Yale Psychiatry Grand Rounds: December 13, 2019

December 16, 2019

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Carolyn Roberts, PhD, Assistant Professor of African Studies, History, and History of Medicine, Yale University: "Violent Medicine: Doctors and the Ethics of Medical Practice in the Atlantic Slave Trade." A Commemoration of 400 Years of Slavery/Perseverance in the United States

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00:01Good morning.
00:03Hello good morning.
00:07I love the Energi.
00:09Thank you all so much for being here. Today's grand rounds answers. A call by the 400 years of inequality project for everyone to observe the 400th anniversary of the arrival of the first Americans to be sold into bondage. In 1619 in Jamestown, Virginia, although we do know that slavery began as early as the 1500s.
00:35The purpose of the observances is to denounce structures of inequality.
00:41Anne to foreground are fundamental and unconditional equality.
00:46We remember so that we refuse to participate in and reproduce structures of D humanization exploitation oppression an inequality.
00:58We know that the ideologies and practices of slavery in this country lay the foundation for many systems of oppression. An inequality for people of African descent and for other socially marginalized groups.
01:12Many of these legacies of slavery are addressed in pieces in the New York Times 1619 project. Today we focus on the field of Madison.
01:24In preparing for this observance. I selfishly looked for someone to help me unlearn some of the historically inaccurate and quite frankly racist accounts of slavery from my own education. I search for someone who could teach us something we didn't already know.
01:43Someone, who could talk about the atrocities of slavery in this country, but also talk about the healing powers in practices that come from within a group of people experiencing such atrocities will I found that person is Caroline Roberts, who's right here at Yale?
02:01Doctor Roberts is a historian of Madison with a joint appointment in the department's of history. History of Science in Madison and African American studies. She also has a secondary appointment at Yale School of Madison in the program in history of Madison and just an aside her lecture course on the main campus entitled Sickness and health in African American history has 300 undergraduate students and next year is probably going to be about 500 students, so there's definitely a want in a need to.
02:31Discuss these topics.
02:33Doctor Roberts is an historian of early modern Medison. She has broad research interest in Madison race and slavery in the Atlantic World. Her research and teachings are animated by the desire to think through how slavery an its legacies inform our current health crisis used.
02:51Professor Roberts is currently working on a book project called to heal and to harm Medison knowledge and power in the Atlantic slave trade. This manuscript represents the first full length study of the history of Madison in the British slave trade.
03:06The books narrative is centered around the pharmaceutical and medical labor performed largely by unknown group of black and British women and men, both enslaved and free.
03:17In studying their medical labor her project illustrates how the slave trade functioned as an insidious an even ghostly knowledge project, which helped propel the modernization of Medison.
03:30Professor Roberts received an MA and PhD from Harvard University and MA from Andover Newton Theological School and a BA from Dartmouth College, so please welcome doctor, Caroline Roberts.
03:52Good morning, it is wonderful to be here with all of you.
03:58So 1619 we're nearing the end of the year.
04:04And the end of our memorial of this really important this important landmark.
04:12One of the things that I focus on is the how the history of Madison is very much a part of thinking through legacies of slavery and the slave trade.
04:23And so that is what we are going to do today.
04:28Many of us are familiar with the litany of medical abuse is in African American history.
04:36From enslaved bodies purchased for medical experimentation and subjected to painful surgical procedures to for sterilization from the Tuskegee experiments to the bio piracy of Henrietta Lacks cells.
04:51And the slave trade really should be a part of this troubling legacy.
04:57So 2 questions direct my talk to you today and the 1st is how did doctors become captors?
05:05How did doctors become captors and the 2nd is? How did African captives become healers so? How did doctors become captors? How did African captives become healers?
05:37The transatlantic slave trade was a watershed event in our collective human story.
05:42It was the largest forced Oceanic migration ever to occur in human history. It began in 1440, one with the Portuguese and ended in 1867, it lasted for 426 years.
05:58Slave traders were responsible for the violent trafficking of over 12,000,000 African children women and men to slave markets in the Americas.
