Hysterectomy Hysteria & Holocaust Hyperbole

 

This post should take approximately 12 minutes to read. It refers to some medical conditions and uses terminology not commonly found outside of medical writing, and with which, if you, like me, are a biological male, you may be unfamiliar, so on a 1 – 10 scale, this post is probably a solid 9.

I will unquestioningly update this post if I am proven wrong about its contents, and as additional information becomes available.

Finally, I took no joy in writing this, so I don’t expect you to find any reading it, c’est la vie. 

Introduction

As I said in my narrative on the About page, I am not a lawyer. I’m no more a lawyer than a Doctor (not the Jill Biden kind, an M.D. or D.O., a Doctor of Osteopathic Medicine), but I’m probably far closer to the former than the latter. Still, unlike an increasingly large percentage of our society, I know how to read; comprehend, retain, recall information; think critically, and apply logic. There’s a good chance you do too, or else you probably wouldn’t be here. 

I’d planned to write about this issue going back to this blog’s beginnings, which admittedly was only last October. Unfortunately, other topics preempted it, and from the perspective of a blogger, I’m still trying to find a proper work-life balance. Still, every once in a while, some Twitter harpy references the allegation reminding me curious and open-minded people deserve to have an objective summary of the claim.

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A September to remember 

Leading up to the 2020 elections, the Institute for the Elimination of Poverty and Genocide, better known as “Project South,” submitted a complaint to the Department of Homeland Security’s Office of the Inspector General (OIG), on behalf of itself, Georgia Detention Watch, Georgia Latino Alliance for Human Rights, the South Georgia Immigrant Support Network, and Dawn Wooten, a licensed practical nurse employed by the Irwin County Detention Center (ICDC or Irwin) entitled “Lack of Medical Care, Unsafe Work Practices, and Absence of Adequate Protection Against COVID-19 for Detained Immigrants and Employees Alike …“. 

While the Project South-Wooten submission is multi-faceted, it came about at the end of a summer of COVID-19-related liberation of detained aliens ordered by courts, some of whom were criminals, and it later turned out violated the terms of their releases and/or went on to commit additional crimes. Nevertheless, there was one part of the document which not only eclipsed the primary purpose of Wooten’s compliant, which went on to take on a life of its own entirely separate from Coronavirus:

“The rate at which hysterectomies are performed on immigrant women under ICE [Immigration and Customs Enforcement] custody at ICDC.” 

Despite being referred to by some sources as ‘a whistleblower complaint,’ the most damning part is not alleged by Nurse Wooten. Instead, it involves stories recounted by “[s]everal immigrant women” (is it me or did Project South just assume the gender of these potential birth-givers) detainees as told to them, but who don’t seem to themselves have undergone a procedure.

NPR reported one woman, later identified by name, didn’t end up undergoing the procedure “because she tested positive for the coronavirus and was [] sent back to the Irwin County Detention Center,” from which she was later removed (aka deported) back to Mexico, her country of origin.

Fact-finding vs. case building

As both my seniority and responsibilities have increased, I’ve often found myself on interview panels. One of my former Supervisors used to ask prospective hires who were almost always already Federal law enforcement officers, explicitly which was more important, fact-finding or case building. The correct answer is fact-finding as it’s similar to the Scientific Method: stating a problem, forming a hypothesis, collecting data by observing and experimenting, interpreting these data, and drawing conclusions (Osterburg, 1981). To build a case is to essentially start from a suspect and a crime and find a way to make the pieces fit, even if that means trying to hammer a square peg into a round hole. It at best has a 50-50 chance of working out, but very likely, an innocent person gets framed.

Still, one needn’t be a newly minted Detective, much less Sherlock Homes, to question the veracity of a complaint including such memorable quotes as:

“Several immigrant women have reported to Project South their concerns about how many women have received a hysterectomy while detained at ICDC. One woman told Project South in 2019 that Irwin sends many women to see a particular gynecologist outside the facility [and] stated that a lot of women [t]here go through a hysterectomy’ [sic].”

or

“More recently, a detained immigrant told Project South that she talked to five different women detained at ICDC between October and December 2019 who had a hysterectomy done.[] When she talked to them about the surgery, the women’ reacted confused when explaining why they had one done.’ The woman told Project South that it was as though the women were ‘trying to tell themselves it’s going to be OK.’ She further said: ‘When I met all these women who had had surgeries, I thought this was like an experimental concentration camp. It was like they’re experimenting with our bodies.'”

