The US medical system is still haunted by slavery

Summary

This video script discusses the historical mistreatment of black women in American medicine, exemplified by Dr. James Marion Sims' unethical experiments. It traces racial disparities in healthcare from slavery to modern times, including the Tuskegee experiments and forced sterilizations. The script highlights how historical abuses have contributed to current issues like high maternal mortality rates among black women, emphasizing the need for a more equitable healthcare system.

Takeaways

• 👨‍⚕️ James Marion Sims, known as the 'father of modern gynecology,' conducted painful experimental surgeries on enslaved Black women without anesthesia.
• 🩺 Sims developed key medical tools and techniques, such as the vaginal speculum and surgical repair for fistula, but did so through unethical experimentation.
• ⚖️ The racial disparities in American healthcare are stark, with Black women 3 to 4 times more likely to die from pregnancy or childbirth-related causes than white women.
• 📚 Harriet Washington, author of *Medical Apartheid*, emphasizes the role of historical racism in shaping today's healthcare inequalities.
• ⚠️ Studies show that even with the same insurance and ability to pay, Black patients receive lower quality care than non-Black patients, reflecting systemic racism.
• 😨 'Iatrophobia' is a fear of doctors and healers, especially prevalent in the Black community due to long histories of medical abuse, starting in the slavery era.
• 🔬 19th-century 'Negro medicine' sought to justify slavery through pseudo-scientific claims of Black inferiority, which led to dangerous medical experiments on Black people.
• 🧬 Eugenics and sterilization policies disproportionately targeted Black women, with forced sterilizations continuing into the 20th century, notably the 'Mississippi appendectomy.'
• 💊 In modern times, reproductive health experiments continued, such as the selective marketing of long-term contraceptives like Norplant to Black teenagers.
• 🏥 Addressing today's high maternal mortality rates among Black women requires acknowledging and understanding the long history of medical racism and inequality in the U.S.

Q & A

Who is James Marion Sims and what is his contribution to medicine?

James Marion Sims is known as the 'father of modern gynecology.' He created the vaginal speculum and pioneered surgical repair for fistula, a complication from childbirth.

How did James Marion Sims conduct his experimental surgeries?

Sims performed a series of excruciating experimental surgeries on enslaved women without anesthesia, including 30 operations on a 17-year-old slave named Anarcha and more on about 11 others.

What is the racial disparity in maternal mortality in the United States?

Black women are 3 to 4 times more likely to die in connection with pregnancy or birth than white women in the United States.

What is iatrophobia and how is it related to the medical treatment of African Americans?

Iatrophobia is the fear of the healer, which has been inculcated in African Americans due to historical abuses by the medical system, leading to distrust.

How did the medical profession treat slaves during the slavery era?

Doctors relied on slave owners for financial stability, verified the fitness of slaves at auctions, and treated sick slaves to protect their owners' investments.

What was 'Negro medicine' and how did it relate to slavery?

'Negro medicine' was an effort during the 1830s to identify black 'inferiority' using both 'science' and the Bible to justify slavery.

What is the historical belief that contributed to the lack of anesthesia use during Sims' surgeries on slaves?

The belief that black people did not feel pain or anxiety was prevalent during Sims' time, which contributed to his choice not to use anesthesia on enslaved women.

How did the eugenics movement in the early 1900s affect African Americans?

The eugenics movement aimed to reduce the childbearing potential of the poor and disabled, including African Americans, leading to forced sterilizations and the 'Negro Project' pushing birth control in the black South.

What was the 'Mississippi appendectomy' and how is it related to the medical treatment of African Americans?

The 'Mississippi appendectomy' was a euphemism for forced hysterectomies performed on African American women, rendering them infertile without their knowledge.

How has the medical system's past treatment of African Americans influenced current health disparities?

The historical mistreatment, including forced sterilizations and experimentation without consent, has contributed to racial disparities in healthcare and a lack of trust in the system, leading to current health disparities.

What is the role of environmental and economic factors in the racial disparities in healthcare?

Environmental and economic factors such as access to good healthcare contribute to racial disparities, but even when minority patients have the same health insurance or ability to pay, they tend to receive lower quality care.

