Rallies by white supremacists in Charlottesville, VA and the subsequent milquetoast response from the White House shocked many Americans. These events invoked a national discussion about how many of our public monuments, built to celebrate triumphs and critical moments from our country’s past, can also exhibit appalling acts of malevolence and cruelty, treatment that today is unacceptable. Similarly, our understanding of medical history has evolved. While many of us are aware of particular atrocities, such as the Tuskegee study or the nonconsensual obtaining of Hela cells from Henrietta Lacks, these stories are by no means isolated, and there are times in our country’s history in which harm was bestowed upon vulnerable populations, especially African Americans. Medical Apartheid unveils the long history of medical experimentation performed on African Americans and highlights some of the origins of our country’s health disparities.
With consistent, adequate treatment, people with HIV have a life expectancy that is nearly normal. However, because HIV often affects the most vulnerable people in our society, getting that consistent treatment remains a real and important challenge. 30 years after And the Band Played On was first published, HIV/AIDS is now often viewed as a chronic illness, rather than the terminal diagnosis it was in the 1980s. For those born after the first AIDS deaths occurred in the US, it can be hard to imagine the fear, denial, stigma, and confusion that accompanied the early AIDS epidemic. Randy Shilts’ And the Band Played On, is a classic work of investigative journalism that chronicles the response of the government, media, medical/scientific community, gay community, and society at large as the epidemic of AIDS unfolded. He portrays the prescient heroes that recognized the danger of AIDS early, but who also paid great personal and professional prices to confront the crises. Ultimately, the book shows the neglect of the early crisis by the government and the media, the battle within the gay community about the “appropriate” response to AIDS, and the apathy of society at large when AIDS was viewed as a “gay” disease.
“In the era of colorblindness, it is no longer socially permissible to use race, explicitly, as a justification for discrimination, exclusion, and social contempt. So we don’t. Rather than rely on race, we use our criminal justice system to label people of color ‘criminal’ and then engage in all the practices we supposedly left behind.” (Alexander, 2)
The New Jim Crow (@thenewjimcrow) by Michelle Alexander lifts the veil of “color-blindness” to expose the comprehensive, deeply routed, and tacitly disguised racialized criminal justice system that functions very similarly to Jim Crow. The authors calls upon the reader to become informed, and to take action. The foreword by Cornel West (@CornelWest) goes so far as to call the book the “secular bible for a new social movement,” and “a grand wake-up call in the midst of a long slumber of indifference to the poor and vulnerable.”
This book is especially relevant to the many clinicians working with disadvantaged and underrepresented minorities, as well as others within the EM social justice and advocacy community.
Unprofessionalism. It is notoriously hard to define and dependent upon the eye of the beholder. And yet, as medical educators, we often are asked to intervene when it occurs. Join our discussion on how to handle a case where a patient discloses to you, the supervising physician, that a resident has been less-than-professional. What would you do?