphone. I hear you don’t either. Why not?

If I had a smartphone, I would not be able to write any other novels. I have a bit of an addictive personality. I’d just be in it all the time. … I’ve got a flip phone. You can text me, but it has to be in the form of a question. I have this alphabetical keyboard. You either get an “OK” or an “N-O.”

A big theme in the novel is that technology has the potential to undermine the doctor-patient relationship. What made you want to focus on this?

I got a call out of the blue five years ago from NYU medical school. They said, “Do you want to be a professor at NYU med?” And I said, “What? Why?” And they said, “We want you to teach.” When I first got there, because I had been out of medicine [and hadn’t practiced since 1994], I figured, “Oh, I’ll look into what’s going on.” And I spent a night at Bellevue.

On the one hand, it’s absolutely amazing what medicine can do now. I remember I had a patient in The House of God [in the 1970s] with multiple myeloma. And that was a death sentence. We came in; we did the biopsy. He was dead. He was going to be dead. And that was that. Now it’s curable.

At Bellevue, I saw the magnificence of modern medicine. But like someone from Mars coming in and looking at this fresh, I immediately grasped the issues of money and effects of screens — computers’ and smartphones’.

And it just blew me away. It blew me away: the grandeur of medicine now and the horrific things that are happening to people who are really, sincerely, with love, trying to practice it. They are crunched, by being at the mercy of the financially focused system and technology.

In Man’s 4th Best Hospital, there’s a fair amount of nostalgia for the “good old days” of medicine in the 1960s and 1970s, before electronic medical records. What was better in that era?

If you ask doctors of my generation, “Why did you go into medicine?” they say, “I love the work. I really want to do good for people. I’m respected in the community, and I’ll make enough money.” Now: … “I want to have a good lifestyle.” Because you can’t make a ton of money in medicine anymore. You don’t have the respect of your community anymore. They may not even know much about you in a community because of all these [hospital] consolidations.

Do you think anything in medicine has gotten better?

The danger of isolation and the danger of being in a hierarchical system — students now are protected a lot more from that. When I was in training, interns were just so incredibly exhausted that they started doing really stupid things to themselves and patients. The atmosphere of training, by and large in most specialties, is much better.

You wrote an essay in 2002 titled “Fiction as Resistance,” about the power of novels to help make political and cultural change. What kind of resistance today can help fix American health care?

When somebody falls down, up onstage at a theater, do you ever hear the call go out, “Is there an insurance executive in the house?” No. If there are no doctors practicing medicine, there’s no health care. Doctors have to do something they have almost never done: They have to stick together. We have to stick together for what we want, in terms of the kind of health care we want to deliver, and to free ourselves from this computer mess that is driving everybody crazy, literally crazy.

Doctors don’t have a great track record of political activism, and only about half of physicians voted in recent general elections. What do you think might inspire more doctors to speak out?

Look at the difference between nurses and doctors. Nurses have great unions, powerful unions. They almost always win.

Doctors have never, ever formed anything like what the nurses have in terms of groups or unions. And that’s a big problem. So doctors somehow have to find a way — and under pressure, we might — to stick together. Doctors have to make an alliance with nurses, and other health care workers, and patients. That’s a solid group of people representing themselves in terms of what we think is good health care.

The profession we love has been taken over, with us sitting there in front of screens all day, doing data entry in a computer factory.

Health care is a big issue for the upcoming election. What kind of changes are you hoping we’ll see?

There will be some kind of national health care system within five years. … You know, America thinks it has to invent things all over again all the time. Look at Australia. Look at France. Look at Canada. They have national systems, and they also have private insurance. Don’t get rid of insurance.

The two biggest subjects for the election are health care and health care. … The bad news is, it’s really hard to get done. The good news is, I think it’s inevitable. The good news is, it’s so bad it can’t go on.

One of the major criticisms of The House of God is that it’s sexist. It seems like your hero, Dr. Basch, has gotten a little more enlightened by the time of Man’s 4th Best Hospital. Does this reflect a change you’ve also experienced personally?

I was roundly criticized for the way women were seen in The House of God.

I remember the first rotation I had as a medical student at Harvard med was at Beth Israel, doing surgery. It got to be late at night, and I was trailing the surgeon around, and he went into the on-call room. There was a bunk bed there, and he started getting ready to go to bed. And I said, “Well, I’ll take the top bunk.” And he said, “You can’t sleep here.” So I left, and in walked a nurse. I was shocked.

Things have changed, and I am very, very glad. I don’t know if it seems conscious — I was very pleased to have total gender equity in the Fat Man Clinic [where the characters in Man’s 4th Best Hospital work] by the end of the book.

What made you feel like it was time to update The House of God?

I write to point out injustice as I see it, to resist injustice, and the danger of isolation, and the healing power of good connection. … We can help our patients to get better — but nobody has time to make the human connection to go along with getting them better.

