Best Quotes from Medical Apartheid by Harriet A. Washington with Page Numbers

Enslavement could not have existed and certainly could not have persisted without medical science.

The apparent solicitude for the health of slaves was not all it seemed.

Public health institutions were few, feeble, and ephemeral, rising momentarily with epidemics of yellow fever or smallpox and subsiding from neglect after the crisis resolved.

The science of race has always been an amalgam of logic and culture.

In short, enslaved blacks often eschewed Western medicine because they suspected their owners of a greater interest in them as capital than in their welfare.

Black contributions to early American medicine included research.

The physician’s certification of the slave’s soundness did not speak to her welfare or happiness, but rather to the ability to extract work from her.

Appeals to God, the importance of moral fitness, and enlisting the help of departed spirits, especially the intercession of ancestors, were all key to the African-based healing process.

Many medical practices of the time were not only misinformed but dangerously so.

Southern physicians supported the slave system with racial medical theories and diagnoses, but the slave system also supported them.

Montgomery has not forgotten the heroic role of the three slaves Anarcha, Lucy, and Betsy, who suffered, not only that they themselves might be cured, but that women injured in childbirth in future generations might be saved from lives of misery and invalidism.

A lie told often enough becomes the truth.

Involuntary medical experimentation was the scientific personification of enslavement.

Violence, pain, and shame joined as physicians forced the enslaved body into medical service, not to cure, but for profit.

A doctor’s ethical responsibility must extend beyond the individual to encompass the context of social injustices.

The experimental abuse of African Americans was not a cultural anomaly; it simply mirrored the economic, social, and health abuses that the larger society perpetuated.

Sims’s refusal to administer ether seems even less defensible in light of his willingness to administer it very freely to another group of women.

The suffering and the benefits have been distributed in an unfair way, leading to distributive injustice.

To perform an experiment without informed consent is a serious medical (and legal) abuse today.

The medical association between assiduous cleanliness and infection had not yet been drawn.

“Our race…is depressed enough without exhibiting one of us with the apes. We think we are worthy of being considered human beings, with souls.”

“I insist that justice in all such works demands that the very best type of the Negro should be taken.”

“The Negro 'with us' is not an actual physical being of flesh and bones and blood, but a hideous monster of the mind.”

“It is impossible for me to repress the feeling that they are not of the same blood as us.”

“These races with depressed and compressed skulls are condemned to a never-ending inferiority.”

“The genuine lusus naturae [trick of nature] is...always a valuable subject of study for the scientific physician.”

“It was a medical gaze, touching her systematically, feeling the depth of her wrinkles.”

“The spectacle of a black person turning white was simply a freakish reversal of nature.”

“A lively epistolatory debate ensued in the pages of the Times, heavily weighted in favor of retaining Benga.”

“Being men of science, they medicalized these feelings.”

"Today, refusing to undergo an operation for a treatable cancer is a tragic mistake, because surgery is the most curative mode of therapy for cancer."

"Without the therapeutic options, patient protections, medical advances, and knowledge that we take for granted today, the hospital was less an institution for healing than a physician-centered venue for learning, training, and experimental approaches."

"The best one could hope for in hospitals and 'poor clinics' was shelter from the elements and a minimum of dangerous untried treatments among the infectious."

"What’s more, this need persists in a more subtle form today."

"Hospitals and medical schools became firmly cemented into the African American consciousness as places of terror, violence, and shame, not of medical care."

"Medical students observed the course of illnesses in blacks for educational purposes, but clinical display grew to encompass prescribing for and treating patients in front of doctors in training."

"The dehumanizing effects of their training might easily have deformed their altruism."

"African Americans had already associated Western medicine with punishment, loss of control over their most intimate bodily functions, and degrading public displays."

"Many questioned whether more than a fear of pain caused him to balk at surgery... his opinion of Western medicine’s ability to help him..."

"The demonstration of black bodies was not limited to the clinic. Publication was as important to a physician’s career in the 1800s and 1900s as it is today."

"The bodies in the basement had been spirited by night from the graveyard—but not from just any graveyard: Most were taken from Cedar Grove Cemetery, an African American burial ground."

"They put my mother on display like a monkey in the zoo," complained retired Brooklyn teacher Frances Oglesby..."

"It was thirty years before her sisters could bear to visit her grave... Addie Mae’s body, like so many buried in black cemeteries throughout the South, is missing."

"Today, the legacy of this 'postmortem racism' survives in policies that continue to appropriate the bodies of 'friendless paupers' such as the homeless—a disproportionate number of whom are black—for medical purposes."

"So, for more than a month, Smith, Yeagin’s niece Minnie Champ, and other family members made relentless inquiries of the police at the Fifth District station house."

"...what role has race played in such events—yesterday and today?"

"African American literacy was still widely outlawed and remained low in affected communities until the early twentieth century..."

"Until the last century, American medical practitioners shared a deep frustration with much of Europe..."

