How to make the medical establishment very angry

Just publish the truth about their history.

During the mid-nineteenth century, medical schools embraced a white supremacist belief in black inferiority and subhumanness. Racism was a social sport upper-class men played to solidify a professional identity rooted in whiteness (figure 1). These heinous ‘educational’ activities included torturing enslaved black people with ‘experiments’, graverobbing their bodies from cemeteries and attempting to detect whether they were faking illness while torturing them as ‘treatment’ (Willoughby 2016). This white supremacy persisted long after legalised slavery ended. The 1910 Flexner Report closed five of the seven black medical schools, preventing 35 000 black physicians from graduating in subsequent decades, amidst deadly black–white health inequities (Campbell et al. 2020). The American Medical Association (AMA) sanctioned this disregard for humanity, banning black physicians from local AMA chapters through the 1960s, thereby denying licensing, board certification and hospital privileges (Baker et al. 2008). This anti-black racism was nothing new. During the early twentieth century, organised medicine cultivated a symbiotic relationship with the Ku Klux Klan, promoting its white supremacist conceptions of race, gender, and sexuality and their related violence (Antonovich 2021). White psychiatrists diagnosed black men protesting during the Civil Rights movement with a dangerous ‘protest psychosis’. Pathologising black people’s resistance to oppression while normalising white people’s violently oppressive behaviour is a long historical arc. It is reflected in diagnoses like drapetomania from the mid-nineteenth century and the overdiagnosis of conduct disorder in racially minoritised children today (Metzl 2010).

That photo is genuinely horrible and shameful. The account is true, every word, and damning. Yet the article that was from triggered outrage from medical institutions. It shouldn’t. I like this comment from Dr Brandy Schillace, about how they should respond:

That’s how we build. That’s how we have real conversation and community. There is amazing relief, Grace, growth, in admitting we are wrong AND acknowledging that the wrong has deeply hurt others. Then both apology and amendment will be genuine, and accepted as such.


  1. raven says


    Drapetomania was a supposed mental illness that, in 1851, American physician Samuel A. Cartwright hypothesized as the cause of enslaved Africans fleeing captivity. Wikipedia

    I had to look that one up.

    As someone on FTBs pointed out recently, every marginalized minority gets their own diseases.
    Women suffer from hysteria.
    Rapid Onset Gender Disorder, ROGD, causes Trans people.

    Wikipedia: The American Psychiatric Association listed homosexuality in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952, but that classification came under scrutiny in research funded by the National Institute of Mental Health.

  2. wzrd1 says

    raven, it’s always entertaining to read homophobes, who will refuse to quote any DSM after the false diagnosis code was dropped after being disproved.
    Their method, the typical oppressor’s method, simply refuse to acknowledge that which disproves their beliefs, claiming theirs is the good science.

    Oh, one other thing to come out of the Flexner Report, closing of those schools and refusal to license physicians left the US critically short on physicians during the 1918 influenza pandemic. Rather than license the Black physicians, they brought out of delicensure and retirement “physicians” who refused to accept germ theory. That resulted in tens of thousands more deaths, as these quackery doctors bled influenza victims and basically used every disproved treatment, resulting in an excess in patient deaths.
    American Exceptionalism, the exceptionalism of the short bus.

  3. wajim says

    Of course the singular word in Dr. Schillace’s statement that triggers the bigots, as it is in the larger American cultural/political space, is “we.” Why do you think they call US “snowflakes”?

  4. birgerjohansson says

    The Swedish medical establishment also has a history with some ugly parts (the institute for racial biology comes to mind, as does non-consentual dental experiments on mentally ‘slow’ during the early 1950s).

  5. eastexsteve says

    My state recently passed SB14, its been signed and will go into effect 9-1-23, barring any legal challenges. Doctor’s can lose their license to practice medicine for treating children under 18 for gender issues. The text of the bill is available online if you’re inclined. Basically it’s the “legal acceptance of discrimination”.

    I never thought we would be ceding ground to discrimination in 2023. I was wrong!

  6. numerobis says

    Yet the article that was from triggered outrage from medical institutions.

    The link is pretty useless. Apparently it’s a thread. I don’t pay the Twitter tax, so no threads for me, I just get the first message and that’s it.

  7. raven says

    Doctor’s can lose their license to practice medicine for treating children under 18 for gender issues.

    Many Red states have passed those laws.
    They’ve all been quickly thrown out in court.

