New Mexico Business Weekly

Face of Business
Doctor without borders. Dr. Arthur Kaufman has never been satisfied with being just a physician. They cure individuals, and hewants to heal communities.
by Thomas Munro NMBW Staff

Arthur Kaufman was headed toward a profitable career as a New York City psychiatrist when he decided to enroll in the Indian Health Service before doing his residency. The experience would change his mind and change his life, giving it the purpose and direction it has had ever since, as he has built an international reputation for work with rural and disadvantaged communities.

1970 to 1971 was a remarkable time to find yourself a white doctor tending to the Sioux in Rapid City, S.D. The Indian tribes of the region were in the midst of rediscovering and reasserting the power of their cultures and communities. By the second year of Kaufman's service in the Black Hills, members of the American Indian Movement, better known as AIM, had climbed and occupied Mount Rushmore, in what turned out to be just a warm-up to the standoff at Wounded Knee in 1972. Working with this group was a crash course in all the challenges and promises of community living.

Kaufman was privately a supporter of much of what AIM was doing, but he soon saw that as a physician he had to maintain a diplomatic neutrality in order to do his job.

"What I learned is you can quickly get caught into factions," Kaufman says. "As a physician you can't take that kind of side."

But he was comfortable being on the "side" of the community he was serving, testifying for American Indians hauled into court during this era of civil disobedience. In court he saw plainly how members of this community were disadvantaged by their poverty, left to rot in jail while wealthier individuals (mostly whites) left on bail. Few doctors would see issues like rampant alcoholism in the native population as "their job," but to Kaufman's open mind it was clearly his responsibility as a physician to get involved.

"It wasn't that I felt skilled in those areas, but I tried to learn skills in the problems that were in front of me," Kaufman says.

But Kaufman didn't just see problems in the native communities. He also saw some strengths he had never encountered before.

"It was very powerful for me to watch a whole community dance," Kaufman says. "I come from New York City, where you don't even know your neighbor."

There was hope in that community bond. He also learned from his Indian Health Service nurse and cultural guide, Josephine Waconda, that there was no substitute for long familiarity with a community in deciding how to best work with a population.

"I saw the power of having Native American doctors and nurses in Native American communities," he says.

Kaufman spent two more years in the Indian Health Service in Albuquerque. By that time he had become committed to healing individuals by healing their communities.

"When you see individual patients, you see the whole world of problems and opportunities," he says. "You just need to have an active mind."

Kaufman took that active intellect with him when he returned to his old neighborhood, Greenwich Village, for his residency at St. Vincent's Hospital -- a residency that was now internal medicine instead of psychiatry.

While there, he allowed himself to notice that many of his traumas were coming from the same address, the old Bleeker Hotel, which he discovered was the largest homeless shelter in the five boroughs.

In those days doctors rode along with ambulances, and when a request to pronounce someone dead came from the Bleeker Hotel, he climbed aboard. What he found was a much more disfunctional society than any he had previously encountered.

"What happened was the city jail would put people there when they were released, and homeless men went in there, and homosexuals and other marginalized populations. Armed guards were keeping these people separated on different floors. They were separated like the circles of hell. There were people yelling and screaming."

The body he had come to inspect was a murder victim that been left to partially decompose in a hallway.

"Right here in the middle of Greenwich Village," Kaufman thought.

He made an obvious observation no one had wanted to make before. He saw that the biggest medical issue for the homeless was that they didn't have homes. So he decided to treat them where they lived, setting up the first health care for the homeless program in the country in the middle of the Bleeker shelter.

"It was a very important learning experience, because it became a disaster," Kaufman says.

While he was providing clinic services, a flower pot fell from a ledge on the building, hitting and killing an old Italian resident of the Village.

"The community rioted," Kaufman says. "They saw us putting a Band-Aid on something they wanted to get rid of, and we were seen as aligned with the things they hated."

The mayor shut down the shelter, which never reopened.

"We went into the community without consulting the community," Kaufman says.

He changed his approach and worked with residents on setting up much smaller shelters where the locals could participate by helping out with soup kitchens. Never again would he give a community what he thought it needed without asking it first.

"That was my conversion," Kaufman says.

Kaufman has since put all these lessons into action in his 34-year career at the University of New Mexico Health Sciences Center.

The community health curriculum he and his colleagues have developed has made the university world-renowned -- it is the second-ranked school in the country in rural medicine and is consistently in the top 10 for family medicine.

Kaufman himself served two terms as secretary general of The Network: Community Partnerships for Health, a project of the World Health Organization, and has traveled the world spreading the word about improving rural health and reducing health disparities through deep knowledge of, and connection with, the communities being served.

Kaufman is now vice president for community health at the Health Sciences Center. His wife, Ellen, and children, Holly and Will, are all practicing physicians.

tmunro@bizjournals.com | 348-8306