"We can only condemn the sad horror hidden in the basement of the MCG..."

"Although black bodies at one time were mostly used in dissection laboratories, it is still debated whether that trend has completely changed or whether the disparities have merely altered form."

"Diagnosis: Freedom," wrote Bryce.

"So little trouble do men take in search for the truth," Thucydides once observed, "so readily do they accept whatever comes first to hand."

"It is obvious taken from the following schedule [taken from the 1840 census] that there is an awful prevalence of idiocy and insanity among the free blacks over the whites, and especially over the slaves."

Here is proof to force upon us the lamentable conclusion that the sixth census has contributed nothing in the statistical nosology of the free blacks.

Dr. Josiah Nott [...] explained that mulattoes were an infertile, weak species, who died at a younger age than did whites.

Those too deranged to work were dumped into almshouses or jails, into which census marshals did not venture.

"The many fallacies and reducing it to an absurdity" - James McCune Smith.

The censuses of the postbellum decades not only perpetuated but also expanded upon the racial libels of the 1840 documents.

He decided that the ultimate proof of the disease’s noninfectious, nonracial nature would lie in inducing pellagra in healthy white people.

Even in the midst of doomed black hospitals and shuttered medical schools, these medical guardians actively refuted the allegations of inherent physical and mental inferiority.

The future of the Negro lies more in the research laboratory than in the schools.

We now know, where we could only surmise before, that we have contributed to their ailments and shortened their lives.

When the PHS sent out notices to invite subjects for spinal taps, the wording clearly indicated that participants were recruited under the guise of treatment.

Those that are treated are only half cured, and the effort to assimilate a complex civilization drives their diseased minds until the results are criminal records.

But the roles of some key African Americans in the study have been exaggerated.

Eunice Rivers, a modestly educated black nurse in the profoundly segregated rural Alabama of the 1940s, occupied the lowest rung in the medical hierarchy.

The Tuskegee Syphilis Study is the longest and the most infamous—but hardly the worst—experimental abuse of African Americans.

What was done cannot be undone. But we can end the silence.

We must never allow a tragedy like the Tuskegee Study to happen again.

The greatest tragedy of the study is that it has failed to serve as a cautionary tale for researchers.

She helped her family eke a hardscrabble existence on a plantation in Sunflower County by picking three hundred to four hundred pounds of cotton a day for one dollar a hundredweight.

But she was not angry: A deeply religious person, she focused her energies on helping others and eagerly awaited the day she would have her own family.

Hamer was one of the last people on the plantation to learn that she would never have a family of her own.

A rage seized her and she complained bitterly about her fate.

But she also grew fascinated by political power as a means to redress injustice.

She was now an uncompromising political dynamo who would become one of the most powerful leaders and symbols of the southern civil rights movement.

She always spoke of her 'Mississippi appendectomy' as the galvanizing force that propelled her into a national leadership role.

Eugenicists invoked the term racial hygiene as frequently as they did the word eugenics.

Involuntary hysterectomies were also commonly practiced in the North.

Without proof, the editorial went on to link teen pregnancy and black poverty in a causal relationship.

"What I really want to come from this... is some type of coalition of victims and survivors of radiation treatments and experiments, so that we can get together and really speak to the issue on a national and on an international basis."

"I’m determined that as long as I breathe, I will address the issue of radiation and how to eradicate this sort of experimentation from the earth."

"We have to do something."

"Despite it all, my parents managed to send two children to college and lived middle-class lives."

"The first recorded black victims of radiation experiments lived around the turn of the century... doctors touted radiation to blacks as an escape into whiteness."

"In order to conform to the ethics of the American Medical Association, three requirements must be satisfied: (1) the voluntary consent of the person on whom the experiment is to be performed... (2) the danger of each experiment must be previously investigated by animal experimentation... (3) the experiment must be performed under proper medical protection and management."

"The answer must be, in every case, no human being should ever have to endure these experiments... not now, not ever."

"The trajectory of Saenger’s medical career did not falter and he never faced criminal charges."

"Many scientists, from rocket pioneer Dr. Wernher von Braun to former Gestapo chief Klaus Barbie, entered the country under the aegis of Operation Paperclip."

"This has really turned our lives upside down, my brother and me."

"We were never told what was going on. We never had witnesses or a receipt for anything we signed."

"No one should ever have to go through what we went through. Not again. Not in a civilized country."

"I feel I’m on display in the zoo sometimes."

"The doctors can’t tell me what it is. They don’t know what I was tested with."

"Suffering ill treatment and assaults. In 1979, nine Oregon prison subjects shared $2,215 in damages."

"Being admitted to the research unit allowed the inmate to avoid the legion of institutional predators."

"Money had a very different meaning for inmates than it had for outsiders."

"The capacity to respond to love is greater than most people realize. I feel almost like a scoundrel—like Machiavelli—because of what I can do to them."

"Prisoners are not the only group of African Americans who live with the threat of being involuntarily subjected to research in the name of therapy."