Outlines

00:00

🩺 The Dark Legacy of Dr. James Marion Sims

This paragraph introduces Dr. James Marion Sims, often referred to as the 'father of modern gynecology,' and discusses his controversial legacy. Despite his medical innovations, such as the vaginal speculum and surgical repair for fistulas, his achievements were marred by unethical practices. He conducted painful experimental surgeries on enslaved Black women without anesthesia, reflecting the broader racial inequalities in American medicine. The paragraph highlights that this history contributes to present-day disparities in healthcare for Black women, especially in maternal mortality rates, where Black women are significantly more likely to die due to pregnancy or childbirth-related complications. The segment also references Harriet Washington's work 'Medical Apartheid,' emphasizing the importance of understanding historical racism in medicine.

05:01

⚖️ The Enduring Impact of Medical Racism and Eugenics

This paragraph delves into the ongoing legacy of medical racism and eugenics in the United States. It discusses how early medical practices dehumanized Black people, with doctors using their bodies for unethical experiments. The narrative moves through history, highlighting the eugenics movement, which sought to control the reproduction of marginalized communities, including African Americans. It mentions controversial figures like Margaret Sanger and her 'Negro Project,' which promoted birth control in Black communities, and the forced sterilizations of Black women, often without their consent, well into the 20th century. This history of coercive reproductive practices contributes to ongoing mistrust in the medical system among African Americans. The paragraph ends by connecting this past to the current crisis in Black maternal health and calls for a more equitable healthcare system.

Keywords

💡James Marion Sims

James Marion Sims, often referred to as the 'father of modern gynecology,' is a controversial figure in medical history. He is known for developing the vaginal speculum and pioneering surgery to repair fistulas. However, his medical advancements were achieved through experimental surgeries on enslaved Black women without anesthesia, reflecting the theme of racism in American medicine. His work epitomizes the exploitation of Black bodies for medical progress, which is a core issue discussed in the video.

💡Maternal Mortality

Maternal mortality refers to the death of a woman due to complications related to pregnancy or childbirth. The video highlights that Black women are three to four times more likely to die from these complications compared to white women, illustrating the stark racial disparities in healthcare. This statistic is tied to the historical and ongoing neglect of Black women's health needs, a key theme of the video.

💡Medical Apartheid

Medical Apartheid, a term coined by Harriet Washington, refers to the systemic exploitation and mistreatment of Black people in American medical history. The video references this concept to explain the historical roots of racial disparities in healthcare, such as the unethical experiments performed on enslaved women by doctors like Sims. The term encapsulates the intersection of racism and medicine, a central theme in the video.

💡Institutional Racism in Medicine

Institutional racism in medicine describes the systemic and enduring racial biases within the healthcare system that result in poorer health outcomes for minorities, particularly Black patients. The video argues that this racism can be traced back to the days of slavery and continues to manifest in modern-day disparities, such as higher maternal mortality rates for Black women. This concept is crucial for understanding the video's focus on healthcare inequalities.

💡Iatrophobia

Iatrophobia refers to the fear of doctors or medical treatment, particularly among African Americans due to a long history of medical abuse. In the video, this term is used to explain why many Black people distrust the healthcare system, given the legacy of exploitation and experimentation on Black bodies, such as the unethical surgeries performed by Sims on enslaved women.

💡Negro Medicine

'Negro medicine' was a term used in the 19th century to describe efforts to identify Black 'inferiority' to justify slavery. This pseudo-scientific practice aimed to prove racial differences through medical experiments on Black people. The video references this concept to demonstrate how medicine was weaponized to reinforce racist ideologies and control Black bodies, a historical practice with lasting effects on racial disparities in healthcare.

💡Eugenics Movement

The eugenics movement, which gained momentum in the early 20th century, sought to control the reproductive capabilities of certain populations, often targeting the poor, disabled, and racial minorities. The video discusses how this movement included forced sterilizations of Black women, highlighting the theme of reproductive control and medical racism. Fannie Lou Hamer's involuntary hysterectomy is an example of this legacy.

💡Tuskegee Experiments

The Tuskegee experiments were a notorious study in which Black men with syphilis were deliberately left untreated to observe the disease's progression. Although not deeply covered in the video, the reference to this event underscores a broader pattern of medical exploitation of African Americans, contributing to the mistrust of the healthcare system. The video suggests that these historical abuses continue to influence health disparities today.

💡Reproductive Health Disparities

Reproductive health disparities refer to the unequal access to and quality of reproductive healthcare experienced by marginalized communities, particularly Black women. The video details how, historically, Black women were subjected to forced sterilizations and experimental surgeries. These injustices have evolved into contemporary issues like higher rates of maternal mortality among Black women, connecting the past to present-day healthcare inequities.

