The Morris Dillard Lecture: Racial Science and Slavery in U.S. Medical Schools: A Roundtable Discussion
December 09, 2022November 30, 2022
Christopher D.E. Willoughby, PhD
Visiting Assistant Professor of History of Medicine and Health, Pitzer College
Author, Masters of Health: Racial Science and Slavery in U.S. Medical Schools
Discussants:
Liana DeMarco, PhD
Post-doctoral fellow, History of Medicine, Yale School of Medicine
Sean Morey Smith, PhD
Post-doctoral fellow, History of Medicine, Yale School of Medicine
ChinyeIjeli
Medical student, Yale School of Medicine
Moderator
Carolyn Roberts, PhD
Assistant Professor, History of Science & History of Medicine;
African American Studies, Yale University
Information
- ID
- 9261
- To Cite
- DCA Citation Guide
Transcript
- 00:00So welcome, everybody.
- 00:02I'm Anna Reesman, director of the
- 00:04Program for Humanities and Medicine,
- 00:06and I'm really excited for tonight's.
- 00:08Session which as you all know will be
- 00:11a round table discussion on racial
- 00:13science and slavery in US medical schools
- 00:15featuring Christopher Willoughby,
- 00:17Sean Smith, Leanna DeMarco,
- 00:19Jinyue Jaylee and moderated
- 00:21by Carolyn Roberts.
- 00:23The event is Co sponsored
- 00:25by my colleague Doctor John
- 00:28Horner and a section of History
- 00:29of Medicine and it's been
- 00:31wonderful honor to work with
- 00:33John on thinking through
- 00:34this event tonight and all of its nuances
- 00:37and John is going to give you some more.
- 00:40Really interesting background on how
- 00:41we got here in a couple of minutes.
- 00:44In the meantime, I want to thank Karen Colby,
- 00:46especially Kathleen Keenan for figuring
- 00:48out all the complicated logistics. And
- 00:51also thank you very much to Antonio
- 00:54and Jay are ASL interpreters
- 00:55for being here with us tonight.
- 00:59So this is the Morris Dillard
- 01:01lecture and I want to just take
- 01:02a minute to say a couple words
- 01:04about Doctor Morris Dillard and
- 01:06then I will turn things over to to John.
- 01:09This lectureship began
- 01:11in 2000, and
- 01:13the fund that supports this talk was created
- 01:15by Doctor Dillard's former students.
- 01:18He was part of the Yale General Medicine
- 01:20faculty based in the primary care center,
- 01:22and in the mid 1970s he founded
- 01:25what became known as the Wednesday
- 01:27Evening Clinic and served as its
- 01:30director for several decades.
- 01:32The Wednesday Evening Clinic,
- 01:33which is currently under the directorship
- 01:35of Doctor Pinar Oray Schrom,
- 01:36has trained generations of Yale
- 01:38Medical students on the essence
- 01:40of primary care and is known as a
- 01:42training site that was far ahead
- 01:43of its time in this regard.
- 01:46Doctor Dillard is remembered
- 01:47by many YS M grads
- 01:49for his wonderful mentorship and teaching,
- 01:51for interviewing more Med school applicants
- 01:53than anyone else ever, I believe,
- 01:55and also for preparing and sharing elaborate
- 01:58dinners for faculty and students both at
- 02:00the clinic and at his home. And finally,
- 02:03I'll just say that Doctor Dillard,
- 02:05who died about four years ago,
- 02:07taught students in the Wednesday evening
- 02:09clinic something that most students
- 02:10don't learn until residency or later,
- 02:12which is the real the art
- 02:14of real responsibility.
- 02:16To care, yes, but to take the next steps
- 02:20of demonstrating and doing the Karen,
- 02:21following up,
- 02:22checking in and just being there
- 02:24for their clinic patients when
- 02:25they were needed. So. Very happy to have
- 02:30today's talk as the Dillard Lecture
- 02:33and thank you everybody and I'm
- 02:35going to turn things over to John.
- 02:45Thank you, Anna, and thank
- 02:46you for those of you who
- 02:49came out in the rain.
- 02:51I think there are something
- 02:53over 50 people on zoom already,
- 02:57and we don't hate you just
- 02:58because you have dry feet.
- 03:00Today, I'm John Warner and I chair history
- 03:04of medicine here at the medical school.
- 03:07And I just wanted to say a very
- 03:09brief word on the project that from
- 03:13which this roundtable grew last year
- 03:17inspired by the Yale and Slavery
- 03:20Working Group that the that is being
- 03:23conducted for the university as a whole,
- 03:27led by my colleague in history,
- 03:28David Blight,
- 03:29Dean Nancy Brown here at the medical school,
- 03:32ask Dean Darren Lattimore and
- 03:35me to convene a group to.
- 03:38Discuss possibilities for a deeper
- 03:41historical investigation of the
- 03:43relationship between slavery and
- 03:45the Yale School of Medicine,
- 03:47and The upshot is a one year pilot
- 03:50project that seeks to explore the
- 03:52entanglements of our medical school
- 03:55with the institution of slavery.
- 03:57Both our moderator and keynote speaker,
- 04:00Carolyn Roberts and Chris Willoughby
- 04:02have been both of them have been
- 04:05enormously generous in their
- 04:07time and thought.
- 04:08And helping me think through
- 04:11and chart our course.
- 04:13For for this particular project,
- 04:15Dean Brown is also funded 2
- 04:18postdoctoral research fellows
- 04:20Leona de Marco and Sean Smith,
- 04:22historians at science sorry historians
- 04:25of medicine and slavery who are
- 04:28also here with us on the panel
- 04:30who began working on the project,
- 04:32began research early this semester.
- 04:36Our aim is to begin to show
- 04:39how the culture of slavery,
- 04:41racial capitalism and the ideologies
- 04:44of scientific racism were infused into
- 04:47the fabric of a medical school located
- 04:50in a New England port city that was
- 04:54engaged in the West Indian trade.
- 04:56And really the ongoing research,
- 04:59their ongoing research I should say
- 05:02is focused on the medical schools
- 05:05relationship to the slave trade.
- 05:07Especially financial benefits and
- 05:10networks of racial capitalism,
- 05:13the content of medical education,
- 05:15including scientific racism,
- 05:17and how racial difference,
- 05:20especially biological difference,
- 05:22appeared in the curriculum and the
- 05:26relationship of the Yale Medical
- 05:28School to the New Haven community,
- 05:30including here the use of African
- 05:32descended bodies in the production
- 05:35of medical knowledge and in the
- 05:37training of medical students.
- 05:39The stories that have begun to emerge
- 05:42really are are their star tell,
- 05:44not mine,
- 05:45as much as I'd like to tell them myself,
- 05:48and I'm very much looking forward to
- 05:50their comments and and reflections.
- 05:52But one thing that's already clear
- 05:55is is just how pervasive scientific
- 05:57racism was in medical teaching
- 06:00and learning here at Yale,
- 06:03often presented with in lectures for
- 06:06students with a dearth of elaboration.
- 06:09Suggesting to us that many of these
- 06:11ideas about the medical meanings
- 06:13of racial difference and the
- 06:16medicalization of blackness were were
- 06:18so self-evident that they just they
- 06:21really didn't need to be elaborated
- 06:23by special comments or explanation
- 06:26by the medical professors here.
- 06:29We're still sorting out the best
- 06:31ways to share our findings both
- 06:34within the medical school and within
- 06:36the larger New Haven community.
- 06:39But it's clear that one aim we
- 06:42share is finding ways to integrate this work
- 06:46into medical education in some ongoing way.
- 06:50And with that, let me turn to
- 06:54introducing the the speakers and
- 06:57panelists for this afternoon.
- 07:00Christopher Willoughby is an historian
- 07:02of slavery and medicine in the United
- 07:05States and a visiting assistant professor
- 07:06in the history of medicine and health
- 07:09at the Pritzker College in Claremont, CA.
- 07:11He's the author of the book
- 07:14Masters of Health, Racial Science,
- 07:17and Slavery in US Medical Schools,
- 07:20which was published this month
- 07:22just a couple of weeks ago by the
- 07:26University of North Carolina Press.
- 07:28Recent enough, that one.
- 07:29Review has come out,
- 07:31but it's in science and it's glowing,
- 07:33so that's a good start.
- 07:35Many, many others follow.
- 07:38With Sean Smith,
- 07:39he edited a book titled Medicine
- 07:42and Healing in the Age of Slavery,
- 07:45published by Louisiana
- 07:47State University Press.
- 07:49He's also written academic and popular
- 07:51articles in places like the Journal of the
- 07:54History of Medicine and Allied Sciences,
- 07:56the Journal of Southern History,
- 07:58and the Washington Post.
- 08:01Sean Morey Smith,
- 08:03we're not going actually in order here.
- 08:07Yes, OK,
- 08:09you've identified.
- 08:11Sean Smith is a postdoctoral
- 08:13research associate here in the
- 08:15School of Medicine examining the
- 08:18historical relationship between
- 08:19slavery and our medical school.
- 08:22He earned his PhD degree
- 08:24at Rice University in 2020,
- 08:26and his own research examines
- 08:29how medical ideas of health and
- 08:32climate were used to alternatively
- 08:35support and to attack racialized
- 08:38slavery in the Anglophone Atlantic.
- 08:41She's currently completing a
- 08:42book manuscript related to that
- 08:45research with a working title,
- 08:47the climate of race in abolition,
- 08:49circa 1730 to 1860.
- 08:54Shawn has also previously published
- 08:55research in journals such as
- 08:57Slavery and Abolition, Abolition,
- 08:59Medical History and Urban History,
- 09:02as well as again Co editing
- 09:06the collection with with.
- 09:10The collection of medicine and healing
- 09:12in the age of slavery with Chris Willoughby,
- 09:14as well as editing a collection
- 09:17Atlantic environments in the American S.
- 09:20Xinyue ijele.
- 09:28Is a MD candidate here at
- 09:30the Yale School of Medicine,
- 09:33currently completing a research here
- 09:35between her third and 4th 4th year.
- 09:38Her research interest include health equality
- 09:41and the politics of healthcare reform.
- 09:44With her. With her classmates,
- 09:48Jinyue developed a didactic session
- 09:51on biological racism in medicine.
- 09:54For the first year,
- 09:57MD student class and has published
- 10:00an evaluation of that session.
- 10:02In clinical teacher versions of this
- 10:07session have been a of the session that
- 10:11she initiated had been a mandatory part
- 10:14of the Yale MD curriculum since 2020.
- 10:19Uh. Though through many other
- 10:24extracurricular activities,
- 10:26she for years as an advocate for students
- 10:29and patients from marginalized backgrounds.
- 10:34Leona de Marco, identify herself.
- 10:37Leona. OK, thank you.
- 10:39We're running out of people.
- 10:40So I think it it's starting to become clear
- 10:43is a postdoctoral research associate,
- 10:46also here at the Yale School of Medicine,
- 10:48as part of the slavery project.
- 10:51She received her doctorate degree in
- 10:54the Department of History and the
- 10:56Program for the History of Science and
- 10:59Medicine here at Yale in May of 2022.
- 11:03Her research focuses on histories
- 11:05of medicine, race,
- 11:07and capitalism in the United
- 11:08States and in the Caribbean,
- 11:11most especially in Cuba.
- 11:13She's currently writing a book on the
- 11:16management of Enslaved Peoples Health,
- 11:19and the medicalization of their productivity.
- 11:22Of their labor on plantations in
- 11:25Louisiana and in Cuba.
- 11:27Her other writings,
- 11:28or some of her other writings,
- 11:30can be found in the Journal of Southern
- 11:32History and in the Journal of the
- 11:35History of Medicine and Allied Sciences.
- 11:37And finally, our moderator at the end,
- 11:42my colleague Carolyn Roberts,
- 11:44is an historian of medicine and
- 11:47science on the faculty here at Yale.
