To summarize this book as concisely as possible, it is about the founding and implementation of the Black Panther Party’s free health clinic programs in the 1970’s. The mere historical value of this book in itself is profound. Although not a new concept, the establishment of clinics like these sets up the terrain for future low-cost community clinics in impoverished areas, and that deserves its own recognition and focus. However I feel that personally the most important idea to derive from this book is the concept of medicalization as a political tool, and not only something that could be meshed into the field of the political, but something which in its present state is by definition political. This was definitely the most crucial idea or ideas I withdrew from the book, and I plan to mention some of this below. In this post I aim to discuss some of the background information relevant to discussing medical inclusion in the United States, discuss important historical situations mentioned in the book, and help develop an understanding of the politics of knowledge surrounding medicine.
I would first like to start with a discussion about the importance of considering the socio-historical context in which conversations around public health and medicine are occurring. This is fundamental to consider not only in a discussion around medicine and healthcare, but also in a study of practically any science that exists. In relation to the medical industrial complex within the United States though, it is important to consider the legacy of exclusionary practices based on race and the moves toward full medical exclusion. That is to say that the race based sciences of the 19th and 20th centuries carry certain customs and traditions of scientifically proving certain ontologies around race which are backed by “empirical data.” To share some segments of this history in brief, America was home to what many consider the most influential scientific racists, Louis Agassiz and Samuel Morton. Morton who used studies of phrenology to prove inherent racial difference and white intellectual superiority, was well received and applauded for the scientific validity of his work which was later discovered to be erroneous in its objectivity. Agassiz, a Harvard professor, was deemed as one of the most prolific minds in science in the world, while also establishing his theories on multiple racial origins of humans. With that being said, it is necessary to note that at least in the past, science and the manipulation of data therein was used to affirm sociocultural contexts about life and promote societal ideals such as slavery. For the purposes of this discussion however, it is important to consider the effects of this type of science on the establishment of medicine. As Alondra Nelson mentions, the hybrid practice of taking “social Darwinism, and the common “folk” understandings of race,” and then reinforcing those theories with an array of legitimizing statistics collected by state and private agencies was neither new nor rare. This was done by people holding academic credentials who collected data, which was then used to legitimize the second class biomedical status of specifically black people at that time. Of course the tests, data, and research were later illegitimized by scientific and political activists since they were filled with errors and lacked real scientific oversight , but the mere existence of this trend is significant.
To give another example, the statistician Fredrick Hoffman published Race Traits and Tendencies in the American Negro in 1896, which was a study claiming that “mortality rates of American blacks were higher than those of whites owing to their racially weak biological inheritance and the ill-effects of emancipation.” This study which was also commissioned by the Prudential Insurance Company, was in turn used to validate discrimination in life insurance policies for blacks, who were denied coverage and deemed as unsafe investments. This study was critiqued and challenged by sociologist W.E.B. Du Bois and the dean of Howard University Kelly Miller for its limitations and arbitrary nature, since the study was almost entirely evaluated in portions of black urban populations characterized with poor living conditions. Du Bois likened the study to “judging the death-rate of Germany from that of Munich, or of arguing that an increase in the death-rate of Paris showed an increase in the death-rate of France.” The reason why I call upon this information is not to simply state past history for the sake of sharing it, but rather to establish a social and political arena in which to understand and discuss biomedical sciences. As contemporary realities indicate, it could easily be argued that the medical and public health nature of black America still possesses its second-class status, and I would argue that a socio-historical understanding is crucial to consider at least at some level.
This consideration is what the Black Panther Party had in mind behind their political and philosophical base in establishing their free health clinics. They desired to create a community service program based on health, and felt they had to confront not only the lack of proper medical facilities for black communities, but also a general disregard for black health at a structural level. To simplify the process of how they founded these clinics down, they would obtain a facility, seek the assistance of doctors, nurses, and other healthcare professionals to donate their time, either buy or get donated supplies, and open up the clinic to the community. In many cases they even applied for and received federal grants to establish and run the clinics and programs. They very uniquely implemented a system of knowledge sharing where professionals would teach and train Panther members on how to perform basic medical tasks, and the members would then follow and teach community members and volunteers of the clinics. Through this method they sought to democratize the dispersal of knowledge, maximize the amount of trained volunteer members, and keep the clinics directly tied to the community as much as possible. They also took a directly political approach in their healthcare services. As Nelson mentions, their approach cultivated “scientific information together with social critique and political analysis.” This is evident with their sickle-cell anemia awareness and treatment program, or in the Party’s requirement of the volunteer healthcare professionals to also undergo political and social training in order to properly asses conditions in the community and be able to care for patients more competently. It is at this subject of political understanding of healthcare with which I would like to conclude, specifically invoking the Panther’s philosophical reading of Frantz Fanon.
Fanon was born in Martinique, went to France in order to study and was trained as a physician in Lyon, France, subsequently studying psychiatry. He was employed by the Fresh government and worked as the lead psychiatrist at a colonial hospital in Algeria when the war for independence broke out. Nelson states, “Fanon’s experiences treating Algerian nationals traumatized by colonial oppression, as well as his observations of the devastating psychological effects of war, compelled him to resign his post and begin working on the side of the Algerian liberation.” It is in this period where Fanon made his transition from psychiatric practice to political theory. Fanon discusses the usage of medical science by the colonial administration in order to categorize and structuralize the colonized Algerian population as pathological, or in other words to constrict the source of an issue as a biologically essentialized problem. He writes in The Wretched of the Earth, “It was confirmed that the Algerian was a born criminal. A theory was elaborated and scientific proofs were found to support it.” It is through this understanding of the French colonial politics of medical knowledge that Fanon recognizes the misplaced subjective derivation of social and extra-medical health conditions as resulting from biological conditions. It is from a political base such as this where the Black Panther Party decided to oppose the potential founding of a psychiatric center at UCLA in the 1970’s which planned to investigate biological models of violence with research focusing disproportionately on black and Latino male youth. It is from this base of understanding which I would argue, for example, we need to understand hypertension and high blood pressure in black and under served communities in the present.
Although this book and post is not directly related to my research, it is fundamental to my future career choice which is why I decided to pursue it. I would also like to make the hopefully obvious note that any critique of a medical industry, as in the case of Fanon’s critique, does not make one anti-medicine. Finally I would like to conclude by saying there is much I left unsaid for the sake of brevity- although I guess that didn’t happen anyway – so I would highly advise those specifically heading into medicine or healthcare as a profession to take the time to read this book. Being in pre-med myself I can say that this book will at the very least help equip you with a necessary understanding for the practice of medicine.