Author: Bryan Wager

When I look back at the beginning of the course, I see a senior biochemistry major sitting down for his first English 100 class. He was only present because he needed an additional class in English in order to apply for medical school in the coming months. He skimmed through the lengthy syllabus, looking for what he had to complete in order to receive an “A” and keep up his GPA. He neglected to notice most of the material provided for him, including the course epigraph. He had other things on his mind, applying medical school, captaining the men’s soccer team, completing his upper-level science courses and figuring out a way to find a little extra time for sleep. From his abbreviated look at the syllabus, he determined that he would likely be able to put in a moderate effort, complete the course then forget it. I am this student. Correction: I was this student. The reason I introduce myself in the third person is that the student I was when I sat down for my first day of class is unrecognizable to the person I am now.

In one of the first days of class, Dr. McCoy asked the room full of students to go back over the syllabus and identify one item in particular. The course epigraph. A quote from Dionne Brand read “My job is to notice… and to notice that you can notice.” It’s very fitting that Dr. McCoy has noticed that students tend to overlook important items when presented with multiple pages of a dense syllabus.  At first read, I believed the epigraph meant, that I should improve my power of observation, and notice small things that I would commonly overlook. In my blog post “Knowledge and the Ability to Notice”, I claimed the ability to notice came through acquiring knowledge. If you learn about things that have happened, you can notice similar things that are happening. I now believe that I was only partially right. The ability to notice is connected to how we think.

The title of the course is Literature, Medicine and Racism. These are topics that are not normally discussed together. The course title led me to infer that everything that we would learn and write would carry enormous weight because of the pain and distress associated with it. I had imagined this course to be full of learning about the history of racism and how it intertwined with the practice of medicine. It was, but only in part. We were introduced to Harriet Washington and her documentation of the problems of discrimination in the medical field in Medical Apartheid. Washington illuminates some of the lesser-known acts of discrimination and cruelty towards minority groups. However, the syllabus contained other books, some of which were considered science fiction. How is science fiction interconnected with Medical Apartheid? Over the course of the semester, it became increasingly apparent that the science fiction novels were far more significant than mere stories but provided import commentary on social issues. In order to interpret the relationship between the novelists we would read and Harriet Washington, I would need to be able to notice and, more importantly, think in a way in which I was unaccustomed.

I was intrigued by a recurring comment that Dr. McCoy provided me as feedback on many of my blog posts. One rendition of the comment was “…keep going, keep thinkING, keep figuring things out.” I realized that my ability to notice wasn’t rooted in my attention to detail but in the process of thought. As a biochemistry major, I have been trained to absorb vast amounts of concrete material that generally was not open to interpretation. Science consists of explicit mechanisms and direct cause and effect relationships. Initially, I approached the stories and concepts presented in this course with my previous mindset. Although this has provided me with the ability to understand many intricate chemical and biological concepts, I was at a loss when presented with materials of fiction. I was unable to grasp the commentaries and their significance, that were presented behind complex fictitious plots, and my ability to comment on major course concepts was limited. I needed practice in thoughtfully navigating socially important course materials and noticing the connections.

Percival Everett’s Zulus is a novel that is very stimulating of thought, but only if you commit to it. At first, I didn’t. Can you blame me? The world was not relatable, the characters were peculiar, and the writing caused me to constantly re-read sections with the hope I could find some context to help my understanding. Even the headings of chapters were filled with abstract quotes and allegories. With some guidance, I was able to navigate the plot but struggled to grasp how Zulus connected to the concepts from class. Dr. McCoy was able to walk the class through a statement made by Kevin Peters, one of the main characters, when he said that “We are the great wound.” This connected to the government’s mistrust of people due to their unpredictable nature as presented in Harriet Washington’s Medical Apartheid. A doctor, in 1867, had purposed that the cause of John Patterson’s mental condition was due to his newly acquired freedom as a former African-American slave. Washington wrote, “The doctor believed that, as with other black patients with this condition, the psychological pressure of caring for himself when Patterson possessed neither the intelligence nor the judgment to do had proved too great, and Patterson had sunk into madness.” This illuminated the tendency of people in power to attempt to prevent the free-thinking in the oppressed class. It was proven to me that Everett is providing social commentary, not just trying to infuriate his readers.

After, Dr. McCoy pointed out that the main character, Alice, might be trapped inside of the actual book.  Everett described Alice’s severed head as being placed in a cube filled with “strange primitive drawings and isolated words, some in languages she did not know, but there, speaking to her.” This quote fell in a section that I did not understand and quickly swept over. Dr. McCoy was able to interpret this section in order to illuminate its significance to the novel. I committed myself to “figuring things out” because I was overlooking significant parts of the novels. So far, I had missed extremely important details to both the story and to the underlying commentary that the author was trying to convey. I did not want to miss anything that important again. I had realized the importance of being able to notice.

The growth in my ability to think through and reveal concealed commentary is demonstrated in my blog post “Who is Mark Spitz ?.” In the blog post, I introduced Mark Spitz both as a character in Zone One by Colson Whitehead and as the Olympic swimmer. The character was given the name because instead of swimming to safety, as his companions did, Mark Spitz fought off a horde of dangerous skels in an incredible act of bravery. However, his act of bravery was really enticed due to his inability to swim. Equipped with the training to notice and the commitment to figuring things out, I began to think about Whitehead’s commentary on racism. Whitehead subtly brings in an element of racism during a conversation that occurred after Gary had been bitten by saying “Plus the black-people-can’t-swim thing.” The conversation also revealed that, in the story, Mark Spitz was an African-American. As a result of noticing these small details, I began to formulate an idea. I created an analogy, where Mark Spitz represents an idea of a better world. The idea that one day all people would be treated as equals without any form of bigotry or discrimination. The idea for hope, that cannot be killed or destroyed even if it faced with a whole world full of forces that opposed it. While this may not have been Whitehead’s message while writing this book, it incited this idea in me. It was a powerful thought. It gave me the hope that if we fight against racism without discouragement we can create a better world for those to come. The deep analysis of the text had a profound impact on me, and it could for everyone. Expanding my process of thought allowed me to understand the weight of the text.

