Sick with Sickle-Cell

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.

The Limitation of Reproductive Rights by Governmental Entities

In the fictional dystopia created by Percival Everett, fertility is a hot commodity, and nobody has it… except for Alice Achitophel. However, Alice’s capacity to bear children is not a superpower, but rather an ability that has not yet been taken away from her. The government-mandated sterilizations that set the stage of Zulus may seem like they would cease to exist outside of the surreal chapters of a fiction novel. Sadly, as I will begin to reveal, involuntary sterilization at the hands of the government is no new phenomena. In the 1970s the Indian Health Service is responsible for sterilizing staggering amounts of Native American women without their informed consent.

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The Snap

In Avengers Endgame (2019), all of the main characters are going through a shared experience. They all have just been through the Snap, which got rid of 50% of the Earths population. Captain America, Iron Man, Black Widow, Thor, Hawkeye, and Captain Marvel are all debating on how to deal with life after this tragic event.

This can be related to the book Zulus, by Percival Everett. The main character Alice Achitophel and those around her are struggling to survive in a world stricken by chemical warfare, much like the Snap. No one is quite sure how to live in a world where the government is controlling everything, even your weight and if you can have kids or not. Alice is an outcast, she is both over weight and pregnant when no one else is. Just like the Avengers are unsure about how to make the world right again and have the outcast group that actually knows what happened and are trying to fix it.

The Avengers eventually are able to get back the other half of the worlds population, through a very large and intense battle, with many deaths and sorrows, as well as the success of getting rid of Thanos, who initiated the Snap. So far in the book Zulus, we have not seen the battle that the rebels will have, if any happens. There has only been conflict between the characters as they figure out what to do with Alice and the baby she is supposed to have. Even though, the baby Alice was supposed to have ended up being a skinnier version of herself. (That I have no idea how to connect to the Avengers)

Zendaya as the Beautiful Face of a Harsh Reality

Most people today would hear the question, “Have you seen the movie The Greatest Showman?” and think of a heartfelt movie of triumph in the face of adversity. The movie even received an eighty-six percent audience rating on rotten tomatoes. The movie introduces its main character as the previous P.T. Barnum and follows his journey of creating the first ever circus. He starts off as a poor man living with his wife and kids when he unfortunately losses his job. Sympathy for his character is immediately built especially with today’s economy grabbing the audience’s sympathy and they are rooting for him and his circus to succeed. He gathers up what he calls in the movie as “a collection of oddities” or his “freak show,” and he exploits them for their uniqueness. Some of the members of his circus included beautiful actresses such as Zendaya and Keala Settle who are taken advantage of by P.T. Barnum in the movie as well as the others.  Barnum’s family moves into an opulent mansion as he starts to make money off of his shows and the members of the circus feel empowered and happy to be apart of it. Barnum’s greed overpowers his moral code and he begins to mistreat the “freaks” that gave him the power and fame in the first place and they band together against him. P.T. Barnum eventually makes his reparations with the crew and everyone lives happily ever after, right? Wrong.

 The truth of P.T. Barnum is much deeper and darker than this movie ever attempts to expose. In Medical Apartheid, Harriet Washington reveals the horrific details of the first “circus.” Zendaya, in today’s society, is a fashion and beauty icon. Not only is she a beautiful model but is highly respected in her discipline of acting as well. She represents the opposite of P.T. Barnum’s motives that are seen in history. One of the atrocities that Washington details in her book is about a slave named Joice Heth. Barnum purchases her from her previous owner R.W. Lindsay and decides to display her and make money off the ticket purchases. Washington lists the reasons he chose her, “Her eyes were gone, the legacy of some unknown ailment, she was toothless, and her uncut horny nails curved like talons.” To compare the icon that is Zendaya who not only a model in looks but whose character in the movie is not a slave with the reality of Joice Heth is disrespectful to the oppression she faced under Barnum’s ownership. Not only were none of the characters in the movies slaves, but Zendaya was the only Black actor that held a main role in the circus. As Washington mentions in the book, the Barnum that we see in history exploited slaves who had disabilities as a result from injuries they received from previous owners and most of her ailments were a results of others brutalities that he paraded around. From the description above of Joice, not many would picture Zendaya to fill such an important and powerful role. The Greatest Showman gives a fictional narrative to the sad story of Joice Heth’s abuse and oppression. In Medical Apartheid, Washington mentions that even after Joice passed away, Barnum once again stripped her humanity in a large viewing of her autopsy in an attempt to prove outrageous claims he made about her age and false medical diagnoses. It’s a shame that the public remains largely uninformed about the true history of P.T Barnum and his exploitative actions. How can one truly know about the sad truth when authentic histories in the media and cinema are directing society to avoid the harsh reality. Barnum, as stated by Washington, focused on the exploitation of black bodies and fueled the racist atmosphere of the time. It’s important for Hollywood and the actors taking part in these movies to think of the real people that these narratives affected. Joice was never given a voice throughout her struggles and Zendaya’s voice lacked the overwhelming strength and courage that Joice and many other victims deserved. Instead of remembering Zendaya’s beautiful face when thinking of P.T. Barnum, remember Heth’s beautiful courage in the face of so much abuse.