💡Racial Disparities in Pain Treatment

Racial disparities in pain treatment refer to the documented tendency of healthcare providers to undertreat pain in Black patients compared to white patients. The video highlights that this misconception, rooted in the belief that Black people feel less pain, is a legacy of racist medical practices from the 19th century. This ongoing disparity in pain management is part of the broader theme of racial inequality in healthcare.

Highlights

A bronze statue of Dr. James Marion Sims, known as the 'father of modern gynecology,' stands in Central Park, but his work was built on excruciating experimental surgeries on enslaved women.

James Marion Sims pioneered the surgical repair for fistula, a complication of childbirth, but his surgeries were performed without anesthesia on enslaved women.

Sims epitomizes the long history of medical racism in the U.S., a legacy that still affects the healthcare system, especially for Black women.

Black women are 3 to 4 times more likely to die in connection with pregnancy or childbirth compared to white women, reflecting a racial disparity rooted in historical injustices.

The belief that Black people did not feel pain or anxiety was pervasive in 19th-century medicine and still affects medical treatment today.

Medical ethicist Harriet Washington emphasizes that understanding the history of racial disparities in medicine is crucial to addressing current healthcare inequalities.

Minority patients, even with similar health insurance as non-minorities, tend to receive lower-quality care.

The fear of medical institutions, known as iatrophobia, stems from centuries of abuse and exploitation of Black people by the healthcare system.

During slavery, doctors often worked for plantation owners, treating enslaved people as property and experimenting on them without consent.

The 1830s saw the rise of 'Negro medicine,' which sought to prove Black inferiority through medical experimentation and pseudoscience.

Sims performed 30 surgeries on a 17-year-old enslaved girl named Anarcha without anesthesia, with other enslaved women forced to restrain one another.

The forced sterilization of Black women continued into the 20th century, with cases like Fannie Lou Hamer, who was sterilized without her consent in 1961.

The American eugenics movement in the early 20th century pushed for sterilizing the poor and disabled, disproportionately targeting Black women.

In 1973, it was revealed that 100,000 to 150,000 women, mostly Black, had been sterilized in Alabama using federal funds.

Reproductive health programs targeting women of color, such as Norplant in the 1990s, were seen as forms of social engineering, furthering racial disparities in healthcare.

Transcripts

At the edge of Central Park in Manhattan,

there's a bronze statue of a doctor named James Marion Sims.

Whose “brilliant achievement carried the fame of American surgery throughout the entire world.”

He’s the guy who created the vaginal speculum, an instrument gynecologists use for examination.

He pioneered the surgical repair for fistula, a complication from childbirth,

And became known as the “father of modern gynecology.”

But that brilliant achievement, was the result of a series of excruciating experimental

surgeries that he conducted on enslaved women.

In a lot of ways, Sims epitomizes the story of American medicine for black women.

It’s a system that’s failing them to this day. From infant mortality to life expectancy,

the racial disparities in health care are staggering.

The gulf between black and white might be widest when we look at maternal mortality.

With black women 3 to 4 times more likely to die in connection with pregnancy or birth than white women.

And that divide can be traced back to doctors like Sims who contributed to a long, largely overlooked,

history of institutional racism in medicine.

Trying to understand a historical problem without knowing its history, is like trying to treat a patient

without eliciting a thorough medical history.

You're doomed to failure.

That’s Harriet Washington, a medical ethicist and author who chronicled the intersection

of race and medicine in her book, Medical Apartheid.

While many of the stark racial disparities in health care can be attributed to environmental

and economic factors like access to good health care, studies show that minority patients

studies show that minority patients tend to receive a lower quality of care than non-minorities,

even when they have the same types of health insurance or the same ability to pay for care.

As African-Americans we've been abused for so long consistently by the system.

Why should we trust it?

Why should we go to when ill?

And that's iatrophobia.

That's a fear of the healer, you know, inculcated by the behavior of those healers unfortunately.

It starts with slavery.

Doctors relied on slave owners for financial stability.

They accompanied plantation masters to auctions to verify the fitness of slaves, and were

called in to treat sick slaves to protect their owners’ investments.

In 1807, Congress abolished the importation of slaves, and in turn pushed black women

to have more children, to essentially “breed” slaves.

Founding father Thomas Jefferson later wrote,

Around the 1830s the abolitionist movement led to the rise of what was called

“Negro medicine,” or efforts to identify black “inferiority” to justify slavery.

And there were polygenists, who tried to use both “science” and the Bible to find proof

that races evolved from different origins.

The 1830s also marked the beginning of recorded experimentation on black women’s bodies.