My growth in the combination of noticing and thinking can be seen in my blog post entitled “Eugenics, Genetic Counseling, and Jacob.” In the post, I discussed the controversial nature of eugenics and the practice of genetic counseling and related it to Octavia E. Butler’s Clays Ark. Two characters in Clay’s Ark, Rane and Lupe shared different opinions regarding giving birth to genetically altered children. Lupe, who at this point in the story is depicted as evil, explains that “Eli says we are preserving humanity. I agree with him. We are.” I paused after reading this line. Butler had trapped me. Do I side with Rane who was portrayed as an innocent victim? Or do I side with Lupe, who Butler uses as a villain? Normally, I would have cut my losses and abandoned the topic because of the controversial nature of eugenics and the weight my words would carry. While noticing that I was afraid of engaging such a topic, I chose to commit to it. I noticed something in the reading and myself and then worked through my thought process.

I didn’t commit to a side, but the process of thought. In my blog post, I explained what I was noticing in the text and in myself. Butler posed a question to me as the reader. I answered it with more questions, which would have earned me a failing grade in my biochemistry courses, but well demonstrated my thoughts. It was difficult for me to find the right words to responsibly navigate this topic. I found myself re-writing the post again and again in order to find the right combination of words that would thoughtfully describe what I had noticed without portraying myself as controversial or insensitive. I realized the significance of what I was actually doing. Like Butler, I was trying to convey the significance of thought about a difficult topic. Letting people decide for themselves what they believe to be right, without persuasion, is the importance of thought. Only through your own thinking can you truly understand troublesome topics and establish your own personal beliefs.  

My understanding of Dionne Brand’s quote changed over the length of the semester.  The first part of the quote reads “My job is to notice”. The significance of this portion was clear to me. In order to be a successful writer, one must be able to notice the intricacies of the world to be descriptive and relatable to readers. At first, the understanding of the second part of the epigraph eluded me. What did it mean to “notice that you can notice”? Perhaps it meant that everyone had the ability to notice and they should be aware of their capability. Of course, like all of the other materials provided, the entire epigraph connects to the course topic. I believe that it means that everyone can indeed notice, and has a responsibility to do so. In order to eradicate racism, every act of discrimination needs to be identified in order for it to be corrected. The latter portion of the epigraph is the more powerful part of Brand’s message. I interpret this piece as a call to action for everyone, including myself, to be aware of the fact that they can initiate change by using their ability to notice. Without noticing deplorable acts, no rectifying change will ever occur.

I have learned a great deal about the history of racism. Although the historical knowledge I have gained is extremely important, I feel that my growth as a thinker is the more beneficial effect of enrolling in this course. I have grown to be able to better understand my own thoughts and to communicate my unique interpretations to others. Everyone has different experiences and will have different reactions and thoughts regarding the text. The world is full of different voices each with something unique to say, and this course has allowed me to be able to responsibly contribute mine. This class has helped to train my ability to notice through improving my process of thought and will have a profound effect on everything that I encounter in the future. I can confidently say that I am now better equipped to navigate the world and have a positive impact on my fellow human beings. There is still a lot for me to learn and much room for me to grow, but the experience that I had during this course has set me on a path to becoming a more complete and socially responsible human being.

As I read Zone One, I was able to notice many intricate ways that the author Colson Whitehead used to provide commentary on social issues. In my last blog post, “Let’s Talk About Teeth”, I discussed the role of teeth in both the novel and in a modern context. I also shared what I believed to be Whitehead’s underlying purpose behind his words. Throughout the course, I have been training my ability to notice. I was able to notice numerous instances where Whitehead hinted at social issues and provided his opinion without openly stating it.  However, there was one concept that I found difficult to unpack and was forced to dig deeper in order to understand Whitehead’s purpose. The naming of Zone One’s main character, Mark Spitz.

Mark Spitz is the name Whitehead gave to his main character. This was not the character’s real name but an ironic nickname given to him by other characters in the novel. He received this nickname when Richie, the Quiet Storm and he were in danger of being overrun by a group of skels on a bridge. Realizing that they were unlikely to overcome the massive group of infected, Richie and the Quiet Strom jumped from the bridge into the river below, escaping what they believed to be certain death. Mark Spitz didn’t move. Instead, “he leaped to the hood of the late model neo-station wagon and started firing.” After remarkably taking down all of the skels, he informed his companions that he could not swim. From then on he would be known as Mark Spitz.

I did not immediately recognize the name Mark Spitz, which may be an unfortunate consequence of being a member of my young generation. Luckily to make up for it, my generation has access to an incredible tool, Google. According to his Team USA Hall of Fame Biography, Mark Spitz was an 11-time Olympic medalist swimmer. Spitz throughout is career set 33 world records and won 9 gold medals at the Olympics. His crowning achievement as noted in his Hall of Fame bio was “in Munich, where he dominated, becoming the first athlete to win seven gold medals in seven events, all in world record time.” Spitz was a dominant athlete, who is considered to be one of the greatest swimmers of all time and achieved massive fame and recognition for his abilities in the pool.

