At USUHS

Well, Daniel Greenberg is at it again -- deceiving the public with misinformation and inflammatory articles that stretch the truth beyond recognition.

Perhaps that is why his Washington newsletter is so popular -- people like to read the kind of trash contained in the gossip

journals, whether true or not.

His "Doctors in Khaki" (Opinion * Commentary, March 23) focuses again on what he knows is an untruth -- that the Uniformed Services University of the Health Sciences is an expensive medical school.

He states, "There's no doubt that the tab per head at USUHS is by far the highest in medical education," which is a blatant lie. In fact, the USUHS cost per graduate (about $0.5 million) is well below the national average (over $1 million).

USUHS is below the 30th percentile for its budget, but above the 70th percentile for number of graduates -- clearly not a cost "the highest in medical education," but rather much below the average.

The figure he uses for cost per graduate at civilian medical schools is $110,000, which is not the cost of medical education at all, but rather the cost the Department of Defense has to pay to provide a scholarship for a four-year commitment from a potential graduate.

The remaining cost of that student's education (over $0.9 million) is paid by federal, state and private subsidies. The total cost is about double that of sending the student to USUHS and getting at least an eight-year commitment of service as a military physician.

My biggest concern is that the military seems to be abandoning the academic base of military medicine, which is so vital to maintaining disease prevention and quality medical care.

There are large cuts in graduate medical education (specialty training), in military medical research, and in the academic centers (e.g., USUHS).

One needn't study the history of medical progress in America for very long to see that many of the great advances have come through military medical research, particularly in tropical medicine, infectious diseases, vaccines, environmental extremes, physical training and nutrition. To abandon this is to take a large step backward.

My other concern in the current controversy about USUHS is the potential abandonment of an academic environment that produces large numbers of career military and Public Health Service physicians who are willing to dedicate their careers to public service.

This is what USUHS is all about. It takes over a million dollars to train a fighter pilot -- why not spend half that to get a physician who is dedicated to public service rather than to his own pocketbook?

John W. Gardner, M.D.

Rockville

Uncomfortable

I find it interesting in Ed Brandt's April 17 article on multicultural education that Dr. Geneva Gay says that children of "color" continue to fail "because they haven't been taught to be comfortable in school."

As a person of color, I can tell you I never felt comfortable in school, never knowing when the next sister or brother was going to whack me for not being prepared.

It also seems to me that another group of people of color, the Asians, seem to do well in school.

A quote from Nancy S. Grasmick, state superintendent of schools, was a real eye-opener in the article.

She said, "Too many reach college and don't know how to live in a diverse society." I find too many reach college that have been short-changed by their high school and not prepared to do college level work.

I= Let's drop multicultural and replace it with mathematics.

A. Bacigalupa

Baltimore

Suburban Blight

I agree fully with the premise of Tim Baker's April 11 column that the growth of suburbs trashes out the city. The growth of suburbs trashes out the country as well.

Frederick, Harford, Carroll and northern Baltimore counties illustrate this dilemma. They contain some of the richest soil on the planet. But Frederick County, a prime dairy farming area in the state, has lost over half of its dairy farms to development since 1971.

These cookie-cutter suburbs have a reverse King Midas touch: When all of the amenities of suburbia coalesce, they become undesirable, and the search ensues for increasingly remote rural landscapes to slash and burn similarly.

Mr. Baker's solution of "effective regionalism" is not likely to resolve this dilemma. Local politicians with an eye to political contributors and their tax base encourage "rows of two-acre lots . . mock Tudor mansions and French chateaus."

This is normally what is meant any time a candidate for office espouses the importance of "economic growth."

My solution would be to build no more roads. Suburbs wouldn't exist without ever-expanding webs of macadam and universal car ownership. Beltways, interstates, bypasses, etc., benefit the suburban affluent and land developers.

Columbia (where Tim Baker writes from) was supposed to be a model city and user friendly to pedestrians. When Columbia became passe, the landed gentry moved down the interstate to Clarksville. Woodbine and Lisbon are next.

