25 January 2018
2: The Missing Narrative
while denied basic human rights, were still able to contribute to scientific
medicine. Gregory Weiss and Lynne Lonnquist’s The Sociology of Health, Healing, and Illness contributes to a
broader history of medicine, but leaves out the significant impact that slavery
and racism have left on the American health care system as a whole. The absence
of Black medical history in The Sociology
of Health, Healing, and Illness further signifies the White history that is
often emphasized in American society. Rewriting Weiss and Lonnquist’s Chapter Two: The Development of Scientific
Medicine is crucial in order to expand upon the magnitude of effect that slavery
and racism have had since before the creation of our nation. The influence that medical professionals have
on African Americans, both during slavery and through today, has limited the
amount of medical services, exploited individuals for research causing physical
and mental harm, and for years fueled the institutionalized racism that is
intertwined in the United States society.
Harriet Washington illustrates the history of Black Americans’
experience with medical professionals in Medical
Apartheid which contributes to the experiences of African Americans today. The combination of Weiss and Lonnquist’s
textbook along with Washington’s novel better explain the full history of American
medicine, but for those individuals who only read The Sociology of Health, Healing, and Illness there is a missing narrative
significant to the health care system today. The medical history of America
contains great advances made by Blacks as well as the unspeakable
experimentation and discrimination which has created the current social
structure of medicine through both functionalism
and interactionism theories; these histories are far too often excluded
allowing the systematic racism to continue.
Eighteenth Century is noted at the “Age of Enlightenment”, most certainly for
Eurocentric individuals, by Weiss and Lonnquist (22). The authors go on to note
“People perceived that they were living at a special time of rapid growth; more
open intellectual inquiry; advancement in the arts, literature, philosophy, and
science; and freer political expression” (22). This definition of the 1700s
leaves out the beginning of the American history which was a special time of
rapid growth as noted by Weiss and Lonnquist, but leaves out the limited
intellectual inquiry and individual growth for Black Americans. The recognition of advancements in science
made my slaves is also absent from Chapter
2: The Development of Scientific Medicine. Slaves, some of which even
unnamed, such as the “negro man” living in Virginia in 1729, was able to create
a syphilis remedy. A snakebite antidote was another breakthrough discovered by
Cesar, a slave doctor (Washington 50). These advancements come through the
unethical research conducted without consent by Whites on slaves as well as the
intellectual advancements that Blacks were able to accomplish, but remain
suppressed in recognition. This is
why Blacks must be added to the future textbooks of medical history.
most in-depth African American medical history noted by Weiss and Lonnquist states
“… conditions for slaves were especially bad… the health of salves was very
poor in both an absolute and relative sense” (25). This goes without noting the
passage from Africa to America that slaves encountered where over 30% of slaves
died en route – not to mention the sexual violence and psychological damage
(Washington 27; Hill 31) . Weiss and Lonnquist do note the passage that Whites
colonists had to endure by stating “…excruciating difficult voyage across the
ocean (typically requiring three or more months) only to be met with tremendous
hardship upon arrival. Though warned about the danger of disease by their
sponsor…” (25). So, not only do the authors leave out the mention of the passage
which slaves had to endure, they portray a story of White pilgrims who were
sponsored and warned of the conditions they were to experience while a large
unrecorded number of slaves died while being transported to America. It was on
this Middle Passage that slaves first experience medical distrust. “Enslaved
women’s vulnerability began on the sea passage from Africa, as recorded in the
1788 memoirs of English ship’s surgeon Alexander Falconbridge…” who goes on to
note sailors were commonly having intercourse with slaves (Washington 45). The
so-called hypersexual slaves were at fault instead of the sailors coercing
slaves into sexual acts. The intoxicating sexual drive was a statement commonly
used and backed up by the scientific racism of the time (Washington 45).