The nickname Mark Spitz may seem entirely ironic, but is also fitting for the character in Zone One. Before the Last Night, Mark Spitz was described through a proposed superlative as “Most Likely Not to Be Named Anything most likely.” He was average, a B-student who was unremarkable until he found the one thing he was truly exceptional at, surviving. This is fitting because the Olympic Swimmer Mark Spitz shared a similar story. In an article authored by Scott Stump for Today, Spitz is quoted as saying “I’ve always thought of myself as a regular guy, and I happened to do something extraordinary in the journey of my athletic career.” Both the fictional character and his namesake were regular people that became special under the right circumstances. Whitehead supports that the new situation benefits his character by stating, “Now the world was mediocre rendering him perfect.”

On the surface, it may look like Whitehead gave his main character the name Mark Spitz as a comedic mocking of the character’s inability to swim. Although the name has a far greater meaning. The Olympian swimmer Spitz was nearly impossible to defeat in competition. Mark Spitz is also impossible to defeat in Whitehead’s post-apocalyptic world. Mark Spitz is seemingly invincible, “He had suspicions, and every day in this wasteland supplied more evidence: He could not die.” How can a single man, in a world full of constant danger and overwhelming amounts of death, be impossible to kill? It is my interpretation that the character doesn’t represent a man, but Mark Spitz is an idea. An idea cannot be killed or destroyed. An idea cannot be defeated much like the Olympic swimmer Mark Spitz. There is power in an idea and it lasts longer than those who believe it. Mark Spitz probably should have died several times throughout the story, but somehow escapes with his life every time, supporting the claim that he represents an intangible concept.

I believe that Whitehead wrote this story to create an analogy for the resistance against social injustice. This idea came to me when Whitehead quietly slides racism into the story. After Gary is bitten, Mark Spitz explains how he earned his nickname and then adds, “Plus the black-people-can’t-swim thing.” Revealed as an African-American character, Mark Spitz uses this conversationally to provide some humor in Gary’s last moments, but I believe Whitehead is cluing readers into his underlying message. The infected skels and stragglers represent social injustice, discrimination, and racism. The world is contaminated with racist ideas and discriminatory practices, like Whitehead’s world is infected by zombies. Inaccurate racial assumptions can spread much like a disease. Misinformation, when spread, can become powerful and difficult to overcome. Whitehead is showing his readers the dangers of what could happen when prejudiced ideas grow beyond control.

In addition, Whitehead’s message includes a beacon of hope. In the analogy, Mark Spitz represents an idea of hope for a better world. There are people remaining who are fighting back against overwhelming odds even though the future looks bleak. Even when everyone around him is dying, he survives.  If we continue to be diligent in our fight against social injustice, even when setbacks occur, we cannot be silenced. Whitehead uses the final scene of the novel as a call to action. Mark Spitz is alone, cornered and doesn’t like his probability of ever finding success, “No, he didn’t like his chances at all.” Whitehead encourages us to “swim” against the tide, and to combat against society’s flawed values. Like Mark Spitz, we all need to step out of the door and continue the fight because a better world is possible. After all, we all “have to learn to swim sometime.”

Teeth are the weapons of the dead. Colson Whitehead, in Zone One, creates a world where teeth are the single most feared object. Incisors, canines, and molars are weapons capable of killing a person and also infecting people to become another member of the vast zombie army. The seriousness and danger of teeth can be felt by Whitehead’s comparison to guns, “a gun to his temple or teeth to his jugular.” Teeth are to be feared as a tool that functions as a weapon against the living. In the apocalyptic world, teeth hold an obvious and significant role in society. Whitehead explains the primary objective of survivors living in Zone One, the “first priority was keeping their limbs and associated parts attached to their bodies free of teeth.” The importance of teeth in this society is established very early on in the novel.

However, Whitehead also subtly indicates that teeth are not only a functional tool but may have additional significance. After discussing the importance of dental health and reading Jack McKeown’s blog post, I realized that teeth are seen as a proficient indicator of socioeconomic status. Whitehead questions the role of teeth in society through Mark Spitz wondering, “Did it work the hairdo, the bleached teeth, the calculated injections, did it transform the country rube into the cosmopolitan?” Society places substantial weight on the condition and appearance of teeth. Unfortunately in most cases, the quality of teeth is dependent on a person’s socioeconomic status and access to dental care. Teeth are another aspect of society that qualify people based upon socially constructed principles rather than substantive content.

White, straight teeth are a trait that many people admire and wish to obtain. Teeth are a variable trait of all human beings and are commonly altered for physical appearance reasons alone. According to a survey conducted by the American Academy of Cosmetic Dentistry, 86% percent of dental patients indicated that a major reason  for receiving treatment was to “improve physical attractiveness and self-esteem.” Less than half (46%) of the respondents listed “for restorative or oral health reasons” as a major reason for seeking dental treatment. Those with financial access to dental procedures see the industry as a tool to improve their overall appearance in accordance with societal values placed on white and straight teeth. While many individuals seek treatment for cosmetic reasons there are patients who require treatment in order to improve their oral health.