Yes, you read that right; one of Project South’s star witnesses compared hysterectomies to the likes of the medical experiments Holocaust victims endured, and more often than not, succumbed to in camps like Ravensbrück or Auschwitz-Birkenau.

With a comparison like that, it shouldn’t come as a surprise outlets started covering the claim before the ink on it had dried, not only the usual suspects like CNN and NPR, but such intellectually curious bastions of journalistic integrity as Rolling Stone, plus ElleGizmodo, and Vox, etc. Of course, this was after Speaker Pelosiforty-three percent of Representatives, and countless Senators had made public statements verbally and/or writing condemning ICE and demanding OIG “immediately investigate the allegations detailed in th[e] complaint,” but only two weeks before deciding that showing up at the ICDC to grandstand as part of a “fact-finding” CODEL (Congressional delegation) was a good idea, and about two months before issuing subpoenas.

Given the number of ICDC detainees who are likely from Latin America, more accurately, the Northern Triangle (El Salvador, Guatemala, and Honduras), I can’t help thinking rather than trying to equate hysterectomies to the Holocaust, an opportunity to instead reference the Guatemalan syphilis experiments was missed though it would have still been an inaccurate comparison. 

Malfeasance, malpractice, and medical necessity 

While a seemingly increasing number of women (detainees or former detainees), at last count “[d]ozens” if you believe NPR, or “fourteen” per Law360 (Paywalled), have come forward since September to implicate Dr. Mahendra Amin in having performed unnecessary hysterectomies or ones to which they either didn’t consent or for which their consent was ill-informed since 2017. 

However, reporting by the Associated Press (AP), which it claims occurred after its “review of medical records for four women and interviews with lawyers [which] revealed growing allegations [] Amin performed surgeries and other procedures on detained immigrants [] they never sought or didn’t fully understand” issues of significant concern for sure. However it went on to indicate that analysis “did not find evidence of mass hysterectomies as alleged in [the] widely shared complaint“.

The AP goes on to say that it “reviewed records for a woman who was given a hysterectomy. She reported irregular bleeding and was taken to see Amin for a D&C [dilation and curettage]” and that “[a] lab study of [] tissue [removed] found signs of early cancer, called carcinoma[] [and] Amin’s notes indicate the woman agreed 11 days later to the hysterectomy,” but claimed to have felt pressured by Amin and ‘didn’t have the opportunity to say no’ or speak to her family before the procedure.” Doctors, the AP said, indicated “a hysterectomy could have been appropriate due to the carcinoma, though there may have been less intrusive options available.”

In addition to treating developed cancer, hysterectomies can be used to treat a myriad of gynecological maladies, including Uterine prolapse, a condition which occurs when pelvic floor muscles and ligaments stretch and weaken and no longer provide enough support for the uterus; Uterine fibroids, noncancerous growths of the uterus; Endometriosis, a disorder where tissue similar to that which usually lines the inside of the uterus grows outside of it; Adenomyosis, a condition in which the inner lining of the uterus breaks through the muscle wall of the uterus; Pelvic inflammatory disease or PID, an infection of one or more of the upper reproductive organs, including the uterus, fallopian tubes and ovaries; and abnormal bleeding. As much outrage as there’s been over hysterectomies, the same people would undoubtedly be equally incensed if the aliens didn’t receive care, thereby creating a no-win situation for detention centers.

The whistleblower complaint filed against Amin by Project South on behalf of Wooten occurred several months after she claims she was the victim of retaliation having been reprimanded and demoted from “a [position as a] ‘full-time’ nurse (with regularly scheduled shifts) to an ‘as-needed’ [one] (without regularly scheduled shifts), all without a proper explanation or adequate justification” for “demanding stricter [COVID-related] medical safety protocols,” after being forced to work two shifts in late June while symptomatic. However, I’m unclear if she ever actually tested positive.

