After emancipation Black people in the devastated south were refused treatment by most doctors and hospitals. This health crisis led Rebecca Lee Crumpler to move south and work at the Freedmen’s Bureau Medical Division immediately after the Civil War ended. As the first Black graduate of the New England Female Medical College, and the only licensed Black doctor out of 54,000 doctors nationally, she treated patients in drastically under-resourced Black hospitals.
New York Times editor Jeneen Interlandi recently said that racism-induced neglect led to black bodies “littering the streets.” This tragedy was used by supremacists to bolster claims of Black inferiority. One Ohio Congressman criticized the Freedmen’s Bureau saying, “No charitable black scheme can wash out the color of the Negro, can change his inferior nature or save him from his inevitable fate.” For most whites, Black illness was only of concern if it threatened them. When some patients were discovered with smallpox in a Freedman’s Hospital in North Carolina, rather than focus on treatment, officials ordered the hospital burnt down!
With the medical community mired in racism, Dr. Crumpler advocated self-care. That’s why in 1883 she wrote a book of “Medical Discourses” for Black mothers and nurses. This “how-to” guide helped many avoid preventable diseases like cholera and bronchitis. Investigative journalist Nikole Hannah-Jones said that Black citizens organized “to push back against this system that’s trying to shut them out completely.”
That determination animated employees at one of our largest hospitals, the Homer G. Phillips Hospital in St. Louis, to serve the Black community. Founded in 1937, it anchored a vibrant African American neighborhood known as “The Ville.” The medical excellence evident at Homer G. Phillips led many to demand quality public health for all citizens, a suggestion vehemently opposed by the nearly all-white American Medical Association.
In 1957, Dr. Montague Cobb, who later served as president of the NAACP, advocated for public health care and hospital integration. With the Civil Rights Act (1964) and Medicare (1965), nearly 3,000 hospitals desegregated. Soon Black professionals became more integral to our nation’s health system. When Bill Clinton appointed Joycelyn Elders as the first Black Surgeon General, she advocated sensible policies regarding sex and drug education. But she was too far ahead of her time and ultimately she was forced to resign. She remained a staunch activist for sensible health policy, another example of the many contributions by Black health care professionals.
Lesson #225: During reconstruction newly emancipated but impoverished Black citizens often lived in crowded conditions with few resources to stay healthy. White supremacists, twisting science to serve the cause of oppression, promoted absurd versions of Social Darwinism. They said that the high death rate in Black communities was simply nature taking its course, ensuring survival of the fittest (and whitest).
Lesson #226: Medical apartheid in America continued well into the 20th century leading to appalling indignities and life-threatening consequences. According to Jeneen Interlandi, in one instance in 1931, “a light-skinned black man gets into a car accident, and he’s taken to a white hospital. (Grady Memorial Hospital in Atlanta.) And doctors there, they mistake him for a white patient, so they start treating him. And it’s only when his family comes to the hospital that they realize he’s actually black. So what do they do? They pull him off the examining table and they send him to the black ward across the street, where he later dies.”
Lesson #227: Rebecca Lee Crumpler’s publication – the “Book of Medical Discourses in Two Parts”- is important not merely because of the practical health information and practical skills that it offers, but because it also is one of the first times a medical authority in the United States tells Black people that their lives matter. We still need to do better in living up to that claim.
Lesson #228: Volumes could be written of the many Black health professionals including: Dr. Patricia Bath who founded the American Institute for the Prevention of Blindness in 1976 and developed the model of health care called Community Ophthalmology; Dr. Alexa Canady, the first African-American woman neurosurgeon in the U.S. in 1981; Emmett Chappelle who held 14 U.S. patents mostly on inventions that improved medical science; Mary E. Mahoney who was the first African-American woman to complete nurse’s training; Dr. Daniel Hale Williams, the first physician in the U.S. to perform open-heart surgery; and, Dr. Benjamin Carson Sr.
Lesson #229: As Surgeon General, Joycelyn Elders rose above politics and narrow-mindedness and became a progressive voice in medicine. She wanted to give Black teenage girls more information and medical care so that they could avoid pregnancy because they would be too young to mother effectively and to avoid their becoming a “captive to a slavery the 13th Amendment did not anticipate.”
Lesson #230: California’s first Surgeon General, pediatrician Dr. Nadine Burke Harris, appreciates the importance of screening for trauma in childhood. In her book, “The Deepest Well: Healing the Long-Term Effects of Childhood Adversity,” Dr. Harris explains that we must take into account the physical effects of psychological trauma. She explains, “A school nurse would also get a note from a physician that says: ‘Here is the care plan for this child’s toxic stress. And this is how it shows up. It could be it shows up in tummy aches. Or it’s impulse control and behavior, and we offer a care plan. Instead of reacting harshly and punitively, every educator is trained in recognizing these things. Instead of suspending and expelling or saying, ‘What’s wrong with you?’ we say, ‘What happened to you?'”