Wednesday, May 2, 2018

Guest Speaker Reflection - Keith Wailoo

Race, Medicine, & Society - Guest Speaker Keith Wailoo


On Tuesday, May 1st, Dr. Keith Wailoo gave a presentation at Washington & Jefferson College about the subject of pain. Wailoo is a professor of history and public affairs at Henry Putnam University. In his presentation, he referred to both of his books: Dying in the City of the Blues and Pain: A Political History. The main theme of his presentation was that pain is not communicable, and physicians often have to take the patient’s word for it. Also, pain is not just medical, it is political.
Wailoo devoted his studies to the subject of Sickle Cell Anemia, its effect on African Americans, and the political ties to the condition. Discovered in 1910, Sickle Cell Anemia became a condition that held low public visibility, and this would continue throughout the 20th century. Due to the symptoms similarity to other diseases, Sickle Cell remained fairly hidden. It wasn’t until the 1960s until Americans began to notice the pain and suffering of African Americans that had long been ignored. However, support for the condition would remain short-lived. There was a major political shift in the United States as the country shifted from liberal to conservative between the 1960s and the 1980s. Come the 1990s, forms of skepticism began to brew as physicians and nurses began to worry about patients faking pain to seek drugs. A new anxiety about drug addiction had surfaced.
Retrospectively looking at the big picture of the time; one can observe the past through the lenses of micropolitics and macropolitics. Through micropolitics, one can observe painful crises that victims endured and the physicians skepticism. Through macropolitics, one ponders whose pain matters? This view is heavily based off the prospect of Biopolitics. Biopolitics exists as observable differences between groups that are disproportionately affected. Biopolitics also covers how one takes care of their own health. Are African Americans really more prone to illnesses? Do they have thicker skin? Are their nerve endings less sensitive than those of a white person? These are questions brought about because of Biopolitics.
In relation to Biopolitics, Wailoo also explained the coexistence issues of undertreatment and overmedication. Patients are sometimes overmedicated, and in Wailoo’s example, he mentioned how it is cheaper to obtain a narcotic that has addictive properties for lower back pain than it is to get physical therapy. Instead of solving the patient’s source of pain; a drug is just thrown their way. Patients are most commonly undertreated when they are knocking on death’s door. Morphine is a narcotic given to ease extreme sources of pain. Wailoo mentioned that physicians will give you enough to make everything normal, but not fun. Palliative Care was a topic of debate and has its origins in Oregon.
On a large scale, Wailoo explained the difference between Red States and Blue States in the United States. Red States are those that generally care about pain in the fetus. Blue States are those of which that generally care about compassion and care at the end of life. Red States care about pain in the earliest stage of life, and Blue States care about pain in the latest stages of life. But what about the middle? What about pain throughout life itself, especially chronic pain? Pain of those with chronic pain is rarely discussed.

Wailoo’s presentation focused on the politics of pain and the history of Sickle Cell Anemia in the United States. Even on the topic of judging pain, it was the courts that made the decision, not physicians. Wailoo’s discussion makes one think of the problems that exist in today’s society and how people currently view pain, either medically or politically. Overall, I believe that the speaker did an excellent job with the presentation and the use of main themes from Dying in the City of the Blues.

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