06:08And the human costs of this traffic are unimaginable.
06:13It defies our ability to truly comprehend the scope of harm and brutality and human destruction that was meeted out over these 426 years.
06:28Many people in the African Diaspora have adopted this key Swahili Term Mafa.
06:35To describe the great disaster, the great suffering the great catastrophe.
06:40And there are.
06:42Remembrances such as this one in Oakland, CA that happen often times on March 26, which is the International Day of Remembrance for victims of slavery and the transatlantic slave trade.
06:55So enslaved children women and men their stolen from their homes and their families and their kin entire families and communities were destroyed.
07:05They're forcibly transported on ships that were called tomb barrows or floating tombs.
07:12On these ships of death African people tried to commit suicide by leaping overboard into the cold rushing waters of the Atlantic Ocean.
07:22They did this with such regularity that it became the normal practice to erect very high netting on every slave ship to prevent their suicide.
07:32When they found rope, they hung themselves in the night, they mutilated themselves in order to die.
07:40One enslaved man worked his fingernails through skin and flesh to try to reach his jugular vein and he lost a pint of blood before he was discovered.
07:53We know from the archives of the soundscape of a slave ship was filled with songs of lamentation.
08:01We know that there was screaming in the night, there were the sounds of people choking from air when stowed below deck and individuals begging and pleading to be allowed to die.
08:14Rape and sexual violence were a normalized feature of the slave ship experience.
08:20At times women and girls tried to jump overboard on Mass in order to escape their rapists.
08:27They were beaten mercilessly and sometimes killed when they fought back against their captors.
08:34But these women and men engaged in armed revolt.
08:39One out of every 10 slave ships had a full armed assault.
08:45Against their captors.
08:49And this is an animated map, which is a visual representation of just part of the.
08:57Slave wages that took place over 426 years.
09:07And the thing to notice here.
09:10Is that one?
09:12Dot represents one slave ship so each dot represents each slave ship each slave ship is contains hundreds of lives.
09:25Each dot was filled with people who were doctors and Doctress is and historians. They were garyo's. They were agricultural laborers, they were children. Their mothers and father's.
09:39Each dot represents one ship and each ship represents hundreds of lives.
10:21And while each dot represents one ship each ship also carried between one and 3 doctors on board.
10:34So how do doctors become captors? How did they get swept up in this human trafficking so we're going to go now to Sierra Leone?
10:48We're going to go to hear the banana the banana islands, which is off the coast of Sierra Leone and.
10:57Picture if you will.
10:59The speech on the banana islands early in the morning picture. If you will a slave ship the slave ship fame it is the month of March and it is the year 1791 so during the 1790s slave. Traders were beginning to warehouse large numbers of children on spaces like the banana islands, and kidnappers often preyed on young children they would prey upon them when their their family members went to labor in the fields.
11:32They're small bodies were tossed into stacks there miles were gagged and the children were often sold multiple times.
11:39So by the age of 8, one young boy commented, and said.
11:45I was very, very sad indeed.
11:48And I had no one to play with.
11:51So these girls and boys they dwelled in a shattered world.
11:56Well, in their captivity ill health affected the children an one boy suffered from an 18 foot long tapeworm.
12:04So his young body was slowly being ravaged by this intestinal parasite.
12:09And as the worm debilitated the child he had a distended stomach had abdominal pain, he had an irregular pulse.
12:17So the boy was in wretched state of discomfort, he was.
12:21I'm expelling slimy, stools, he was vomiting frequently perpetually thirsty deep dry coughs that left him fitful and in distress.
12:33And so we don't know how this child came to be on board this floating dungeon. All we know about him comes from.
12:41William Dyneley, who was the young boys doctor and captor.
12:47So this is a letter from Doctor, William Dyneley from March 1791, the part that is underlined says I have.
12:55That, he cured a boy, he has a boy, which quitted meaning expelled a tapeworm 18 feet in length. No person would have given 5 shillings for him now, he is worth 40 pounds.
