Tuesday, April 5, 2011

Book Review: Medical Apartheid by Harriet A. Washington

I decided to read Medical Apartheid after finishing The Immortal Life of Henrietta Lacks last year. I'd seen several reviews of the latter that recommended Medical Apartheid to those who were interested in learning about the entire history of unethical medical treatments imposed on ethnic minorities (specifically, Black people, though individuals of Hispanic descent are also discussed) in the United States. In the interest of expanding my knowledge on this subject past Henrietta Lacks and the Tuskegee experiments, I decided to give Medical Apartheid a shot.

I wound up enjoying it quite a bit, but it was very different from The Immortal Life of Henrietta Lacks. Since Washington's scope is far broader than Rebecca Skloot's, the book is organized very differently. The tone is also quite a bit more serious and technical, and the work revolves around a set thesis rather than relating the narrative of the (immortal) life of an individual person. Washington's thesis is that one of the reasons that Black people have such poor health outcomes relative to those of white people is that their long history of being exploited by white doctors and researchers has led to a state of culturally ingrained iatrophobia, or fear of doctors and medicine. Having read a number of books tangential to the subject (mainly involving the tense relations between white women and women of color over the reproductive rights movement), I was familiar with the concept but largely ignorant of the history behind it. In this way, I found Medical Apartheid to be quite enlightening.

Washington does a wonderful job distilling three centuries of often convoluted histories into a cohesive narrative. The first part of the book, which moves mostly in chronological order, details the experiences of Black individuals from colonization to emancipation, delineating the ways in which the institution of slavery procured numerous bodies for medical practitioners to experiment on as well as detailing the appalling ways in which slaves were treated by doctors (many of them so dreaded the treatments they were forced to endure that they would work even when deathly ill). Post-emancipation, Washington switches organizational gears and moves towards a topical treatment of specific incidents (or clusters of incidents) which have taken place since the end of the Civil War. Washington hits the commonly-known issues surrounding the Tuskegee experiments and what happened to Henrietta Lacks, but she also probes deeper into a number of other, lesser-known practices such as:

  • Medical schools and hospitals stealing bodies from black graves to be used as cadavers, a watered-down version of which persists today).
  • Black people, but especially Black children, being disproportionately represented in the potentially dangerous phases of clinical trials.
  • Black prisoners being coerced into participating in clinical trials.
  • "Mississippi Appendectomies," or hysterectomies performed without the knowledge or consent of the woman, and the racially fraught nature of birth control campaigns.

All in all, very enlightening. 4 out of 5 stars.

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