As our semester comes to a close and I reflect upon the overarching themes that came from our coursework, I find myself gravitating towards the motif of race, specifically in how the contemporary interactions between people of color (POC), especially Blacks, and institutions of care have been influenced by these historical events. I am also compelled to discuss how these interactions have been swayed by, and cyclically exert influence on, the modern retelling of the social history of medicine and its use of race.
Throughout the course, I had the opportunity to review books utilizing race in many different ways. This included critical reflections on the biology of difference and race (especially in its prevalence and use in science, medicine, and politics), newly emergent accounts of lost and underrepresented histories of marginalized ethnic, racial, and social groups, and racialized frames of disease biography and ontology. As such, the works I’d like to highlight in this course review include Alondra Nelson’s 2013 Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination; Nelson’s 2016 The Social Life of DNA: Race, Reparations, and Reconciliation After the Genome; Keith Wailoo’s 2011 How Cancer Crossed the Color Line; and Ian Whitmarsh and David S. Jones’s 2010 What’s the Use of Race?: Modern Governance and the Biology of Difference. These books at large discuss the implications of race in the social history of medicine, coalescing into a comprehensive overview of how science and medicine interact with and acknowledge the social dimensions of race (Whitmarsh and Jones, 2010 & Nelson, 2016), as well as giving rise to the lost scores of historically marginalized communities (Nelson, 2013 & Wailoo 2011).
Many of these readings are complimented well by other sociological concepts, including intersectionality – the health care that POC communities received in the past not only depended on their race, but also other facets of their social identity, including socioeconomic status (SES), gender, age, geographic location, and much more. Implicit bias was also another concept that came up in these readings, as well as our course discussions. Unequal treatment of POC communities, especially Black Americans, today is based on harmful historical narratives of othering, racial profiling and stereotypes, and systematic (now systemic) oppression justified on the basis of race. These things still exist in social norms and understandings of race, and individuals can sometimes act upon them, leading them to display implicit bias, and if left unchecked, can be harmful – just look at how Muslims are treated in America today, for example: how some contemporary discourse has continued to shed hatred and reify othering on this religious group because those in power refuse to acknowledge their bias. Or look at the way Black individuals are discussed in the news when they are wrongfully murdered, incarcerated, or discriminated against.
I am appreciative for this course having had a focus on racialized perspectives of medicine/looking at the practice of medicine, science, and society with strong acknowledgements of race and ethnic social stratifiers. A painful truth we must contend with as academics, is, however, understanding how contemporary scholarship and discourse fails to accurately encapsulate the experiences of, and give voices to underrepresented, underspoken, and widely marginalized POC groups in America, despite current discourse condemning racial injustice and inequality, the #BlackLivesMatter movement, for example. For our studies and academic pursuits to be just and to produce accurate and substantive reflections of the whole society, it is important to continue with acknowledgement and critical engagement with race in both the societal and individual sense (i.e. checking our predispositions and implicit biases). It is also prudent to welcome, encourage, and strive for racial and ethnic diversity among academic environments and scholars – many disciplines emerged and have found success through the utilization of whiteness as the primary and normative lens, but fail to acknowledge and transcend beyond this dated framework.
One note that I would like to add, is that I haven’t seen any of our coursework necessarily tackle critical race theory – there have been some works that have looked at the influence of power from the institutional level, but none with a strong focus on the race component of power and othering. I believe engaging with critical race theory is a potentially necessary next step in canvassing a robust diversity of scholarship. Employing methods, like medical ethnography, may also help engage effectively and directly with communities that have previously had no means of communicating their lived-in experiences. It is a disheartening and disturbing political and social terrain for many POC groups, but the discipline of the social history of medicine has an exemplary potential to right some of history’s wrongs by welcoming and engaging with these seemingly invisible communities that were once wronged by science and medicine. Nelson’s, Wailoo’s, and Whitmarsh and Jones’s work are a promising start.
(Some of) The Social History of Medicine’s Greatest Hits and Misses)=
- 1909 – 1979:
- (MISS) 20,000 forced sterilizations during the early 20th century that occurred in the span of almost 70 years. These sterilizations included mentally ill or handicapped individuals, Puerto Rican women, Native Americans, and generally poor, uneducated and minority populations. The goal of these sterilizations was to prevent unwanted genes to taint the White/Aryan gene pool, directly aligning with eugenic ideologies that suggested a genetic supremacy of the White/Aryan race. By tying race, behavior, and intelligence to genetics, racial hierarchies and othering of people of color lasted well into contemporary times.
- 1932 – 1972:
- (MISS) The “Tuskegee Study of Untreated Syphilis in the Negro Male” takes place in Alabama. The clinical study sought to observe the natural history of untreated syphilis, deceiving and knowingly putting in harm’s way 600 uneducated and impoverished Black participants by withholding treatment. The study was highly unethical, and highlighted systematic issues with racism and science research protocols. This led to the production of many codes of ethics and review protocols for protecting human subjects in human research and experiments, including the 1979 Belmont Report, the Office of Human Research Protocols, federal regulations, and institutional review boards (IRBs).