- 11:50She joined our faculty right after
- 11:53receiving her PhD degree in History
- 11:55of Science at Harvard and holds joint
- 11:59appointments in the departments of History,
- 12:02History of Science and Medicine,
- 12:03and African American Studies she also holds.
- 12:08Secondary appointment here in the medical
- 12:10school in our history of Medicine Department.
- 12:13Her research interests concerned
- 12:14the history of race,
- 12:16science and medicine in the context of
- 12:19slavery and the Atlantic slave trade.
- 12:23This includes attention to the
- 12:25critical role played by African and
- 12:28African descended medical and health
- 12:31knowledge in the Atlantic world.
- 12:33Doctor Roberts is currently working
- 12:35on several book manuscripts.
- 12:37Including one that has the title
- 12:40to heal and harm medicine,
- 12:43knowledge and power in the
- 12:45British slave trade,
- 12:47which is under advanced contract
- 12:49with Harvard University Press.
- 12:51In her teaching,
- 12:52she uses history as a platform
- 12:54for exploring exploring present
- 12:56day crises related to race,
- 12:58racism and health,
- 13:00and she is the 2021 recipient of Yale's
- 13:05prestigious Klaus Prize for teaching.
- 13:07Excellence in the humanities,
- 13:09and maybe I can close by just giving
- 13:12you a a sort of quantified sense
- 13:15of how popular her teaching is.
- 13:18She's has a lecture course that
- 13:20she's teaching next semester,
- 13:22registration just open and it's
- 13:24already over 500 people who would
- 13:26like to take the course making it,
- 13:29I believe and in fact I don't believe,
- 13:31I'm absolutely certain the largest
- 13:33humanities course offered at Yale
- 13:36University. And so with that.
- 13:38I will turn it over to you, Caroline.
- 13:43Thank you so much.
- 13:45It's wonderful to be here.
- 13:46I'm thrilled to have the opportunity
- 13:49to participate in this important
- 13:51discussion on racial science and
- 13:53slavery in US medical schools.
- 13:56In a 2021 article published by a
- 13:59recent graduate of Yale Medical School,
- 14:01Max Jordan Tiako.
- 14:03He wrote the following.
- 14:05Quote historical and contemporary
- 14:08patterns of racial exclusion
- 14:11fundamentally shape medical schools,
- 14:13and current institutional structures
- 14:15often serve to entrench rather than
- 14:19dismantle racial inequality for students,
- 14:22faculty, and patients.
- 14:24End Quote.
- 14:25So it can be challenging for many
- 14:28to wrap their minds around how
- 14:30and why racial inequities exist in
- 14:33American medicine and healthcare.
- 14:35But we now have over 2 decades of
- 14:38research that conclusively proves
- 14:40that a patient's race or ethnicity
- 14:43negatively impacts the quality and
- 14:45type of care that they receive.
- 14:48Unequal treatment is not new.
- 14:51It's part of a long and complicated
- 14:54history of medical practice and
- 14:56healthcare in this country.
- 14:58This is a history that we have
- 15:00yet to fully reckon with.
- 15:02But it's critical for understanding
- 15:04how we got here,
- 15:05to this particular moment
- 15:08in American medicine.
- 15:09So doctor Chris Wilby,
- 15:11who I'm thrilled to welcome today,
- 15:14is offering us an important
- 15:16part of this history.
- 15:18One of the missing pieces that we've
- 15:20had in understanding the history
- 15:22of race and medicine in the United
- 15:25States concerns medical schools.
- 15:27Very little historical literature exists
- 15:29concerning the role of medical education.
- 15:33In fostering unequal treatment,
- 15:35Doctor Willoughby,
- 15:36who I will now respectively call Chris,
- 15:40has authored a groundbreaking book
- 15:42that offers us such a vantage point.
- 15:45His book Masters of Health,
- 15:46which is based on deep archival research.
- 15:50Does an excellent job of demonstrating
- 15:53how racial science was embedded
- 15:55in medical school education from
- 15:57the very beginning.
- 15:58As Chris writes,
- 16:00quote this book helps explain why
- 16:02racial thinking rooted in the history
- 16:05of slavery has been so difficult to
- 16:08expunge from contemporary medical practice.
- 16:11End Quote.
- 16:12So I'm going to turn
- 16:13things over now to Chris,
- 16:15and then we will hear from
- 16:18Leanna and Sean and Shania.
- 16:21Thank you,
- 16:21Chris.
- 16:23Thank you. I I was excited when I heard that,
- 16:25you know, three extra students wanted
- 16:27to get into my history of modern
- 16:29medicine lecture, so I'm going to
- 16:31try and share my screen here. That.
- 16:37And then hopefully I'm going to look forward
- 16:39the whole time after that.
- 16:44Yes.
- 16:53Close this I think.
- 16:58Well, all, I've got way too
- 17:00many thank yous anyway,
- 17:01so we're getting this done.
- 17:04This is my first in person talk
- 17:05since my books been published,
- 17:06so I need to express a lot of
- 17:09gratitude for being invited by
- 17:10Anna Reisman and John Warner to
- 17:12the program in Humanities and in
- 17:15medicine in the section of the
- 17:17history of medicine for sponsoring.
- 17:19It's also particularly an honor
- 17:21to be here in this room full of
- 17:23so many scholars I deeply admire.
- 17:24This book couldn't have been written
- 17:27without John Warner's groundbreaking work.
- 17:30I also want to acknowledge Naomi Rogers,
- 17:33who has been a really generous
- 17:35supporter since I met her at the Upenn
- 17:37Archives as a third year grad student.
- 17:40And she came up and said,
- 17:41what are you doing with these dissertations?
- 17:44So Sean, as you know,
- 17:46we edited a book together.
- 17:48Liana and I go actually way back.
- 17:50And Carolyn and I have also
- 17:52worked together much,
- 17:52and I'm very excited to be in
- 17:55conversation with my new colleague,
- 17:56Chinya Jelly.
- 17:59So it's an honor to be here and
- 18:01thank you all for coming out tonight.
- 18:03I know the weather was not so
- 18:05welcoming and I also should
- 18:06give a quick content warning.
- 18:08My talking gauge is, unsurprisingly,
- 18:10with themes of medical racism,
- 18:12but also suicide and includes images
- 18:15of spaces with human remains.
- 18:17Some quotes also contain dated
- 18:20racial terminology.
- 18:21So with that said,
- 18:23I'm glad to be here talking to you tonight.
- 18:26Ah,
- 18:27there we go.
- 18:30So I'll do so first by discussing
- 18:33an individual story of how medical
- 18:35professionals embrace a racial science
- 18:38affected diverse individual lives.
- 18:39The story acts as a segue to describing
- 18:42the book's larger argument about how
- 18:44medical schools became the central
- 18:46site for the dissemination of bio
- 18:48determinist racial science in the last
- 18:50decades of chattel slavery in the US.
- 18:54Finally, for most of my talk,
- 18:55I'm going to focus.
- 18:57On how race was actually taught
- 18:59in the medical school,
- 19:00examining a pedagogy that asserted that
- 19:04anatomical racial differences were real.
- 19:06And that they could be used to organize
- 19:08the United States into racial hierarchies.
- 19:11And I also consider the reception and
- 19:14legacy of this pedagogy through analysis
- 19:16of medical student dissertations.
- 19:19But I want to begin, though,
- 19:20by telling you the history of
- 19:22storman as a window into the intimate
- 19:25effects of antebellum racial science.
- 19:27On an individual life.
- 19:30Stormont was born in Little Demaco
- 19:32land which is near the border of
- 19:34contemporary South Africa and Namibia,
- 19:36and on the map on the screen you
- 19:39can actually see where little
- 19:41Namaqualand is located on the Atlantic
- 19:43Coast of South Africa.
- 19:45By the time you arrived in Boston in 1860,
- 19:48he was approximately 16 years old.
- 19:51Already he had experienced a chaotic life.
- 19:53Dispossessed of grazing lands,
- 19:55as a child his family hunted and gathered for
- 19:59food in the shadows of Dutch settlements.
- 20:02As a teenager,
- 20:03Stormont trekked himself more than 1000 miles
- 20:06to the coastal Indian Ocean City of Natal.
- 20:08After working as a guide
- 20:10for white hunting parties,
- 20:11storm on weight made one
- 20:13more desperate decision.
- 20:15He came to Boston in search of
- 20:17a better life. Instead,
- 20:19he ended up in a PT Barnum exhibit
- 20:21at the city's Aquarial Gardens,
- 20:23on display with four other
- 20:25men from Southern Africa.
- 20:26And you can see a broadside
- 20:28here which depicts him.
- 20:32Stormont was forced to portray
- 20:34stereotypes of African indigeneity.
- 20:36Every day he had to perform what exhibitors
- 20:39called the war and Love Dances while
- 20:41holding objects like clubs and Spears.
- 20:43In less than a year,
- 20:44Stormont hanged himself.
- 20:46The story sent shockwaves through the
- 20:48Boston press only six months earlier.
- 20:51Newspapers were attempting
- 20:52to justify the exhibit.
- 20:54Exclaiming that the arrangement between the
- 20:56promoters and the South African Government,
- 20:59or British Government and South Africa
- 21:01was nothing like the slave trade,
- 21:03this was a particularly awkward time for
- 21:06Bostonians to be trafficking in Africans.
- 21:08The secession crisis began
- 21:10just months after the exhibit,
- 21:11and the city was the center of
- 21:14the American abolition movement.
- 21:15Left out of newspapers was how Stormonts
- 21:18body was given to Harvard Medical School,
- 21:21where they turned his remains
- 21:23into teaching tools and supposed
- 21:25evidence of racial difference.
- 21:27It's critical, though,
- 21:28to understand that stormonts tragic suicide
- 21:30may not have been just a case of desperation.
- 21:32He likely believed in an afterlife.
- 21:35Many African religions,
- 21:36as well as syncretic forms of Christianity,
- 21:39did not see suicide as immoral.
- 21:42Thus.
- 21:42Storm on suicide may have been one more
- 21:45attempt to wrest control over his existence,
- 21:48whether in the name of escape,
- 21:49rebellion,
- 21:50or a pursuit of a better afterlife.
- 21:53More broadly,
- 21:54though,
- 21:55his history reminds us of the
- 21:57profound cost of creating and
- 21:59disseminating racial theories.
- 22:0119th century medical students learned
- 22:03supposed racial differences on
- 22:05the bodies of people like storman,
- 22:07scientists at Harvard measured
- 22:09and made casts of his remains.
- 22:11He was an unwilling participant in the
- 22:14production of 19th century racial science.
- 22:16Moreover,
- 22:17collections of people's remains brought
- 22:20prestige and scientific legitimacy to
- 22:22the to medicine and the allied sciences.
- 22:25His life is as much a part of this
- 22:28history as are the accounts I will
- 22:30give of antebellum faculty like
- 22:32Joseph Liddy of the University of
- 22:34Pennsylvania or Oliver Wendell
- 22:36Holmes of Harvard.
- 22:37Masters of Health then captures
- 22:39Titanic shifts in the history
- 22:40of American Medical education,
- 22:42spanning from only one medical
- 22:44school in 1765 to over 50 at the
- 22:47start of the Civil War.
- 22:49During this period,
- 22:50physicians like like Declaration
- 22:52of Independence, signer Penn,
- 22:54Professor, abolitionist,
- 22:56and racial theorist Benjamin
- 22:58Rush could truly believe that
- 23:00chattel slavery was in decline.
- 23:03This was, of course,
- 23:04prior to Eli Whitney's invention of
- 23:06the modern cotton gin the 1790s.
- 23:07After that,
- 23:08slavery began to expand again
- 23:11geographically in the newly
- 23:13formed United States.
- 23:15Yet by this point,
- 23:16the United States also had an
- 23:18active abolitionist movement.
- 23:20Thus,
- 23:20US medical schools were profoundly
- 23:22shaped by developing during a century
- 23:25of national and Atlantic debates
- 23:27over the abolition of slavery,
- 23:29beginning with 18th century
- 23:32colonial abolition initiatives.