13:13No person would have given 5 shillings for him. Now he's words over 40 pounds. So it might seem that Williams in Lee was an old hand in the slaving business. He was able to figure out how much this enslaved boy would be worth when the ship eventually arrived in Jamaica to deposit their human cargo, but this was William Denley's first voyage.
13:38This was his very first patient.
13:41He was a father of 7 he was married to a woman named Jane and they lived in a town called dumb freeze in Schottland. This is an image from the 18th century and this is an image of dumb freeze. Today it's a flourishing market town and in southeast schottland.
14:00So what is happening to William Denley in this moment?
14:06In the few short months from the time, William left his wife, Jane and his 7 children and headed to Africa. William had rapidly adapted to slave trade Medison.
14:17This father of 7 had transformed a sick and frightened child into a vendible good.
14:24The surgeon enabled the boys recovery and simultaneously maximized his saleable potential.
14:31Now, some people when they hear this story. They think well, he did heal the boy after all.
14:38Right.
14:40But by healing this boy.
14:42William also subjected the child to other kinds of parasites.
14:47The others who would feed off of the boys increased capacity to labor.
14:52And his value as a liquid asset.
14:55This healthy boy was money in Williams pocket and it was money that Jane needed to run their household economy.
15:03And a lot of money was at stake during the late 18th century slave trade. Doctors earned between one hundred and 150 pounds, which was 4 times. The median annual income for a family in the British Isles.
15:17But the most lucrative part of doctors pay was in the form of privilege slaves.
15:24In other words, some of the patients that these doctors cared for. It would become their property and they would be able to sell them when they reach the West End West Indies.
15:35So during the hiring process medical men actively negotiated to get more privileged slaves as part of their bonus.
15:44So here is a letter from slave trade doctor and he's saying I received your obliging favor mentioning the terms for a person to act as a surgeon on board, a vessel in the African trade. I understood there were 2. Sometimes, 3 slaves allowed to a person of the faculty. The medical faculty in that situation, we be kind enough to say if two slaves can be allowed.
16:08So they were actively negotiating to get more privileged slaves as part of their bonus.
16:15Now the economic basis as you can see it incentivized dehumanisation.
16:22Doctors received bonuses also based on the overall value of the enslaved cargo.
16:29And so they went to extraordinary lengths in order to increase the overall value of the slaves in a particular cargo.
16:38So for example, Doctor James Arnold served as doctor on board the slave ship the Little Pearl.
16:45And he recounted having to be a silent accomplice accomplice in the murder of a sick anime. See Ated African boy who was intentionally starved to death.
16:56So the boy was kept on board the ship and hid.
17:02So that no one knew he was there, they refused to give him food, so that in 9 days. The boy died because he was so sick he would have brought down the overall value of the cargo and the men on board. The officers on board were going to get a percentage of this pay so they intentionally starved the boy to death.
17:26So the structure.
17:28Of doctors compensation.
17:31Within a medical system.
17:34Shapes the nature of medical practice that occurs within it.
17:40The generous pay offered by slave trade merchants required doctors.
17:45To become human traffickers, the sellers of human beings and to be violent captors.
17:53And this becomes.
17:55Quite clear when we think about the clinical context of slave trade Medison.
18:06The first encounter African captives had with European doctors was the force medical inspection.
18:15Doctors were responsible for selecting viable laboring bodies to be trafficked across the Atlantic.
18:21And this task was considered critical for the success of the voyage.
18:26The force medical inspection that occured little resembled the patient practitioner relationship in early modern European Medison.
18:35In during this period of time routine consultations between patients and practitioners, often occured fully clothed and touch was not a main part of your clinical encounter you learned how to treat your patients through talking and through learning your patients biographies learning about how they were sleeping. How they were eating how they're eliminate ING? What kinds of emotional state. They were in you? Talk to them. You listen to their patients narratives, but not in the context of the slave trade.
19:06Doctors had to develop new techniques of bodily inspection, an observation to forcibly investigate the human body without consent as a labor specimen.
19:18This is from a French text PlayStation How do commercial americ it was written in Amsterdam in 1783 and what we see here is an Englishman examining a slave and he's licking the chin to determine if the sweat indicates any kind of illness.
