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Breaking barriers in medicine and race

Yale Medicine Magazine, 2011 - Spring


The second black woman to enter the School of Medicine became a pioneer in sickle cell disease.

A medical student in a time charged with racial tension in America, Yvette Fay Francis-McBarnette, M.D. ’50, echoes black Yalies before her who consistently reported getting along well with their white classmates. “We were a close-knit, supportive group,” she said.

Perhaps this atmosphere motivated a 22-year-old Fay Francis, as she was known, to write a letter to the Pittsburgh Courierduring her second year of medical school. “I have been urging all the prospective [black] medical students I know to apply,” she wrote, “but most [feel] it would be a waste of time. This is not true.” Francis-McBarnette concluded that as long as blacks were not represented in top schools, “the number of Negro doctors and nurses [would continue] decreasing.”

The daughter of college-educated schoolteachers who emigrated from Jamaica, Francis-McBarnette always knew that she would go to college. After skipping several grades in school, she enrolled at Hunter College when she was just 14 and earned a bachelor’s degree in physics in three and a half years. At 18, Francis-McBarnette was too young for medical school and unable to get a job in a lab in New York City. Those jobs were reserved for white applicants, she was told. So she got a master’s in chemistry at Columbia instead. In 1946, at the age of 19, she was the second black woman to enroll at the Yale School of Medicine.

Despite her letter to the Pittsburgh Courier, Francis-McBarnette had no involvement in the civil rights movement. But in the medical profession, she broke barriers for women and blacks. While running a private pediatric practice, directing a clinic at Jamaica Hospital in Queens, and completing a second residency in internal medicine, Francis-McBarnette raised six children with her husband of 54 years, Olvin McBarnette, now a retired district superintendent for the New York City Board of Education. Among her children are three attorneys and a schoolteacher.

In medicine, Francis-McBarnette broke barriers for sufferers of sickle cell disease. She began using prophylactic antibiotics 15 years before their effectiveness was confirmed by an article inThe New England Journal of Medicine.

Francis-McBarnette first heard of sickle cell disease and its mostly black victims in the 1950s during her pediatrics residency at Chicago’s Michael Reese Hospital. The hospital, which closed its doors in 2009, served the city’s black population, which was increasing due to the migration of African Americans from the South to the North. “I went home and tested all my relatives [for sickle cell],” she said.

In 1966, in private practice and an attending pediatrician at Jamaica Hospital, she launched the Foundation for Research and Education in Sickle Cell Disease with colleagues who included Doris Wethers, M.D. ’52. The foundation was instrumental in opening the first comprehensive sickle cell clinic of which Francis-McBarnette became director.

The pediatrician was soon invited to Washington to sit on an advisory committee before then-President Richard M. Nixon signed the National Sickle Cell Anemia Control Act in May 1972.

Since 1970 she had been successfully treating sickle cell children with prophylactic antibiotics. “I stayed on antibiotics for 35 years,” said Cassandra Dobson, D.N.Sc., a lifelong patient of Francis-McBarnette, who started on the regimen in 1971. “If I hadn’t, I would’ve died.”

And by 1970, five years before New York State mandated the screening of infants for sickle cell disease, Francis-McBarnette’s organization had already screened some 20,000 schoolchildren. That year in the May issue of the Journal of the National Medical Association, the doctor called for treatment that would allow those with sickle cell disease “to pursue their education, earn a living, and rear their families.” These endeavors were unheard-of for sickle cell patients, who barely lived to adolescence when Francis-McBarnette started practicing.

“I was told I was going to die at 5, at 10, at every milestone of my life,” Dobson said.

On the pediatrician’s then-controversial advice that her patients do anything they wanted to do, including bear children, Dobson had children, became a registered nurse, and earned her doctorate in nursing. Francis-McBarnette recently attended Dobson’s 50th birthday party, where Dobson said in a speech that she wouldn’t be celebrating this milestone if it weren’t for “Dr. Francis.”

When Francis-McBarnette’s first patients lived beyond age 18, Francis-McBarnette referred them to adult doctors, but they refused to go. “They don’t know anything about me. I’m staying right here with you,” her patients told her. So in 1978, at age 52, Francis-McBarnette completed a residency in internal medicine and a fellowship in hematology at Bronx-Lebanon Hospital Center so that she could continue to care for her former pediatric patients.

Like Dobson, Maureen Michel has also been a lifelong patient of Francis-McBarnette. When she was visiting New York from Haiti in 1975, Michel, then 9 years old, was hospitalized. Now 44, Michel saw Francis-McBarnette until the doctor retired in 2000. Today, in the course of searching for a new doctor, Michel still meets many who do not know what sickle cell disease is. “My whole life, every time I go to the emergency room, I call Dr. Francis. ‘Do you think this medication is good for me?’ When she retired, I didn’t know if I would ever find any doctor like her, and to tell you the truth, I never have.”

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