Dying in the city of blues reflection

Overall, there are multiple layers of depth in this book as we discussed in class about how much the disease is "real" , how is Sickle Cell cultural, and how is it a political issue? I was most curious in this book about the connection to the music style of blues throughout the piece. When Wailoo uses lyrics from Mephis Minnie I could not help but be drawn to think about the Tuskegee Experiment by Don Byron's Tuskgee Experiment. Both authors first use music as a form of alternative expression. Blues came from and was adaptive from the hardships and difficulties of everyday life. In musical expression blues was song in a call and response format. So in Memphis Minni "Meningitis Blues", she would sing one verse and the idea was that her listeners would respond back with the same verse. In that sense, Sickle Cell pain can be a cultural and biological idea.

Dying in the City of the Blues Part 3

            In the final part of Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health, Keith Wailoo further details sickle cell disease at its height in the early 1970s and how it was portrayed in both the government and the media. Wailoo notes that, “[a]s the malady became a national cultural symbol, many more groups with their own agendas entered the discussion about what it signified, reshaping the meaning of the disease both nationally and in cities like Memphis.”[1] With the disease being widely discussed in the media, the government, and groups such as the Black Panther Party, as well as the militancy surrounding black politics in the late 1960s into the early 1970s, “the malady seemed to illuminate ‘the race problem’ itself in 1970s America.”[2] With sickle cell disease being widely discussed in the 1970s, what factors led to its steep decline in national conversation in the late-20^th century into the new millennium? After finishing Wailoo’s book, it is seen that the evolving War on Drugs and its effects on the African American community can explain why sickle cell disease’s importance in national conversation steeply declined.

            As President Reagan intensified the War on Drugs in the 1980s, as well as his view of African American mothers on welfare to be “welfare queens driving Cadillacs,”[3] the prevailing narrative of drug-addicted African Americans looking for ways to obtain drugs through the hospital emerged at the end of the century. In this sense, then, the narrative surrounding sickle cell disease changed as well. While the media portrayed African Americans suffering from the disease as innocent victims in earlier decades, they became vilified in the 1980s; “[t]he new image of sickle cell disease- an expensive, inner city, chronic illness in which too-liberal pain management might actually produce drug addicts- reflected the changing political landscape.”[4] It is interesting to note, as well, that the visibility of sickle cell disease, after its perception of the 1980s, slowly fizzled out in the 1990s; “[b]y the end of the twentieth century,,, the attention paid to sickle cell disease receded noticeably. Over time, the plight of sickles had been dragged into a broad spectrum of clinical and social debates.”[5]

            Overall, then, it is seen that the portrayal of sickle cell disease in the United States changed each decade following its discovery. Originally seen as a devastating disease that affected innocent African Americans to an excuse for African Americans to demand more drugs from hospitals, Wailoo demonstrates that “[w]herever there was a racial controversy, sickle cell anemia might be evoked.”[6] As the narrative of sickle cell disease changed throughout the 20^th century, though, the overall remains about pain treatment for African Americans.

             

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[1] Keith Wailoo, Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill: The University of North Carolina Press, 2001), 165.

[2] “Concern with Urban Problems Spurs Interest in Sickle Cell Anemia,” New York Times, July 25, 1971 in Keith Wailoo’s, Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill: The University of North Carolina Press, 2001), 166.

[3] Ibid, 202.

[4] Ibid, 204.

[5] Ibid, 231.

[6] Ibid, 231.

Dying in the City of the Blues Part 2

            In the second part of Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health, Keith Wailoo details the events that caused the attention around sickle cell anemia to rise to the national level, beginning in the 1950s. Wailoo emphasizes the importance of World War II for the United States and how the healthcare industry, as well as race relations, changed in the post-war era; “[t]he involvement of African Americans in the war effort produced a new discourse on race and health, a discourse that was tinged with disturbing questions about inequality, democracy, and citizenship.”[1] How, then, did the innovations in the healthcare industry and the return of African Americans from the war change spark an increased interest in sickle cell disease at the national level? From this section of the book, it is evident that the changing race relations, as the country was on the eve of the Civil Rights movement, and a new focus on the lives of African Americans factored into the increased interest and research in sickle cell disease.

             As World War II ended and African American veterans began returning home, the fear of a rise in racial tensions spread throughout the country, particularly in the South; many Southerners feared that African Americans would want better treatment, especially in healthcare, because of the equality they experienced in the army. This fear came to fruition as a new African American middle class emerged following the war. As Wailoo states, “[i]f whites could ignore the existence of blacks in earlier decades, they could not do so after the war.”[2] With African Americans demanding greater equality, events that led to the Civil Rights movement also played a role in the visibility of sickle cell disease in the country.

One such example was Brown v. The Board of Education in 1954, which banned segregated public schools in the United States. Focusing on the psychological effects of segregation on African American children, the media became more interested in the lives of African American children; “[i[f black children were still peripheral to these mainstream health concerns, the push for racial equality and school integration would make them increasingly visible in the 1950s. The rising social awareness of sickle cell disease reflected a convergence of racial politics and a new disease economy.”[3] With an increased interest in the welfare of black children, the steady rise of the Civil Rights movement in the South, and an increased focus on family healthcare, it is seen that these different factors contributed to sickle cell disease being discussed and researched at the national level.