According to the FDI World Dental Federation, oral disease affects 3.9 billion people worldwide and untreated tooth decay occurs in nearly half of the world’s population. They also report that 110 billion dollars are spent annually treating oral conditions, and worldwide more is spent on oral healthcare than in the treatment of cancer or respiratory diseases. The FDI also claims that oral disease can be extremely damaging when untreated, “ Oral disease is associated with significant pain and anxiety, as well as disfigurement, acute and chronic infections, eating and sleep disruption, and can result in an impaired quality of life.” The treatment of oral conditions is an extremely expensive endeavor and there are many Americans that lack the financial means to receive necessary treatment.

The Washington Post Article, authored by Mary Jordan and Kevin Sullivan, titled “The Painful Truth About Teeth”, brings light to the separation in dental care due to socioeconomic status. Jordan and Sullivan report that more than a third of American adults have no dental coverage. Although there are proven detrimental overall health implications that come with oral disease, Medicare, “which covers 55 million seniors and disabled people, does not cover dental problems.” Many of these people cannot afford supplemental dental insurances and are forced to go without. Jordan and Sullivan also explain that “if you are poor enough and live in certain states you can get coverage through Medicaid.” However, only 38% of dentists accept Medicaid and it only covers an average of 37% of the bill, leaving even those with additional government aid unable to receive imperative dental treatment. American people are desperate for affordable medical care. The article also describes a free medical clinic in Maryland where 1,165 patients waited to receive dental treatment of serious oral conditions. Many lower-class Americans are not receiving the support that they require in order to receive necessary treatment while many Americans use insurance to help pay for cosmetic treatments.  

There is a serious separation in dental treatment, between socioeconomic classes, that needs to be addressed. I believe that Colson Whitehead is very creative by placing a heavy reliance on teeth in Zone One and hinting at the disparity in dental coverage. Zone One is a novel that tears down societal constructs and coerces readers to question what is truly important. Whitehead describes the teeth of skels as “black”, “rotten” and “broken” and hints at the idealized appearance through the American Phoenix mascot as “square and white.” When the skels finally overrun Zone One and prevail over a camp of the American Phoneix, black teeth overcome white teeth. I believe that Whitehead is providing the commentary that the superior white teeth provide no actual benefit and are simply a social construct. He forces the readers to question whether or not society should be using dental care as a socioeconomic indicator rather than necessary universal medical treatment.

What is society? Merriam Webster defines society as “a community, nation or broad grouping of people having common traditions, institutions, and collective activities or interests.” In other words, society is made up of people and the culture that they establish. Culture is made up of everything that people create whether it is art, music, entertainment, fashion, and many more aspects that make up the daily lives of people. Society and culture are social constructs that are developed by people to enhance the everyday lives of people. These are things that seem important and concrete to members of society. Colson Whitehead, in Zone One, describes what happens when society falls apart.

The Last Night marks the end of the civilized non-zombie society when the plague is released and tears throughout the world. Whitehead constantly refers to the pre-zombie society with a sense of fragility. In retelling the memories of Mark Spitz on The Last Night, Whitehead describes Mark’s family home and behaviors of his parents as mundane and material. The parents were normally focused on “every room, every reconsidered and gussied square foot, was an encroachment into immortality’s lot line.” Like the rest of society, Mark Spitz and his parents were consumed by culture and felt safe and secure in the societal roles. They placed value on material things that society valued. However, the “twin leather recliners equipped with beverage holders”, carried no value after Mark Spitz walked in on his mother chewing on the intestines of his father. Society had fallen.

Throughout the entire story of Mark Spitz finding his way in this new world, Whitehead consistently reminds us of how the old society has died and a new society has taken its place. The American Phoenix is the name given to the post-infection society. The phoenix is used to symbolize the attempt to reboot society and restore it to its former glory. The government in Buffalo hopes for a return to the past and does not consider the changing circumstances of the world. Human nature is resistant to change as Whitehead explains that the “tendency of the human mind, in periods of duress, to seek refuge in more peaceful times, such as a childhood experience, as a barricade against horror.” People hold on to what they know, even when the entire world has changed around them. The people of Zone One try to find hope that eventually society will return to what it once as even though that is an impossibility. Society cannot return to what it once was it needs to change and adapt to current situations.

I could not help but connect the social constructs of society to the idea of race. Returning to Geraldine Heng’s definition of race in The Invention of Race in the European Middle Ages, “ that race is a structural relationship for the articulation and management of human differences, rather than a substantive content.” Race, like society, is a social construct put in place by people of social influence. Racism is a purely social idea that is used as an attempt to explain obvious human differences and is not based on concrete evidence. The collapse of society in Zone One is analogous to the abolishment of slavery. Both are monumental changes in society, the plague in Zone One had a negative impact while the end of slavery had a positive impact. In both cases, due to the nature of human beings, there were people who held on to the old ideals of the outdated society. As Whitehead points out, if the change in society causes duress, humans return to ideals of past times. This may be a reason that racism remains present in our society today.

 Persons of power during the time of slavery became accustomed to the organization of races.  Even with changing circumstances in the world, there are people resistant to change, which makes racism difficult to truly eradicate. There were many people that belonged to a society that racial distinctions were an accepted part of society. Even after the major societal change many of these individuals held on to the previously accepted ideas. Unfortunately, the racist beliefs were passed down to children and to subsequent generations. The human nature to hold on to past beliefs after times of change is a major reason that I believe racism remains in existence today. Racism is an intangible idea that will remain in the world until individuals who perpetuate the ideas are able to recognize the fact that it is no longer a sanctioned aspect of society. I believe Whitehead is trying to convey the idea that people need to fight against societal ideals of the past, and that the world changes and we need to change with it.  