19:41So, in slave children women and men.
19:45They were stripped naked.
19:48From head to foot every part of their bodies was inspected.
19:53Inspecting just one enslaved person could last for hours.
19:59So surgeons, they peered into the eyes of captive Africans.
20:04To see that the eyes were bright and glistening because a film over the eyes could indicate diminished site or disease.
20:11Doctors open the mouths of the enslaved to check that their throats were free from ulcers that their teeth were not loosened that gums were not discolored or dis. Dick age because that could indicate scurvy or venereal disease.
20:25The enslaved were commanded to jump and move and flex their chains limbs and refusal to comply brought whips blows punches and kicks upon the terrified captives.
20:37Their pulses need to be strong they're breathing needed to be easy, and not labored their backs were to be straight and their chests needed to be wide.
20:47Doctors inspected boys and men's penises they touched their scrotums. They fingered their testicles to make sure that they were free of inflammation and swelling and ulcers and scabs.
21:00Under threat of violence enslaved women and men had bend over at the waist or get down on their knees and lean on their elbows with their buttocks in the air for anal and Rectal Expections.
21:15Surgeons force their fingers into the anus and into the rectum to check for abscesses or fistula.
21:22And if a fistula was suspected. The surgeons typically inserted a blunt pointed probe.
21:29For confirmation.
21:31Medical practitioners checked for softap tumors known as Ficus is an they studied groins for marks on the skin such as scars left from syphilitic pustules.
21:45During the hours long inspections captive African girls and women underwent additional procedures.
21:52Women and girls were examined to see if they had previously born children.
21:57Surgeons grasp their breasts to check their fulness and their firmness.
22:03While ships captains looked on slave trade. Doctors Fingered, the girls and women's labia's to check for inflammation and for tumors.
22:11And his girls and women wept inconsolably, according to one observer. Mariners pin them to the ground and held their legs wide open. So surgeons could inspect the mouth of their vaginas for lesions, they inspected their clitoris for tumors.
22:29They thrust their fingers through the vagina to the cervix to check for abnormalities.
22:41So once the enslaved were purchased and put on board.
22:46The doctors labor continued.
22:51Keeping hundreds of chained and beaten an incarcerated people.
22:56Alive on these floating prisons went beyond managing infectious disease.
23:03The enslaved wanted to escape they wanted to kill their captors, they wanted to kill themselves.
23:09So doctors had to commit chronic and pervasive violence to keep their incarcerated black commodities alive.
23:21So medical practitioners, they engaged engaged in armed battle.
23:25Against the enslaved when they rose up in shipboard rebellion.
23:30Onboard thousands of slave ships doctors whipped African Captives, who refused to eat.
23:37Laisa rating their flesh to preserve them for sale, beating them and then caring for the wounds they themself inflicted.
23:46Historian Marcus Rediker called the Atlantic slave trade of 400 year hunger strike.
23:52Medical practitioners were equipped with bullets knives with thumbscrews an with the speculum oris to force feed. The enslaved while breaking off their teeth in the process. This is an example of the speculum oris.
24:05Which was a medical tool that was repurposed for the slave trade and one commentator who worked on board many slaving vessels, said that the above is used when the slaves are sulky. It's an interesting term, which frequently happens. But they shut their mouths against all sustenance and this with the determination to die.
24:26And it was necessary their mouth should be forced to open to throw in nutriments that they who had purchased them might incur no Los by their death.
24:36The speculum oris.
24:42So when the enslaved attempted to hang themselves with rope in the night.
24:46When they mutilated themselves when they attempted to puncture their jugular vein as one man did that. I described earlier doctors had to physically restrain them. Doctors were equipped with a pharmaceutical Arsenal.
25:01Lee drove Medecins down the throats of captive Africans. They drained their blood. They plunged metal pipes into their rectums.
25:10To administer enemas.
25:13Mariners pin them down or hovered nearby with whips or pistols in hand to ensure that they complied.
25:20During the course of an illness. Some medical practitioners whipped punched, kicked and cursed the enslaved when they're on the brink of death, mourning the loss of their profits.