- 23:34My argument is threefold.
- 23:371st.
- 23:38As white physicians faced a
- 23:39crisis of public confidence in the
- 23:41first half of the 19th century,
- 23:43doctors embraced medical schools and
- 23:45bio determinist racial theories as a
- 23:48means to establish their sole legitimacy
- 23:50in a competitive healing marketplace.
- 23:53Thus, I argue that racial thinking quite
- 23:56literally underwrote the professionalization
- 23:57of medicine in the United States.
- 24:00Second, the proliferation of medical
- 24:03schools allowed physicians to lay claim
- 24:06to being a national profession with a
- 24:09shared ideology instead of practices.
- 24:11By the end of the antebellum era,
- 24:13a whole generation of physicians
- 24:15emerged that were trained to see
- 24:17racial groups as defined by imagined
- 24:20anatomical and physiological differences.
- 24:23Racial groups, students learned,
- 24:24were also suited to and healthy
- 24:27in specific environments.
- 24:29Thus, faculty could argue that racial
- 24:32difference was anatomically ordained.
- 24:33And that plantation labor in the
- 24:36southern subtropics was uniquely
- 24:37healthy for people of African descent.
- 24:433rd and finally unpacking the life
- 24:45stories of people like Storman,
- 24:47whose skulls were displayed at Harvard,
- 24:50reveals that US racial medicine can
- 24:52only be completely understood through
- 24:54a transnational lens that captures
- 24:56the breadth of the African diaspora.
- 24:59Even before slavery was abolished,
- 25:01medical racial theories were
- 25:03connected to and being applied to
- 25:05the potential colonization of Cuba,
- 25:07Liberia and other parts of
- 25:10the global tropics.
- 25:11Thus, I argue that medical schools
- 25:13were the central site for the
- 25:15dissemination of racial science in the
- 25:16United States before the Civil war.
- 25:18In revealing how,
- 25:19early American physicians created
- 25:21a culture of racial theorizing.
- 25:23I analyzed the relationship between
- 25:25schools and diverse black communities
- 25:27in the United States and abroad,
- 25:29from New York City to South Africa.
- 25:32No.
- 25:35Here I wish to note some relevant
- 25:36context about the history of racial
- 25:38science and medical schools as frankly
- 25:40essential to understanding this history.
- 25:421st. Compared to the 18th century,
- 25:46where US medical schools only granted
- 25:48a little more than 200 MD's in total.
- 25:51Close to 30,000 were granted
- 25:54from 1840 to 1859.
- 25:56During this period,
- 25:57schools were founded in significant
- 26:00numbers in the Northeast SE and Midwest.
- 26:052nd. Few black people were admitted
- 26:08to medical schools during this period.
- 26:10James Mccune Smith,
- 26:11pictured on the slide above,
- 26:14was the first American African
- 26:15American to receive an MD,
- 26:17yet he had to attend medical
- 26:19school in Glasgow.
- 26:20Samuel F McGill,
- 26:21on the other hand,
- 26:22had emigrated to Liberia as a
- 26:24child before returning to attend
- 26:25medical school in Dartmouth.
- 26:30Early state medical licensing also
- 26:33actively excluded black practitioners.
- 26:353rd during the 1840s American race,
- 26:39American scientists increasingly
- 26:40embraced the theory of polygenesis,
- 26:43the notion that each race was created
- 26:45by God for separate environments,
- 26:48correlating, generally speaking,
- 26:50to different continents.
- 26:52During this period,
- 26:54Polygenesis briefly supplanted Monogenesis
- 26:56among scientists in the Christian world.
- 27:00Naturalists have long contended that
- 27:02all humans derive from one single pair,
- 27:05IE Adam and Eve, and this was monogenesis.
- 27:08After the Darwinian Revolution began in 1859,
- 27:11though, the supposed anatomical racial
- 27:14traits outlined by Polygenists had
- 27:16continued violence in American medicine.
- 27:194th.
- 27:20Antebellum medical student dissertations.
- 27:23A key piece of evidence.
- 27:24We're not akin to modern dissertations
- 27:27that emphasize original research.
- 27:28Rather,
- 27:29they were derivative and reflected what
- 27:31a student learned about mainstream
- 27:33ideas on a specific medical topic.
- 27:36Many were plagiarized,
- 27:37and one medical professor in the 1870s
- 27:40even suggested a ritual burning of them
- 27:43every year to celebrate the 4th of July.
- 27:46The point being,
- 27:48dissertations reflected medical pedagogy,
- 27:50not original scholarship.
- 27:52Therefore,
- 27:53they're particularly useful,
- 27:55as we'll see,
- 27:56for studying the history
- 27:57of medical education.
- 28:02In early American Medical schools,
- 28:04faculty discussing race directed
- 28:05much of their attention to anatomy,
- 28:08dissection and human remains.
- 28:09And here we can see above a crude
- 28:13illustration of a dissection demonstration
- 28:15at the University of Pennsylvania.
- 28:18For example.
- 28:19Antebellum racial scientist and
- 28:21medical professor Samuel Morton
- 28:23included racial skull measurements
- 28:25in the anatomy textbook, he wrote.
- 28:27So, too did Penn faculty like William
- 28:30Horner and his successor, Joseph Lyddy.
- 28:33Lectures illustrated this further.
- 28:35Faculty like Lyddy or Oliver Wendell Holmes,
- 28:38senior at Harvard,
- 28:40describes supposed anatomical
- 28:42differences across the body.
- 28:45In his anatomy lectures at
- 28:46Penn from 1853 to 1891,
- 28:48Joseph Lyddy taught students that supposed
- 28:51racial about taught students about
- 28:53supposed racial differences in the cranium,
- 28:57going into depth on facial
- 28:59angles and cranial capacity.
- 29:01Lydia told his students that there
- 29:03were more significant anatomical
- 29:05differences between lions and
- 29:07tigers than black and white people.
- 29:09Yet, he claimed,
- 29:10no naturalist said that these
- 29:12felines were separate, were the same.
- 29:15Species.
- 29:17Specifically, why D demarcated numerous
- 29:20supposed anatomical characteristics
- 29:22peculiar to African descendants bodies,
- 29:25including narrower pelvises,
- 29:27longer limbs in relation to the body,
- 29:30longer foot, shorter toes, shorter neck,
- 29:34smaller and longer heel bone,
- 29:36and no arch in the foot.
- 29:38To his students, Lydy depicted
- 29:41African descendants as diverging from
- 29:44whites literally from head to toe.
- 29:46These small differences were
- 29:48negligible on their own,
- 29:49lighty contended.
- 29:50But when combined,
- 29:52they defined African descendants
- 29:53as an entirely distinct species.
- 29:58Methodologically speaking,
- 29:59lecturers employed a visual style to
- 30:02teach these supposed differences that
- 30:04blended oral content with demonstration.
- 30:07And here we can see this is an
- 30:09image of an anatomical theater
- 30:11in London during the same period.
- 30:13Visual and tactile instruction were
- 30:15meant to make medical and supposed racial
- 30:18knowledge easy to retain and empirical.
- 30:21That's a critical part in the
- 30:24introductory lecture to his first
- 30:26session at Harvard in 1847.
- 30:27Oliver Wendell Holmes plainly explained
- 30:29that his lectures would be highly visual,
- 30:32whether they be on race or any other subject.
- 30:36In fact, his motto was illustration.
- 30:39He told his students that anatomy
- 30:41was an inherently optical discipline,
- 30:43and in most respects,
- 30:44students learned more from visuals
- 30:46than rhetoric.
- 30:47Holmes, first point of importance here, then.
- 30:49Is that anatomical lectures with
- 30:52a visual component allowed for
- 30:54greater retention.
- 30:55He believed that students could understand
- 30:57and retain information better about the
- 31:00human body when it was transmitted.
- 31:01Through this rhetorical,
- 31:03visual and tactile instruction.
- 31:05Holmes also argued that the second
- 31:07power of a visually oriented anatomical
- 31:10lecture resided in observations
- 31:13ability to render anatomical
- 31:15knowledge objectively real.
- 31:17As Holmes explained,
- 31:18I have attempted therefore to
- 31:20render visible everything which
- 31:22the eye could take cognizance of,
- 31:24and so turn abstractions and
- 31:26catalogs of names into substantial
- 31:28and objective realities.
- 31:30Holmes used images,
- 31:31models and anatomical specimens as a part
- 31:34of a larger pedagogical approach to anatomy.
- 31:37Essential to his lectures about
- 31:39racial difference were the images
- 31:41that surrounded him as he explained
- 31:44whites supposed anatomical superiority.
- 31:45And in this image you can actually
- 31:48see a hanging skeleton pictures,
- 31:50hand drawn images of skulls and heads.
- 31:53So we don't know what their lecturing about,
- 31:55but it very well could have
- 31:58been racial difference actually.
- 32:00He even contacted Polygenist in
- 32:02Harvard colleague Louis Agassiz for
- 32:04works from his private collection
- 32:07Holmes commissioned in large artistic
- 32:09reproductions of figures from prominent
- 32:12racial science texts like Harvard
- 32:14Medical School Grad Charles Pickerings,
- 32:16the races of man.
- 32:18Most visuals and pickerings
- 32:19monograph were sketches of people
- 32:21that he encountered during the
- 32:23United States exploring expeditions
- 32:25circumnavigation of the globe,
- 32:27which lasted from 1838 to 18.
- 32:3042 and a little sidebar here.
- 32:32That book is also one of the first
- 32:35publications by the Smithsonian,
- 32:36and it's a pro polygenesis book.
- 32:42Building on visuals,
- 32:43lectures also had tactile components.
- 32:45Anatomical objects were passed
- 32:47around the room, for example.
- 32:49Skulls were displayed.
- 32:51Holmes even instructed students in the
- 32:53specific methods of measuring crania
- 32:55and how to use a cranial ometer.
- 32:56And that's an illustration of
- 32:59Samuel Morton's craniometry.
- 33:01Both Lydia and Holmes teaching careers
- 33:03spanned the antebellum and post bellum eras.
- 33:06In short, the racial theories
- 33:08taught in the antebellum medical
- 33:10school had an enduring,
- 33:11rather than fleeting effect.
- 33:17Students also wrote about anatomical
- 33:19difference in their senior theses
- 33:21hailing from South Alabama.
- 33:23When Jay Ramsey McDowell arrived
- 33:25in Philadelphia in the 1850s,
- 33:27he was certainly well versed
- 33:29in the white racist thought
- 33:31pervading Alabama's black belt.
- 33:33His 1857 thesis, though,
- 33:35displayed the medicalization of
- 33:37this racial worldview and the
- 33:39specific influence of his professor,
- 33:41Joseph Lyddy. For example,
- 33:43McDowell was one of several students who,
- 33:46in their theses,
- 33:48paraphrased liedy,
- 33:49telling the class that black and
- 33:51white people were anatomically more
- 33:53different than lions and tigers.
- 33:55As well as learning about racial
- 33:57science and a bustling northern
- 33:58metropolis through medical education,
- 34:01McDowell was Privy to a broader
- 34:03set of influences.
- 34:04In his thesis,
- 34:05he cited Louis Agassiz,
- 34:07the same Harvard Polygenist,
- 34:08along with deceased European luminaries
- 34:10and comparative anatomists like Georges.
- 34:13Duvier and Petrus camper.
- 34:15Camper invented a method for
- 34:18measuring facial angles.
- 34:19Education expanded Mcdowell's
- 34:21worldview and social network.
- 34:23Comprised of half Southern students,
- 34:26schools like the University of
- 34:28Pennsylvania brought together white male
- 34:30youth from across the Mason Dixon Line.
- 34:32Together,
- 34:33these students extended their
- 34:35knowledge beyond the parochial racism
- 34:37of southern plantations and instead
- 34:39embraced a cosmopolitan racial
- 34:41science that was being disseminated.
