As often happens in American history, horrific people are revered and truth is evaded.
Dr. J. Marion Sims, the "father" of modern gynecology, earned his fame on the backs of black women. Sims often took plantation owners as clients and sympathized with them when their "property" (read enslaved black people) was "damaged." This was the case with Anarcha, Betsy and Lucy.
Anarcha, was an enslaved woman who suffered a traumatic childbirth, which left her with an unbearable fistula tearing. Anarcha was taken to see Sims, who had little to no knowledge of how to operate on vaginas, and used Anarcha as, for lack of a better term, a lab rat. According to the New York Times, "Sims honed his skills by performing scores of painful operations on the genitals of black slaves. His early attempts so often failed that he operated on one young woman 30 times." It is important to note, Sims was able to perfect his craft by performing experiments on Anarcha, Betsey and Lucy, without anesthesia. Sims was then able to use his perfected techniques on white women (who received anesthesia), making him a prominent and revered doctor in the field of gynecology.
I often find myself avoiding the sickening history of medical experimentation in America. I find it hard to digest the horrific details, to imagine the pain, fear and suffering endured by those who were forced to lay on operating tables and have evil men poke and prod at their insides.
When I heard Anarcha's story, I couldn't help but realize that Sims legacy still continues to haunt hospitals today.
Modern narratives of black women's experiences at OBGYN offices reflect the disturbing reality that misogynoir is pervasive in medical treatment. Almost every black woman I know has experienced unimaginable disrespect at the gynecologist.
"Are you really a virgin"
"I'm going to test you for STDs anyway"
"Are you positive your partner is faithful to you?"
Aggressive Pap smears.
Disregard for complaints about pain.
The list goes on.
In 2016, PBS reported that survey results from medical students showed "medical students believed that African-Americans felt less pain than white patients, and even thought their skin was thicker." Additionally, a 2002 report from the Institute of Medicine found that black Americans received less effective care than their white counterparts for nearly every disease studied.
Obvious to most people of color, doctors are not immune to racism. Despite their advanced studies, they are rarely faced to confront the ways their preconceived notions influence how they treat their patients. This unacknowledgement of how historically racist medicine has been, fuels the belief that race is biological. This belief then leads to undertreatment of pain for black patients and disturbing instances of discrimination in hospitals.
Nonverbal communication appears to be the most insidious factor in making black patients feel unwelcome and disregarded. Dr. Barnato, an associate professor at the University of Pittsburgh who did a study on nonverbal communication, says the following about doctors who would interact with black patients: “They would use more closed posture and they had their arms crossed, or had their hands in their pockets. They would stand further away from the bed, they would spend more time looking at the nurse or the monitor and less time touching the patient.” Tene T Lewis, an associate professor of epidemiology at Emory University, led a review that looked at research on self-reported experiences of discrimination, and health. "If you are African-American or Latino and you present to the emergency room with a broken leg or a kidney stone, for example, you’re less likely to be given analgesics at the recommended level, it doesn’t matter what part of the country you’re in, it doesn’t matter what type of place you’d present to, that we’ve seen fairly consistently.”
There are efforts to more effectively train medical students and doctors about "implicit biases" and the long term health impacts that differential treatment has on people of color. The Association of American Medical Colleges hosts a workshop at many American Medical Schools, titled "The Everyday Bias Workshop", in hopes of making students confront their racism. Their training "is an evidence-based, dynamic one-day workshop in which you will explore how your assumptions impact choices around communication, innovation, hiring, engagement, management, promotion, marketing, and building organizational culture. This unique professional development opportunity is aimed at diversity leaders in academic medicine and other professionals in healthcare and biomedical research."
Although the AAMC is working towards solving a lofty and institutionally embedded problem, many wonder if this is enough. We have a long way to go before America reckons with its racist and traumatic past. In the meantime, use sites such as blackdoctor.org (to find a doctor who makes you feel comfortable and respected), support black students interested in medicine and hold your physician accountable to providing you and your family with high quality healthcare.
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