25:32One Doctor Doctor Thomas Aubrey recounted that 6 slaves were kicked punched and beaten so often during their illnesses.
25:41That, they would cry out.
25:43And that they would quote.
25:45Creep under one of the platforms and hide them selves and die there.
25:54This is Thomas Clarkson, who gathered evidence about the slave trade.
26:06And when Carpenter said that the slaves in the sick. Berthar suffered to die in their own filth and are then thrown overboard like dogs.
26:15If they refuse the medicines that are offered them, they're beaten with a cat.
26:19Cattle ninetails their jaws forced open an the Medecins poured forcibly down their throats.
26:26Another man James Morley in 1790, he tells us I've seen. The surgeons mates on giving them medicines forced the panic. In between their teeth and throw it over them in a manner that not 1/2 of it has gone into their mouths. This was done when the poor. Wretches have been wallowing or sitting in their own blood or excrement.
26:47Hardly having any life.
26:49And this with blows with the cat damning them for being silky black.
26:54I do declare that I have known that the doctors made report asleep dead and have him thrown overboard when there has been life in him and he has struggled in the water after being thrown overboard.
27:05End Quote.
27:10So as a captive population.
27:14African people had been so utterly dehumanized.
27:20Rendered so socially and culturally inferior on one hand and so economically valuable on the other.
27:29That medical violence wielded against their bodies and minds had become an acceptable normative an institutionalized practice.
27:37Across centuries remember the slave trade is going on for 426 years.
27:45Doctoring was placed in service to large scale commercial forces that incentivized an extreme form of human exploitation.
27:56And the doctors dispassion tored the African people under their care that error, they instilled the money that they so eagerly took for their privilege slaves. It shows in chilling ways how medical practice can so easily be transformed.
28:13In 2 places of.
28:15Profound harm.
28:17Right.
28:19So the slave trade forced African people into a unique and troubling relationship with Western Medison, long before even setting foot in the Americas.
28:29But our story does not end there.
28:33Hum.
28:36African captives were also functioning as healers, so we are going to return to West Africa.
28:46This is Cape Coast Castle, some of you may be familiar with this image. It is located in present day gonna.
28:53Cape Coast Castle was the British slave trading headquarters during the entire T of the slave trade.
29:00And this was a slave fortress constructed it was a kind of distribution center that help manage the flow of enslaved people in women and men and children being shipped to the Americas.
29:13But managing this flow of incarcerated people at places like Cape Coast Castle. It proved a challenge for Europeans because when Europeans arrived in West Africa. They were biological outsiders.
29:26In a merciless disease environment.
29:29They were faced with tropical diseases that they were completely unfamiliar with.
29:34There was hyper endemic malaria and yellow fever.
29:38And it was very difficult for them to understand and figure out how to stay alive long enough so that they could carry out this trade in human flesh.
29:50So what the Europeans did particularly the British this was one of their strategies for survival was to enslave West African Healers.
29:59Who would be permanently held at slave factories like Chaos Castle?
30:04And they would care for sick West Africans were being shipped to the Americas as well as care for sick Britons.
30:13We have evidence of them in a lot of the records that that are present in the UK. It's hard to see here. I know, but that's the first arrow says a tomb doctor. Jack doctors voice Oh. Jack is someone who I study. Jack began his medical apprentice at the age of 8 years old, and became a doctor in his own right working as enslaved healer at Cape Coast Castle until he was the age of 25.
30:44We also have here a woman named Amano, who is labeled as a doctress so we have many healers that appear in these records.
30:55So the medical knowledge that enslaved Africans had became highly prized and sought after.
31:02And one Anglican Chaplain at Cape Coast Castle named John Smith. He became a student of the West African healing techniques that he was observing being made use of by these enslaved healers.
31:16And So what John Smith did was he gathered up his knowledge and transmitted it to London.
31:23And it was sent to the Royal Society in London.
31:26And it was published in 1697 in their publishing Oregon called the philosophical transactions.