Wooten’s complaint goes on to suggest that “[Amin]’s taking everybody’s stuff [uteruses and tubes] out. That’s his specialty, he’s the uterus collector … is he collecting those things or something…”  

It so far remains to be seen whether claims made against Dr. Amin will be ultimately be substantiated, and though a search of his medical licensure information shows him to be “a doctor in good standing with no public disciplinary action,” his career as an “obstetrics and gynecology specialist” seems—there was only one “Mahendra” Amin found to be licensed by the state of Georgia—to include two lawsuits for malpractice, including one where the Respondent was found “negligent in clamping [the Plaintiff’s] uterus during a hysterectomy, resulting in significant injuries that required two additional surgeries to repair,” and one a decade earlier where the Respondent was found to have negligently proscribed a medication postpartum, which led to the patient’s death. He was also part of “a [2015] civil settlement [along] with the Hospital Authority of Irwin County (ICH),” a privately-owned and operated hospital in the county and eight other physicians where “[t]he Defendants agreed to pay $520,000 to resolve allegations [] that they caused false claims to be submitted to Medicare and Medicaid.” However, the hospital ended up paying the entire amount.

To be clear, given Amin’s apparently documented history of questionable care and fraud, I’m certainly not saying I don’t believe anything alleged to have occurred at Irwin did and that the claims are #FakeNews. Instead, I’m relying on familiarity with countless examples of journalists and politicians making assertions about immigration, which later either aren’t what they seemed, don’t accurately reflect what happened, or were blown out of proportion. Plus, detained aliens sometimes lie. 

The three lies

Mark Twain, in one part of his twenty-five part autobiography, “Chapters,” in an anecdote about “Figures often beguil[ing] [him]” referred to “three kinds of lies: lies, damned lies, and statistics” which he attributed to former British Prime Minister, Benjamin Disraeli, and though the origin is more likely Anglo-Irish “author and satirist” Jonathan Swift, “[b]est known for writing ‘Gulliver’s Travels,’” Twain is also widely believed to have once suggested ‘a lie will go round the world while the truth is pulling on its boots,’ both well describe the situation that was brewing in South-central Georgia. 

An example of a lie would be suggestions ICE was involved, whether directly or indirectly, in what is alleged to have occurred at Irwin. You see, while the ICDC is an immigration detention center, it’s neither owned, operated, or controlled by the Agency. As the name suggests, the facility is owned by Irwin County Georgia and contracts with ICE and the U.S. Marshal Service through an Intergovernmental Agreement or (IGA). 

Under the heading “Medical Services,” the Irwin IGA contains the following clause (note: it’s a direct quote from the original document; however, I’ve increased the indent and added line breaks to improve readability and the link to the NCCHC):

“The Local Government is financially responsible for all medical treatment provided to federal detainees within the facility. 

The Local Government shall provide the full range of medical care required within the facility including dental care, mental health care, pharmaceuticals, and record[-]keeping, as necessary to meet the essential standards of the National Commission of Correctional Health Care’s Standards for Health Services of Jails (current edition).

The Local Government will submit to the Federal Government requests for approval of all treatment to be provided outside the facility. The Federal Government shall be responsible for the cost of approved outside medical treatment.

In the event of an emergency, the Local Government shall proceed immediately with necessary medical treatment. In such an event, the Local Government shall notify the Federal Government immediately regarding the nature of the federal detainee’s Illness or injury, type of treatment provided, and the estimated cost thereof.

The Local Government shall promptly forward medical invoices for outside medical care to the Federal Government within 30 days of receipt.”

Not mentioned in the agreement or by the anti-enforcement and detention crowd is that as an immigration detention facility, ICDC is subject to oversight by the Health Service Corps (IHSC), a subcomponent of ICE’s Enforcement and Removal Operations (ERO) which “comprises a multidisciplinary workforce of over 1,600 employees, including federal civil servants, U.S. Public Health Service (PHS) Commissioned Corps officers and contract health professionals.” 