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[1] in Keith Wailoo’s Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill: The University of North Carolina Press, 2001), 86.

[2] Aubrey Bowsen, “Superstition and Syphilis,” review of Roark Bradford’s This Side of Jordan (London: Harper and Brothers, 1929) in New Amsterdam News, March 1929, in [L.S. Alexander] Gumby Collection of the American Negro, Scrapbooks (New York: Columbia University Libraries, 1971-74), in Keith Wailoo’s Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health (Chapel Hill: The University of North Carolina Press, 2001), 96.

[3] Ibid, 108.

Race, Medicine, & Society Notes - April 26, 2018

Race, Medicine, & Society Notes - April 26, 2018

Discussion Questions:

1. What was the cultural context in which Sickle Cell became visible to Americans in the 1950s?
2. What were the cultural and scientifics changes that were happening in the 1950s that impacted the ways Americans thought about sickle cell? How does sickle cell shape larger debates?

Social visibility: Viewpoint of people, awareness of particular condition that is prevalent in society during the time (impact), Ex: Flu season, more women die from lung cancer but breast cancer is more well known

vs

Clinical visibility: Viewpoint of medical professionals, awareness by research

Pain is uncommunicatable

• Memphis Minnie used metaphor for pain

Cultural Conditions

Sickle Cell Anemia

What are the social conditions that are changing in 1940s-1960s that will change the way people think about Sickle Cell Anemia?

• African American veterans
• Segregated Blood

Disease Focuses: Malaria, Syphilis, Tuberculosis, -> Cardiac disease, Polio, Leukemia, Cancer

Cardiac disease gains popularity in 1950s

Polio killed a lot of children, nobody wanted their kids to go out (transition of disease), - Public health crisis solved with Polio vaccine

Throwing money into doing research would lead to cure/vaccination being invented

“Solve this problem before the Soviets do”

Studying Sickle Cell Anemia because a lot of funding would be poured into it

Why Memphis?

• 48% African American
• Results would be easily seen
• ‘Up and Coming’
• More popularity for Memphis if successful, Memphis as a modern, progressive city

Brown v Board of Education

• Issue about well-being children (psychological damage caused by segregation)
• Segregation within schools

Sickle Cell Anemia & Segregation of schools caused suffering of children, which would require government intervention (p108)

Ebony Article:

• Normal (middle class) African American family
• Children struck by Sickle Cell Anemia
• Family had to sell many possessions to afford medical bills
• Child suffering (external force shattered good lifestyle)

Dying in the City of the Blues - Chapters 3 & 4

Chapters 3 and 4 of Keith Wailoo's Dying in the City of the Blues discusses the changes to the American healthcare system within the post-World War II era. African American's viewpoints began to change following the war due to the treatment received within the army. A soldier, Van Dyke, wrote about his observations from within the ranks, "There are thousands of negroes whose point of view is being decidedly changed by the army. They've getting equality like they never dreamed of, and I believe it'll have far reaching effects. The ignorant, bigoted, poor-white trash in the South will create the big problem if and when we start to arbitrate the race question."1 From within the army, Van Dyke foresaw changes that would happen in society based off of the treatment towards African Americans in the army during World War II.
Within Memphis, African American consumers for healthcare drafted the idea of a new hospital. This new hospital would economically benefit the city and provide healthcare to many. However, the mayor, Watkins Overton, opposed the idea. Overton believed that the hospital would not be a sound business and the idea was too unstable. How would the institution be staffed and how would black nurses be trained when the University of Tennessee did not admit African Americans for professional training? Overton launched the MacLean report as an outside study to observe the problem within Memphis. At the conclusion of his study, MacLean called for the construction of a new private hospital for African Americans that would be located beside the John Gaston Hospital. African American students could go through residency training; to increase the amount of African American doctors since there was a trend of very low amounts of young African American doctors. This was a step forward for Memphis' black community and was a part of the changes that occurred to American healthcare following World War II. 

1. Wailoo, Keith. Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health. Chapel Hill, NC: Univ. of North Carolina Press, 2001. 88.

2. Wailoo, Keith. Dying in the City of the Blues. 101.

Dying in the City of the Blues - Reading 2

'"We know have Negroes with us," wrote Robert Van Dyke in October 1943, "although the only contact we have with them is in the latrine. They are well educated naturally or they wouldn't be in this company. I just don't like the idea though. Naturally, there is nothing I can do about it."

This quote is a statement that really stood out to me because it truly shows just how much black people were looked down upon over their skin color, nothing else. Back in this period of time, it was commonly said that African Americans lacked intelligence and were poorly educated. However, this quote is from a white person, who is admitting that the Negroes are naturally well-educated, yet he still states that he is against the idea of them being involved. At least those who said/thought that African Americans were not intelligent could use that as an excuse to not want them being involved in the military services, this man knows that they are intelligent, yet just doesn't want them present due to their skin color.