- 34:43From cities around the Atlantic world.
- 34:46In short,
- 34:47students learned about anatomical
- 34:49racial difference 1st through textbooks,
- 34:52then through lectures that promoted
- 34:54something akin to active learning,
- 34:56and finally,
- 34:56some students wrote about racial
- 34:58difference in their senior theses.
- 35:02Unsurprisingly, Polygenesis ideas were
- 35:04rife with internal contradictions.
- 35:07Frederick Douglass pointed out many
- 35:08of these shortcomings in a speech
- 35:10at Western Reserve College in 1854.
- 35:13For example, pioneering cranial ologist and
- 35:16anatomy professor Samuel Morton routinely
- 35:19fetishized Egyptians as the progenitors
- 35:21of so-called Western civilization.
- 35:23As Douglas noted, though,
- 35:25about Morton's descriptions of Egyptians.
- 35:28They would have been considered black
- 35:29and unsavable on Morton's own terms.
- 35:32Douglas asserted a man in our
- 35:34day with brown complexion,
- 35:35and here he's quoting Morton's
- 35:37nose rounded and wide lips thick,
- 35:40hair black and curly.
- 35:41And back to Douglas would, I think,
- 35:44have no difficulty in getting
- 35:45himself recognized as a *****.
- 35:50Sadly, a bloody civil war and the triumph of
- 35:54emancipation did not lead to the abolition
- 35:56of racist medical school curricula.
- 35:59In his 1874 thesis at the
- 36:01University of Pennsylvania,
- 36:02Student and Philadelphia native
- 36:05Hollingsworth Neal wrote about the
- 36:07anatomical peculiarities of black people.
- 36:10While the nation had abolished slavery
- 36:12and Darwinists had mostly usurped
- 36:14polygenists and scientific circles,
- 36:17Neil's thesis closely resembled
- 36:19antebellum theses on racial anatomy.
- 36:22In familiar fashion,
- 36:23he argued that black people had
- 36:25longer forearms and narrower pelvises.
- 36:27Neal cited his experiences dissecting
- 36:29black people's bodies and measuring
- 36:32their skulls as a basis for his
- 36:34assertions of white superiority.
- 36:35He explained the frontal bones of the skull,
- 36:38besides having a smaller cranial
- 36:40capacity and a receding direction,
- 36:42have also larger supraorbital protuberances,
- 36:46very suggestive of the formation
- 36:48in the gorilla.
- 36:49While historians have treated the
- 36:51civil War as a significant turning
- 36:53point in the history of medicine.
- 36:54Neal illustrated that in terms of
- 36:57racial anatomy. Not enough had changed.
- 37:03These are just a few examples from my book,
- 37:05which illustrates how early American
- 37:07Medical schools helped enshrine the use
- 37:09of racial categories and medical practice.
- 37:12A focus on institutional racism allows us
- 37:14to unpack how these ideas persisted well
- 37:17after the deaths of their original authors.
- 37:21Ivy League anatomy faculty like
- 37:23Holmes and Lydy taught for more years
- 37:26after the Civil War than before.
- 37:28Moreover, we know that the Darwinian
- 37:30revolution did not change the way they
- 37:33described racial and anatomical differences.
- 37:35It's worth noting that Lady was one
- 37:36of the first American converts,
- 37:38prominent American converts to
- 37:40Darwinian evolution.
- 37:41Thus Polygenesis lived on,
- 37:43and how physicians were trained
- 37:44to see black people's bodies as
- 37:47anatomically distinct,
- 37:48even as they believed natural selection,
- 37:50not God,
- 37:51was responsible for these differences.
- 37:54Likewise,
- 37:54in the wake of this new racial medicine,
- 37:57physicians could claim that it
- 37:59was black people's bodies.
- 38:01Not their poor treatment on plantations
- 38:03or poverty in the north that cause
- 38:06them to have disparate health outcomes.
- 38:09In short,
- 38:10in Masters of Health,
- 38:11I argued that this institutionalization
- 38:13of racial thought in early America
- 38:16has helped justify the persistence
- 38:18of health disparities across profound
- 38:20ideological and political changes in U.S.
- 38:22history.
- 38:23During their earliest attempts
- 38:25at professionalization,
- 38:27medical faculty created and disseminated
- 38:29racial theories that claimed biological,
- 38:32not social,
- 38:33determinants or responsible
- 38:35for health disparities.
- 38:37Thank you so much,
- 38:37and I look forward to the discussion.
- 38:59OK, everyone hear me. Well,
- 39:03thank you for this talk, Chris,
- 39:05and the impressive book that it's based on.
- 39:07I know I'm going to be coming back to this
- 39:09one many times about the following years.
- 39:12So as John mentioned,
- 39:13I'm one of the postdoctoral researchers
- 39:15for the Y Simon Slavery project.
- 39:18And so tonight what I want to do is consider
- 39:20how Chris's narrative can be applied
- 39:22to the history of Yale Medical School.
- 39:25To do that, I want us to think about
- 39:27how racial science may have shaped
- 39:29the materiality of medical education,
- 39:31especially the process of acquiring.
- 39:33Bodies for dissection and whose
- 39:34bodies were used in dissection.
- 39:37This is something Chris details
- 39:38extensively in his book,
- 39:39and it's also something that we're
- 39:40learning more about in our research.
- 39:43So one example of this
- 39:44comes from a letter that one Yale
- 39:46medical student sent to another Yale
- 39:48medical student in the winter of 1836.
- 39:51Now for the non historians in the audience,
- 39:53it is really important that this
- 39:55source is personal correspondence,
- 39:56which was actually one of the most private
- 39:58forms of writing in the 19th century,
- 40:00even more private than Diaries
- 40:02which were sometimes shared in
- 40:04social circles and published.
- 40:06And this correspondence was
- 40:07also between two close friends,
- 40:09so they talked about things
- 40:10that they definitely would not
- 40:11talk about in other settings,
- 40:13including, it seems,
- 40:15a clandestine incident of body snatching.
- 40:18The author of the letter recounts
- 40:19how he and several other medical
- 40:20students stole the body of a black
- 40:22sailor who had been stabbed a few
- 40:24days prior and had died that morning.
- 40:27The student doesn't give this man a
- 40:29name or seem to know who stabbed him.
- 40:31There is no indication of how
- 40:34the medical students found
- 40:33out about this man's death, but
- 40:35it is clear that once they did,
- 40:36they acted fast.
- 40:37The student explains that they
- 40:39carried the body to the college
- 40:40against the consent of what he
- 40:42calls a number of the lower
- 40:43orders of society. Who
- 40:45saw what the students were doing,
- 40:47objected to it immediately,
- 40:48and then followed them back to the college.
- 40:51This rabble, again using
- 40:53the medical students words,
- 40:54may have been the Saylor's friends,
- 40:57his community in New Haven,
- 40:59or perhaps just bystanders who are
- 41:00abhorred by what they were seeing.
- 41:03We don't know for sure,
- 41:04but we do know that there were
- 41:05witnesses and they were angry,
- 41:06to say the very least.
- 41:09The student goes on to describe what
- 41:10they did with this man's body once
- 41:12they got back to the medical school.
- 41:13He writes that quote.
- 41:14We carried him into the cellar of the
- 41:17college and threw a rope around him.
- 41:18The mob,
- 41:19seeing this with no small degree of anxiety,
- 41:21inquired why that was done.
- 41:23The answer they got was only to
- 41:25prevent him from getting away.
- 41:26End Quote.
- 41:28The rope he's talking about was
- 41:29part of a suspension system that
- 41:31was used to hoist the body,
- 41:33the body of the sailor from the
- 41:35cellar up into the anatomical
- 41:37room directly above it.
- 41:38Again,
- 41:38this was all done in front of onlookers.
- 41:41The medical student explains that once
- 41:42the sailor's body was hoisted up, he was,
- 41:44quote, safe and out of their reach.
- 41:46And that day he lay on
- 41:48the demonstration table.
- 41:49The rabble left the college
- 41:50with murmurings of threats
- 41:51and blasphemy and quote.
- 41:54So the student
- 41:55admits that this whole incident
- 41:57may have caused a bigger fuss.
- 41:59But he says that because the sailor
- 42:00had no relation to the college,
- 42:02they were able to get away with it
- 42:04and eventually complete a dissection.
- 42:06He says that this man's body was,
- 42:08quote one of the best subjects
- 42:09to ever lay on the anatomical
- 42:11table in this institution. Quote.
- 42:13And it turns out this sailor's
- 42:15body was just one of several being
- 42:17held at the college that winter.
- 42:18The medical student ends the
- 42:20letter by telling his friend that
- 42:21there are five subjects currently
- 42:23laying in the dissecting room,
- 42:24but students and faculty had not experienced,
- 42:26quote, any inconvenience for
- 42:28the security of those subjects.
- 42:29UN quote.
- 42:32So.
- 42:34What strikes me,
- 42:35I guess 1st about this letter is the
- 42:37casual tone of such a violent act.
- 42:39And the second thing is it made me
- 42:42think of Chris's analysis of the
- 42:44Racial Critical Clinical detachment
- 42:46that physicians developed through
- 42:48teaching and learning and practicing
- 42:50racial silence for a racial science.
- 42:52More specifically,
- 42:53I think this episode captures how that
- 42:55gaze shaped and was shaped by the social
- 42:58and cultural dimensions of dissection.
- 43:01Here we have what seems to be an
- 43:03opportunistic theft of a sailor's body.
- 43:05We know that a sailor would have been
- 43:07someone who was lower socioeconomic status,
- 43:10definitely more so than medical students,
- 43:12in addition to being a black person.
- 43:15And we also see an immediate
- 43:16reaction from the community,
- 43:17similar to the communities that
- 43:19Chris actually identified in his
- 43:20book in New York and Philadelphia,
- 43:22who did resist this kind
- 43:23of medical exploitation?
- 43:27And finally, we have a description of body
- 43:29capture and display that I think perfectly
- 43:31encapsulates what Chris calls the white
- 43:34supremacist spectacle of medical education
- 43:36and anatomical education specifically.
- 43:39Not only is a black man's body literally
- 43:41strung up in the medical school in front of a
- 43:43public audience and against their protests,
- 43:45but the student writing this letter
- 43:47clearly believes that he and other
- 43:48medical students had a right to do this.
- 43:50He views the witnesses as
- 43:52little more than annoyance,
- 43:53whom he only acknowledges to make sure
- 43:55that they're staying away from the body.
- 43:57He also says that the people
- 43:59who complain about the theft of
- 44:01bodies are just inconveniences.
- 44:02Basically,
- 44:02he displays no inclination to consider
- 44:05the humanity of his so-called subjects.
- 44:07This man included the sailor,
- 44:10just what they can do for them,
- 44:11him as a white medical student.
- 44:14So I'll
- 44:15leave it there. Look forward to hearing
- 44:16what my fellow commentators will say.
- 44:24Good evening everyone. Umm, like Lianna,
- 44:28I'm one of the researchers looking at
- 44:31the Yale schools and School of Medicines
- 44:35Historical connections with slavery.
- 44:39And I want to similarly
- 44:41situate what we're looking at
- 44:43in terms of Chris's research.
- 44:46And I've known Chris actually
- 44:47for quite a few years now,
- 44:49I think probably about 7:00.
- 44:51And I have to say
- 44:53as much as we've talked, we've
- 44:54had dozens of conversations about his work,
- 44:56my work, other things in the
- 44:57history of slavery, medicine.
- 44:58I was really excited to read this book,
- 45:00and even more excited when I realized
- 45:03how much there was for me to learn,
- 45:05even despite all of our
- 45:07conversations over all these years.
- 45:11And. Among other things I think Chris's
- 45:15book does really well is it shows
- 45:17the international and interregional
- 45:20connections within the United States of
- 45:24medical practice the way that a lot of us,
- 45:28his medical professors and other
- 45:30writers are consciously thinking about
- 45:33international forms of medical education,
- 45:37especially what sort of the French
- 45:39models which were at in this
- 45:41period in the 19th century like.
