Medical Apartheid – Harriet A. Washington (2007)


Subtitle: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.

Well, this read left me a bit shattered, not because it’s so graphic, but because it’s so true and it hasn’t stopped – even in this day and age. This is a well-researched look at the history of medical apartheid, which means, basically, the history of medical experimentation on African Americans from the era of slavery to the present day. It’s an incredible read about an important (and much neglected) topic and although it was one of the hardest reads I’ve had in a long time, it’s an important addition to the history of African Americans here in the U.S.

I think that most Americans are aware of the Tuskagee syphilis experiment  from 1932 to 1972 under the auspices of the U.S. Public Health Service. This was a long-term experiment to observe the natural progression of syphilis in untreated subjects, but under the inexcusable idea that the subjects (i.e. the people in the study who had syphilis) believed that they were getting medical care when in fact, quite a few weren’t – and just so medical professionals could see what happened in the lifetime of a poor syphilis patient.

These patients were severely economically disadvantaged (mostly sharecroppers) and poorly educated, and included 600 people who believed that they were receiving free medical care, meals and free burial insurance for participating in this study, a study that even gave 201 participants syphilis (who didn’t have it before), and none who were given penicillin (despite all the evidence that this fairly new antibiotic would cure their disease). (Sorry – that’s a rather long sentence, but I trust that you can keep up.)

(It’s insane that this happened, and continued to occur until the 1970’s. My god. I don’t even have words to put here to describe how PO’d I am at this situation. It’s beyond my vocabulary.

And you know what’s worse? That the medical establishment continued to abuse this population ever since slavery, and it’s happened over and over again. And when you read this book, I hope you’ll feel as disgusted as I am.)

One more example that’s more modern: there are several examples of medical studies looking at new technology (e.g. artificial medical devices or treatment approaches) that are totally based on studies filled by African-American participants. Yes, when the final device is approved and comes to market, the population who tested it for the manufacturers are actually now least likely to afford access to its benefits. Grrrrrrrr.

Back to the book: Washington has done an excellent job writing this book through the perspective of her journalistic lens, and the book’s divided into three parts: the first is about the history of medical experimentation wrt the African-American population; the second is about more recent cases of medical abuse and research, and the third examines how this history has impacted African Americans and their current views on the (mostly) white medical establishment of today.

I worked for almost a decade in public health at the local City Health Department, and when we would offer medical screenings, some folks would participate but there were times when our services were not as well attended as we had hoped, and frankly, after reading this book and learning this history, I fully comprehend any hesitation to do so. I, too, would be careful with any of my interactions, as well, if I had grown up knowing this history of continued racial and medical discrimination against my friends and family.

And this book carefully covers decades and decades of continued abuse of the African American population. It wasn’t just in the “olden days” – it continued up until close to the end of the 20th century, and actually, probably continues in some places to this day if you consider who continues to populate medical studies offering “free health care if you’ll help us with our studies”.  (It’s usually the highly disenfranchised, socially and economically disadvantaged people with few options for health care. Don’t even get me started on the availability and access to effective dental care….)

The Tuskagee study is usually the most famous study that characterizes this trend, and due to the whistle blower who let the cat out of the bag on that*, there is now an Office for Human Research Protections (OHRP) and federal laws and regulations requiring Institutional Review Boards (or IRBs) that are meant to protect human subjects in studies. (The OHRP is under the U. S. Department of Health and Human Services now.)

So – as you can probably surmise, this was a powerful read for me and it just underscores how tough and amazing the African American population are: these guys survived slavery, medical discrimination, civil rights injustices and more. Just imagine how different life for African Americans could have been without this century’s continued discrimination in almost every aspect of life. Goodness me. I’d also be very very careful when dealing with the medical establishment (or the white establishment in general) if I’d grown up learning this history and yet still continuing to thrive despite the odds.

There is nothing that I can say to make this right, so my advice would be to read this, let it in sink in, and then look at your own communities to see how you can impact them in a positive way somehow. I’m not sure that I really like the direction of this country’s administration right now (understatement of the year), but how to change that? (1) Vote. (2) Make your part of the world more just, kind, and fair in any way that you can.

This was an amazing and thought-provoking read. I hope it is for you as well.

* Someone had to whistle-blow on this study??…

Where in the world…?

hello-600x400Well, hi. I’m here in the world, but have not been able to work on my blog with the regularity that I like due to overload at work and home. Spring tends to be the busy time at work, and then in my non-work time, I’ve been researching a trip that I’m taking with my lovely old mum and twin sister which is fun but does take up some time and energy. (It’ll be worth it in the end, for sure.)