Mass transit is the only thing that can save the countryside and the city. Ask the Baltimore Orioles about the benefits of mass transit.

Paul R. Schlitz Jr.

Baltimore

Asbestos Death

My husband died on Feb. 25 at the age of 55 of a cancer contracted due to his exposure to asbestos. Mesathelioma, the cancer my husband suffered from, was not a self-inflicted disease. It was inflicted upon him.

His illness was not the result of a lifestyle or sexual preference. He was in excellent health, except for the cancer growing in his chest cavity.

Yet I see or hear no telethons, celebrity-sponsored campaigns or media attention given to the need for money for research for this particular cancer. Is it because this is a blue-collar disease?

Dorothy M. Fertig

Fallston

Jay's Complaints

Peter A. Jay may be right in saying (Opinion * Commentary, April 14) that many judges, lawyers, clerks, court reporters and corrections officials would have to find other work without drug dealers like the twice-tried "Eugene." As an appellate public defender in Washington, I would.

But if I found other work, I hope I would still be able to make cogent arguments, unlike Mr. Jay in this instance. Those who profit from offering public criticism, including both of us, should be careful what they say.

Mr. Jay's first complaint -- about the mistrial caused by jurors who apparently concluded independently that there should have been fingerprints on the $10 bill -- does not arise from the "industry" of criminal justice professionals.

On the contrary, occasional unpredictable results are inevitable in the constitutionally established system of trial by a jury of one's peers. I'd be interested to see Mr. Jay's attack on that.

Mr. Jay's second complaint -- that Eugene's conviction after the second trial was reversed because his lawyer persuaded the Court of Special Appeals the prosecution had introduced unduly prejudicial evidence -- seems to suggest that the lawyer had a choice not to make that argument.

The suggestion is incorrect. A lawyer is not a judge. If an argument that may benefit a defendant can reasonably be made given certain facts and existing law, it cannot ethically be discarded without the client's consent. Thus, a defense lawyer has considerably less freedom of professional expression than, say, a columnist, who has no client whose interests are paramount. Perhaps Mr. Jay also means to suggest that the state's attorney's office should not have decided against a third trial, but I don't think that's his point.

After all, he says sympathetically that the prosecutors were "twice burned," as though their well-meaning efforts were just overwhelmed by their frustration and their other work.

Mr. Jay should check the state's attorney's conviction rate, including guilty pleas and judicial verdicts on stipulated facts, some time. For every case like Eugene's, hundreds of convictions stick.

What to do with convicted drug dealers is a real problem, and it deserves full public discussion.

But getting dealers convicted, if they are caught and strong evidence exists, is hardly ever difficult for competent prosecutors. Statistically few retrials are ordered, particularly in undercover drug sale cases. To suggest otherwise, as this gentleman farmer does, is irresponsible.

Allen E. Burns

Lutherville

Is Illegitimacy the Cause of Our Social Ills?

I read with interest and dismay Susan Reimer's column of April 7. With interest, because I do have a child without benefit of marriage, with dismay because the column was a painful reminder of how married parents choose to view those who are not.

People fail to realize that upper middle-class males have been fathering children without benefit of marriage forever, and it has been only in the last few years that these young women have found a collective voice to ensure the children are taken care of by their fathers.

It is not the case for poor young women of our community. You simply can't get renumeration from someone with no fixed address or job.

The most shocking statement from this column was that illegitimacy is a worse social problem than crime, drugs, welfare or homelessness because it drives everything else.

Look again. A lot of homelessness is due to deinstitutionalization of mentally unhealthy citizens without regard to how these people can successfully integrate into a "mentally healthy" society.

Welfare? Yes, we do need reform. We have generations of people of all colors on our welfare rolls, not out of want but out of a hopelessness I hope never to experience. A hopelessness borne out of a government increasing the welfare for new children and decreasing programs to help these women get off the rolls.

The government has to acknowledge partial responsibility for perpetuating these problems.

I guess the statistical evidence would be numbing. We've helped to create this situation and now it's catching up with us. Why does one suppose people are having sex earlier and earlier? Could it be partially due to media saturation?

We all want to be better, do better and look better. Where do we find the answers?