- 45:43Three models of medical education.
- 45:48And I also have to say like his
- 45:51his use of MD theses may seem.
- 45:53Obvious it may be like, ohh, yeah,
- 45:55he's reading this document that exists,
- 45:57and of course they exist.
- 45:58But what's really smart about his use
- 46:00of theses is that it's showing not
- 46:03just that an idea was transmitted,
- 46:04but that it was picked up and repeated,
- 46:07right? And a lot of times when
- 46:09we do intellectual history,
- 46:10it's really easy to demonstrate
- 46:11that somebody wrote an idea.
- 46:13It's really hard to see who read it,
- 46:16who repeated it, and who thought about it.
- 46:18And so by by doing this model,
- 46:21he's or he's analyzing both medical lectures.
- 46:24As well as textbooks and then comparing
- 46:26how that comes out in the MD theses.
- 46:29It really does a good job of
- 46:31showing what people are learning
- 46:33in this medical education.
- 46:36And so. A lot of
- 46:38what I've done during my time here
- 46:40at Yale is to look at a lot of
- 46:43these sources that Chris mentioned,
- 46:44to look at the lecture notes we have
- 46:47from students and medical professors
- 46:49about what was actually being taught.
- 46:53And then also again to look at the MD
- 46:56Theses that students wrote to see,
- 46:58you know, again like Chris is doing
- 47:01sort of what they learned. And.
- 47:05I'm going to focus a little bit
- 47:06on the differences between what
- 47:07I've seen here at Yale compared
- 47:09to to what Chris has identified.
- 47:11But I would say in general it's
- 47:12in the same ballpark, right?
- 47:14Yo, was not a school that
- 47:16that Chris really examined.
- 47:17But you see a lot of the same patterns.
- 47:20What I mean by that is in the medical
- 47:25lectures. There are repeated.
- 47:28But very sparse mentioned about race,
- 47:32about diseases being connected
- 47:35with different populations,
- 47:37especially in hot climates,
- 47:40which is basically a euphemism
- 47:41for places that have slavery.
- 47:45Umm. And. And it it what's striking is
- 47:50that this shows up in in virtually.
- 47:54Every set of lecture notes for
- 47:56a professor at some point.
- 47:58But these kinds of references are often
- 48:00mentioned with all with almost no
- 48:02supporting evidence, which to me says.
- 48:05These are such widely held ideas and beliefs
- 48:08that they don't really have to be proven,
- 48:09they just have to be mentioned.
- 48:12And then, you know, the medical student,
- 48:13the audience sort of knows what that means.
- 48:18And also say that.
- 48:21A lot of Chris's focus is on
- 48:23the anatomy lectures right,
- 48:24because these these are the areas
- 48:26where you can really see racial
- 48:28science and and it's traditionally
- 48:30been located in terms of the
- 48:32measurements of facial angles.
- 48:34So Chris mentioned or bones,
- 48:36things like that.
- 48:38But it's also striking to me in the in this,
- 48:42in this way, that I've described how
- 48:43how these racial ideas just pop up.
- 48:46In fields you wouldn't expect,
- 48:48and I would say probably the most
- 48:51distinct example of that that I
- 48:53saw reading lectures here at the
- 48:55university was in a lecture that
- 48:58was essentially about chemistry.
- 49:00Not bodies,
- 49:01and in fact this lecture was about color
- 49:04and the way that color and heat connect.
- 49:07Particularly the idea that if you leave
- 49:08something of a darker color out in the sun,
- 49:10it gets hotter. And.
- 49:14Near the end of this lecture,
- 49:16there's sort of a set of
- 49:17rhetorical questions about look,
- 49:18doesn't this explain all these little things?
- 49:20And one of them is why
- 49:25people described as *****.
- 49:28That their darker skin allows them to
- 49:30work better in these hot climates, right?
- 49:32And this isn't a lecture.
- 49:33Again, it's chemistry.
- 49:34It's about color.
- 49:36It's in theory,
- 49:36not about bodies at all.
- 49:37And yet there's this one rhetorical
- 49:39question thrown in a list of about 5 or 10.
- 49:42That references race and
- 49:44the importance of color.
- 49:45And that obliquely references slavery,
- 49:48right?
- 49:48And this idea that you need people
- 49:51from Africa to work in places like
- 49:53the American S because effectively
- 49:55white people can't do that.
- 49:56And this is a widely held idea at this time.
- 50:02And also say this is something
- 50:03we haven't done yet, but but that
- 50:05Chris's book is directly inspiring
- 50:07is we need to do the research to
- 50:09look at what textbooks are being
- 50:11shared at Yale and what whether or
- 50:13not they have racial ideas as well.
- 50:15And we have lists of textbooks,
- 50:16but we haven't actually opened them up yet,
- 50:18and I tracked them down.
- 50:20The first thing I'm definitely
- 50:21going to do is look at Chris's
- 50:22footnotes and see which
- 50:23of these books he's already identified.
- 50:27Um. And since I think I've
- 50:29probably used most of my time,
- 50:30I I will say one other thing that I
- 50:34found really great about Chris's book
- 50:35and also his presentation that we've
- 50:37also have a sense of here at Yale and
- 50:41that is students are traveling well
- 50:43most well most of this medical students
- 50:46are relatively local from Connecticut.
- 50:51Sort of Northeastern New York,
- 50:53you know, Western Massachusetts,
- 50:55Long Island, even.
- 50:57There are also significant clusters
- 51:00of medical students coming from
- 51:02the US S places like Mississippi.
- 51:05But also West Indian Islands and even
- 51:08Brazil that we don't know why they
- 51:10would choose necessarily to come to
- 51:13Connecticut for medical education.
- 51:15But it definitely suggests that these
- 51:18these people coming from deep slave
- 51:22societies whose medical education
- 51:23is almost certainly being funded
- 51:25by their connection to slavery,
- 51:27are coming to places like Connecticut,
- 51:29really shows this, this, this network,
- 51:32this international network of
- 51:33students and medical knowledge that
- 51:35I think is crucial to Chris.
- 51:37So I'll stop there.
- 51:38Thank you.
- 51:42Hi everyone. My name is Tina.
- 51:44I'm a medical student.
- 51:46Can you guys hear me OK? Fantastic.
- 51:48So I should start by saying
- 51:50that I am not a historian of
- 51:53slavery or of medical education.
- 51:55So when I was asked to be on this panel,
- 51:58I assumed that I was asked to
- 51:59be on the panel because I'm
- 52:00currently a Med student,
- 52:01so I can speak to the legacy of
- 52:04slavery and biological racism in
- 52:06the Med school curriculum today.
- 52:10So I was struggling to figure
- 52:13out of the many experiences I've
- 52:16had and the stories I've heard,
- 52:18what can I share in 5 minutes?
- 52:21So I'm going to give you a couple
- 52:23of anecdotes and then I'm going
- 52:25to touch on an anatomy class
- 52:26in cadavers or as we call them,
- 52:28donors and because that's something that
- 52:31Chris talks about in depth in his book.
- 52:35So my first anecdote has to do
- 52:37with a lecture that was one of
- 52:39the last lectures we had in 2020
- 52:40before the COVID pandemic.
- 52:42So it was in person,
- 52:43and it was a lecture given by a premier
- 52:47pulmonologist at the school who was,
- 52:49and who undoubtedly went on to be part of
- 52:51the Yale response to the COVID-19 pandemic.
- 52:56Long story short,
- 52:57she said that on average,
- 52:59black people have smaller lungs and
- 53:02smaller lung capacity than white people.
- 53:05After class,
- 53:05I walked up to her at the podium.
- 53:09I'm kind of distraught.
- 53:11And I said,
- 53:12I mean if the data actually
- 53:14bears this out that black people
- 53:17have similar lung capacity.
- 53:19How do we know that there isn't
- 53:21some sort of confounding factor
- 53:23like some other meddling factor?
- 53:26For example,
- 53:27maybe because of segregation and
- 53:30housing in the United States,
- 53:32black people live in places
- 53:34with pollution and so it affects
- 53:37their lung health.
- 53:38If that's true,
- 53:39wouldn't that mean that we are
- 53:41missing people who are sick
- 53:43and need treatment from us?
- 53:44And isn't that bad?
- 53:46And she said that would be
- 53:47terrible if it were true.
- 53:49But um,
- 53:50our understanding is black people
- 53:54do better at a certain lung
- 53:58capacity than white people do.
- 54:00So basically they're fine with
- 54:02the smaller lung capacity.
- 54:04Umm.
- 54:05Needless to say,
- 54:06after doing some of my own research later on,
- 54:09I found that there's very
- 54:11there's no evidence for that.
- 54:13There's no good evidence for any of the
- 54:15claims that she made in front of class.
- 54:18And was so interesting to hear
- 54:19my colleagues say that a lot of
- 54:21these claims are made to these Med
- 54:22students without much elaboration,
- 54:24because that's my experience
- 54:25in 2019 up until now.
- 54:27The claims are made with no
- 54:30elaboration unless you ask for it,
- 54:32and even then not a lot of
- 54:34good data is presented.
- 54:36A lot of these.
- 54:38A lot of these studies that people
- 54:41cite in making these claims
- 54:42are review articles of review
- 54:44articles of review articles of
- 54:46studies that were done in the
- 54:48late 1800s or the early 1900s.
- 54:53With very small sample sizes and
- 54:55we're simply just not rigorous,
- 54:57but you'll find them in current resources
- 54:59for doctors and medical students today,
- 55:02including up to date,
- 55:04which is basically Google.
- 55:05For doctors,
- 55:06it's supposed to be evidence based.
- 55:11So. I've got an another anecdote from
- 55:15my time doing a rotation on the wards.
- 55:18So I was doing an anesthesia rotation
- 55:21and it was my day in OB GYN anesthesia.
- 55:25So basically anesthesia
- 55:27for people giving birth.
- 55:28I was super excited about it and I was
- 55:31working with a black female resident
- 55:33and she was the only black resident
- 55:35that I met on my anesthesia rotation
- 55:38on the entire time and we were working
- 55:40with a older white attending attending.
- 55:43The doctor in charge.
- 55:46And he told us that based on
- 55:47his own anecdotal evidence,
- 55:49working with hundreds of patients,
- 55:51he believed that black people's
- 55:53spines were deeper in their backs
- 55:56than white peoples or Asian peoples.
- 55:59Um, and this is relevant because when
- 56:01you're installing an epidural to give
- 56:03anesthesia for someone giving birth,
- 56:05you have to hit a particular spot in
- 56:08their back to make sure you're delivering
- 56:10the anesthesia to the right place?
- 56:13So he told this to the resident,
- 56:15and to my astonishment,
- 56:17it seemed like she believed it.
- 56:20And eventually we went in to see
- 56:23an Asian American patient who
- 56:25was really gracious in letting us
- 56:27work with her as trainees.
- 56:32And it was the residents
- 56:33turn to do the epidural.
- 56:35I think she'd done one or two before,
- 56:37and so she attempted.
- 56:38She gave it maybe two or three
- 56:41tries and she did not succeed.
- 56:42And the attending had to step
- 56:44in and place the epidural.
- 56:45So it took something that should
- 56:47have taken maybe 10 minutes,
- 56:49ended up taking around 30.
- 56:51I'm sure that was uncomfortable for her,
- 56:54and I'll never forget what the resident
- 56:55said as we were leaving the room,
- 56:57which was her spine was deeper
- 56:58in her back than I expected.
- 57:04Lastly, I'm going to talk about the cadavers
- 57:06that we use for anatomy class at Yale.
- 57:09We refer to them as donors,
- 57:12and that comes from the idea that they
- 57:15willingly donated their bodies for us to
- 57:17use in class before we start anatomy class.