Racism in the Ranks: Discrimination in the Armed Forces

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.

Imposter Syndrome and Its Invisible Grasp on Medical Students

Imagine both helping to bring one of modern medicine’s most fundamental procedures to America and preventing an epidemic. Now, imagine doing all this and not receiving credit for it.  In our world ruled by copyrights and publications, this situation can be difficult to imagine. However, in 1721 this was far from reality.  An excerpt in chapter 2 of Medical Apartheid recounts the story of Onesimus: the man who helped make inoculation mainstream in the United States. When Onesimus shared his knowledge and experiences of the procedure in Africa with the man who kept him enslaved, Cotton Mathers, Mathers used this information to advocate for widespread smallpox inoculation in Boston. He also submitted a report to the Royal Society on the topic, and as a result reaped acclaim for preventing an epidemic and making inoculation a widespread Western practice. On the contrary, the mastermind behind the technique, “came to share the fate of nearly every slave who contributed to medical research: facelessness” (73). I interpreted this “facelessness” as a forced separation of Onesimus from his contributions. This alienation he experienced reminded me of more modernly acknowledged phenomena: imposter syndrome. People with this condition often feel uncomfortable acknowledging that they are wholly responsible for their successes. This condition is very common, especially for people in the medical field, but it is still not recognized by many: including its victims. In my writing I hope to both raise awareness of what imposter syndrome is and why it occurs, as well as how we can combat it so that more people can feel valid and responsible for all that they have accomplished.

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Be Informed

Our course epigraph ““My job is to notice…and to notice that you can notice.”–Dionne Brand, from notes that Beth during the question-and-answer session following Brand’s March 2, 2013 reading at the Northeast Modern Language Association in Toronto” (course syllabus), makes me think about all the things that I have never noticed and been blind to. I feel as though it is better to know than to not know, and I feel as though it is your job to be an informed citizen wherever you are. My whole life I have been blind to the fact that our modern medicine has gone through experimentation with the use of slaves without their consent. So many people have never questioned the history of our medicine and therefore have never known the horrors of how it came to be. This makes me truly upset, and one goal I have for this semester in this class is to learn as much as I can about how our modern day medicine has come about so I can be more informed and inform others. In the first few chapters of Medical Apartheid by Harriet A. Washington I have learned so much more than I feel I would have learned about this matter in my whole life. I never knew that gynecological instruments were tried involuntarily on slaves. I also learned that there are many accounts of people of color going missing, and when they pass away their bodies are awarded or sold to medical schools for students to run experiments on. There was a man named Ota Benga, who was taken from his country and awarded to Samuel Phillips Vernon after finding that his family and tribe had been slaughtered. Benga was locked in the monkey habitat at the zoo and put on display for everyone to see. They locked Benga up so that they could show the theory of evolution. After attacking people they released Benga and the African American people of the community raised money so they could send Benga to college. He ended up committing suicide years later. Stories like this would never have been told if it were not for Harriet A. Washington writing this book. We learned in class that iatrophobia is the fear of medicine, and many people of color have this fear because of the horrendous history of how modern medicine came to be. I mean who can blame them? I find myself getting upset reading about all these things that have happened in our history that no one has talked about, none of this is common knowledge. Another goal I have for this class is to become informed, and inform other people. While there is not much we can do about the past now, knowing about all these things can keep from having history repeat itself.

Noticing

Upon reading the course epigraph, I begin to think about in class, noticing each other talking. In every class period, there is tons of conversation about the reading we completed for class. But these conversations are about noticing things from the text, and noticing what others are noticing.

In the book Medical Apartheid, by Harriet Washington, there is so much to notice. We can notice that there are so many horrible things happening to innocent people through out history. Many of these horrible things include using unclaimed bodies for scientific work, being used for medical experiments without consent, being exploited for having medical deformities, that many other humans have, just because your skin is different, and many other things. In class, we can notice these things and learn about them, but the real learning comes when we notice what others are noticing.

When we notice what others are noticing, we can learn their perception on the topic. Not only do we learn what we think about and understand, we learn about what others think. I can use this knowledge to set a goal for myself. This goal being that I want to notice what others see more often. I want to learn not just my own noticing, but what other classmates notice. Having more discussions about the text and really thinking about what others are saying, talking more and including my own thoughts to help others learn as well.

Noticing what others notice is how you learn more things. The course epigraph really gets me thinking about learning new things from my classmates.

Where Our Power Comes From

The gains of society which have made based on abhorrent evils are significant. I find it deeply unsettling, just how much of modern medicine is based on human experimentation and non-consensual research. Entire fields of medical study being based on research which violated the human rights of so many leads to questions about how mankind has benefitted from its capacity for evil. The accounts read on Dr. Sims and his use of enslaved women for practice before utilizing what he learned to cure Caucasian women is a story which to me, encapsulates the disturbing long term moral dilemma of unethical medical research. When research can benefit all women for generations to come and save countless lives, are we right to benefit and prosper off of them so long as we recognize their evil origins? The answer is not so simple.