Washington’s text gives an example of the conflict
theory which entails the powerful Whites dominating a society with conflict
between values (Lopez). The values in this example are the ethical values which
protect Blacks from exploitation while Whites in charge are more interested in
the economic benefits of slavery. The Development of Scientific Medicine
elaborates on the struggling journey White colonists had to face, even though
warned by their sponsor, but does not include the history of sexual health
violations, first documented cases of medical distrust due to coercion, nor the
months long journey that slaves had to encounter – all without a warning from
their sponsor. The addition of these narratives are essential to better
understand the patterns of health disparities through the conflict theory.
addition, Interactionalism, the
impact that individuals have on each other in day to day activities, is also
provided by Washington through scientific racism (Lopez). The medical advances
noted in The Development of Scientific
Medicine go without noting the “… research findings, explained by
scientific theories, and promulgated by whites who were sympathetic to or were
actively profiting from the institution of enslavement, so, not surprisingly,
scientific racism provided medical and scientific justifications for slavery”
(Washington 32). This goes to elaborate that doctors and slave owners would
create social norms in order to have slavery justified. Also, the “blame-the-victim” approach during
slavery blamed slaves for creating or faking illness and is carried into the
physician-patient relations of today. Blacks are blamed for their health issues
through the interactionalism theory,
or the day to day interactions that occurred between the powerful whites and “inferior”
Blacks. This can be seen today by the way that Blacks are treated differently
by health care providers or the fact that Blacks suffer more greatly affect by
low socioeconomic status, poor nutrition, financial stress, low community
relationships, and low access to care (Williams and Sternthal). Being treated
poorly by health care providers is not a new concept to African Americans. The
daily lives of slaves were controlled by their masters which included the need
for medical attention. Dr. Ephraim McDowell, the first physician to
successfully practice ovariotomies, notes in one of his journals “As the tumor
was fixed and immovable, I did not advise an operation; though, from the
earnest solicitation of her master… I agreed to the experiment” when performing
surgery on a Black slave (Schachner 87). These personal interactions of the
master deciding on the slaves’ health care has cared on to modern day society
where health disparities have largely been in favor of White decisions.
As noted in
lecture, there has been a long history
of social factors contributing to social medicine including during the
Industrial Revolution where rapid urbanization sparked the interest for public
health (Lopez). Looking back at dark history forgotten is difficult, but doing
so can prevent the same mistakes. “Scientists expressed whichever opinion fit
their political needs at the moment” (Washington 41) which was used to describe
the basis of scientific racism. This can still be seen today with politics
playing a role in scientific funding of diseases, medication, and birth control.
Before the Industrial Revolution, and untouched both in class and in
Washington’s Southern Discomfort chapter,
is the time period right after freedom of slaves. Emancipation was a time of
great social conflict where the
Southern Whites still dominated the social and political powers affecting newly
freed Blacks’ rights to healthcare. Shirley Hill explores the time period just
after Blacks gained freedom and describes the lack of rights they were given.
Once slavery was
abolished, the medical profession promoted theories of black inferiority
through a form of scientific racism that argued the health issues facing
African Americans were due to their inherent moral, biological, and cultural
deficiencies. For the bulk of the 20th century a racially-based dual health
care system offered African Americans substandard care, often in overcrowded
segregated hospital wards.” (30)
African Americans were left out of
the public health narrative post-slavery just as they were left out of Weiss
and Lonnquist’s The Development of
Scientific Medicine. The “separate but equal” Jim Crow laws created large
health discrepancies as Southern White America, as well as the North, was not equip
to handle the freedom of slaves. Instead of an inclusionary process, newly
freed slaves were “restricted access to care and medical education” among other
rights (Hill 29).
is elaborated on by Weiss and Lonnquist with the section on the Flexner Report which states “… the
number of medical schools be reduced to 31 and that medical education be
subjected to formal regulation” (31). This comes off of as a positive federal
regulation in The Sociology of Health,
Healing and Illness, but was actually detrimental to the medical education
of Black Americans. Only 2 of the 155 remaining medical schools allowed for
African American students (Lopez). The Flexner Report of 1910 was only 108
years ago which signifies the institutionalized racism by reducing Black
Americans the opportunity to join the medical field of research and practice
(Lopez). Searches in the American Journal
of Sociology (AJS) and the American
Sociological Review (ASR), from the earliest dates available: 1895 and 1934
respectively, comprised of “race and health”, “health inequality and race”,
“health inequality and ethnicity”, and “health disparity” provided just 32
results in the year of 2008 with 14 being since 1990 (Williams and Sternthal 2).