Mara Gordon is a family physician in Camden, N.J., and a contributor to NPR. You can follow her on Twitter: @MaraGordonMD.

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Ethane And The Plastics Boom

America’s natural gas boom has also made it the world’s biggest exporter of ethane. It’s a building block for plastics, and U.S. gas is helping fuel the global plastics industry.



STEVE INSKEEP, HOST:

A boom in one industry is fueling another. For years now, the United States has been the world’s largest producer of oil and gas. That has kept natural gas prices low. And to tell you what other industry that helps, I have one word – one word – plastics. Here’s Reid Frazier of StateImpact Pennsylvania and the public radio program The Allegheny Front.

REID FRAZIER, BYLINE: Natural gas is mostly used for heating homes or fueling power plants. But it has another key ingredient you may not have heard of – ethane, a building block of plastics. President Trump brought attention to it a few months ago when he visited the site of a chemical plant Shell is building in Pennsylvania.

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UNIDENTIFIED PEOPLE: (Chanting) U.S.A, U.S.A, U.S.A.

FRAZIER: This plant, like a number of others being built in the U.S., will convert some of the region’s ethane into plastic. Trump told workers this was bringing the country big economic benefits.

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PRESIDENT DONALD TRUMP: American manufacturing. And we are reclaiming our noble heritage as a nation of builders again.

(APPLAUSE)

TRUMP: Nation of builders.

FRAZIER: But there’s so much natural gas and ethane that chemical plants in the U.S. can’t use it all. Turns out, this has been a lucky break for the European chemical company Ineos. In 2011, its own supplies of ethane from the North Sea were running low, says Warren Wilczewski, an economist with the U.S. Energy Information Administration.

WARREN WILCZEWSKI: Ineos looked at the United States where ethane supply was growing and where – especially in the Appalachian region, that ethane had, like, no place to go. And they recognized an opportunity.

FRAZIER: Ineos commissioned a fleet of ships, the first ever to carry ethane by sea, to move shale gas from a port near Philadelphia to plants in the U.K. and Norway. Ineos officials did not agree to an interview for this story, but here’s CEO Jim Ratcliffe in a company video.

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JIM RATCLIFFE: I think for some of these assets in Europe, it’s the only way they can survive. If we can bring some of the U.S. economics across to Europe…

FRAZIER: The U.S. has quickly become the world’s leading exporter of ethane, feeding growing plastics industries in India and China. And those exports are expected to keep growing. Back in 2016, it was big news when U.S. methane arrived in Scotland.

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UNIDENTIFIED BBC REPORTER: It is the first delivery for Ineos of shale gas into the U.K. It’s arriving at Grangemouth later this morning.

FRAZIER: And Grangemouth is home to Scotland’s biggest petrochemical plant and refinery.

KEVIN ROSS: You can see some of the flares down there, operating some of the silo towers across there, and some of the many cooling towers that are actually onsite.

FRAZIER: Kevin Ross is president of the Scottish Plastics and Rubber Association and runs a local plastics testing company. He says American shale gas has allowed Ineos to restart one of its production units. The plant is now running at full capacity. That’s not just good for the 1,300 people who work there, but for the suppliers and contractors, like him.

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ROSS: Watch your feet.

FRAZIER: At the nearby lab where his company tests plastic materials, he shows me what looks like a glossy plastic pipe.

ROSS: Almost certainly, because of what it’s made of, it’s either nuclear, pharmaceutical or military – almost certainly – because it is so expensive.

FRAZIER: So it’s a pipe?

ROSS: It is a pipe on steroids. It is a very high-performance pipe.

FRAZIER: Ineos got hundreds of millions of dollars in loan guarantees from the U.K. to retrofit the Grangemouth plant for American shale gas. But it’s also pushed for its own local supply. It wants the U.K. to allow fracking, the controversial technology that breaks up rock deep underground to get oil and natural gas. And that plan was met with intense opposition. Norman Philip, with Friends of the Earth Scotland, opposed fracking because of what he’d heard about it from communities in the U.S. and Australia.

NORMAN PHILIP: People were telling us of gas leaks. They were telling us of, like, children having headaches, and there was a toxic element of it.

FRAZIER: The pushback has resulted in an ironic twist to this story. In 2015, Scotland put in place a moratorium on fracking, and the U.K. government recently did the same. So fracking is illegal in Britain, even though it’s still legal to import shale gas produced by fracking in the U.S. Lee Sinclair is a railroad engineer at the Grangemouth petrochemical plant. He has mixed feelings about this.

LEE SINCLAIR: I think it’s a good idea, just the fact that we’re getting gas from somewhere. And the only thing I don’t like about it is Scotland said, no, well, you’re not fracking here. So they decide to go to America to get his gas.

FRAZIER: He’d rather the U.K. get a local supply. But for now, he says, America’s boom in gas and ethane is helping him keep his job. For NPR News, I’m Reid Frazier in Grangemouth, Scotland.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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