No doubt we have all benefited from the evil deeds of medical practitioners like Dr. Sims. Whether directly or indirectly, a large part of male and female population alive today can chalk up their high odds of survival to the knowledge gained by Sims. I think ultimately what is important is to not excuse the horrors perpetrated in this way by lauding the men behind the knowledge. While it is important to acknowledge the sources of our knowledge and the individuals who brought about their development, we should always keep fresh in our minds the evils done by those we learn from. We should celebrate the life saving techniques we have today and use them, but vow never again to utilize the sordid methods which lead to their realization. Professor McCoy’s acknowledgment of this was something which caused me to think a great deal about ends justifying means and how this is never a mindset which we should fall into. Fortune’s bones has had me thinking of just how important it is to be intimate and not to look away from the horrors done in the name of progress.

I sincerely hope that when Doctor Porter dissected Fortune and had to look upon the damage done to his body, that he came to terms with what he did, and understood the full extent of the wrongs he had committed. When he wrote “I enter Fortune and he enters me.” I believe that the Doctor did come to understand that he had hurt a person, a father, a son, and a brother, tortured him for a lifetime and done a truly horrible thing. I believe that this kind of intimacy is important, not only for those who committed the horrible crime of slavery, but for us in the modern world for whom slavery can easily and dangerously become a distant memory bound to history books. It is important for Fortune’s Bones and the deep scars they bare to be visible in a museum. Despite being dead, Fortune’s body is a living reminder of what mankind is capable of when we abandon morality for the possibility of knowledge. We should never forget where our foundation has come from. We must always remember the evils done in the past so that we do not repeat them.

The most important thing to remember is that the legacy of harm which left its marks on Fortune’s bones is not limited to them. The legacy of racism and the racial complexities of our time are things we must always work to overcome in our personal lives. We can do this by recognizing where our power has come from and treating others with kindness and empathy.

Heng and I Notice, Will You?

The definition of notice is “ the fact of observing or paying attention to something.”While reading “The Invention of Race in the European Middle Ages: Inventions/Reinventions” by Geraldine Heng, I’ve used this ability to absorb all she has to offer in this powerful text. While reading this work, one can immediately grasp the many historical instances of race profiling from the 1200’s. Jews and muslims were to be set apart apart from Christians by dress, or Jews were to wear badges to be able to be identified amongst a crowd of people. Her definition of race pertains to the lasting impacts our “pre modern” acts of racism have left on today’s society without ignoring the events of the past. The events that occurred in a time where no definition of race was present doesn’t exclude them from pertaining to the definition that we have today. They were “legal” acts of violence and could be considered a form of terrorism by more modern standards. Heng talks about how race merges with a kind of hierarchy system that includes class, gender, and sexuality. It is no longer epidermal, it morphed into a bigger monster that is even harder to unravel and beat down.

Race has become a type of, as Heng puts it, “empty vacuum” that can change figure in every instance engulfing other ways of categorizing people and raising the white privilege pedestal influenced by all ranges of past pressures and occasions in history. There is no singular point in time where the origin of race emerged and that contributes to it’s successful succession through time. One instance in recent history, the 9/11 attacks of the twin towers of New York City, Muslims were further alienated as an inferior “race” following this day. This shows the development of an ethnoracial categorization, one made out of ignorance and fear. This category can be compared to others present in today’s society such as “Middle Easterners” and “Arabs.” These labels simply group very different people into one large group that continues to culturalize race and its definition. Muslims reside in a range of, in Heng’s terms, “ethno-races” and national origins that after the 9/11 attacks, have been put together into one people. In the 1200’s “pre modern” times, Muslims were ostracized and grouped with the Jews. This formed the foundation of where we validated them being a homogeneous group once more after the attacks. Heng argues that people must recognize the medieval past and that it will always exist as a basis for modern acts of racism, even though the vocabulary didn’t exist.

A quote from Dionne Brand, written down in Professor Beth McCoy’s notes reads, “My job is to notice… and to notice that you can notice.” Although many would think in the previous analysis that a lot was noticed during this close read, most would neglect to notice what Heng has noticed as well. The key to gaining the most from any interaction you have with a text, is you must notice each other. Although the ability to meet Geraldine Heng as a student reader of her work is slim to none, one must notice her notice on a deeper level. What stood out was this quote, “Current masks of race are now overwhelmingly cultural.” The obvious meaning of this is where race and culture mesh and force otherwise unlikely people into a single inferior group. While coming back to this quote in my notes I “noticed” the word mask in a different light than previously before. After gaining all of Heng’s knowledge by the end of this paper the word mask spoke volumes. It embodied everything in the paper in one single word. This interwoven beast called race that we as people have created is all based on each other’s “masks.” Superficial characteristics have shaped the entire dynamic of race as we know it today. All people are born the same with the same innocence, ready to start life, and then you are given your “mask.” One that decides how you will be treated and viewed before you’ve had the chance to create your own. Black is damned, white is saved. Black as cowards and white as brave, the hero. Until we learn to delve beneath the mask made of skin color, culture, sexuality, and experience and realize underneath we are all the same, history will continue to repeat itself.