One doctor performed experimental c-sections on slaves.

Another one perfected the dangerous ovariotomy - or removal of an ovary - by testing the procedure on slave women.

In fact, half the original articles in the 1836 Southern Medical and Surgical Journal

dealt with experiments on black people.

And then, of course, there was James Marion Sims, whose reputation is etched in history...

and on that statue in Central Park.

Between 1845 and 1849, Sims began performing experimental surgeries on a 17-year-old slave named Anarcha.

He eventually performed 30 operations on Anarcha, and more surgeries on about 11 other female slaves.

When his male colleagues could no longer bear to assist him in inflicting pain on the women, the slaves took turns restraining one another.

Yet, paintings depicting Sims, Anarcha, and other slave women, presented a subdued version of his experiments.

Even though anesthesia was introduced in 1846, Sims chose not to use it for his experimentation with slaves.

His practices echoed one of the most prevalent, and dangerous beliefs in medicine at the time:

that black people did not feel pain or anxiety.

This book from 1851 titled "The Natural History of Human Species," claimed

Studies released as recently as last year demonstrate that black people are less likely to be treated for pain - particularly in the ER.

There’s even one from a children’s hospital that found the same to be true for kids.

And just this year, Pearson Education, a leading educational publisher, issued an apology and

recalled nursing textbooks that included racist stereotypes, like this section that said

Well what does it mean when you say that someone doesn't feel pain?

Among other things you're speaking about their humanity.

These are all part of that suite of beliefs emanating from the 19th century, that we still have not shaken off,

despite all our knowledge and sophistication.

They're deeply ingrained.

Doctors like Sims might fit the “Dr. Frankenstein” stereotype, but they weren’t outliers.

Historically, Southern doctors who used black bodies for troubling experiments were the norm.

It’s a very common question, how can we judge our forebears?

You know those guys in the 18th century who practice medicine in a way that appalls us today

and we think, how could you do that?

I did not judge the practicioners based on our own ethics. I judge them based on the ethics of their time.

It was not acceptable back then, we just did not hear from the people who protested against it.

After the Civil War ended, the 1900s brought a wave of immigrants to the US.

It sparked a race “panic,” and coincided with the birth of the American eugenics movement.

One of the movement’s key objectives was to reduce the childbearing potential of the poor and disabled.

Leaders included birth control pioneer and Planned Parenthood founder Margaret Sanger,

who eventually devised the controversial “Negro Project,” or family planning centers that pushed birth control in the black South.

It was a project that even garnered support from W.E.B DuBois, a founder of the NAACP,

who wrote that black people bred “carelessly and disastrously.”

By the mid-1930s, more than half the states passed pro-sterilization laws.

And often, sterilization was forced.

In 1961, future civil rights leader Fannie Lou Hamer went to the hospital to have a tumor removed,

but was subjected to a hysterectomy without consent.

The procedure - which rendered women infertile without their knowledge - was so common in

the South that Hamer is said to have dubbed it the “Mississippi appendectomy.”

African-American babies were no longer economically valuable,

And African-Americans themselves had gone from being a resource to a nuisance.

In June of 1973, the SPLC uncovered 100,000 to 150,000 cases of women who had been sterilized with federal funds in Alabama.

Half the women were black.

In recent decades, women of color continue to be exposed to dubious reproductive health programs.

In December 1990, the FDA approved a contraceptive called Norplant. And it was selectively marketed to black teenagers in Baltimore schools.

Norplant fans like David Duke, the former KKK grand wizard, even introduced legislation

to give women on welfare an annual reward of 100 dollars if they agreed to get Norplant.

That bill never passed.

But the implant ignited a debate on whether long term contraception - like Norplant that lasted five years - could be used as a form of social engineering when pushed on to specific communities.

Today, as we continue to lose black mothers at alarming rates, a deeper look at the past may be a good step toward creating a more equitable health care system.

Hi guys, thanks for watching.

Of course, there's a lot more to the history of how the US medical system has mistreated people of color than we could fit in the video.

Everything from the Tuskegee experiments to Jim Crow laws segregating hospitals.

But we hope it starts to give some context to the racial disparities we see in medicine today.

ProPublica has been reporting on the disparities in maternal mortality in the US, and how it's the most dangerous industrialized country in which to give birth.

Check out that feature piece in the link below.

And we're seeking your help in understanding the problem. So if you nearly died during pregnancy or you know someone who died due to childbirth related complications, then check out that link in the description.

Thanks again!