The patient's family wasn't ready for the man they saw. He was tall, had the girth of the Harvard football player he once was and seemed self-assured.
Dr. Pearlman Hicks looked at the patient in the emergency room and thought, "Oh, please, I really don't want to take care of this guy"--the man had the words Ku Klux Klan , accompanied by a Confederate flag, tattooed on his stomach.
The man's family looked at the black plastic surgeon nervously.
" 'Ah, you sure you want to do this?' " Hicks remembered them asking. The man had severely injured his hand.
Family Questioned Everything
"I took care of it," said Hicks, a surgical resident at the time, "but he was very concerned and the family questioned everything I did: 'Isn't that too long to leave in the stitches? Shouldn't you do this? Shouldn't you do that?' But the guy did very well.
"Later on he came in to see me and said, 'You know, I was really embarrassed when you came in and I had these tattoos on. I had them put on when I was a kid. I'd like you to take them off for me.' "
Hicks took them off.
"Of course, that was after several months of him being my patient. He realized that I didn't treat him any differently because he had a KKK tattoo, and he wasn't treating me any differently because I was black," Hicks said. "Most people, if you treat them OK, they'll treat you OK. But some people, you just don't know. There are some bad apples out there. I get my share of them, too."
Hicks is a rare man in a rare specialty. Among the 552,716 practicing physicians in the United States, only about 3,000 are plastic and reconstructive surgeons, according to the Chicago-based American Society of Plastic Surgeons.
And of the approximately 14,000 black doctors in the country, only 37 are in the field of plastic and reconstructive surgery, according to the National Medical Assn., the American Medical Assn.'s black counterpart. And only seven of those blacks have been certified by the American Board of Plastic Surgery.
When he came to California in 1979, the Harvard-educated Hicks became the first board-certified black plastic surgeon in the state. Now, there are four. One is his partner, Dwight L. Roberson, and the two others are in the San Francisco area.
As with neurosurgeons, there isn't a need for hundreds of thousands of plastic surgeons, physicians say. There are enough to serve the country's needs. But, also as with neurosurgery, plastic surgery requires one of the longest training periods in medicine--seven years of residency, compared with three to five for most other specialties. The time and expense discourage many doctors from entering the field.
Blacks are even slower to enter this specialty because so few have been exposed to it, said Iven LeFlore, who in 1976 became the second black in the nation to be certified as a plastic surgeon.
Black Schools Don't Teach It
The District of Columbia physician explained that the country's two major black medical schools--Howard University and Meharry Medical School--have no plastic surgery programs. These historically black schools have produced most of the nation's black physicians.
"So if the two major schools don't have it, blacks are not going to have much exposure to (the field)," he said. "I'm fairly sure that's why blacks are so slow to get started in this area."
Hicks, 40, was elected head of the department of plastic surgery at Long Beach Memorial Hospital last month and has a private practice with offices in Beverly Hills, Long Beach and Inglewood. He always wanted to be a doctor and knew early in his training that he wanted to be surgeon. A sports injury paved the way for the kind of surgeon he would become.
"I used to play football at Harvard, but I broke my ankle the last year and didn't play," Hicks said. "I got a job at Massachusetts General Hospital in Boston, and I worked in the laboratory with some ear, nose and throat doctors who were doing surgery on animals."
Stumbled Onto Literature
He learned a little about surgery and research in the process and immersed himself in medical literature. By chance, much of what he read "happened to be about plastic surgery of the head and neck."
After he graduated from Harvard in 1968, Hicks went on to medical school at Case Western Reserve University in Cleveland and immediately sought out the school's plastic surgeons.
"I would go and watch them do operations and meet them in the emergency room. . . . They were technically very skillful and did a lot of very delicate work. I was fascinated."
After medical school, he put in five years as a general surgical resident at Case Western's University Hospitals and was made chief surgical resident there from 1976 to 1977. Then he went back to Massachusetts and completed two years of plastic surgery residency at Harvard University; in his last year there, he was chief resident in plastic surgery at Boston Childrens Hospital and the Peter Bent Brigham Hospital.