"Jailed subjects were also inoculated with herpes, vaccinia, and wart viruses and were exposed to Staphylococcus and Monilia."

“What’s done to children, they will do to society.” —KARL A. MENNINGER, M.D

“American medicine has not spared black children its very worst abuses in the name of scientific research.”

“Black boys were fated to be the violent products of ‘parental psychopathology’ or ‘adverse rearing environments.’ Why? According to the researchers, because of their poverty and their ethnicity.”

“Indeed, it appears the only ‘diagnosis’ these children had was the one conferred on them by the investigators.”

“The press raised a hue and cry when it discovered the nature of the experiment but failed to recognize it as part of a pattern: This was just one of many psychiatric experiments in a movement to expand diagnoses of mental illness.”

“The element of stigmatization is key in understanding certain racial disparities in research with children, because such research is not an egregious exception for black children; rather, it is the norm.”

“Such racial selection could stigmatize not only the participants but all black and Hispanic boys as ‘born criminals.’”

“It is difficult to know where to begin in listing the ethical outrages of this study.”

“Locating black violence in the genetic complement of black boys nourishes excuses to abandon social therapeutic approaches.”

“Shall we concentrate upon unfounded speculation for the violence of some—one that follows the determinist philosophy of blaming the victim—or shall we try to eliminate the oppression that builds ghettoes and saps the spirit of the unemployed in the first place?” —STEPHEN JAY GOULD

"The burden of guilt is common coin in prison, but Calvin Johnson knows the crushing agony of innocence."

"Faith in God sustained his spirit, and in 1986, Johnson finally found physical deliverance in DNA, which proved him innocent."

"DNA evidence has powerful uses beyond liberating the innocent."

"The real significance is not that DNA got them out, but that DNA provides a window into the criminal justice system to see what went wrong with the system to let so many innocent people be convicted."

"Human error sometimes sabotages genetic wisdom...Scientists and technicians in genetic laboratories have made errors and have even falsified DNA test results."

"If we reviewed [all] prison sentences with the same level of care that we devote to death sentences, there would have been more than 28,500 non-death-row exonerations in the past 15 years rather than the 255 that have in fact occurred."

"Clearly, DNA testing is no substitute for justice."

"Most—54 percent—of all convictions proven to be unjust involve African American men wrongfully convicted of assaulting white women."

"Biological race does not exist, because all humans share the same genes. Although the proportions of genes differ, meaning that genetic differences exist, these variations map very poorly onto what we think of as races."

"If physicians fall back into the antebellum habit of treating blacks' ailments according to race, will not this condemn many to poorer, stereotyped, less appropriate care?"

"They had me chained to the bed for three weeks... If I were ill, I couldn’t go anywhere."

"...the shackles should give way to more medical approaches that address the root causes of illness."

"TB is no longer easily cured with the drugs that worked so well fifty years ago."

"Confining medically underserved TB sufferers fails to address impaired health, poor access to care, crowding, and homelessness—the root causes of the tuberculosis upswing."

"The fear of being locked up may dissuade people with TB from seeking treatment."

"For example, they try to do directly observed therapy [DOT, in which a nurse or other public-health professional watches a patient to ensure that medications are correctly taken]."

"Instead of focusing on education and other routes of increasing compliance, doctors routinely withheld protease inhibitors from people in lower socioeconomic groups, such as… African Americans."

"AIDS has become increasingly identified with black people, who became perceived as the vectors of the disease."

"Many black people cannot believe diseases such as AIDS or hepatitis C can affect 'someone like me.'"

"Should the factor that heralds AIDSVAX success in minorities be confirmed, it may not be biological or 'racial' at all; it may be a behavioral or environmental factor.”

"It has become appallingly obvious that our technology has exceeded our humanity." —ALBERT EINSTEIN

"This is nothing, nothing like I thought it would be. If I had to do it over again, I wouldn’t do it. No ma’am. I would take my chances on life." —JAMES QUINN

"Patients may find any chance at life irresistible and may not hear caveats about the limitations of the therapies, even if they are offered."

"The informed-consent process consists of much more than obtaining a patient’s signature on a piece of paper."

"The forms tend to exaggerate benefits and to underplay risks, presenting an overly optimistic view regarding quality of life during and after the experiment."

"Such errors can mislead patients like James Quinn into unmet expectations from their experimental devices."

"Hope and Artifice"

"Safe, nonexploitative research into surgical technology is in everyone’s best interest, but... medical policies and practice will have to do a better job of shielding black Americans from abuse."

"Although the researchers sought the advance consent of subjects, many black Americans shift the burden of decisions to their proxies... Therefore, even in experimental scenarios, African Americans may be further marginalized."

"In their downturn, they too took on the dominant values of their political systems, allowing the powerful to act as they wished—that is how we wound up with black bodies playing the role of 'tests' for white entry into the future—human medical guinea pigs."