For a lot of people it's what is shown on TV and in ads. Our schools have failed to teach them to read and think as individuals. Some lose interest and can only watch and imitate.

The results from studies from the '50s and '60s and now are comparing apples and oranges. Pre-1968 we didn't have Woodstock, love-ins, sex and drugs thrown at us.

Our generation, of which Ms. Reimer and I are part, left a legacy of irresponsibility and pass-the-buck mentality. All of our blinders kept us from seeing what kind of seeds we were sowing.

Why also do you think a lot of these young women choose having babies over abortion?

That's obvious. If you live with little or no hope and very few if any dreams, what more to soften the heart and make you feel you've done something than to hold your very own soft, sweet smelling, gentle baby?

I cut my teeth on the belief women can have it all, you don't need a man for anything.

So we go it alone. And it's a hard choice. Abortion? -- been there -- not again. I've chosen responsibility. I give just as much legitimacy to the child I had without marriage as the one I had at age 20 within a marriage. To me there is no difference.

I also choose not to put tags on either of my children, as is our habit . . .

I part company with Ms. Reimer when she passes judgment. No one has the right to judge another. If we must, I would hope it would be with compassion and open-mindedness.

We tend to pass judgment when a situation arises that we helped create but now is making us extremely uncomfortable, and we would gladly revert to days of less choice so we don't have to think about it until tomorrow.

Sometimes, just sometimes, it's easier to raise a child alone, especially when one parent is of no use at all because of drugs, physical or emotional abuse.

The important things about raising children are love, honesty and trust. My children trust I will do the very best I can. When I make a mistake and say I am sorry, children are wonderful at saying it's OK.

I hope we, as a society, can hug all of our children, sincerely say we are sorry, we've made some big mistakes and, with love, honesty and trust, help each other to fix them.

Linda A. Heath

Edgewood

Blaming Jews for Crucifixion of Jesus

Tim Baker's fine March 28 essay on the legacy of the passionarratives and Christian/Jewish relations and Elsworth Bunce's reasoned response and defense of the text of the gospel of John underscore the sensitive and difficult nature of such an enterprise.

One of the difficulties inherent in Dr. Bunce's defense of the gospel's writers stems perhaps from the fact that most people, unless they are scholars, have no vehicle with which to understand the nuances he gives to the term "the Jews" in the gospel of John.

While many scripture scholars would concur that term is not to be read as referring to all Jews of Jesus' time but rather to "the Judean Jews" -- or specifically the priestly class -- nearly all who hear that phrase during Holy Week hear what I heard as a child: The responsibility for the death of Jesus lay with the Jewish people of his day.

All texts have many lives. The first life occurs when the words are initially written and have a particular meaning for the audience for which they were intended.

The second comes about when the words are read at another period in history and are understood through the lenses of that age.

This is most certainly true of these passion narratives. It is both ironic and tragic that no sacred texts have borne more weight and caused more pain and anguish than these.

Dr. Bunce is of course correct that there was infighting in the early years after Jesus' death between the two strands of Judaism, Rabbinic Judaism and the sect later to be known as Christianity.

But the pattern of demonization and all its consequences, as far as we currently know, did not have its genesis until the writings of Melito of Sardis in the Second century.

Following on the interpretation of the gospels by another early church father, Justin Martyr, Melito identified the Jews as the killers of the Lord and of God himself.

Given what the texts do actually say, it is perhaps not surprising that such an interpretation was then embraced by other church scholars, the church's hierarchy, the lower orders of clergy and finally the lay people themselves.

The anti-Jewish seedbed planted by Melito had become a firm foundation upon which a superstructure of religious intolerance was to be built.

That superstructure, which eventually became a time-honored tradition of dehumanization and demonization through a pattern of language and thought, clearly played a significant part in the deaths of hundreds of thousands of Jews by self-proclaimed "Christians" during the 1,900 years since Christianity's birth.

Today, Christians of all denominations are struggling with how to present this passion story every year without continuing the canards of the past.

