On Thursday evening, Carolyn Roberts, assistant professor of history of medicine, spoke about medicine in the slave trade to an audience of about 30 students and faculty at Sterling Hall of Medicine’s Beaumont Room.
In her talk, Roberts — who specializes in the study of early modern medicine with a particular focus on race and slavery — discussed underexamined aspects of medical innovation involving exploitation of marginalized groups in pharmaceutical and medical labor.
Her talk focused on uncovering medical practice in the transatlantic slave trade, the largest forced oceanic migration. Roberts showed the extent of the phenomenon with a timelapse from 1441 to 1967 of boats traveling across the Atlantic Ocean, which carried 12 million African women, children and men to the Americas.
“The slave trade can be thought of as the largest force of oceanic migration, which changed the world as we know it,” Roberts stated.
Roberts described the slave trade as a medically managed enterprise, explaining that it contributed to the transformation of medical management into an intercontinental pursuit.
During this period, medicine became an integral part of a proprietary and violent enterprise and became involved in complex racial dynamics.
Narratives of medical innovation have long been Eurocentric, and neglected the role of racial minorities in the evolution of western medicine, according to Roberts.
“It’s fascinating to think about how Europeans first arriving in West Africa to participate in the slave trade had to rely on indigenous medical knowledge of West Africans to combat endemic diseases that they knew little about,” she said.
Since slaves who survived and who were fitter would generate greater profit, health was a commodity during the transatlantic slave trade, and European doctors were hired to care for slaves on the journeys.
Sharing an anecdote of a Scottish doctor, Roberts showed that being a transatlantic slave doctor was often an economic necessity, as it was the best paying medical job available. In addition to salaries and bonuses, the doctors were also paid in slaves, whom they sold for money. The profession was entrepreneurial — doctors had to rely on their healing abilities as opposed to their occupational titles, and in order to gain employment, they had to outcompete midwives and others who could also heal people.
Roberts further discussed the dark aspects of slave trade history, citing a source that compared medical examinations of potential slaves to the inspection of a horse. To choose which slaves would be brought on the transatlantic journey, doctors inspected bodies without consent. Slaves were stripped naked and every part of their body examined and probed.
Roberts connected these historical narratives of race to continuing problems in medicine today, including the undertreatment of “black pain,” lower standards of medical care for immigrant and low-income populations and the black maternal mortality crisis.
Part of the problem appears to be an unconscious bias formulated through community environments and lack of education, Roberts said. Initiatives like the Programs for Humanities in Medicine at Yale School of Medicine strive to combat these biases in order to prevent repeating past injustices in medical neglect, violence and abuse.
“Medicine has been embroiled in such important questions in what it means to heal. The relationship between doctor and patient requires a tremendous building of trust,” Roberts explained. “Once this trust is betrayed, patient-practitioner relationships become fragile and tenuous. Rebuilding this trust is very much necessary, although it will require time.”
These insights bring a new appreciation to the sacrifices it took to bring medicine to its current state-of-the-art form today. Modern medicine must not only celebrate the progress of medical innovation but also reckon with the harms it has done, according to Roberts.
The School of Medicine’s Programs for Humanities in Medicine invites several speakers each semester to discuss topics in humanities that provide novel perspectives on medicine. The program places an emphasis on how the humanities can help inform the doctor’s work in diverse communities.
“The importance of history is easy to underplay, especially in certain professions where there is so much knowledge required to treat problems,” Roberts explained. “Talks like this encourage medical students to think about how the past challenges in medicine linger into the present.”