The tragic history of American medicine failing the Black community

Zahra Jawad, BA Politics and Economics

Content warning: surgical procedures and medical negligence

If 2021 has shown us anything, it is the incredible capacity for clinical innovations at the heart of modern medicine. Several Covid-19 vaccines, developed with cutting-edge technology, have been approved and widely manufactured in just a matter of months. Our ability to quickly address and remedy illness and disease has exponentially grown in the last century. While many are quick to celebrate these achievements, their significance is often heightened by our ignorance; a dark history lies behind the frameworks of Western medicine.

Like American policing, institutionalised racism still lingers within modern medicine. Even after slavery was abolished in America in 1865, the barbarism that haunted Black citizens remained prevalent. Medical schools and research centers were known to rely on theft of Black bodies to use as anatomical material, a practice that continued into the early 20th century.

The veneration of America’s ‘father’ of modern-day gynecology shows us the extent to which we are prepared to ignore the racist history of medicine. J. Marion Sims, an American physician, revolutionised modern day gynaecology and is credited with developing the surgical procedure to fix Vesicovaginal Fistula (VVF) – a tear occurring between the uterus and bladder.

Sims’ achievements came at the cost of many - he was known to have partaken in a wide range of gruesome procedures involving Black women. During the 1830s, Sims perfected the surgery for VVF after carrying out the procedure on enslaved women, such as Anarcha Westcott who is infamously depicted in the painter Robert Thom’s ‘Great Moments in Medicine’ series, without their consent. A paper published by the Journal of Medical Ethics found that Sims didn’t use anaesthesia when carrying out the operation, often resulting in the women dying of shock if they hadn’t already succumbed to internal bleeding.

This was practiced by many doctors alike and led to a dangerous ideology within medicine that persists today - that the white man feels pain differently from his Black counterpart. Charles Hamilton Smiths’ The Natural History of the Human first codified this idea, stating that ‘the darker American races can tolerate pain unbearable to that of the white man.’

A study conducted by the Association of American Medical Colleges (AAMC) found that a staggering 40% of first and second year medical students believed that Black people’s skin was thicker than White people’s. Myths continue to circulate that Black people’s nerve endings are less sensitive long after Sims’ practice came to be seen as barbaric.

Serena Williams’ shocking story of the birth of her daughter is an appalling example of the persistence of these myths. Williams, who had a history of blood clots, began to deteriorate shortly after undergoing an emergency Caesarean section. She pleaded with doctors to give her a CT scan and administer IV heparin, but her nurse assumed Williams’ pain medication was making her delusional. When she finally convinced her Doctors to send her for a CT scan, it revealed several blood clots had settled in her lungs.

Williams says she was lucky; for many Black women, this stigma around their pain proves fatal. Black women are the primary victims of the racial prejudices that exist within medicine. According to the Centres for Disease Control and Prevention (CDC), Black mothers in the US die at 3 to 4 times the rate of white mothers during childbirth.

Mass immigration to America in the 1930s contributed to the birth of the eugenics movement which aimed to curb the proliferation of non-White births. During this time, the Supreme Court upheld forced sterilisation laws for African Americans and other ethnic minorities in 32 states. A horrific 20,000 men and women belonging to minorities underwent the sterilisation procedure without their knowledge and it was only during the mid-Twentieth Century that the practice came to be seen as a barbaric product of pseudo-science.

Institutionalised racism in medicine still persists and despite growing awareness and the rise of anti-racism movements in the last two decades, skepticism and fear still linger in the traumatised Black community and other minority groups.