- 57:21They give us a short presentation
- 57:23that is kind of anonymized,
- 57:25but it tells us a little bit about the people
- 57:29who donated their bodies for us to use.
- 57:32It gives us a I think the age that they
- 57:35were when they died and their occupation
- 57:37and I think their gender as well.
- 57:40A lot of them were homemakers
- 57:42or a white collar workers.
- 57:44And when I got to class I discovered
- 57:47that virtually all of the donors
- 57:49were white except for one.
- 57:51And this was in 2020 when I
- 57:53was taking this anatomy class.
- 57:57And I thought. Maybe it's a good thing
- 58:01that most of the donors are white,
- 58:04based on the history that I've heard here,
- 58:07based on the history.
- 58:08That I learned from Doctor Warner
- 58:10and his history of medicine.
- 58:12Lectures about body snatchers,
- 58:14people using the bodies of
- 58:18enslaved people for anatomy,
- 58:20hanging them up in a by a rope like a noose.
- 58:26I don't. Even to this day,
- 58:27I don't think I would donate my body
- 58:29to be used in an anatomy class.
- 58:31I I am an organ donor,
- 58:33but I don't think I would
- 58:34give it up for that purpose.
- 58:36And this is only tangentially related.
- 58:38But I'll it was kind of chilling for
- 58:40me to hear the students who were
- 58:43working on that particular donors
- 58:44body complain about the amount of fat
- 58:46tissue they had to cut through to get
- 58:49to the thorax and to look at the lungs.
- 58:52I was like even in death,
- 58:54you can't fit the beauty standard.
- 58:56Umm. So that was really tough.
- 58:58I think I might have gone over my time and
- 59:00there's so much more I could have said,
- 59:02but I hope everyone asks
- 59:04whatever questions they have.
- 59:08Thank you so much to each of you for.
- 59:14I think. Can you hear me?
- 59:16Yeah. Thank you so much for.
- 59:19All of these reflect and.
- 59:22You know one of the things
- 59:25I would love to do.
- 59:27Because of this material.
- 59:28Hearing about this history.
- 59:34It's difficult to see the connection.
- 59:38So clearly and so strongly.
- 59:41And the impact of that house on
- 59:44current medications and all the people
- 59:46doing this saying that this thing
- 59:48sounds fun with all of these sports.
- 59:50The real cost to that kind of work,
- 59:53and there's kind of emotional labor
- 59:55that goes into the right space.
- 59:59And So what I'd like to do
- 01:00:02is to is to stay with China.
- 01:00:05And I would love to hear
- 01:00:09you speak about you develop.
- 01:00:12To oh, is this better? Oh, OK. Is this on?
- 01:00:18Yes OK do I need to repeat anything? Umm.
- 01:00:25Any ideas? OK, wonderful.
- 01:00:29And So what? I want to start with
- 01:00:32Genia because you have worked to
- 01:00:35create a different kind of curricula.
- 01:00:38That takes on biological racism that
- 01:00:40is mandatory in the medical school for
- 01:00:44the for the first years, I believe.
- 01:00:46I'd love to hear you speak about that.
- 01:00:49And I love also for for Chris and
- 01:00:52Leanna and Sean to reflect on what you
- 01:00:55describe about the changes that you're
- 01:00:58making in terms of how medicine is
- 01:01:01being taught and connect that with the
- 01:01:04histories that you've been studying,
- 01:01:06what kinds of shifts.
- 01:01:08Are you hearing from China when
- 01:01:10she is talking about this?
- 01:01:12What are the points of reference
- 01:01:14that you feel are most important
- 01:01:16for us to amplify when we think
- 01:01:19about how to undo this history?
- 01:01:23OK, as I said before,
- 01:01:24there's a ton I could say.
- 01:01:26I'll start by talking about the
- 01:01:29intervention this educational session
- 01:01:30that me and some of my friends made.
- 01:01:33So my friends and classmates,
- 01:01:35Muz autumn and Ln,
- 01:01:37they are African American students, as I am.
- 01:01:40After the death of George Floyd in 2020
- 01:01:43and sort of the amplification of the
- 01:01:45voice of the Black Lives Matter movement.
- 01:01:47We tried to figure out what we
- 01:01:49could do as Med students in this
- 01:01:52like very prestigious institution.
- 01:01:54And we read a book.
- 01:01:57Gosh, what was it called?
- 01:01:58Fatal inventions. Home.
- 01:02:04Dorothy Roberts, thank you.
- 01:02:05Written by Dorothy Roberts,
- 01:02:07a legal scholar.
- 01:02:08That was about the concept of biological
- 01:02:11race and basically dispelled the idea.
- 01:02:14You know,
- 01:02:15a couple 100 pages explaining to people why.
- 01:02:18People of different races are
- 01:02:21not biologically different,
- 01:02:22and this book came out I
- 01:02:24think in 2019 or 2020,
- 01:02:25so that shows you how pervasive
- 01:02:27these ideas still are.
- 01:02:28Basically,
- 01:02:29we we based a workshop with a lecture
- 01:02:32component from Dorothy Roberts and some
- 01:02:35discussion questions on this book.
- 01:02:37And we convinced faculty in charge
- 01:02:40of the orientation session for
- 01:02:43the first year Med students to.
- 01:02:46To let us include this session.
- 01:02:48And it it took a lot of work
- 01:02:50to convince them,
- 01:02:51but in the end we got it and
- 01:02:53and it was a smashing success.
- 01:02:54A lot of the students enjoyed it.
- 01:02:58I I have a friend and classmate who
- 01:03:00participated in the session a bunch with,
- 01:03:02along with a bunch of other faculty from.
- 01:03:07Or, sorry, graduate students from various
- 01:03:10departments in the humanities at Yale
- 01:03:12who are assisted us in this session.
- 01:03:14So it was a team effort. And.
- 01:03:20Yeah, it was great and I hope that
- 01:03:22we were able to convince people
- 01:03:24that biological race is not real.
- 01:03:26We thought it would be the best to
- 01:03:28have this session at the beginning
- 01:03:30of the first year because we knew
- 01:03:32that they would encounter these
- 01:03:35concepts of biological racism,
- 01:03:37these racist concepts,
- 01:03:38in lectures because we had as first years.
- 01:03:44So we thought this was probably the
- 01:03:48most effective thing we could do.
- 01:03:50So could you say a little bit about how
- 01:03:54sort of how the teaching progressed?
- 01:03:56You were doing the reading,
- 01:03:58the the reading of fatal and invention
- 01:04:01and there were, were there small group
- 01:04:03discussions sort of pedagogically,
- 01:04:05how did you approach it?
- 01:04:06And I'm thinking about this just
- 01:04:09because of the wonderful sort of
- 01:04:11like pedagogical sort of insight
- 01:04:13that we've gotten so far on the
- 01:04:15panel about how they're teaching
- 01:04:18these racist sorts of information.
- 01:04:20The visuals, the, the repetition,
- 01:04:23the the kind of the utter,
- 01:04:26the iterative nature of this knowledge
- 01:04:28being repeated over and over again.
- 01:04:31And so I'm wondering from you as
- 01:04:33you think about the pedagogy of
- 01:04:36what it was that that you know,
- 01:04:38came out of this.
- 01:04:42What do you think in
- 01:04:44terms of how that course?
- 01:04:48Can do the work of combating.
- 01:04:52I don't know a couple of years
- 01:04:54of lectures for example.
- 01:04:55And do you have ideas about?
- 01:04:58How to sort of bring that forward in in
- 01:05:02medical education past just the first year?
- 01:05:05And you also reflected on
- 01:05:07it in a piece of writing.
- 01:05:08And so any of those,
- 01:05:10any of those sorts of things
- 01:05:11that you want to sort of do to
- 01:05:13fill fill this in for us as well.
- 01:05:15Be wonderful, right.
- 01:05:18So pedagogically,
- 01:05:20he started with objectives, right.
- 01:05:23And that's something that we've seen
- 01:05:24modeled by a lot of our faculty.
- 01:05:26You start by what you want people
- 01:05:28to understand and be able to do and
- 01:05:30then you work backwards from there.
- 01:05:32So we thought we want people to
- 01:05:34understand first of all that.
- 01:05:37Races are not biologically different.
- 01:05:39That's a social construct.
- 01:05:40That's something that we wanted
- 01:05:42people to understand and something we
- 01:05:44knew that a lot of medical students
- 01:05:46and faculty did not understand.
- 01:05:49And then we also wanted to teach
- 01:05:52people strategies to be able to
- 01:05:54confront these notions as they
- 01:05:55encountered them in class and on the
- 01:05:57wards when they were seeing patients.
- 01:06:02So from there, so in order to address
- 01:06:05the first objective of teaching
- 01:06:07them biological race is not real,
- 01:06:10we had the lecture component from the author
- 01:06:12of the book and then the workshops were.
- 01:06:17Well, one aspect of it was book
- 01:06:20discussion questions to sort of drive
- 01:06:22that point home and to address maybe
- 01:06:25counter arguments that people would give,
- 01:06:27counter arguments that we anticipated and
- 01:06:30then the other section was real scenarios
- 01:06:33based on what we had encountered in lecture.
- 01:06:38Are basically like, you know,
- 01:06:40a a faculty member says this racist thing,
- 01:06:43what do you do?
- 01:06:45Um, so the section leaders,
- 01:06:48which were upper year medical students
- 01:06:52and also humanities grad students.
- 01:06:55Talked students through these scenarios and
- 01:06:57helped them figure out what they would do.
- 01:06:59And then later in our
- 01:07:01evaluation we asked students,
- 01:07:02did they feel like they are more
- 01:07:05effective at completing the goals that
- 01:07:07we set out after we did the session.
- 01:07:11And generally,
- 01:07:12people did feel a little more
- 01:07:14confident and a little stronger.
- 01:07:15We saw something that we already knew,
- 01:07:17which is it's tough to push
- 01:07:20back against superiors.
- 01:07:21Medicine is really hierarchical,
- 01:07:23right?
- 01:07:23So it's tough to confront a faculty member
- 01:07:25that's supposed to be teaching you.
- 01:07:29Thank you so much. That's wonderful.
- 01:07:32And so I'd like to turn now to to
- 01:07:34Chris and to hear you reflect on
- 01:07:37putting your book in conversation
- 01:07:38with what China has described in
- 01:07:41terms of this medical curriculum.
- 01:07:44Well, first I just want to say thank you.
- 01:07:47The, the anecdote you just gave is the
- 01:07:49kind of thing that took, you know,
- 01:07:52the book is made-up of finding these
- 01:07:54small moments that people don't say in
- 01:07:57public and people ask me all the time.
- 01:08:00What do they do in medical schools?
- 01:08:03I wish I knew so, but I know that these
- 01:08:07ideas don't appear out of nowhere.
- 01:08:09So one thing I've I've been
- 01:08:11thinking and a collaborator,
- 01:08:13and I've been trying to work on
- 01:08:15an article about the need for more
- 01:08:17history of medical racism education,
- 01:08:19and I wonder what that faculty
- 01:08:21member would have thought.
- 01:08:23If they knew that the biggest
- 01:08:25popularizer of the idea of smaller
- 01:08:27lung capacity was Samuel Cartwright,
- 01:08:29the inventor of the theory,
- 01:08:31or the disease, you know,
- 01:08:33say inventor of disease called drapetomania,
- 01:08:36which was a disease that supposedly
- 01:08:37caused enslaved people to run away.
- 01:08:41I would like to think.
- 01:08:43I don't know, I still have some faith
- 01:08:45in humanity after writing this book
- 01:08:48that that would give someone pause.
- 01:08:50But yeah, I think one of
- 01:08:52the biggest things it's.
- 01:08:53Just stunning is.
- 01:08:54That this is happening on a
- 01:08:57day-to-day basis still in the
- 01:08:59medical school and how how we get.