IHSC purports to “deliver[] quality [medical, dental and mental health care] in accordance with nationally recognized standards and professional peer-reviewed guidelines” at “20 designated facilities throughout the nation,” plus oversight medical care for detainees “at approximately 112 non-IHSC staffed detention facilities;” however, isn’t without controversy and been described in a leaked e-mail to Matthew Albence, then ICE’s acting-Deputy Director as “severely dysfunctional” with “unfortunately preventable harm and death to detainees ha[ving] occurred.”

Criticism of and about IHSC’s care and internal and external supervision is warranted. Still, readers can probably agree that similar ones can and have been made about that provided by the Veterans Administration over the years, whether or not they are deserved. Still, just think, for those of you who aren’t veterans, soon we’re going to have “Medicare-for-All,” and will get to see for ourselves first-hand, plus can look forward to competing with illegal alien public charges the Harris… err, Biden administration won’t likely be detaining anyway for finite medical care. Perhaps, if we’re lucky, Cuba will send us some Doctors?

If attempts to directly implicate ICE to what is alleged to have occurred at Irwin are a lie, then painting Irwin as some sort of ‘Auschwitz of the South’ comparing events at it to “genocide” defined as by the 1948 UN Convention on the Prevention and Punishment of the Crime of Genocide as:

“acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such:

(a) Killing members of the group;

(b) Causing serious bodily or mental harm to members of the group;

(c) Deliberately inflicting on the group conditions of life calculated to bring about its

physical destruction in whole or in part;

(d) Imposing measures intended to prevent births within the group;

(e) Forcibly transferring children of the group to another group

should be an example of a ‘damn lie’ as should this notable admission published by the Washington Post and later picked up by the AP

“Priyanka Bhatt, staff attorney at Project South, acknowledged [] she did not speak to any women who had a forced sterilization, and said she included the allegations in the report with the intention of triggering an investigation into whether or not the claims were true.”

That desire to find out ‘whether claims compared’ to an aspect of one of the worst examples of genocide, or alternately the killing of Armenians by Ottoman Turks between 1915-1920; the 1932-33 Soviet manmade famine of Ukraine known as the Holodomor; the Indonesian invasion of East Timor in 1975; the Khmer Rouge killings in Cambodia during the mid-to-late 1970s; Rwanda in 1994, where an estimated 800,000 Tutsis and moderate Hutus died; and the 1995 massacre at Srebrenica, Bosnia, nearly caused an international incident. Not to worry, I’m sure if the allegations aren’t corroborated, the Biden administration and Georgia Bar will work as quickly to charge and sanction Bhatt as state bars are considering doing for Republicans for objecting to concerns about the 2020 election, whether or not they are linked to the 06 January 2021 “coup” attempt (pause with me for a moment to laugh at the absurdity of the possibility).

Okay, now that I’ve recovered myself, let’s talk lastly about statistics, sweet, sweet statistics! While the number of hysterectomies performed by Dr. Amin remains as-yet-unknown, especially in relation to the number of female detainees held at the ICDC during the same period, according to the Centers for Disease Control (CDC), hysterectomies were “the second most frequently performed surgical procedure (after cesarean section[s]) for [] women who are of reproductive age” in the United States between 2006 – 2010, with “11.7 percent of women between the ages of 40-44 [having] had [one],” and [a]pproximately 600,000 [] performed annually in the United States.”

Conclusion

The bottom line is that detained aliens are human, and those in need of medical care should get it, but it should be no better or worse than an American would receive, especially since Americans pay for it. The jury is out on the manner of Amin’s treatment of detainee patients, but he’s clearly been convicted in the court of public opinion, and unfortunately has dragged LaSalle Corrections down with him and further damaged ICE’s reputation in the process.

Ultimately, I’m less petty than my detractors, so while I loathe propagandizing, I wouldn’t call for those peddling it being banned from Twitter or anywhere else; I’m looking at you, S. 386 mob, but tweets and “stories”—pun intentional, like those featured above definitely should have had a disclaimer of some sort about unproven claims applied. After all, it seems only fair, especially if they might incite violence, right?

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