31:33This is the first sort of record of West African healing that appears in European Records in sort of a lengthy kind of treat us focused on the Gold Coast or present day gonna.
31:49And.
31:51What Smith observed in what he describes in his letters and in this document? Which is available online Smith observed plans being dried in the sun and powdered and sniff to cure headaches.
32:04He said swollen limbs were washed with an infusion created by boiling the ooh. Nana plant, which cause fluid retention to dissipate.
32:13Doctors they boiled plants and they mix them with pom pom wine and they drunk this to cure Constipation.
32:22Stomach aches smallpox worms, venereal diseases toothache scurvy and hemorrhaging were among the lengthy list of cures that Smith discovered from these enslaved African Healers.
32:36And so European observers, they witnessed first hand. These curative techniques and the amount of commentary in the archival record is surprising in its in the plethora that exists and I'm just going to show you a few more examples. So this is Willem Bosman. He was a Dutch Slave Trader. He wrote this treatise in 1704. It was translated into English in 1705.
33:03And one of the things that he talks about. He says the green herbs. The principle remedy in use amongst the knee grows are such wonderful efficacy. This does much to be deployed that no European physicians. As yet applied himself. The discovery of their nature an virtue for I don't only imagine but firmly believe that they would prove more successful in practice of physics, which is another way of saying Medison then the European preparations.
33:32And so commentary like this is also found a little bit later in the 18th century. This is from 1720. These are directores of Cape Coast Castle that are saying we should be glad to have the assistance of enable Gardner, one that is well acquainted with the herbs as we believe that there may be many symbols. These are medicinal plants found here. A very great benefit being observed to be made use of by the natives and pharmacy as well as surgery.
34:02And who succeed in many good cures in both.
34:08We have William Smith in his voyage to Africa describing that the enslaved people there. The most skillful botanists. The knee grows. You know well the use of every herb and plant and always apply them with such success. But the cures wrought by them. See Matt sometimes to be a little less than merin culas.
34:29And so this is some of the commentary that is disseminating.
34:35We know today that many of the remedies that they were using actually did work.
34:45The Bongiya tree.
34:47Enslaved Healers on the windward coast. They used bark from the Bongiya Tree to help ease difficult pregnancies.
34:54And its antioxidant and anti-inflammatory properties have been confirmed through phytochemical screenings.
35:02We have also the Dewey tree.
35:06We have evidence of medicinal cordials being made with bark from this tree steeped in Palm wine and drunk.
35:13Today it is one of the most widely used medicinal plants in Africa.
35:18And the bark and the leaves exhibit powerful anti inflammatory and anti bacterial activity.
35:27We also have here velvet tamarind.
35:31The enslaved healers at Cape Coast Castle. They were growing velvet tamarind in their gardens. The inhabitants soaked the pulp of the fruit in water and the resulting beverage was then consumed by fever. Patients with positive results. The positive results were because it is an effective antimalarial. It inhibits the growth of power plasmodium falciparum parasite, which as many of you know causes malaria.
35:56So the things that they were observing guavas for dysentery papaya seeds for worms, which are still used today plantains for diarrhea, pepper for gastrointestinal complaints. Palm wine was a diuretic. Kola nuts were used as a digestive aid and a stimulant.
36:14All of these remedies were being used.
36:18But one of the most important jobs.
36:21That these enslaved healers in these enslaved healers these doctors and doctors is.
36:26People like a tomb in a mono and Jack.
36:29One of the most important things they had to do was to go into Cape Coast Castle into what was called the black hole.
36:38The underground incarceration units to care for the enslaved toward being shipped to the Americas.
36:47This is an image of.
36:49One of these black holes.
36:57Enslaved children women and men.
37:00Were chained and kept in darkness?
37:02With no natural light except for narrow iron grates that lead in snippets of air in fragments of light.
37:10The Black Hole was notorious for killing those who are long contained within it.
37:16They were penned in like captive beasts, they had to fight off rodents and vermin.
37:21The enslaved were fed out of troughs and they had to defecate in tubs that overflowed causing a suffocating stench from urine an from feces.
37:31They lay on the damp ground with little air naked.