- 1933 – 1945
- (MISS) The Law for the Prevention of Hereditarily Diseased Offspring rendered forced sterilizations legal to prevent the spread of hereditary diseases in Nazi Germany. This resulted in a decade of violence, with 400,000 individuals forcibly sterilized and 6,000 passing due to medical complications from the sterilization procedures. Disabled and “unfit” Jewish and Roma populations were subjected to “Euthanasia” during this time — the T4 program killing 250,000 innocent people on the basis of eugenics and “racial hygiene.”
- 2000:
- (HIT) Nadja Durbach publishes “‘They Might As Well Brand Us’: Working-Class Resistance to Compulsory Vaccination in Victorian England” in the Social History of Medicine journal. It is one of the most highly cited articles in the journal, and serves as a critical cultural and sociopolitical examination of the historical English Anti-Vaccination movements that were founded originally as opposition to the 1853 Compulsory Vaccination Act. Durbach draws from sociology, anthropology, and political science to examine how the Anti-Vaccination movement has strong origins in class stratification. An interesting piece to compare to modern anti-vax thought today. (https://doi.org/10.1093/shm/13.1.45)
- 2006:
- (HIT) Steven Johnson publishes The Ghost Map: The Story of London’s Most Terrifying Epidemic – and How It Changed Science, Cities, and the Modern World, a narrative based exploration of the Broad Street cholera outbreak in London, one of the deadliest in London’s history, and how two important London figures, John Snow and Henry Whitehead, helped to navigate the epidemic. The Broad Street outbreak served as a foreshadowing of the challenges newly emerging urban areas would face amid a world modernizing with haste, and point to the role of technology, the production and reification of (institutional/societal) knowledge and expertise, and the important of efficient and well-constructed infrastructure and governmental-science collaboration in effective public health decisions. Overall, The Ghost Map is a riveting and necessary exploration of a truly monumental moment in the social history of medicine.
- 2010:
- (HIT) Ian Whitmarsh and David S. Jones publish What’s the Use of Race?: Modern Governance and the Biology of Difference, which explores the use of race primarily in the light of governance, and how developments in genetic differences between races have reified racial categories, and in turn, influenced law, science, and medicine. The book exemplifies a growing acknowledgement of the social implications that are associated with scientific difference, i.e. the social construction of race and its relation to genetic variation across populations.
- 2011:
- (HIT) Keith Wailoo publishes How Cancer Crossed the Color Line, an overview of the transformation of cancer awareness, and narratives of cancer as it pertains to gender and racial social dimensions. Wailoo employed film and fiction, medical and epidemiological evidence, and patient accounts in writing this book, these sources helping Wailoo come to understand cancer’s role as a disease in America, and its’ intersection with social dimensions of gender and race. The way that Wailoo addresses race in this book is are important in reforming implicit biases and stereotypes prevalent in society today, as well as in creating a holistic and inclusive history of medicine in America.
- 2013:
- (HIT) Alondra Nelson publishes Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination, an exploration of the little-known story of the Black Panther Party’s extensive and multifaceted participation in health activism during the late 60s and early 70s. it is an overview of the interdisciplinary implications of the Black Panther Party’s health advocacy, spreading across sociological, anthropological, historical, and political studies and disciplines, among others. The organization’s reach regarding health advocacy has been shown little to no focus or highlight, even at the height of these specific efforts, making this archival and synthetical work foundational and valuable.
- 2016:
- (HIT) The Society of the Social History of Medicine executive committee releases roundtable working paper to officially document and affirm the guiding values of the society, with an overarching theme of self-reflection and critical engagement and assessment emerging. The document also highlighted the inclusion of more interdisciplinary, civic, educational, and political approaches to create more substantive and holistic outputs from the discipline’s work. (https://doi.org/10.1093/shm/hkz113)
- (HIT) Alondra Nelson publishes The Social Life of DNA: Race, Reparations, and Reconciliation After the Genome, an examination of the social prowess afforded to DNA by its use beyond the laboratory. Through ethnographic and case study methods, Nelson revisits reconciliation projects on an international/transnational scale, looking at how these types of projects stand as main benefactors in producing the social power and social life that DNA boasts. This book is an excellent affirmation of the sentiments from Whitmarsh and Jones’s What’s the Use of Race?: Our practice of medicine cannot be divorced from racial/ethnic categories, and it is not an option to ignore or exclude these categories and their social implications, so we must approach these practices with a firm understanding and recognition of the sociopolitical implications of race and genetic difference.
- 2020
- (MISS) ICE detention camps forcibly sterilizes detainees, targeting immigrant populations disproportionately and unethically, as well as echoing historical sentiments from the early 20th century. (https://www.npr.org/2020/09/18/914465793/ice-a-whistleblower-and-forced-sterilization)