    Trans Health Care Bans Blocked by Judges, GOP Isn’t …

    The Intercept
    Jul 6, 2023 — Federal judges, both liberal and conservative, in six states have now blocked laws banning transition-related health care for minors, including … › 2023/07/06 › trans-health-ca…

    These laws violate the 14th amendment. 2. Due process.
    3. Equality under the law.

    States cannot arbitrarily pass laws discriminating against other people or classes.
    It’s part of that Democracy thing and Freedom thing, some people might have heard about.

  8. chesapeake says

    Medical bias continues. This is from a 2021 study:

    ‘inequities in health care are pervasive, from access to quality of care, and a new study finds that common opioids such as codeine and morphine are more often prescribed to white patients than to Black patients treated within the same health system…

    White patients received both more pills and stronger doses, according to the study, published Wednesday in the New England Journal of Medicine. In about 90% of the 310 health systems studied, the opioid dose prescribed to white patients was higher than the one prescribed to Black patients. On average, white patients received 36% more pain medication by dosage than Black patients, even though both groups received prescriptions at similar rates….

    Racial bias — including the erroneous belief that Black patients feel less pain than white patients — could be behind these disparities. “[The disparities are] likely driven by how physicians approach or assess the perception of pain in Black versus white patients,”

  9. chesapeake says

    The article above reminds me of how slaveowners believed black people felt less pain than whites and so it was ok to inflict painful things on them and to not give them blankets in the winter.

  10. raven says

    I never thought we would be ceding ground to discrimination in 2023. I was wrong!

    Roe versus Wade was overturned in 2022.

    So, after women lost their right to control their own bodies and run their lives, who was going to be next? There will be a next and then another next.

    Don’t call this anti-Trans persecution a “moral panic”.
    That is just wrong.
    There is nothing moral about it and they aren’t panicking either.

    Trans people make an easy target because there aren’t very many of them at 0.6% of the population and they don’t have a lot of formal legal protections.

    .1. It is simply hate for hate’s sake and an anti-Trans people witch hunt to…hunt down and beat up on…witches.
    .2. By now the GOP knows these laws will be thrown out in court.
    This is just the fundie xian/GOP version of virtue signaling.
    “See, we hate Trans people. We persecute Trans people. Aren’t we just so vicious and evil. Look at us. Look at us!”
    .3. A few of the fundie xians/GOP have already taken the next logical step.
    Already there are calls at for example, CPAC, to just kill all the Trans people.

    If you are going to be Nazis, might as well go all the way, I guess.

  11. chrislawson says

    For a good paper on the moral failure in Tuskegee (and also the NZ CIS study) with an excellent demolition of recent attempts to exonerate the original researchers (looking at you, Pinker, you f***er), I highly recommend Paul and Brookes’ The Rationalization of Unethical Research: Revisionist Accounts of the Tuskegee Syphilis Study and the New Zealand “Unfortunate Experiment”.

    It’s free full-text and very readable.

    At the very start of the study, it was not unethical to follow people with syphilis to learn more about its natural progression because there was no effective treatment at the time. But that was the only ethical standard the study met. In every other way, the study was grossly unethical for many reasons, most obviously the lack of consent, the wilful withholding of crucial health advice that put entire families at risk, and the collection of data from invasive procedures such as lumbar punctures that served no clinical purpose. When the study continued past the 1940s while secretly withholding a safe, effective treatment, it became not just unethical but outright criminal.

    A while back I used to think that one of the defensible aspects of the study was that it was funded to provide education and health services that were not available to other Black families in Alabama. I now realise this was a way of exploiting racial discrepancies to entrap participants. Sure, you could leave the program, but good luck getting your kids into a good school or your family good medical care.

  12. raven says

    From the article cited above in #9:

    In Arkansas, U.S. District Judge James Moody Jr. found the state’s ban to be both definitively unconstitutional and based on a total lack of scientific evidence. An eight-day trial examined ubiquitous Republican claims that gender-affirming treatments for youths are too experimental, harmful, often regretted, and banned by numerous European nations. All claims were found to be false, unconvincing, and contrary to strong evidence.

    Arkansas Attorney General Tim Griffin nonetheless vowed to appeal the judge’s extensive and detailed ruling, repeating the same discredited lines about “protecting our children against dangerous medical experimentation.”

    No wonder these anti-Trans witch hunt laws keep getting thrown out.
    The Red states can’t defend them. All they have are lies.