37:36And 113 year old boy named Ottobock Aguano.
37:40He never forgot the cacophonous groans and cries that echoed through the cells of this slave dungeon.
37:47He lived there for 3 days before being sold to slave traders.
37:51The memory was permanently imprinted on his young mind.
37:57Enslaved doctors and doctors is had gone into these subterranean Dungeons.
38:03And it cared for them.
38:05They had taken leaves from the Castor oil plant, they steeped them in hot water.
38:11They wrapped them around swollen limbs.
38:14To reduce the swelling.
38:16They spooned mis porridge into their mouths to give them strength. They picked limes from the garden and fuse the line with Malagueta Pepper to ease their intestinal distress.
38:28The Healers anointed the grief stricken population with Palm oil to heal their frayed nerves.
38:35Hold leaves from the plant and tree were placed upon their heads to ease headache pain.
38:42Some of the Healers were indigenous priests and priestesses and they provided amulets or sacred power objects to captives prior to their departure and we know from archaeologists that some of these healing objects did travel across the waters wrapped around the necks and the arms of the enslaved.
39:02These ritual objects reconnected the enslaved with the powers of the spirit world.
39:08And so the therapeutic skill of enslaved Africans.
39:12It ended up being prized across the America's.
39:15It was a way to fight for wholeness in the midst of Dehumanisation.
39:21Healing if
39:23We really can say that it existed.
39:26In the context of something like the slave trade.
39:30Can perhaps best be described as the power to indure?
39:37So why does this history matter today? Why does this history matter today?
39:43And I know that we are going to try to.
39:47Rap up I want to make sure that we have plenty of time for questions.
39:52But this history matters today.
39:55For some very important reasons.
39:58For the enslaved who only experienced white medical faces.
40:03At the end of a lash.
40:05Or when their cervix was being forced open on the African coast while women wept.
40:11Their stories offer a hunting reminder.
40:15They remind us that millions of enslaved children women and men who are trafficked across the Atlantic. Those at landed in 1619, he ran beyond.
40:25But they bore within them violent Savage and terrifying medical memories.
40:31That lived in their bodies and in their minds.
40:35When we trace the history of medical abuse in African American history, we must remember that those.
40:42Before even setting foot in the Americas.
40:46Those captive Africans were already in the process of trying to heal.
40:51From the abuses of slave trade Medison.
40:55But as we've heard they also had other medical memories as well.
40:59From the enslaved doctors and Doctress is who had cared for them.
41:05Now, how do we understand the labor that these enslaved doctors and doctors is performed.
41:11From one perspective we could think that because they were enslaved and because they were caring for people who would be sent into the Atlantic traffic.
41:20To be used as laborers in the Americas, we could think well, they're only functioning to support.
41:27A global form of Labor and capitalism.
41:34But only perpetuated this harm.
41:39But from another perspective we can imagine and think about their labor as being part of a longer.
41:46Movement.
41:49Of African insurgency in the realm of Madison.
41:54Or medical knowledge and medical practices and cultures of healing, and curing were used across centuries into our present moment.
42:03So that black people could care for themselves and their communities in places where life.
42:10Resembled death.
42:13We have women like Lulu, Wilson, who was blind in this picture, she wasn't enslaved woman who was interviewed.
42:21She was made blind because of the violence that her mistress slave owners wife perpetrated against her for snuff into her eyes and so Lulu Wilson was blind, but Lulu Wilson served as.
42:39A nurse for 50 years right.
42:43And this is Lulu Wilson.
42:49We have things like Nigro Health week.
42:52No.
42:53Black people after the abolition of slavery.
42:59When they were living in segregated spaces when there were very few hospitals that they couldn't get to.
43:09They were living in places where there were only sewers outside their doors.
43:14Crowded into these little alleyways forced to live in places that were just full of disease.
43:23They're getting sick they are dying the larger white population is saying well. It's because they're black well. It's because they are not fit for freedom look. They can't even take care of themselves and So what do they do? They started Nigro Health Week. It lasted for 36 years and so you had people in their communities working on sanitation efforts working on vaccinate vaccination programs.