In Colson Whitehead’s novel Zone One, the story follows Mark Spitz and his fellow “sweepers”. Being a “sweeper” involves leaving the safety of the camp and ridding a designated area of Zone One of zombies. The primary target of the volunteer sweepers were zombies known as “stragglers”. Stragglers are a form of zombie that is not outwardly aggressive and present a reduced risk to the remaining unaffected. Stragglers are thought to be “mistakes” as the Lieutenant puts it. These zombies are stuck in a task or in a location that had some significance to them during their life and posed no threat except the slight possibility of infecting others. Whitehead describes stragglers as regular people that when infected become trapped in a moment after being infected. He describes the straggler existence as “…winnowed to this discrete and external moment.” Stragglers are a small percentage of the zombie population that do not attack humans. In essence, stragglers are like humans that paralyzed in shock. The zombies and the healthy are regular people that are only separated by the fact that some are infected and others are not.

Mark Spitz and the other sweepers are tasked with simply putting a bullet in the head of any straggler they find and place the body in a body bag. I, along with Mark Spitz,  have some apprehension about the treatment of the stragglers. When Mark, Gary, and Kaitlyn find a straggler bent over a copy machine, Mark instinctively asks the group “What if we let him stay?… He’s not hurting anyone.” His indication of unease caused a similar feeling for me. What if the infection can be cured? The Lieutenant explains to Mark that there are Nobel prize winners working on a cure. In my opinion, because the stragglers do not present a clear danger and have the potential to be cured, they should be kept alive until their affliction is completely understood. They may still be, at least partially, human.  However, I understand the panic associated with keeping these zombies alive because the knowledge of the plague is not yet completely understood. Mark explains fearing the unknown by saying “The plague doesn’t let you in on the rules; they weren’t printed inside the box.”

This idea reminded me of something that I had overlooked while reading. That even if stragglers weren’t curable, they still were once human, as were the skels. The sweepers treat the remains of the infected with indifference. It was common practice for sweepers to simply place a body into a bag and throw it from a window to the street. The practice was only halted because it created a mess and a possible source of infection, not because they were defiling the remains of someone formerly human. The Disposal unit disposes of bodies by the use of a machine called “The Coakley”  which is capable of converting almost all of the infected remains into smoke and ash. The lack of humane treatment of the remains is clear in the speech of one of the disposal technicians Annie, “Usually we like to stuff as many as we can in there before we fire it.” The cremation of the remains is conducted without any sort of care and respect for the dead. All of these zombies, through no fault of their own, were infected by a plague. Does the mere fact that they were infected prevent their remains from receiving the same respect as the remains of healthy humans? There are many cultures and religions that call for certain treatments of the dead, and none of them involve being shot out of an incinerator as ash by the handful. Ashes of the dead cover New York City. It is important to note that the characters in the novel would have no way of knowing what post-mortem rituals that the infected desire. However, I believe that the healthy should at least attempt to treat the remains of the dead with respect because they too were once fellow humans.

The mass disposal present in Whitehead’s novel is parallel to actual historic events of maltreatments of corpses. Nina Golgowski, of the HuffPost, reports that approximately 7,000 bodies were located under the University of Mississippi Medical Campus. This land was home to the Mississippi State Lunatic Asylum 80 years prior to the mass grave’s discovery. Like in Zone One, these remains were disposed of in an efficient, though careless, way that was not in agreement with the post-mortem wishes of the deceased. Many descendants of the inhabitants of the asylum wish for the bodies to be exhumed and identified in order to learn about their family lineage and finally determine what happened to their ancestors. I believe that this needed to occur for a greater reason. The insane asylum inhabitants were never given a proper burial. The Social Life of DNA, by Alondra Nelson, describes events after the discovery of a mass African-American burial site in 1991. Hundreds of African-American slaves that lived during the 1600s were buried underneath what is now lower Manhattan. In an effort to determine genetic information on the inhabitants of the ground, the bodies were exhumed. However, the researchers failed to treat these remains with respect as well. The exhumation was conducted with “…little consideration given to the conservation of the remains.” Their remains were treated as if they were less than human in life.  It is noble to want to identify the dead in order to give their families closure about their ancestors, but the bodies themselves are worthy of respect. Like in Zone One, the infected were discriminated against after their demise. These are all human remains and deserve to be treated with the respect that they warrant as recently deceased human beings. Whether or not the remains belong to former slaves, those considered mentally insane or people who have been infected, they deserve proper burials or cremations. After all, our last acts as humans are to be put to rest.

All parents want their children to be happy and healthy. Harriet Washington, in Medical Apartheid,  states that the discovery that many human traits followed a Mendelian pattern of inheritance allows reliable predictions of the outcomes in the child. There are many genetic conditions that a child can inherit from its parents that may be fatal or very detrimental to its quality of life.  Eugenics, as defined by Phillip K. Wilson of Encyclopedia Britannica, is the “selection of desired heritable characteristics in order to improve future generations.” From this definition, it seems that Eugenics may be a scientifically beneficial approach to limit the amount of genetic-based disease in our society. Washington points out that “Eugenicists proposed that society use medical information about disease and trait inheritance to end social ills by encouraging the birth of children with good, healthy and beautiful traits.” In light of this quote, scientists could use knowledge to benefit unborn children so that when born are able to live healthy lives and avoid diseases that their parents may be carrying. With the use of genetic information, parents can be armed with the knowledge to make an informed decision on whether or not to have a child that may fall subject to genetic disease. So why is the practice of eugenics looked upon with disgust? It’s simple. Persons of power, as Washington puts it, “…confused the concept of biological hereditary fitness with those of class and race.”

