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Wednesday Feb 17, 2016

Let's Shine a Light on Black Contributions to Medicine

For some, February means an extra day off work for Presidents Day. Many look forward to Valentine's Day each year. Still others see the month as an opportunity to raise awareness of cardiovascular disease in women(www.goredforwomen.org).

For me, February represents a time to reflect on the contributions of people of color who helped make this country great. In the field of medicine, there have been many black scientists, physicians and technicians who invented, improved or initiated practices from which we benefit today. 

NIH image

HeLa cells are seen dividing under electron microscopy. The cells, originally taken from a young black patient, Henrietta Lacks, without her knowledge, have been used in medical research for decades.

I also think about the people who have contributed to science without even knowing it. 

We celebrate Black History Month to highlight stories that have somehow faded into the background of U.S. history. Although we rejoice in the victories of people such as Rosa Parks and Martin Luther King, Jr., there are myriad others whose names most of us would never recognize.

My grandparents lived in Haiti when it was one of the few independent black nations in the world, if not the only one. They reminded me that when they were still children in the early 1900s, walking freely in Haiti, life was far different for blacks a relatively short distance away in the United States.

Until recently, science often advanced on the unknowing backs of minorities. The blister of the Tuskegee syphilis trial(www.cdc.gov) conducted from 1932 to 1972, still causes us to flinch today. 

It is within this context that I remember Henrietta Lacks. If you haven't read The Immortal Life of Henrietta Lacks(rebeccaskloot.com) by Rebecca Skloot, I strongly recommend it. In 1951, this wife and mother died at age 31 from cervical cancer. Her cells were harvested without permission for study.

Better known as HeLa cells, they were used in the development of the polio vaccine and were the first human cells to be successfully cloned. The cells' replicability allowed them to be mass-produced and distributed all over the world for research. This was done without the knowledge of the Lacks family, whose members were neither recognized nor compensated for this contribution. It was not until 2013 that NIH officials formally recognized the Lacks family(www.nbcnews.com) for their matriarch's contribution to medical research.

Indeed, the incredible scientific gains made using the cells of this woman stand in sharp contrast to the fact that many of her descendants lacked the means to pay for their own medical care(www.nytimes.com). Such disparities reverberate throughout the black community. They serve as a constant reminder of the chasm between quality and equity. For some, this experience serves as a litmus test for each encounter with a medical professional. Indeed, it's important that we as physicians recognize there's a steep hill of skepticism we need to climb when caring for many of our patients.

One of the reasons why we celebrate Black History Month is that we, as a culture, do not count black history as part of our history. We don't hear enough about the Henrietta Lackses, the Charles Drews(profiles.nlm.nih.gov) or the Daniel Hale Williamses(www.pbs.org) in our collective history classes.

We relish the fruits of many black authors, philosophers and academicians, but there is so much black history that goes unseen by mainstream culture. We aren't taught, for example, about the slaves used for medical experimentation(www.buzzfeed.com) in the antebellum American South.

Some might argue that there are many contributors to our society, from all backgrounds, that go unheralded. Others might retort that all people, regardless of background, should be recognized for their merit. I agree with both perspectives.

However, our institutional systems of learning remain anemic in color. The value placed on contributions to science is determined by our ingrained bias. It is demonstrated by Nobel prizes awarded and NIH grants received(www.nature.com). It is displayed by who is prominently recognized in our history books versus who is mentioned as an afterthought.

Ideally, one would have the ability to see value and worth without the tainted spectacles of bias. However, bias is rooted our subconscious and requires methodological maneuvers to surface. We as scientists can all relate to that. As one of my mentors in medical school taught, "You don't know what you don't know."

We are trained as doctors to believe that the history is the most important part of the physical exam. I have come to appreciate the truth of this simple statement. Each patient is the result of generations of history, good and bad. Part of my job is to decode that potential. 

Today, I wanted to share a bit of black history -- our black history -- because whether or not you knew the story behind the HeLa cells, chances are that you have benefited from them. I hope that one day our learning experiences will reflect the kaleidoscope of culture and diversity that makes us Americans.

Marie-Elizabeth Ramas, M.D., is the new physician member of the AAFP Board of Directors.

Posted at 03:00PM Feb 17, 2016 by Marie-Elizabeth Ramas, M.D.

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