43:49The sermons that were coming out of Pulpits during Nigro Health. We all talked about health.
43:56It was about racial uplift.
43:58And racial self care because all they had.
44:02Where is themselves?
44:05We have of course, Marcus Garvey in New York City and the black Frost nurses nurses that March proudly even though they were kept out of all of the professional nursing organizations.
44:16And yet they were there saying We are here to care for our communities.
44:24We have of course, the medical committee of civil rights.
44:28The desegregation of the AMA the desegregation of hospitals.
44:33People coming from New Haven and all across the country to go to places like Soma.
44:40To March into say we are going to fight and stand with?
44:47People who are the most vulnerable and marginalized in our communities.
44:53We have the Black Panthers medical self defense.
44:59Trying to find a way of fighting against medical discrimination.
45:04And, of course, the very famous breakfast programs that they had.
45:09Feeding little children, so that they could do better in school in a time before breakfast programs work done in our communities.
45:21And we have of course, black health matters this hashtag.
45:27So you see from the slave ship all the way to the present too.
45:32This.
45:34Medical school students standing up on behalf of black lives.
45:40Even here on this campus in 2014.
45:45There is a way of thinking about.
45:49This history.
45:51So that we can remember.
45:54That when
45:55Life did resemble death when suicide did seem like the best option for many.
46:03That we have rallied.
46:06We have stood up in so many ways.
46:10To preserve and protect and to advance black health.
46:15Now the importance of this.
46:18Must be obvious to most of you in the room because Medison today is in need of healing.
46:26African American people continue to struggle with distrust toward a profession that still treats their race as a health problem.
46:35They still received desperate quality of care.
46:39They're accused of noncompliance.
46:42Rather than being considered as sacred human beings who are struggling with toxic stress trauma in under resourced neighborhoods.
46:53Mental health concerns.
46:55Food deserts that are right around this neighborhood.
47:01Ideas of black inferiority continue to shape the medical care that African people of African descent receive in the United States, the patient practitioner relationship remains fraught.
47:12Biases and stereotypes continue to result in disparate treatment and this.
47:18Is flashing across our newsfeeds with stark regularity?
47:24This is probably familiar to you.
47:28What's killing America's black infants racism is fueling a National Health crisis.
47:35Too many doctors still believe dangerous racial stereotypes.
47:42Some medical school students still think black patients feel less pain than whites.
47:48That's something that I find in my sources from the 1600s.
47:53The 1600s.
47:56Black patients half as likely to receive pain medications as white patients study finds findings show racial bias in emergency room prescriptions.
48:08Should police violence be viewed as a public health issue?
48:14The little understood mental health effects of racial trauma.
48:21Why racism in health care is still a problem today minorities get fewer treatment options and poor communication from doctors?
48:31One of the most chilling statements that I have ever heard happened when I first came to GAIL and I was a graduate student at Harvard, finishing up my dissertation and I gave a talk here.
48:43At Yale and to medical school students came up to me after the talk and he said.
48:50I feel like I'm living in the aftermath of the history that you just presented on the slave trade and doctors in the slave trade.
48:59And I asked why.
49:00And he said, because of the way I see my attending professors treating black patients.
49:08As a graduate student, finishing out my studies.
49:14And having not had many conversations with people at medical schools at that until that point.
49:21I was speechless.
49:24And remain so.
49:28There is so much.
49:30That we need to do.
49:33And.
49:35For those of you who are encouraged.
49:40To see yourself within?
49:43This longer history of health activism.
49:47An insurgency.
49:50I would invite you to remember these enslaved doctors and doctors is little boys like Jack women like a mono and.
50:00Men like a tomb.
50:03Because they went into the black hole.
50:08They had very little resources available to them.
50:11And they were forced to do this labor.
50:14But they tried to do it in a way that would make at least some bit of good.
50:20To help provide strength to help provide the power to endure.
50:26Because the reality is that?
50:29We have injured.
50:32And in many ways, we have thrived.
50:36And we have changed this world and we can continue to do so. Thank you all so much.