Getting out and Staying Out
The 19th-century game-changing shift in medical training and the need for Black bodies
I watched a good bit of Jordan Peele’s Academy Award-winning film Get Out with a blanket over my head. Horror and thrillers have always been on the Hell No List for me. Nancy Drew mysteries were too scary for me, so forget anything that opened up portals to hell or murderous lone wolves. I found horror as a genre useless. This was to some degree, ignorance of course. A film can be a meditation, fixing on a theme or an idea, and giving an audience an hour or two to sit before it. Horror can be very useful as a genre to explore our cultural memory and fears. We might wonder why we never learned to see the monster right in front of us. How did our bias warp the clear signs? Why did we decide to go into the cabin anyways?
Peele’s fictional nightmare articulated and captured a real, Black fear in the air. I admit I initially thought his premise was slightly exaggerated. Yes, racism is bad. Yes, racism kills. But White people over generations conducting medical surgeries to profit and advance the health of other upper-class, wealthy people? That never happened.
Right?
In the 19th century, American hospitals and clinics were starting to organize and rise in number and prominence. Two key changes in expectations also shifted the medical establishment.
Training. Medical training was now longer and more thorough than the typical one-year stint with an older doctor who gave you some anecdotes and then sent you off to figure it out on patients.
Treatment. Patients began expecting their medical professionals to come to them with prior, extensive hands-on experience.
Private physicians coming to the home was generally the time-old tradition, and as the hospitals and clinics grew, it stayed that way. Why? Because it was a known, open, clearly communicated fact by the medical establishment that the hospitals and clinics were not primary spaces of treatment, but experimentation and teaching. The only people who dared go to hospitals and clinics were enslaved people dragged there by their enslavers, dirt poor immigrants, or laborers of other backgrounds who had absolutely run out of options.
Harriet Washington demonstrates in chapter four of Medical Apartheid, The Surgical Theater, that the hospitals and clinics across the country needed bodies for their medical students. The vast majority by far of bodies that were non-consensually, tested, operated on, experimentally treated, and dissected for medical students were Black ones. Free Black people had to navigate a world where tons of nonsensical infractions would lead to mass incarceration. Upon being incarcerated, if the local hospital or clinic needed bodies for instruction purposes, the prison would hand over the “guilty”.
The demand for Black bodies grew, and hospitals would strike deals with enslavers. Old or injured enslaved people were costly to enslavers, so the hospital will take them and board them in exchange for permission to use the enslaved as live teaching subjects. The enslaved were not allowed to leave or refuse whatever procedure the students or professors wanted to do on them. Often times the enslaved would be treated, only for the doctors to go ahead and continue with an unnecessary amputation or experiment to “see what they could learn.” Hospitals advertised, competing for students, the great quantities of Black bodies they had for students to learn on. Advertisements were put out for enslavers to please send Black people to them in exchange for money. If the Enslaved person survived the horrors of the hospital, the enslaver might get a kind of treated slave back to keep working!
Washington quotes the statements of doctors who warned and taught their students that these methods “were not for White people” and that the care and treatment standards had to remain different. You couldn’t possibly put White people through what Black people were designed to suffer. Amputations for White people were a last resort, but a first step for a curious doctor on a Black patient. “Clinical Material” as they were known, had to meet certain specifications because the doctors were open about how painful and experimental the teaching procedures were. Armed with the illogical justification that Black people had thick skin and terrible morals, they carried on with this in spite of the pain that was evident on their tables.
Because the medical establishment rarely accepted anyone that wasn’t a White man in their schools, the establishment remained solidly White and male, and that perspective and culture shaped generations of people and their healthcare. Washington noted the pervasiveness across state and city of the callousness with which Black people in the clinical material notes were written about. She noted how quickly sympathetic doctors’ notes would start and how over just a year, indifference marked their writing. Few but not many were there to challenge the doctors who blamed common illnesses on Blackness, took pieces of Black people home, or think about any kind of legal obligation to the people they were studying on. It was only when outcry across the land from abolitionists and Black doctors grew louder that the medical establishment started using code to advertise the great supply of Black bodies that made up the institutions.
No one really wanted to go to hospitals during this time, especially not the people who knew exactly what was happening to people based on their socially constructed race. The blatant knowledge of these crimes was so well known, that enslaved people had to be forced to go and for generations, if they had the choice, would avoid the hospitals and clinics.
Today, medical experimentation in this tradition routinely takes advantage of people who under better circumstances, would not expose their bodies to American medical testing. Hospitals with access to low-income or historically marginalized populations can be either a blessing or an old curse for the community. Are we routinely checking for bias in training? In the care of patients who do not have the power to sue? Whose legal status might put them on shaky ground to demand fair and respectful treatment?
The end of this short chapter on the medical display of Black people reminds us that an entire system unleashed medical practitioners who had been trained to see Black people as freakish subjects and not patients. It pricks us to think about the ongoing beliefs and assumptions that lead most of us to unconsciously treat the pain of White looking at people with more urgency than Brown and Black people, who in our social memory are the people destined to suffer. What this chapter invites us to think about has of course a much wider application. It can help us reframe who we think the victims are in our wars, in the news accounts of different kinds of issues, and what we expect people different from us to endure. Why do we think that? Would we want to endure similar things?
Carol Gilligan’s prescription for a different dumpster fire -patriarchy that destroys democracy- is love and empathy. In the face of such depressing facts of the terrible things we do to each other, is that awareness that the opposite of Love isn’t hate, but indifference. Indifference helped build this American Medical culture, but empathy and awareness can absolutely change it.
And to Jordan Peele, I apologize. I didn’t realize this place was haunted.