Another piece of the reading that stood out to me was when there were the examples of the newspaper cartoons that represented how Red Cross refused to give Negro blood to white Americans. I knew of this before, but reading it made just how messed up it was stand out even more. Given the time period, it originally did not shock me that doctors would not give a white person Negro blood. Also, knowing that there was this new disease being associated solely with African Americans made it less shocking that doctors would not want to mix their blood. However, these white soldiers would be left to die instead of being given the blood of an African American. The white military doctors were so reluctant to mix the blood that they truly could see no difference between, hence the blood bags needing to be labeled to differentiate, that they would let a fighting soldier die instead of giving them the blood transfusion that they needed.

In-class notes from 4/24 "Dying in the City of the Blues"

1. Discussion questions
1. Sickle cell
1. Panthers were very interested in sickle cell anemia and became involved with activism
2. Tested people for sickle cell anemia but not much came out of it besides testing
3. Became a political issue for African-American
1. Black genocide
1. Failure of us government to pay attention to sickle cell didn't put money into researching, created a further example of the medical disregard for African-American in the eyes of the government
2. How should we consider sickle cell anemia as a biological disease or condition, and also a cultural construction?
1. Observable condition-sickle cell anemia
1. Genetically inherited
1. Red blood cells that are normally round develop a sickle shape and starts to block up capillaries because they do not flow very easily then
2. Biologically real
1. Page 4- James Brian Herrick
1. African-American cultures were already aware of this, many discoveries in Africa on this but a different name.
3. Cultural construction
1. The way it was viewed in society
1. Culture
1. “Culture is the “set of stories” that americans tell one another in order to make sense of their lives”
2. “There is a contest of stories in the public atmosphere. Not all storie are equal. Stories that people tell have to compete with one another for public legitimacy.”
2. Biopolitics
1. Reference notes on Mbembe “Necropolitics”
2. Biopower appears to function through dividing power into those who must live and those who must die.
1. A rehab center for a specific drug
3. The subdivision of the population into subgroups, and the establishment of a biological caesura  between the ones and the others.
1. Incarceration
1. If more troops get sent to prison than others
4. In the economy of biopower, the function of racism is to regulate that distribution of death and to make possible the murderous functions of the state
1. Groups that you see as racially inferior are the ones that you are willing to let die
5. Butler, Precarious Life
1. “Who counts as human? Whose lives count as lives? And finally, what makes for a grievable life?... Each of us is constituted politically in part by virtue of the social responsibility of our bodies.”
2. “Those whom we kill are not quite human, and not quite alive, which means that we do not feel the same horror and outrage over the loss of their lives as we do over the loss of those lives that bear.. Similarity to your own”
4. Key question
1. How did different groups construct discourses about race and disease in Memphis in the early 20th century, and why were those narrative important? What political and social impact did they have?
1. If this disease becomes so important in the 1970’s, why weren't people paying attention to it earlier?
1. 
   
2. If health is a commodity, why/what is it valuable and to whom?
1. 
   
3. Is memphis unique? What was going on in Memphis to allow for this impact of African-Americans?
1. Memphis was a hot spot for african-americans working in labor jobs or in the home
2. It became a small priority to those owners and such to make sure that their workers were healthy so they could continue to profit off of them
3. Page 26
1. Transportation gateway to the north and the west
4. Large population of African-americans page 27-28
1. Went from 50,000 in 1900 to over 40,000 in 1940
5. Shift in valuation of african-american patients
1. Page 37
6. Marginalization of midwives and nurses
1. Page 38-39
7. Political party system
1. Page 41 and on
8. Infant mortality rate in the region
1. Page 61-64
1. Memphis emphasized the dangers posed by blacks in the town
1. “Black people can't take of their children. A reason that they should remain away.”
2. Page 70
9. South was weary of stereotype
1. Page 66
2. What stories were being told about (or not told) about Sickle Cell anemia in memphis in the first third of the 20th century, and how were they important in shaping broader debates about race, health, and citizenship?
1. Certain diseases and disabilities were more visible if they were more convenient or popular in medical field
1. White-self interest
2. Sickle cell
1. Overarching narrative of the disease affecting black people
2. Prone to disease
3. Black people migrating to these cities
4. Black health being a commodity
1. If these people make me sick i could die
2. Good gene vs bad gene
3. Hereditary disease vs environmental diseases that were happening at the same time
4. Infant mortality rate
1. Explained away the statistics by saying that infant death rate was high due to african-americans
5. Notes on question 2 above
1. Great migration
2. Era of biological racism
3. Genetic diseases and environmental diseases
4. Pain and the communicably of pain
5. Page 56
1. Stereotypes of blacks harboring infectious disease creating anxieties
1. Helped to perpetuate the ideas about sickle cell anemia
1. People began to be afraid of contracting disease from them
2. Helped to solidify notion of african-americans being less suitable
6. Page 55
1. More inclined to treat them for those diseases than sickle cell
2. Sickle cell symptoms look a lot like other diseases most common in area
1. Reasons it wasn't treated
1. Limited knowledge of the condition