According to Wilson, eugenics is commonly associated with practices that took place in Nazi Germany during the 1930s and 1940s. In Wilson’s article, the German government adopted eugenic practices of involuntary sterilization in order to build a master race. Wilson also points out that “…Germany extended its practices far beyond sterilization in efforts to eliminate the Jewish and other non-Aryan populations.” Hitler did not use eugenics to help limit genetic disease but instead as propaganda to galvanize his supporters in his racist efforts. Hitler would not be the only person of power that contributed to eugenics being used as a tool of racist oppression instead of medical benefit.

 Washington points out that Americans were being sterilized as well, as many as 4000 in 1934 alone. In America, 27 states had laws that provided for the “compulsory sterilization” of groups such as the “feebleminded, those on welfare or those with genetic defects.” (Washington) Like the Nazis, the American government officials were requiring sterilizations of groups of people without attaining any form of consent. African-Americans made up a large amount of those who were sterilized through legal means. Washington also explains that outside of the law that there was a common practice of involuntary hysterectomies and the practice was so common in Mississippi that is was referred to as a “Mississippi Appendectomy.” Atlanta’s Southern Poverty Law Center filed a class-action lawsuit that resulted in the discovery that “…100,000 to 150,000 women had been sterilized using federal funds and over half of these women were black.” Eugenics being used as a tool of oppression against certain classes and races and not as a tool to benefit society as a whole.

After investigating the past crimes committed in the name of eugenics, a thought occurred to me. I thought of genetic counseling and wondered about its relationship with eugenics. In a blog post, authored by Ricki Lewis Ph.D., it is argued that genetic counseling is not a form of eugenics. Lewis explains that genetic counseling includes genetic disease carrier and BRCA mutation testing for potential parents. Carrier gene testing can detect whether or not parents are carriers of hundreds of genetic diseases and advise them on the chances of their potential child inheriting these diseases. Mutant BRCA gene testing identifies if the BRCA genes for DNA repair are altered. If they are, future children would have greatly elevated risks of several cancers. Lewis argues that these types of genetic testing are not a form of eugenics for a simple reason: “…the important descriptor of eugenics is INTENT; that of medical genetic screening and testing is CHOICE.” In other words, genetic counseling differs from eugenics because it allows for informed consent. I agree with Dr. Lewis. The initial reason that eugenics was perverted into what it is known as today, was that people of power attempted to alter society through forced means. Genetic counseling takes the positive aspects of the eugenics and gives parents information in order to properly make a decision on whether or not to have a child. In addition, genetic screening is not mandatory and potential parents must provide informed consent before taking part.

One of the main goals of genetic counseling is to offer information about genetic diseases that would be passed down to children. Knowing this, I considered the children of the Clay’s Ark community in Octavia E. Butler’s Clay’s Ark. Butler describes Jacob as a “catlike” child who was quadruped and “built for speed”. The members of the community have a compulsion to breed children and thus have no interest in preventing the birth of their genetically altered children. However, Rane reacts to the child similar to that of a eugenicist, “What the hell are you doing sitting in the middle of the desert giving birth to monsters and kidnapping people?” Rane clearly believes that the birth of these children should be avoided. The community members have no possible way to control their births because they are controlled by the microorganisms that infect them regarding this matter. Even so, Lupe argues in defense of giving birth to children with the infection,  “Eli says we are preserving humanity. I agree with him. We are.” Butler is extremely talented at posing questions to readers that have no clear answer. Through this dialogue between Rane and Lupe, Butler provoked me to ask several questions of myself. Is Rane right to believe that these children are dangerous to the world and their births should be controlled? Even if the members of Clay’s Ark community could refrain from having children, would they give up their basic human right to reproduce? Would they be willing to give birth to a child that they know will carry the disease? She was able to trap me into thinking like a eugenicist and also a parent. Honestly, I do not know what to think of these questions and I believe that is part of Butler’s genius.

After having the privilege of hearing about the process of human scientific studies and the nuances of informed consent with Dr. Ben Chapman of North Carolina State, I was left with a troubling thought about what it means to be informed.  Chapman, in his podcast Food Safety Talk Podcast Episode 163: “Grown on Chia Pets”, discussed a particular participant that challenged the consent process of one of his studies.  The chief complaint of the participant was that he felt betrayed that he was not properly informed before taking part in the study. To avoid biased results, researchers often use deception studies. Deception studies, by nature, cannot fully inform participants on the true aim of the study. The question I was left with was: Should we allow deception studies to continue being used?

In Percival Everett’s Zulus, Alice is offered safety by being smuggled out of the city to a rebel camp by Theodore Theodore.  Alice consents. However, her consent is meaningless. When she consents the only information she was given is that Theodore Theodore says “I will do everything I can to help you”.  Later, Alice finds out that she will be subjected to imprisonment and a violating verification of her pregnancy. Although Alice provided consent by asking for help, she in no way consented to the horrible acts she would have to endure.  Alice was extremely uninformed and forced to suffer because of the deceit of the rebels. To properly consent, Alice needed far more information than what she was provided.  Alice was not informed of everything that she would later encounter and therefore is a violation of informed consent.

