[Peace-discuss] review of Medical Apartheid

[martin smith]

here's an excellent book for your Christmas list...
              While Michael Moore’s Sicko brought the issue of single-payer health care to the fore, one unpleasant detail has been neglected in the debate over universal coverage.  The fact that 47 million are uninsured in the U.S. and that the lack of insurance kills some 18,000 every year is a painful reminder of the sickness of the system.  But Harriet A. Washington’s Medical Apartheid exposes a more sinister facet of the “scientific” world--the dark history of medical experimentation on African Americans.
                While other works have revealed the story of abuse and exploitation against Blacks in the name of science, notably Allen M. Hornblum’s Acres of Skin and Martha Stephen’s The Treatment, Washington is the first to provide a synthesis of abusive research on Black bodies from slavery to the present.  In so doing, the author provides a stinging indictment of the medical establishment and a racist healthcare system that cannot be dismissed as the scurrilous practices of a few bad apples.  From hospitals to prisons, from medical school anatomy classes to circus freak shows, and from federally to privately sponsored research, Blacks have been unwitting subjects of abusive experimentation at higher rates than any other ethnicity. 
              Washington’s scholarship reveals bone-chilling tales of crimes against humanity that rival Nazi “Angel of Death” Josef Mengele.  For example, James Marion Sims, M.D., is celebrated as “the father of American gynecology” and memorialized with monuments, including a statue in NYC's Central Park.  Yet less honored is the hidden story of how he developed his innovative medical technique of suturing women’s vaginas by practicing on unanesthetized slave women.  Slaves provided Sims with the perfect test subjects because they could not refuse his macabre experiments, allowing him to hone his prized skills through a high rate of surgeries made possible only by the slave system.  Despite the availability of ether, Sims refused to administer it.  The shrieks from Sims’ “patients,” with many undergoing multiple painful surgeries, led his assistants to quit, leaving the enslaved women to restrain each other.  

        With the professionalization of the medical establishment emerging in the mid-nineteenth century, Sims epitomized the rising tide of for-profit healthcare.  Sims’ new technique brought him royalty-like status in the medical world, as he won medals and fame that made him the toast of Europe.  But, according to Washington, his stature came at the price of human suffering that was considered acceptable, as long as it was conducted on Black bodies.
              Yet Sims is but one figure in a long and troubled history of racist abuse in the medical establishment.  Most famous is the notorious Tuskegee Syphilis Study, from 1932 to 1972.  The U.S. Public Health Service (PHS) promised free medical treatment to hundreds of desperately poor and sick male sharecroppers in Alabama inflicted with syphilis.  However, rather than treatment, the PHS denied them proper care with the intention of studying the ravages of the disease on the Black body.  Little did the men know that the true purpose of their participation was to provide Black bodies for autopsies.  Undergirding the experiment were common racist assumptions in the medical community that Blacks suffered diseases differently than whites due to physiological differences, such as hypersexed bodies and “underdeveloped” brains.  
              Washington provides new insight into the Study by taking on common false myths, such as exaggerated claims of Black complicity in the research.  She also points out that throughout the decades of research, the experiment was never hidden and was conducted openly with its results, including autopsy reports, published regularly in prestigious journals, revealing the medical establishment’s complicity.  
              The Tuskegee nightmare ended due to public pressure that demanded new guidelines to regulate federally sponsored research; however, abusive medical studies on African Americans continued unabated.  Washington traces the lineage of the Norplant contraceptive, which was marketed and tested on poor black teenagers in Baltimore public high schools in the early 1990s, to the eugenics movement and the forced sterilizations during the Jim Crow-era South.  The device caused serious side effects and was later recalled and taken off the market.  As well, during 1992-1997, Black children in NYC’s Washington  Heights were targeted by a Columbia University-sponsored experiment to determine a possible genetic trait for violence.  The school prescribed the cardiotoxic drug fenfluramine to Black boys and lured them into a racially-biased and scientifically suspect experiment with gift certificates for Toys “R” Us.  
              However, Washington’s larger thesis that African Americans suffer from iatrophobia, a fear of medicine, due to the long history of abuse and exploitation is over-generalized and incomplete in describing the vast disparity between the health of white and Black America.  According to the author, heart disease claims 50 percent more African Americans than whites, and a Black woman is 2.2 times as likely to die of breast cancer than a white woman.  Yet the solution to these problems will require a more radical overhaul of the medical system than the author’s suggestion of maximizing protections through legislation and improving racial integration within the medical establishment.  Despite the author’s weak antidote to the problem, Medical Apartheid is a much needed prescription that should be read by everyone serious about winning single-payer coverage and fixing the sick and racist system of U.S. health care. 
  -martin smith



       
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