Wheeled into the operating room last January, staring up at the massive arms of the robot with which a surgeon would remove my cancerous gland, I was hit with an unusual realization: I owe a debt of gratitude to President Lyndon Johnson and the Immigration and Nationality Act of 1965.
Why? Without that legislation, the surgeon who operated on me probably wouldn’t be here. Nor might the doctor who pioneered the procedure. Nor the philanthropist who financed the research. Nor many workers at the company that makes these robots or those at a different company that designed the chips that enable the robot.
As my ordeal with cancer shows, immigration has become critical to our health. Immigrants account for more than a quarter of physicians, surgeons and personal care aides and about a fifth of nursing assistants.
I’m not sure we realize that immigrants help keep us alive: Just look at West Virginia, a state hostile to immigration where aging residents have died before getting off the wait list for home health aides.
While many Americans — including politicians this election year — dwell on stories like the Venezuelan migrant accused of killing a Georgia nursing student, they often forget the critical ways immigration has historically benefited us. A century ago this spring, the United States slammed the door on large sections of the world, and we could be on the verge of doing so again.
That I am so cognizant of the importance of immigrants is the result of two coincidences. The first is that I teach a class on practical writing at Stanford Business School. Frustrated by the cynicism that has pervaded my 3,000 students, many of whom were only teenagers when Donald Trump was elected and are skeptical of the government, I began showing a slide documenting the benefits they enjoy from legislation that originated in the 1960s. For one, many Stanford Business School students — I would guess roughly a quarter — come from families that would not be in this country if not for Mr. Johnson’s Immigration and Nationality Act.
Before that act, America’s immigration policy explicitly favored white immigrants from Canada and Northern and Western Europe while keeping those from South Asia, East Asia, Africa and Eastern and Southern Europe at bay. The goal, in the words of the State Department in the 1920s and echoed many times afterward: “to preserve the ideal of U.S. homogeneity.”
Over time, many Americans grew ashamed of a system that was explicitly based more on prejudice than fairness. So in 1965 Mr. Johnson signed the Immigration and Nationality Act. It didn’t throw the doors wide open, but it gave priority to immigrants with family in this country and to refugees. It also favored skilled workers. Since then, the number of immigrants in the United States has more than quadrupled. Immigrants account for 15 percent of the population, the largest share in history.
The second coincidence: For two years I’ve worked on a book about Intuitive, the Sunnyvale, Calif., maker of the robot that would be used for my procedure. In doing so, I came to know immigrants with remarkable skills, like Dr. Mani Menon, who pioneered the robotic removal of the prostate that is now used in hundreds of thousands of surgeries worldwide annually. He emigrated from southern India in 1972 in part because his wife was Muslim and he was Hindu “and it was uncomfortable for us socially, so we decided to go somewhere where we could be comfortable,” he told me.
Dr. Menon could not have pioneered the robotic prostatectomy without someone to finance his research: another Indian immigrant, Raj Vattikuti. A decade after the 1965 act, Mr. Vattikuti went to Detroit as a computer engineering student. After building a successful business, he, with his wife, Padma, donated $40 million for research on prostate cancer and breast cancer. The Vattikuti Urology Institute at Henry Ford Hospital in Detroit is where Dr. Menon pioneered the use of robots in urologic procedures.
And the urologist who performed my surgery, Dr. Vipul Patel, told me he is the grandson of Indians, was raised in Britain and moved to Los Angeles in 1984 for high school and college.
Many workers I interviewed from Silicon Valley told stories of ancestors fleeing persecution, much like many of today’s immigrants. One is the son of refugees from the Khmer Rouge internment camps in Cambodia; another escaped Vietnam as a child in an exodus known as the boat people. One’s family fled Cuba after Fidel Castro seized their property. A top executive is the grandson of Eastern European immigrants, including a maternal grandmother who escaped with one sister but lost the rest of her family to ethnic cleansing in Ukraine early in World War II.
As at most Silicon Valley companies, many thousands of Intuitive’s 13,000 employees — the company doesn’t track exactly how many — are immigrants or children of immigrants from places that were out of bounds for more than half the 20th century.
Now immigrants are 19 percent of the American civilian work force, according to the Bureau of Labor Statistics. In Silicon Valley, it’s almost half, estimated the National Immigration Forum, an immigrant advocacy group.
Yet coinciding with the arrival of these immigrants in recent decades has been a growing hostility. In April Mr. Trump wished for more immigrants from “nice countries,” citing Denmark, Switzerland and Norway. After his conviction on May 30 for falsifying business records, he railed against “millions” who were “pouring in” unchallenged, mentioning China and Congo.
During his presidency Mr. Trump supported the Raise Act, an unsuccessful bill to halve legal immigration through a merit-based system that awarded points for age, education, salary and ability to speak English. But Akhila Satish, a scientist and an entrepreneur in Palo Alto, Calif., found a problem in the reasoning of the bill’s supporters: From 2000 to 2017, when the Raise Act was introduced, about 40 percent of American Nobel Prize recipients were immigrants. “And under the Raise Act the majority of these laureates would have been prevented from staying in the U.S.,” Ms. Satish wrote in a 2017 opinion essay in The Wall Street Journal.
I understand that many Americans call illegal immigration their top concern. And they think that businesses sometimes hire immigrants — in the country legally or illegally — instead of American workers because they can pay them less. I recognize the need to rationalize our immigration process. But in an election year when immigration is a partisan issue, we should also remember the profound difference immigrants have made in our lives.
At the “Many Voices, One Nation” exhibition at the National Museum of American History in Washington, you can see a lab coat that belonged to Dr. Menon and an early surgical robot. The exhibition pays tribute not just to him but also to two of his Indian American colleagues, Mr. Vattikuti and Dr. Mahendra Bhandari. The three established the Vattikuti Urology Institute. In doing so, they helped ensure that robotic surgery would continue to evolve. And that I and many other people would thrive — and recognize the importance of immigrants.
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