    An eight-day trial examined ubiquitous Republican claims that gender-affirming treatments for youths are…
    .1. too experimental
    A lie. These treatments are decades old with a lot of reserch to back them up.
    .2. harmful? A lie.
    What is definitely harmful is outright, full blown persecution of a tiny minority that is already haveing a hard time.
    There is no doubt the fundie xians/GOP are deliberately harming Trans people.
    That is in fact, the whole idea.

    .3. often regretted
    The data on this says this is wrong. Regret runs around 1% which is very low.
    8% of people regret having children.
    50% of people regret getting married.
    .4. banned by numerous European nations. Another lie.
    Apr 28, 2023 — No legal prohibitions have been put in place in Europe, as they have been in more than a dozen U.S. states, where physicians risk losing their …

    Some European nations have begun restricting puberty blockers, driven by the same reasoning in the USA. Hate of Trans people by right wingnuts and fundie xians.

  13. wzrd1 says

    chesapeake @ 10, from what I’ve been told, Black patients don’t receive opioids due to physician preconceptions on addiction, believing that Black patients have a greater potential for becoming addicted to the opioid analgesic.
    Total bullshit, not reflected in any research, but it was part of clinical instructions in the past.

    In yesterday’s news stories on CNN, there was a Black mother who had a caesarean section, who 10 hours after giving birth, despite the father’s incessant pleas, bled to death in her hospital room. The US already has a developing nation maternal death rate, it’s worse for any people of color, falling far below developing nations survival rates.
    Well, I guess the US needs to have someone to look up to, might as well be the developing nations. Hell, if we pay attention to them, maybe we’ll develop a civilization someday.

    raven @ 14, you forgot the cases blown out of court and into low earth orbit after the judge explained in the ruling that the debate minutes of the legislature that passed some of these laws had openly discussed the religious origin of their legislation.
    Which has prompted the religious fundies to switch to the zany argument “that some so-called law” won’t allow their repression, that so called law only being our very first amendment. What hypocrisy it is when one sheltered behind the very amendment one decries as immoral! But, for them, it’s amoral to not want to force their morality upon others, even at gunpoint. Precisely like terrorists want to do.

  14. chrislawson says

    I remember reading a paper showing that a large proportion of recent medical graduates in the US believe that Black people’s skin is innately stronger and requires more force to penetrate if you need to take bloor or put in an IV line. This paper was not that old (within the last 15 years iirc). It floored me, particularly because I know that this would not have been learned from textbooks or published literature. It’s an example of how the so-called ‘hidden curriculum’ in medicine can be a powerful force, in this case, with adverse effect.

  15. crocswsocks says

    PZ, thank you so much for introducing the name of Brandy Schillace to me. I have just read about her briefly and I think I’ll enjoy her work a lot.

  16. lakitha tolbert says

    The sheer irony is that many people think it’s that same bias that protected Black communities from the Opioid epidemic that struck white suburban communities so hard. I’m inclined to agree with that which gives me mixed feelings because the trade off for not having yet another drug epidemic ravaging our communities is some other form of individual suffering, I guess.

  17. jrkrideau says

    @ 8 numerobis
    Try this

    If Dr Schillace calls this a great paper, it makes me think that the standard of writing in medical journals is slipping fast. It is not terribly well written and seems incredibly jargonny.

    That it is an “important” paper seems extremely likely. It needs to be de-jargonized and greatly expanded. I suspect that thoe authors have been constrained by some kind of word limit to compress fairly complicated arguments and examples into a straight-jacket. I have seen the some when an author tries to squeeze a series of 8 or 9 experiments into a Nature word count.
    Come to think of it, the authors might want to consider a monograph.

    The paper seems to be making a lot of arguments that are based on Western, possibly, Anglophone practices. It would be interesting to if some of the same issues are relevant in China, or the former Soviet states where in Soviet times, I belive the majority of doctors were female.

    Maybe I can run it by one of my doctors who trained in Iran and then did her residency in Halifax NS.

    As something of as aside the authors talk about 80 hour weeks. Airplane pilots and truck drivers have strict work hour limits My doctor does not need sleep?

  18. Sonja says

    I attended a funeral of a great Minneapolis physician, also a WWII veteran, bronze star recipient. In his eulogy there was the story that, while in basic training in Louisiana, he volunteered at the local hospital, helping by stitching up emergency-room patients. He was told not to give any local anesthetic to the African-American patients, an order he ignored.

  19. scuba says

    wzrd1 @ #3:
    “American Exceptionalism, the exceptionalism of the short bus.”

    Hey hey, what the complete fuck is this?

    Please think about the harm your words can do before you use such a nasty term. Cannot believe I am having to say this in 2023.