- 01:09:02I just genuinely think that nobody,
- 01:09:04no modern physician,
- 01:09:06wants to be associated with these
- 01:09:08ideas that they don't see as ideas
- 01:09:10rooted in the plantation and stealing
- 01:09:13bodies from public graveyards and.
- 01:09:18It just wouldn't it be
- 01:09:19amazing if Samuel Cartwright got it right?
- 01:09:21Like, what are you?
- 01:09:22Yeah, sorry, I'm just was floored by that.
- 01:09:24I'm still recovering.
- 01:09:25But I think this what's so profound,
- 01:09:27especially on anatomical differences,
- 01:09:29almost all of these odd
- 01:09:32ideas come from people who.
- 01:09:35Are 19th century Polygenists who?
- 01:09:39Nobody else is citing them
- 01:09:41for and for any context,
- 01:09:42but they just get reproduced, reproduced,
- 01:09:44cited and cited and cited to where you
- 01:09:47think you're citing somebody from 1970,
- 01:09:49but you're really citing
- 01:09:51somebody from 1830 and I think.
- 01:09:54I mean, first,
- 01:09:54I think, you know,
- 01:09:55we all owe you a round of
- 01:09:57applause for doing that.
- 01:10:02It's the kind of work I would I've
- 01:10:04always I want to see and I think.
- 01:10:06Adding in addition to Dorothy
- 01:10:08Roberts's profound work,
- 01:10:09and I love how she actually
- 01:10:11includes history in her sociology,
- 01:10:12but yeah, also getting into what?
- 01:10:14Where do these ideas come from?
- 01:10:15They don't emerge out of nowhere.
- 01:10:17They're not.
- 01:10:19They're not 21st century ideas, they are.
- 01:10:22Ideas by people who were bleeding
- 01:10:24people at the same time and
- 01:10:26giving them opium like those
- 01:10:27were the main therapeutics.
- 01:10:29So maybe we can discard one more terrible
- 01:10:32idea from the 18th and 19th century.
- 01:10:37Thank you so much and Leanna.
- 01:10:42So. Discussion. Yes, it was
- 01:10:47what sorry. Yes, it was wonderful. It was
- 01:10:51a wonderful discussion and again I just
- 01:10:52want to say thanks for getting the
- 01:10:54the program off the ground.
- 01:10:57And yes, I think it was wonderful
- 01:10:59to have an opportunity to,
- 01:11:00like Chris said, excavate those.
- 01:11:03The the the long history of these
- 01:11:06ideas and also to have a space
- 01:11:08where people could come in and
- 01:11:10having read the Dorothy Roberts
- 01:11:12book and just talk a little bit,
- 01:11:15do a little bit of self reflection,
- 01:11:16take an assessment of what
- 01:11:18their ideas of race were
- 01:11:20before they read this book.
- 01:11:22Tried to be honest about that, right.
- 01:11:24And also to understand that,
- 01:11:25you know, we're all there,
- 01:11:26we're all there really to grow from that,
- 01:11:28whatever it was that the
- 01:11:30baseline was coming in.
- 01:11:31And I really appreciated
- 01:11:32too how I mean one of the.
- 01:11:34I'm not sure if it was an objective,
- 01:11:36but one of the things that was made
- 01:11:38extremely clear was there is no upgrade.
- 01:11:42We are not, you know, there is no question
- 01:11:45now anymore about the biological,
- 01:11:50the biological nature of race.
- 01:11:52But just like I I just really
- 01:11:54appreciated that there was no,
- 01:11:56you know, there was no need for me as
- 01:11:58a discussion to even hear someone out
- 01:12:00if they wanted to talk about that.
- 01:12:02I was just, you know, I just had.
- 01:12:05I had the, the backing tube, you know,
- 01:12:08to shut that down if I did hear that.
- 01:12:09And I just think that
- 01:12:11is a huge deficit. That is
- 01:12:12obviously a huge development, right?
- 01:12:14If we're not even questioning these
- 01:12:16things anymore, we're just stating them
- 01:12:18as facts that they are, then I I mean,
- 01:12:21I feel like that is really huge
- 01:12:23because that is of course, I think.
- 01:12:27I mean for for me, approaching the
- 01:12:29history of race and medicine too,
- 01:12:31I there was always something, especially
- 01:12:32before I read Dorothy Roberts book,
- 01:12:34where I would wonder why do scientists
- 01:12:37and doctors keep debating this?
- 01:12:39What is I'm not a, you know, a geneticist.
- 01:12:41Maybe I'm missing something
- 01:12:43way in the details here.
- 01:12:44And then after reading that book,
- 01:12:46I realized, no,
- 01:12:47there is absolutely nothing there.
- 01:12:50And so I just really appreciated the,
- 01:12:53the new path forward that no,
- 01:12:55we're not going to discuss this.
- 01:12:57Anymore we are starting on a on a different
- 01:13:00playing field basically and yeah and.
- 01:13:03And just as I said and just to finish
- 01:13:05I guess as I said I really do think
- 01:13:08that's got to be the first step to.
- 01:13:10Working through this history to addressing
- 01:13:13it in a concrete way as it happened,
- 01:13:16but making sure we're not repeating
- 01:13:17it for the next generation of people of
- 01:13:20doctors. Thank you so much. And Sean?
- 01:13:25Yeah. Let me
- 01:13:26just repeat. I mean,
- 01:13:27it's really exciting to actually.
- 01:13:29Here an example of people like
- 01:13:31actively fighting these ideas in
- 01:13:33this context because, you know,
- 01:13:35a major point I think of all of
- 01:13:36our researchers, historians is
- 01:13:38the way that these ideas persist.
- 01:13:40They persist across all kinds of boundaries.
- 01:13:43They're insidious, they're everywhere.
- 01:13:44And what's so hard about them is they
- 01:13:47often get repeated without like sort
- 01:13:49of a conscience engagement, right.
- 01:13:51And that I think forcing people to
- 01:13:54engage consciously is like probably
- 01:13:56the the main thing we can do to like.
- 01:13:59Change people, right?
- 01:14:02I think it's in the epilogue of
- 01:14:03Christ's book he mentions a study from
- 01:14:05I don't know the 2010 or so about.
- 01:14:08I think it was in Virginia.
- 01:14:09They 162016.
- 01:14:11Yeah.
- 01:14:11So UVA they did a study and they
- 01:14:14they pulled medical students
- 01:14:16about like different kinds of.
- 01:14:18Like racial differences, right?
- 01:14:21And. Medical students.
- 01:14:24Claimed that they believed a
- 01:14:26lot of things that you know.
- 01:14:29It's the best seem outdated.
- 01:14:33But one of the
- 01:14:34things that I, I think has come out of
- 01:14:37follow-ups to that study too is that
- 01:14:39when you educate people and like point
- 01:14:41out that these ideas exist but that
- 01:14:43they're wrong and that they're outdated,
- 01:14:45that people do change.
- 01:14:46And this doesn't just change
- 01:14:48the way people think.
- 01:14:49It actually changes how health outcomes
- 01:14:52and therapeutics right. It changes.
- 01:14:54It tends to level racial disparities
- 01:14:57in prescribing pain medication,
- 01:15:00for instance. And so I.
- 01:15:02I don't think I need to repeat the
- 01:15:04historical stuff because I think
- 01:15:04these two covered it really well.
- 01:15:06But it's it is really exciting
- 01:15:07to see people actively working
- 01:15:09on this in medical school.
- 01:15:10Then it's not just us
- 01:15:13like cursing these people
- 01:15:14in the 19th century.
- 01:15:19Wonderful. I want to pause because
- 01:15:22I looked at the time and I know that
- 01:15:24we want to have questions from the,
- 01:15:27our, our virtual guests and our
- 01:15:29guests in the audience here.
- 01:15:31So is this a good time for us to do that?
- 01:15:34Yeah. OK. So I want to open
- 01:15:38it up here and I think.
- 01:15:41Professor Warner, you are looking at
- 01:15:44the the questions perhaps that are
- 01:15:47coming through virtually as well.
- 01:15:50OK, wonderful. Oh, wonderful, wonderful.
- 01:15:54So I'll open it up here for those
- 01:15:59gathered for us to ask a question
- 01:16:01to any of our panelists.
- 01:16:07Yes.
- 01:16:36Moment.
- 01:16:56I don't know if it would be helpful for me
- 01:16:58to repeat that if the people on zoom and
- 01:17:01and OK so Professor Rogers very helpfully
- 01:17:04asked this question about how do we address.
- 01:17:08These issues at the clinical level,
- 01:17:10what kinds of interventions might be possible
- 01:17:14to do and I'd love to hear from from Eugenia,
- 01:17:18but also from our historians if you
- 01:17:22feel like there is also a role for
- 01:17:25history in those moments as well.
- 01:17:28And so can we start with you China?
- 01:17:31Yes, so. You all will be happy to
- 01:17:34know that it's not just me and my
- 01:17:36friends working on this, right?
- 01:17:38There's a network of mostly trainees,
- 01:17:41so medical students and residents
- 01:17:42around the country who've been
- 01:17:44trying to address this issue,
- 01:17:46and some of the work that
- 01:17:48they've been doing includes.
- 01:17:49There's there's some algorithms
- 01:17:53that are built in to our computer
- 01:17:57software and everything that we use
- 01:17:59to to help us make clinical decisions
- 01:18:01that actually include race as one of
- 01:18:04the factors in their calculations.
- 01:18:06And all that sounds wild,
- 01:18:07but it shows up in a lot of places
- 01:18:09in medicine.
- 01:18:10One example is EGFR,
- 01:18:12which is a measure of how well your
- 01:18:15kidneys are working that actually
- 01:18:17includes a variable for race.
- 01:18:19And so that's something that Dorothy
- 01:18:21Roberts addresses in her book and
- 01:18:24something that as students and
- 01:18:25residents around the country have
- 01:18:27been trying to get changed and taken
- 01:18:29out of the algorithm and they've
- 01:18:32been successful at a lot of places.
- 01:18:35I wish I was more up to date on this,
- 01:18:36but I know they're in the process
- 01:18:38of doing it here and they might
- 01:18:39have already succeeded.
- 01:18:40So that's very exciting.
- 01:18:41There are other examples of that that we also
- 01:18:44discussed in the workshop that we developed,
- 01:18:45for example.
- 01:18:48Women or people who are giving birth,
- 01:18:53you're making the decision whether
- 01:18:55to let them attempt a vaginal
- 01:18:57birth or do a C-section.
- 01:18:59There are a lot of things that
- 01:19:00factor into that decision,
- 01:19:01and there's actually like
- 01:19:03an equation that we use.
- 01:19:05And that equation I think still
- 01:19:07includes race as a factor.
- 01:19:10So if someone is black or Hispanic,
- 01:19:12you are less likely to let them
- 01:19:14proceed and try a vaginal birth.
- 01:19:17And we know that vaginal births.
- 01:19:18Healthier in a lot of ways the
- 01:19:22the recovery is shorter.
- 01:19:24So.
- 01:19:25That's happening in 2022,
- 01:19:28but that's another thing that
- 01:19:29people are trying to change.
- 01:19:32Thank you so much, Cheney and Chris,
- 01:19:35would you like to would you
- 01:19:37like to give some thoughts?
- 01:19:39Well, I think one of the things that I I
- 01:19:41found in my book and where I end is that.
- 01:19:44Kind of tend to
- 01:19:46think that like everybody's at the same
- 01:19:48place at but faculty live for a long time.
- 01:19:52I don't know what to say
- 01:19:53about that, but they they seem to
- 01:19:55and the standards of education,
- 01:19:57the standards of knowledge are
- 01:19:59different when they're teaching from
- 01:20:01when when they when they learned it.
- 01:20:04So I think. Actually having some required
- 01:20:07training for anybody who's teaching
- 01:20:09medical students would be fantastic.
- 01:20:12And then you also have a standard
- 01:20:14to hold them to as if like it's
- 01:20:16very hard as people point out,
- 01:20:18there's a hierarchy, hierarchy in history.