The health of the Black population in America has been neglected in the
discipline of medicine since before the Constitution, and The Flexner Report by
no means helped end the lack of attention.
The reasons these
issues need to be added to Weiss and Lonnquist’s book as well as other
textbooks is because the scientific racism of the America’s past has continued
to today creating health disparities for Blacks and other minorities. The “new
morbidity” is defined as “… threats to health from domestic violence, drug
abuse, crime, and the pervasive sense of inferiority that is the result of
discrimination” which affects minority populations in America (Angel and Angel
1156). After WWII, the federal government and other funding agencies avoided
politically sensitive issues of research and instead focused on biological
approaches causing the new morbidity to increase without attention (Angel and
Angel 1156). Other health disparities include high infant mortality rates for non-Hispanic Blacks compared to
non-Hispanic Whites. Racial segregation and low SES, both factors largely
unaddressed, are two major factors of infant mortality rates (Trinh and
Zabala). Examples of these health
disparities that Blacks face need to be implemented into Chapter 2: The Development of Scientific Medicine to bring awareness to the issues that stemmed from slavery
and continued to today. Weiss and Lonnquist discuss “In society in general and
within medicine, powerful groups are decisive due to the resources they have
acquired. They get their way, not because they successfully persuade, but
because they coerce and repress the less powerful” (32), but do not mention the
examples of Black Americans being coerced from the birth of our nation until
today by the powerful members of society in medicine and beyond.
advancements of scholars from most of history were mentioned in Chapter 2: The Development of Scientific
Medicine. Uncovering why Blacks were left out of history is the next
challenge for society to unravel and create innovative measures to increase
Black history, success, and health. The
addition of Black medical advancements and the experience Blacks had through
experimentation is essential to the future of both societal advancements and
incorporating Black history and White history to complete the true history of
America. History should not be covered up; instead it should be learned from. Washington’s
Medical Apartheid provides insight
into the significance of medical professionals’ impact on African American
slaves which has led to the health disparities and iatrophobia which Washington
defines as Blacks’ fear of medicine (21). This fear of medicine needs to be
erased through education and equity and finally end the “scientific racism”
that was created by the founders of America.
Angel, Jacqueline L., and Ronald J. Angel.
“Minority Group Status and Healthful Aging: Social Structure Still Matters.” American Journal of Public
Health 96.7 (2006): 1152–1159. PMC.
Web. 21 Jan. 2018.
Hill, Shirley A. Inequality and African-American
Health: How Racial Disparities Create Sickness.
Policy Press at the University of Bristol, 2016. Web.
Lopez, Kim. “Chapters 1 and 2: Medical Sociology
and History of Scientific Medicine; Brief intro
to Medical Apartheid”. Medical Sociology. The Ohio State University.
Columbus. 11 and 16
Jan. 2018. Lecture.
Schachner, August. Ephraim McDowell: “Father of
Ovariotomy” and Founder of Abdominal Surgery. Louisville, KY:
Philadelphia, London: J.B. Lippincott Company. 1921. https://archive.org 22 Jan. 2018.
Trinh, Anne and Amanda Zabala. “Infant Mortality in
Franklin County”. Medical Sociology. Columbus
Public Health. Columbus. 18 Jan. 2018. Lecture.
Williams, David R., and Michelle Sternthal.
“Understanding Racial/ethnic Disparities in Health: Sociological
Contributions.” Journal of health and social behavior. 51. Suppl (2010): S15–S27.
PMC. Web. 21 Jan. 2018.