Hylton I Lightman MD DCH (SA) FAAP

June 18th is my anniversary.  Not my wedding anniversary.  June 18th this year marked 40 years since I immigrated to the United States and became an American citizen.  I have spent more time in my adopted country than in South Africa, my country of birth.  It’s great opportunity to reflect on this country.

When I was growing up in South Africa, there was no television until 1978; even then, it was limited to three hours per day.  It was the “olden days” when “internet” and “WiFi” were not yet words.  South Africa then was under the influence of the Dutch Reformed Church.  Books and movies were censored or banned outright.  My friends and I thought the United States was a vast, faraway place filled with protests, violence, and unrest (sounding 2024), where Hollywood directors ruled the roost (also sounding 2024).  When the television show “Dallas” came to South Africa, people believed that JR Ewing was the prototypical American male.

Even though I spoke English when came here (English has always been my primary language, not Zulu, as many of you believe), it was quite the adjustment to learn “American English.”  The language and idioms are different.

On July 4, 1984, I was in South Nassau Communities Hospital as the only medical doctor in charge of pediatrics.  I was paged that day to the “OR.”  OR – “What’s that?,” I asked the operator.  She laughed and hung up the phone.  Popping Advil because of the headache from the learning curve, I finally got down that OR was the Theatre, ER is Casualty, DR is Labor and Delivery and a band aid is a plaster.  My “plaster,” by the way, is not plaster of Paris for casting fractures.

It did not stop there.  Diaper is nappy, the trunk of the car is the boot, the engine area is the bonnet, traffic lights are robots and pacifiers are “dummies.”  Most important, a can of coke is the thirst-quenching tin of cold drink.  It took time but I got down the language and its idioms, culture, vast distances between destinations, hoardes of people everywhere, brisk pace and lack of leisure time.  Driving on the other side of the road and 4-lane highways was terrifying for a while.

The cultural experiences notwithstanding, America has offered me the opportunity grow in several areas.  First is my career.  I was blessed that I did not have to completely retrain when I came from South Africa.  I completed a fellowship and then “hung out” the proverbial shingle, so to speak.  I love my patients and experience the greatest joy in watching them grow into healthy adults who marry, begin their own families and start yet another generation in this practice.

Little did I know when hanging out that shingle to start building a private practice that health care would become an industry and that insurance companies would turn it upside down and inside out.  “Managed care” is such a misnomer because the reality is that “You manage and you care, Doctor, while we insurance companies, well – let you care about the patients.”

Knowing what I know now about the industry, would I still hang out that shingle?  Yes.  Despite the obstacles, I am gratified to know that I help people.

This country should be proud of its plethora of programs to meet people’s health care needs.

  • Women Infants and Children’s program (WIC) helps pregnant and nursing women and their children up to five years of age with nutritional and other needs.
  • Through early diagnosis and treatment, Early Intervention (EI) helps change the trajectory of development for babies, toddlers and young children.
  • The Supplemental Nutrition Assistance Program (SNAP) provides healthy and affordable nutrition options to many Americans.
  • Vaccines for Children provides vaccines to patients on Medicaid, Managed Medicaid and Child HealthPlus as well as to those who are underinsured or have no insurance.

These four programs are but the tip of the iceberg.  We are a country that has cared about its citizens.

America has also given me the opportunity to be an Orthodox Jew and be supported in it.  People here (at least in major cities with significant Jewish populations) are aware of the concept of Shomer Shabbos.  This was unheard of in South Africa 40 years ago.  My friends and I struggled through medical school, internship, residency and the army to keep Shabbos then because the country lacked an awareness of it – and with HaShem’s help, we prevailed.  During the compulsory army service, it was not uncommon to encounter anti-Semitism from the commanding officers once they saw the yarmulke under your government-issued beret.  There was no person or office to complain to.  You had to make do and daven for Siyata Dishmaya. Because of the Commanding Officer’s anti-Semitism, I even spent 3 weeks on the Angolan front lines – not a place for a Jewish boy, especially one who was a lousy shooter.  This was a special unit of well trained “Vilde Chayas” that were hunting terrorists.  They were appalled that I had been sent there and helped me get back to a safe place.

In America until recently, we walked the streets in a state of freedom.  Thankfully, we are not a police state where you have to be worried whether someone will turn you into the government authorities, college campuses notwithstanding.  I’m not so sure that my American born peers and even my American born children appreciate freedom of speech and living in a democracy.  Our children’s schools are supplied with textbooks and many school districts offer busing.  Rabbonim, askanim and others have built an infrastructure so we can live as Jews as we go about our lives in America.  It is no small thing.  And never should we take it for granted, even for a moment.

As important, we need be involved in our communities and country.  We should vote in every election and never take this country for granted one moment.

G-d Bless America.

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