- 01:20:20Also we don't like to go around correcting
- 01:20:23people who might control our job in future.
- 01:20:26So I think, I think having an actual built
- 01:20:29in system to make sure that you know,
- 01:20:32nobody comes in and says all
- 01:20:34black people's lungs are smaller.
- 01:20:36And that if they do that,
- 01:20:38that person has to then be,
- 01:20:39I'm not going to say we take
- 01:20:41them off to the gulag,
- 01:20:42but they have to have some sort of
- 01:20:44discussion and it should be also
- 01:20:46more proactive than just waiting
- 01:20:48for somebody to say something.
- 01:20:50But but when you have that previous
- 01:20:53standards then I think you can
- 01:20:55hold people accountable much better
- 01:20:57wonderful and some brief thoughts
- 01:21:00also from from Leanna and Sean and
- 01:21:03then we'll go to a zoom question.
- 01:21:07I'll just say two they even in history.
- 01:21:11You, you encounter people who have
- 01:21:14ideas about race that I would
- 01:21:16say are not factual.
- 01:21:19And um. And sometimes that's a colleague,
- 01:21:22sometimes that's maybe a professor.
- 01:21:24And you know, I think it's
- 01:21:27important in all fields to try to
- 01:21:29have these discussions right and.
- 01:21:31You know, and try to point out like no,
- 01:21:33this idea isn't. Isn't considered
- 01:21:36fractional anymore, right? Like.
- 01:21:40I you know, the and there's a lot
- 01:21:42of diseases and medical conditions
- 01:21:44that in the public imagination are
- 01:21:46still very much tied to race, right?
- 01:21:48Sickle cell anemia is,
- 01:21:49is probably the most well known one.
- 01:21:51And while there's sort of correlation with
- 01:21:54like racial statistics in the United States,
- 01:21:57it's important to point out that
- 01:21:59those racial categories that we start
- 01:22:01with are social categories, right?
- 01:22:03They're based on a biological reality,
- 01:22:05but they're not.
- 01:22:07Actually biologically,
- 01:22:08biologically pertinent and if
- 01:22:10you look at like.
- 01:22:12A A map of West Africa,
- 01:22:14right where a lot of in enslaved people
- 01:22:17in the Americas originally came from.
- 01:22:19There's huge variation in
- 01:22:22that sickle cell trait,
- 01:22:23but it at very at at the level of
- 01:22:26individual like genetic populations,
- 01:22:28right to to generalize across all those
- 01:22:32little tiny populations which were in
- 01:22:36different ways isolated for different
- 01:22:38periods of time or intermingled.
- 01:22:39You know you know these are these.
- 01:22:42Races are made-up of lots of
- 01:22:45little populations, right?
- 01:22:46And so to think to like to
- 01:22:49assign those little trades to to.
- 01:22:51A whole race,
- 01:22:52right?
- 01:22:53Which again is this artificial grouping
- 01:22:54that's supposed to have a biological reality,
- 01:22:56but is it really?
- 01:22:58Tends to be much more based on
- 01:23:00outward types that don't have a lot
- 01:23:01to do with things like genetics, so.
- 01:23:04Thank you. And Leanna,
- 01:23:05did you have anything to add
- 01:23:07just just to say I totally agree with
- 01:23:10what Chris and Sean are saying and I
- 01:23:12would also love to see more historians
- 01:23:15in clinical settings however that that.
- 01:23:17You know, can be made possible.
- 01:23:20And I think it needs to be the kind
- 01:23:24of history where we're not just
- 01:23:26celebrating ourselves for being
- 01:23:28better than like some of the guys,
- 01:23:30the two medical students that
- 01:23:31I talked about tonight, right.
- 01:23:32It has to be in conversation with
- 01:23:35other medical students who are
- 01:23:37experiencing and seeing, you know,
- 01:23:39the fact that racist attitudes are still
- 01:23:41alive and well and in clinical practice.
- 01:23:43So it needs to be,
- 01:23:45needs to be taught as a thing
- 01:23:46that's ongoing and we need to be.
- 01:23:48And continually unraveling not just
- 01:23:49something we've safely put behind us.
- 01:23:53Thank you so much and Doctor Warner. Yeah.
- 01:24:01That I think gets at
- 01:24:02helped. How do we relate?
- 01:24:04Looking at the history and doing
- 01:24:06something now isn't going to do it,
- 01:24:08so I'll just read it. They're right.
- 01:24:11The medical student being should
- 01:24:13be praised because she's awesome.
- 01:24:14We agree with them.
- 01:24:17But she's questioning authority
- 01:24:19at personal risk in her career.
- 01:24:21What can the medical school to
- 01:24:23change the structure so that she
- 01:24:25wouldn't never need to figure out
- 01:24:27where the racism is in her education?
- 01:24:32What a good question. Umm, Gina,
- 01:24:36do you have ideas about this?
- 01:24:41So. I agree with with what's
- 01:24:43already been said by my colleagues.
- 01:24:46If we could hold faculty to some sort
- 01:24:49of standard, then it wouldn't be my
- 01:24:51job to try to hold them to a standard
- 01:24:54and to try to argue with the people
- 01:24:56who are supposed to be teaching me,
- 01:24:58and also to come into class wondering if
- 01:25:02what I'm learning is correct or not. So,
- 01:25:06yeah, hold faculty accountable and decide on,
- 01:25:10decide that this is the truth, right?
- 01:25:12Because it is decide that biological racism.
- 01:25:16Is. Wrong.
- 01:25:17And then actually inject that
- 01:25:21idea into the curriculum.
- 01:25:24There are efforts already being made.
- 01:25:26So a faculty member member named
- 01:25:28Doctor Beverly Shears was appointed
- 01:25:30the head of the HealthEquity thread.
- 01:25:33And her what that means is her job
- 01:25:35is to look at all of the curriculum
- 01:25:38across the four years for Med
- 01:25:40students and I guess find all of
- 01:25:42the racism and sexism and homophobia
- 01:25:45and xenophobia and take it all out.
- 01:25:48I don't know how that's going at the moment,
- 01:25:50but um, I think that's a start.
- 01:25:53Absolutely.
- 01:25:54Absolutely.
- 01:25:55And let's see, how are we doing for time?
- 01:25:58We are at time.
- 01:26:00Would it be OK for us to spend just
- 01:26:03another couple of minutes hearing
- 01:26:06final thoughts from our panelists?
- 01:26:09Yeah.
- 01:26:09So I would just love to hear any
- 01:26:12last thoughts that you would
- 01:26:13like to give to the audience.
- 01:26:15Umm, final thoughts and reflections.
- 01:26:19And starting with with Chris and then
- 01:26:21we'll move our way down the table.
- 01:26:24Well, and thinking about that last question
- 01:26:26also a little bit, is that one of the,
- 01:26:29I think the big takeaways of my book is that?
- 01:26:32These are institutional problems.
- 01:26:34They need to be solved institutionally,
- 01:26:37both in in terms of individual institutions.
- 01:26:39But nationally, we can look at
- 01:26:41individual professors I discussed,
- 01:26:43but they're interchangeable.
- 01:26:45The person before them.
- 01:26:47And no offense to all the professors here,
- 01:26:49but they're they're just firing one
- 01:26:54person or focusing on one bad actor
- 01:26:57isn't going to solve this problem.
- 01:27:00It's an institutional problem.
- 01:27:03From. A wide reaching one.
- 01:27:05So I think where it needs to
- 01:27:07be addressed is at the, the,
- 01:27:09the level of the institution.
- 01:27:10And it's,
- 01:27:11it shouldn't be China's responsibility,
- 01:27:14it just shouldn't be and yeah.
- 01:27:17Oh, that's it.
- 01:27:18Thank you.
- 01:27:21I don't have
- 01:27:22much to add to that except to
- 01:27:25say that I I very much agree.
- 01:27:29And I would also like to see
- 01:27:32really institution because it
- 01:27:33is an institutional problem,
- 01:27:35more institutional driven and housed
- 01:27:36projects to deal with these kind of like
- 01:27:39the project that Sean and I are working on.
- 01:27:41But even into the more recent past,
- 01:27:43I think there's, I mean you know,
- 01:27:45our project is just going up
- 01:27:47until the Civil War, 1865,
- 01:27:49the end of the Civil War.
- 01:27:51But there, you know we've
- 01:27:53already talked about the, the,
- 01:27:56the legacies of the issues though.
- 01:27:59We are discovering and how they continue
- 01:28:01to shape the relationship between
- 01:28:03the medical school and New Haven and
- 01:28:05New Haven and also the relationship
- 01:28:07between New Haven and the hospital,
- 01:28:09I think in particular.
- 01:28:10So there's still so much.
- 01:28:13To be done,
- 01:28:14and I would really like to see
- 01:28:16just more institutional backing for
- 01:28:18major research projects like that.
- 01:28:22Yeah, and I
- 01:28:23also build on what Chris said about
- 01:28:25the need for institutional change.
- 01:28:27But it's also about larger culture,
- 01:28:30like outside of institutions,
- 01:28:32it's right ideas of race.
- 01:28:35Pervade our culture because our culture,
- 01:28:37our culture, really all the cultures of the
- 01:28:41world at this point have been reckoning,
- 01:28:44creating, reckoning,
- 01:28:45dealing with ideas of race for oh,
- 01:28:48at least 500 years, right.
- 01:28:50Like this is this is like a
- 01:28:51long term persistent problem.
- 01:28:52But what it's also done is,
- 01:28:54is it's left all these tiny things.
- 01:28:56It's left at medical education,
- 01:28:57but it's also left in the wider society.
- 01:28:59And so I think you know these approaches
- 01:29:01that Tina is talking about in the
- 01:29:04medical school and we're talking about.
- 01:29:05We also need to try to bring these sort
- 01:29:07of into our wider lives, right, you know?
- 01:29:11Help. Kindly correct friends, you know,
- 01:29:14correct parents or whoever, right?
- 01:29:17That that when these ideas come up,
- 01:29:19be like
- 01:29:19I, you know, I don't really think
- 01:29:20that's true right? Just something.
- 01:29:22Kind right? Because I don't think
- 01:29:25being super. Aggressive helps,
- 01:29:27but but on the other hand we need to.
- 01:29:31As a as a wider culture, as a,
- 01:29:32as a whole society need to to
- 01:29:34confront racial stereotypes,
- 01:29:36incorrect information about
- 01:29:38the biological ideas of race,
- 01:29:39really, wherever we see it,
- 01:29:41I think that's crucial.
- 01:29:45Yes, I think Sean said it so well,
- 01:29:47I'd I would ask everyone in the room,
- 01:29:50everyone on zoom, if you hear these sorts
- 01:29:53of ideas which you undoubtedly will like,
- 01:29:56someone saying that races
- 01:29:59are biologically different,
- 01:30:00try to address it, try to question it.
- 01:30:04Please educate yourselves by reading books
- 01:30:07like Masters of Health written by Chris or
- 01:30:10Fatal invention written by Dorothy Roberts,
- 01:30:13so you know how to make these arguments.
- 01:30:15Um. And it is part of the larger culture.
- 01:30:19It's not just medicine.
- 01:30:21As Chris so eloquently pointed out in his
- 01:30:25book, Madison had a role in establishing
- 01:30:29scientific race, biological racism.
- 01:30:30So we have a role of in getting rid of it.
- 01:30:34I I, I think a lot of the
- 01:30:37responsibility lies with doctors,
- 01:30:39with the medical field.
- 01:30:41To dispel this,
- 01:30:42people look at us as educators and leaders.
- 01:30:47Thank you all so much.
- 01:30:48And I just wanted to say an
- 01:30:51additional congratulations to
- 01:30:53Chris for this magnificent book.
- 01:30:55It is going to be the beginning of I
- 01:30:58think many conversations at many places
- 01:31:00around the country and internationally.
- 01:31:03And so thank you all for coming and it's
- 01:31:05been wonderful to be here with all of you.