Harriet A. Washington describes another situation of uninformed consent in her book Medical Apartheid.  She recounts a story from Jesse Williams about participating in a footwear experiment that was really an attempt to induce a foot fungus that was extremely difficult to treat. “Investigators went to remarkable lengths to deceive inmates about the harms inherent in the tests”. This is clearly a violation of attaining properly informed consent. While Williams was prison he was never given a consent form. Even if he had the ability to consent to a study of this nature, he was grossly under-informed about the true nature of the study.  Williams experienced a lack of informed consent because he has deliberately misinformed about the aims of the study. He was also not aware of the risks that accompanied the true nature of the experiment. Williams’s lack of knowledge of risks and the true goal of the experiment would have prevented his ability to provide informed consent if he was given the opportunity.

Alice and Williams’s situations demonstrate a clearly unacceptable lack of information. However, deception studies also withhold information from participants. Deception studies are considered necessary and ethical in today’s human research environment.  According to the University of Wisconsin’s Health Sciences Institutional Review Board, deception studies are necessary in order to  “obtain unbiased data with respect to the subjects’ attitudes and behavior when complete or truthful disclosure is expected to produce biased results”. Human beings often aim to please, so if they know the aim of the study they tend to alter their behavior. The IRB of the University of Wisconsin indicates that researchers are allowed to active deceive and passively deceive research participants. Active deception involves providing inaccurate information to participants. Passive deception is intentionally withholding information that is vital to the study. Alice experienced passive deception because she did not fully understand what would actually occur at the rebel camp. Williams experienced active deception because the information provided was inaccurate to the actual details of the study. Alice and Williams both experienced deception in ways that current researchers utilize.

If the deception that was described in Medical Apartheid and Zulus was considered unjust, should researchers today be allowed to use the same methods? Yes, because there are oversight organizations that prevent deliberately detrimental practices. Chapman deliberately deceived his study’s participants by not disclosing that they would come into contact with non-pathogenic E.coli bacteria. I believe that Chapman was just in doing so because the Institutional Review Board protects participants. The IRB ensures that studies can only involve minimal risks to participants and risks described to the participants cannot inaccurately represent actual risks. In William’s case, the risks were not described accurately and thus an oversight board would have prohibited this study.  Institutional review boards also have provisions that force researchers to reveal the actual details of the study to participants and allow them to withdraw from the study and completely eliminate any data acquired. These provisions protect subjects from initially consenting and then not being able to revoke their consent. Subjects may not be fully informed at the beginning of the experiment but are completely informed before their information is used.

In an ideal world, deception studies would not be necessary. True informed consent is currently not a reality in human studies. Deception is required in order to gain accurate knowledge to provide a benefit to the population as a whole. As long as research participants are not being taken advantage of and only experience minimal risk, deception studies should be allowed to continue. In the case of Chapman, deceiving his participant was a source of great regret and felt that he personally had a responsibility to revise his study to avoid problems in the future even though his study held up to IRB guidelines. Researchers, like Chapman, act in good faith and are subject to many rules that ensure the full protection of participants. While willingly deceiving research subjects may seem in bad taste, it remains a necessity.

Harriet Washington, in Medical Apartheid, recounts the story of Walter Clement Noel. In 1904, Noel was a first-year dental student from a wealthy black family. He was admitted to a hospital for pain, bruising, and sores along with other symptoms. Noel was diagnosed with Herrick’s anemia, which is known today as sickle-cell anemia. At the time of the diagnosis, James B. Herrick the attending physician published the findings and also claimed “…Noel’s was a disease that struck only blacks” (Medical Apartheid, 155).  Unfortunately, this inaccurate idea was soon widely accepted in the medical community and set the stage for sickle-cell to be a facet of systematic racism in the medical field.

During my undergraduate education as a student majoring in biochemistry, I have had the opportunity to study sickle-cell anemia. I have become familiar with the molecular and evolutionary basis of sickle-cell. Sickle-cell anemia affects the hemoglobin of red blood cells and causes them to have an altered form. According to Meredith Wadman, of Nature, the sickle-cell gene is a mutant “S” gene that replaces the normal “C” gene. People that have two copies if the mutant “S” gene, exhibit red blood cells that have a “half-moon shape” and altered function.  Wadman also explains that people who carry one of the “S” genes do not typically exhibit symptoms of sickle-cell but are less susceptible to effects caused by the malaria parasite due to a slightly altered formation of hemoglobin.

Sickle-cell anemia in the early 1900s was wrongly used as evidence for the inferiority of black people as a race. Washington explains, “the erroneous belief that sickle-cell anemia strikes only blacks became fully entrenched, thus reinforcing belief in the inherent inferiority of African-Americans”(Medical Apartheid, 156).  Although sickle-cell anemia is characterized as a disease that disproportionally affects people of African descent, the high rates of disease are not due to any racial differences. The theory of evolution says that traits that are advantageous to the survival of an organism will have an increased frequency. The gene for sickle-cell is no different. People who resided in Africa, where the malaria carrying mosquitos are native, were more likely to survive if they carried one of the mutant genes for sickle-cell. Medical practitioners of the Noel’s time saw this condition as a disadvantage of the black race when really it is only present because it was advantageous. In addition, the sickle-cell gene does not exclusively reside in people of African descent but in all races. Washington describes it best by explaining, “…the common denominator of sickle-cell disease is not race, but living in proximity to the malaria bearing Anopheles mosquito”(Medical Apartheid, 155). Sickle-cell anemia is not based in racial differences but in ancestral location.