The Roman Catholic Church, since Vatican II, has led the way. With considerable effort through official documents and instructions, the clergy are being informed of the necessity of changing the way Jews and Judaism are presented in liturgy, teaching and preaching.

Most of the Protestant denominations, too, are beginning to attempt to address the same challenges.

But change across the face of Christianity can be slow and difficult. Last year, the second highest official in the Russian Orthodox Church went comfortably public with his condemnation of the Jewish people, trotting out the "Protocols of the Elders of Zion," the old czarist forgery about a world-wide Jewish conspiracy.

And he didn't end there. After blaming the Jews for the economic woes of Russia, he pinned on them the deicide charge, as if to somehow explain the rationale behind what he believed to be the demonic and hence destructive nature of this people within his land. Collective responsibility for the death of Jesus -- 20 centuries later.

The eminent New Testament scholar, Daniel Harrington, wrote recently, "Christians should honestly admit the presence of negative attitudes toward Jews and Judaism in the New Testament while affirming that such polemics of the past are not part of the Christian gospel we are called to proclaim today."

Understanding the past, and thoughtful reflection on its meaning for Christians and Jews today, will serve in the long run not just as a strengthening force in each of these two faith communities, but in the greater world community within which each of them resides.

Peggy Obrecht

Baltimore

Dealing with Behavioral Problems

In the March 23 letter entitled "We Don't Hold Psychiatry in Contempt," Professors Richard E. Vatz and Lee S. Weinberg continue to argue that most behavioral and emotional disorders are not illnesses, and they object to the current practice of mandating mental health insurance coverage to treat them.

Drs. Vatz and Weinberg state that they do not believe "that drug abusers take drugs because they have a disease" and that "life is problematic, and too many wish to label all of life's problems as illness."

They cited my concession that "most mental illness is not physical illness," and they offer the compromise that insurance coverage be mandated for only those with severe mental health problems.

Professors Vatz and Weinberg, even though they have roused the ire of many of us, focus on issues that not only mental health professionals but we, as a society, need to address.

By conceptualizing behavioral and emotional disorders as "disease driven," such disorders come under the medical rubric and therefore are more likely to receive the necessary treatment to correct them.

As Drs. Vatz and Weinberg correctly state, such disorders are "currently most effectively managed through the mental health system," which has "deep roots in American culture and a well established organizational structure."

I would agree with Drs. Vatz and Weinberg that most mental disorders are serious problems in living.

They are not diseases but are caused by twisted, faulty thinking and distorted perceptions of reality; poor and under-developed emotional controls, and the inability to cope behaviorally with perceived stress.

However, because they are not disease does not mean that they should be ignored or left untreated. Simply leaving afflicted individuals to fend for themselves often results in them becoming unproductive, or even counter productive, members of society. This obviously costs us billions of dollars over the long run.

Like it or not, the "medicalization" of many behavioral and emotional problems has led the way to their recognition and treatment.

If there were no mandated mental health coverage, who would authorize sufficient funds and personnel for treating these serious disorders?

Currently, many of the mental health centers that treat drug and alcohol abusers are under-funded and undermanned, leaving many needy clients waiting for help. Those who are fortunate enough to have insurance coverage can seek private psychiatric care and in-patient treatment if it is needed.

Many children diagnosed with Attention Deficit, Oppositional Defiant or Conduct Disorders receive little or no assistance because some insurance companies and even schools categorize their problems as strictly behavioral, rather than as emotionally or mentally disordered.

The consequence of marginally attending to the problems of these youngsters is now being driven home with a vengeance.

Yet while we debate whether serious living problems are the result of disease and whether there should be mandated mental health coverage, as a nation we are still failing to deal directly with the causes of these proliferating disorders, and we are not providing the resources and strategic interventions to correct them.

As a result, our social problems are worsening and the need for prisons is increasing.

Most mental health professionals are not interested in "medicalizing all human problems and therapeutizing the population," as Professors Vatz and Weinberg state.

Rather, they are concerned with teaching patients, and even the general population, to utilize the science of psychology to improve the quality of human life.

Paul Lavin

Towson

The writer is assistant professor of psychology at Towson State University.