And you know – I have been reading. I’m just about to finish up a non-fiction called “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present” by medical scholar Harriet Washington. Goodness me. This has been a very difficult and serious read, not because the content is complex but because the content is true and almost too horrible to contemplate.

Washington’s thorough research seems to cover almost every instance of when the U. S. medical system has experimented on the African-American population over the years, with the (white) medical establishment doing everything from giving an unnecessary and unwanted HIV vaccine to healthy infants (without the parental consent) to digging up bodies to sell for dissection at medical schools, from lying to study participants about receiving treatment (the infamous Tuskagee study) to hideous other well documented incidents of other abuses to a population with no recourse to change any of this.

Obviously, this is a tough read for me (as it would be to anyone), and I’ve had to take some breaks – how can people be so horrible to each other (specifically to African-Americans)? – and at the same time, I think it’s important to know this history, and I’ve also been under a tight deadline to finish this since it’s an unrenewable inter-library loan. (And yes – I could have forked over the cash to buy my own copy, but I’m on a book-buying ban AND I’m learning that I’m better as a one-book-reader than trying to juggle several).

Long story short – it’s been an intense reading week and so not much time or energy for putting together a blog post. But trust me – one will be coming on this particular read as I think everyone who is aware of social justice in any form should learn about this issue. One must know the past to influence the future, I think.

I’ve also been reading “Hope in the Dark: Untold Histories, Wild Possibilities” by Rebecca Solnit which is a series of hard-hitting essays on how activists have changed the world for better, even when it’s tough to see the progress. (It’s been helpful to balance the terror that has been coming out of the WH lately.)

So – some hard hitting books here, and once I’m finished with the Washington book, I’m probably going to be heading for some lighter reading to balance things out. It’s astonishing to me that there are years and years of this documented medical abuse and yet no one did anything about it. No wonder that the African-American community tends to stay away from the American health care system. I would as well if I knew that history.

So – that’s where I am at right now. What’s new, Blue’s Clues?

All Involved – Ryan Gattis (2015)

book387All Involved is a far-ranging novel that explores the aftermath of the 1992 LA riots that occurred right after the end of the trial for the police officers who were involved in the beating of Rodney King. In 1992, I’d just finished graduate school and was very busy working my little heart out at an all-consuming job, so I remember this but not in very great detail. However, I do remember the six days of rioting in LA when the streets in South Central were in a state of chaos day and night with law enforcement struggling to regain control. Additionally, with the emergence of the Black Lives Matter (BLM) movement, this seems pretty recent and relevant history even though it was actually 24 years ago. (Huh. Most college students weren’t even born then so it must seem pretty Olden Days to them.)

Anyway, this novel weaves and interweaves (and then weaves again) the many disparate characters whose lives were impacted by the riots in some way. There are representatives from both sides of the law – the lawless and the enforcers – and each chapter sees the events through the PoV of that character. You have to keep your wits about you, and it’s ambitious, but if you don’t daydream (a la me) you’ll probably be fine. (I might suggest a diagram at the back of the book for reference as it can get a mite confusing at times. The glossary was a good tool though.)

So as the story progresses, the reader sees the events play out through the eyes of various gang members, through a firefighter, through a nurse (receiving the injured at the ER), and through the friends and other contacts of these characters. It’s well done, and I found it drew me in and had me reacting in the immediate present as the riots built up to a crescendo and then wore out. It’s quite the ride, and I enjoyed it.

The only thing that niggled me was that Gattis is a white guy, but he wrote through the eyes of several people of color (POC), and I’m just not comfortable with that. How can a white privileged guy know what it’s like (really like) to be a socio-economically disadvantaged gang member in East LA? To the author’s credit, he does acknowledge having talked to numerous sources to get their experiences, but really, at the end of the day, I think it’s a tad awkward for someone in his position to pretend to “know” what life is like for someone from a very different background. And it’s not just one character, either. It’s character after character, which just seemed to be a large assumption on his part. However, is this the perspective of a similarly privileged white woman who might be over-sensitive about the issue? It just seems that it’s presumptive to write through the eyes of someone of a different race when the whole incident around which the plot revolves is a racial issue (which the Rodney King riots all boiled to in the end).

But then again, it is classified as fiction and I’m not grumping about anyone writing as a vampire when they clearly haven’t ever lived their life as a vampire. I’m not sure. I just think it’s a little insensitive (for a white man) to co-opt Latin@ and African American characters at a time when race is such the hot-button issue that it is right now. What would you think?

But – good read all the same. Various reviewers on Goodreads have compared it to the TV series The Wire, but I think that that was a much stronger end product than this.