The idea that this disease was a physiological downfall of black people is not only incorrect but set up systematic racism in the medical community for years to come. In an article authored by Jennifer Adaeze Okwerekwu, the unfortunate truth about lasting systematic racism towards sickle-cell patients today is brought to light. As a third year medical student, Okwerekwu came across a sickle-cell patient in immense pain that had a fever and a cough that required treatments including fluids, pain medication and oxygen. She planned to ask her resident, her superior, to order these treatments. However, Okwerekwu then explains that she “… came to realize that she needed more than that: She had symptoms of acute chest syndrome, a leading cause of death for patients with sickle cell disease.” This may not seem that significant, but it shows the lack of urgency that medical professionals take with sickle-cell patients. Emergency room systems are supposed to match the most serious cases with the most experienced and competent physicians. Okwerekwu, who at the time was not a licensed doctor, raises the question “As sick as she was, why was I, a medical student, the first one to evaluate her?” The patient required urgent care by an experienced physician. The mistake of making the sickle-cell patient a low priority could have cost their life if Okerekwu was less capable and did not recognize the symptoms.

The medical care of the patient that Okwereku treated was simply not a priority for the medical staff. The racial history of sickle-cell anemia has caused a lack of priority in research and patient care.  In Okwereku’s article she comments on how research for sickle-cell is disappointing as well. “More people suffer from sickle cell than cystic fibrosis, but cystic fibrosis research gets 3.5 times the funding that sickle cell does.” Okwereku, as a doctor of color, states in her article that she is recommitting herself to treat patients equally and notice when her “attitudes have been wrongly shaped by racism, whether subtle or overt…” This lamentable story demonstrates one of the many ways racism remains present in our society.  Washington, throughout Medical Apartheid illustrates many ways in which racism plaques the medical community.  Hopefully, in the near future, more doctors will follow in Okwereku’s footsteps to continuing to notice and combat discriminatory practices.

Toni Morrison in her novel Home, tells the story of Frank Money, an African-American Korean War veteran who returns home and is forced to battle racism.  Frank, like so many other veterans, suffers from Post Traumatic Stress Disorder.  The men who fought in the Korean War witnessed countless acts of violence and returned home severely emotionally damaged. Frank as an African American was not only forced to endure battle and the loss of his best friends in Korea but racism as well. 

According to the Korean War Legacy Foundation, racism towards African Americans servicemen remained a concern during the Korean War. Just two years before the United States became involved in the conflict in Korea, President Harry Truman signed Executive Order 9981 officially ending segregation in the armed forces. Truman believed that African-American troops were honorably risking their lives and deserved to be treated with the upmost respect. Unfortunately, many high-ranking military leaders simply ignored the President’s new legislation, as many units remained segregated.

Although this was a major step for African-American civil rights, acts of racism towards black soldiers did not cease.  In an article titled Black and White in Vietnam, Gerald F. Goodwin of the New York Times wrote of time he spent with soldiers during the Vietnam War, which took place years after the conflict in Korea. Goodwin explains that African-American soldiers were frequently denied promotions and were more severely punished than their white counterparts. For only making up 11 percent of the total servicemen in Vietnam, African-Americans accounted for 34.3 percent of court-martial punishments.  Not only were black soldiers unfairly punished, but also assigned to more dangerous posts. This inequality resulted in African-American deaths representing 25 percent of all of the American deaths in Vietnam. In light of the discrimination that took place in Vietnam, one can estimate the magnitude of inequality that took place during the Korean War.

Soldiers willing to lay down their lives in service of their country should be hailed as heroes, regardless of their ethnicity.  The acts of courage displayed of African-American servicemen often went unnoticed and unrewarded.  However, African American soldiers returning home from World War II were treated with far less hospitality than they truly deserved.  Isaac Woodard Jr. fought bravely in the United States Army in World War II and was honorably discharged and returned home to the United States. Only hours after being discharged, Woodard was pulled off of a bus by police and was beaten, resulting in the loss of his eyesight (Korean War Legacy Foundation).  Woodard’s story was not the only heartbreaking atrocity that took place. However, his story is noted as a major reason that Truman signed Executive Order 9981 into law. 

Frank’s PTSD in Home is attributed to the loss of his fellow soldiers in battle and the killing of a defenseless Korean girl. It is without question that Frank is an imperfect man. He committed an unforgivable act of violence that clearly haunts him and is a main cause for his alcohol abuse. However, Frank is also a victim. He witnessed the deaths of some of his best friends and was forced to deal with the added stress of being an African-American in the armed forces. I possess a great deal of sympathy for Frank. I believe him to be a good person who was unfortunately jaded by racist beliefs of the time.  He protected his sister since he was just a boy and felt a great deal of guilt for leaving Lotus and enlisting in the military. A man who feels guilt by engaging in a selfless and honorable act cannot be bad person by nature. His environment and experiences twisted him into a man capable of killing an innocent girl. I believe that Frank is a complicated character who was coerced by racist institutions into becoming a man of sin.

After all Frank Money is a fictional character, but he represents a generation of African-American veterans. He is an analogue for veterans who chose to fight for their country even though their country treated them as less than human. I consider this act of the highest honor. As a descendent of veterans, I understand the sacrifice and selflessness of fighting for a country. Racism and discrimination is unacceptable, especially when it occurs to brave men that are willing to leave their lives and families to protect their nation. The military owes these men immense gratitude and reform. President Harry Truman realized the sacrifice of black servicemen and began to repair a broken system with the signing of Executive Order 9981.  In modern times, discrimination remains present in the armed forces, as Carla Herreria reports that black soldiers are currently two and a half more times as likely to be punished through a court-martial or nonjudicial means than their white counterparts. Even though discrimination remains prevalent in the military today, efforts should continue in order to make sure that African American heroes are being treated as they rightfully deserve.