Decompiling Oppression #13
Sam McVeety
As I write this week's entry, I hold desperately to the hope that we are living through a time of rapid change. With Minneapolis in the midst of crossing its own Rubicon (by beginning the process of dismantling its police department), will other cities (and states, and countries) follow suit? This is a time, now more than ever, when we must stubbornly cling to the audacious idea that transformative change is the only way to address systems that have entrenched themselves for centuries.
Another heartening sign is that we have begun to finally name racism for what it is -- a devastating public health emergency. Dr. Ruth Gilmore calls racism "state-sanctioned or extralegal production and exploitation of group-differentiated vulnerability to premature death", and her words have never felt more urgent. Our current moment draws much of the public's focus to police violence (and to a lesser extent, disparities in the impact of COVID-19), but this is only a fraction of the full story of racism's impact on public health. This week, we'll take a closer look at the racialized history of medicine, drawing heavily on Harriet A. Washington's Medical Apartheid.
To understand why a public health response is so needed, and so long overdue, we must first understand the long history of white doctors' exploitation of Black patients, and of medical racism more broadly. A particularly egregious case, which cuts across race and gender, is that of Dr. Marion Sims, credited as the "father of modern gynaecology". As Washington describes in meticulous detail, Sims refined and developed his techniques on enslaved Black women, forgoing anesthesia during these harrowing operations. (White) majority public sentiment has only recently begun to gather against Sims, with statues and tributes being removed and withdrawn. The cruel legacy of this work endures today, as "the overwhelming majority of women who suffer from vesicovaginal fistula are poor blacks without access to quality health care—women in sub-Saharan Africa." (Medical Apartheid)
Fundamentally, medical (and scientific) racism is a project that implicitly or explicitly adopts essentialist ideas about race, pathologizing Blackness in particular. When confronted with a disparity in outcomes, medical racism seeks to assign blame to Blackness itself, rather than society's (lack of) regard for Black lives (in the same way that it assigns blame for poverty and other social factors). Though the manifestations of this pattern change over time, it has endured over centuries. In the 1800s, phrenology and other racist scientific disciplines purported to prove the inferiority of Blackness. In the 1900s, intelligence tests like the SAT were designed with the aim of validating and enshrining white supremacist notions of racial superiority. Today, when we find that AIDS is "twenty-five times more common in black women than in white women" (Medical Apartheid) or the vast disparities in deaths from COVID-19, we still hear voices questioning whether the primary cause might be something inherent in Blackness, rather than the cumulative structural oppression of the last 400 years.
This history extends into reproductive rights, as well. Beyond the work of Dr. Sims, there is a long history of forcible sterilization of Black bodies and illicit medical studies (including the infamous Syphilis study) of various treatments that were too dangerous for white trials. One need look no further than today's statistics to find that American eugenics are hardly a thing of the past, with "one-third of all adult Mississippi women and 57 percent of all Mississippi women sixty-five and older say[ing] they have undergone a hysterectomy." (Medical Apartheid)
Finally, the hypocrisy of medical racism is particularly apparent in the mind-bending reversal of dogma that occurred at the turn of the last century, where "Medicine had once justified slavery on the basis that blacks were hardier than whites and so were ideally suited to survive and to work in harsh climates that would have meant death to more delicate whites." (Medical Apartheid) To repeat: after centuries of slavery, "justified" (in part) on the supposed predisposition of Blackness to manual labor, medical science, confronted with the inconvient facts of appalling public health outcomes for Black communties, declared that they had been wrong all along. Not wrong about medical racism, though, but simply mistaken on the balance of hardiness between the races, and that these outcomes were clearly the fault of the people that bore them.
While sometimes hard to bear witness to, I hope that the selections above have helped to show that the violence of structural racism extends far beyond the confrontations happening in our streets and precincts. With that in mind, here are this week's invitations:
Personal: Imagine if you knew that your family and community had a history of being exploited by the medical community. How would it change your relationship with your doctor?
Communal: The Affordable Care Act reduced racial disparities in health insurance coverage. As your communities and politicians propose future changes to the health care landscape, ensure that they have an explicit goal of reducing racial disparities.
Solidarity: Surge operates at the intersection of medicine, race, reproductive rights, and gender, centering Black women, women of color, and queer and trans people. Please support them and their work.
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