Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health / Edition 1

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Overview

This groundbreaking book chronicles the history of sickle cell anemia in the United States, tracing its transformation from an "invisible" malady to a powerful, yet contested, cultural symbol of African American pain and suffering.

Set in Memphis, home of one of the nation's first sickle cell clinics, Dying in the City of the Blues reveals how the recognition, treatment, social understanding, and symbolism of the disease evolved in the twentieth century, shaped by the politics of race, region, health care, and biomedicine. Using medical journals, patients' accounts, black newspapers, blues lyrics, and many other sources, Keith Wailoo follows the disease and its sufferers from the early days of obscurity before sickle cell's "discovery" by Western medicine; through its rise to clinical, scientific, and social prominence in the 1950s; to its politicization in the 1970s and 1980s. Looking forward, he considers the consequences of managed care on the politics of disease in the twenty-first century.

A rich and multilayered narrative, Dying in the City of the Blues offers valuable new insight into the African American experience, the impact of race relations and ideologies on health care, and the politics of science, medicine, and disease.

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Editorial Reviews

From the Publisher
An informative, though unsettling, scholarly account of the African American life experience throughout the 20th century. (Choice)

Wailoo's comprehensive telling is the definitive story of race and health in the United States. (Library Journal)

This unassuming masterpiece of revelation focuses a new, more precise lens on the intersection of race, illness and politics. (Publishers Weekly, starred review)

A brilliantly original approach to understanding the shifting nature of race relations over time as well as a unique perspective on the twentieth century history of Memphis. (Memphis Commercial Appeal)

This remarkable text on the social construction of the illness speaks of how ancient, bloody, brutal and enduring the facts of racial disparity in health and care really are in the American experience. (Nature)

Memphis Commercial Appeal
With an engaging but authoritative style, [Wailoo] provides a brilliantly original approach to understanding the shifting nature of race relations over time as well as a unique perspective on the twentieth century history of Memphis. Truly a rare find.
Publishers Weekly
A compelling demonstration of how powerful and significant [the] underappreciated interaction between illness and race has been. . . . This unassuming masterpiece of revelation focuses a new, more precise lens on the intersection of race, illness and politics.
Library Journal
Wailoo's comprehensive telling . . . is the definitive story of race and health in the United States.
Choice
An informative, though unsettling, scholarly account of the African American life experience throughout the 20th century.
Memphis Commercial Appeal
With an engaging but authoritative style, [Wailoo] provides a brilliantly original approach to understanding the shifting nature of race relations over time as well as a unique perspective on the twentieth century history of Memphis.
Charles Rosenberg
Imaginative and sophisticated, yet readable and accessible, this is a book that will find a diverse and enthusiastic audience.
Publishers Weekly - Publisher's Weekly
From slavery onward, diseases real and imaginary have played significant and complex roles in race relations. Wailoo, professor of social medicine and history at UNC-Chapel Hill, focuses on one disease, sickle cell anemia, in one city, Memphis, to fashion a compelling demonstration of how powerful and significant this underappreciated interaction between illness and race has been, in particular tracing a cycle of ignorance of illness and suffering among blacks, to recognition of the reality of sickle cell disease and back to a disregard for black pain and suffering. American discovery of sickle cell anemia in 1910 was followed by decades of obscurity (some doctors simply denied its existence). But a 1934 report that Memphis led the nation with an 11% infant mortality rate was a difficult turning point, eventually leading to medicine displacing cotton as the city's prime economic focus. From the 1940s to the 1970s, there was a growing acknowledgement of sickle cell disease and an increase in medical services provided to the African-American community (though, according to Wailoo, treating sick black children was an easier racial accommodation on the part of the white establishment than acknowledging issues of black power), culminating in the 1972 Sickle Cell Control Act that brought Memphis $500,000 for research. This high point of celebrity and sympathetic visibility contrasted sharply with the 1990s, when medical authorities began again to question the reality of pain inflicted on sufferers by the disease - due, according to the author, to the establishment's increasing focus on treatment costs and the resurgence of stereotypes about blacks and drug use, in particular (unwarranted) fears that prescribing painkillers would lead to drug addition. This unassuming masterpiece of revelation focuses on a new, more precise lens on the intersection of race, illness and politics. (Mar.) Copyright 2001 Cahners Business Information.
Library Journal
Wailoo (social medicine, Univ. of North Carolina-Chapel Hill) sets forth a history of sickle cell disease (SCD) from the academic perspective of social medicine. In this overly detailed, scholarly examination, Wailoo investigates the entire spectrum of the social, cultural, scientific, economic, political, and, most especially, racial aspects of the disease. He unifies and focuses his narrative on the underlying health history of black Americans from slavery through current-day managed care and the rise of SCD from near-invisibility to a major national medical research effort. In Wailoo's comprehensive telling, the story of SCD in Memphis is the definitive story of race and health in the United States. It is a fascinating narrative based on scholarly hypotheses that bear hints of an academic dissertation. Nonetheless, the book is recommended for academic, medical, and larger public libraries because Wailoo makes clear how SCD and all the issues surrounding it reflect societal crises at the intersection of black culture and American health politics. James Swanton, Harlem Hosp., New York Copyright 2001 Cahners Business Information.
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Product Details

  • ISBN-13: 9780807825846
  • Publisher: The University of North Carolina Press
  • Publication date: 3/26/2001
  • Series: Studies in Social Medicine Series
  • Edition description: 1
  • Edition number: 1
  • Pages: 360
  • Product dimensions: 6.40 (w) x 9.40 (h) x 1.20 (d)

Meet the Author

Author of the award-winning Drawing Blood: Technology and Disease Identity in Twentieth-Century America, Keith Wailoo is Martin Luther King Professor of History, jointly appointed in the Institute for Health, Health Care Policy, and Aging Research, at Rutgers University. In 1999 he received the prestigious James S. McDonnell Centennial Fellowship in the History of Science.
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Read an Excerpt

Introduction
Pain and Suffering in Memphis

Throughout history, numerous diseases have been used to draw attention to the African American body and to represent particular aspects of the "African-American condition." In the 1850s southern physician Samuel Cartwright invented "dyaesthesia Aethiopis," a disorder that he claimed caused "obtuse sensibility of the body" and insensitivity "to pain when subjected to punishment" in slaves. The "disease" was a convenient invention, for it could be used to highlight just how different enslaved blacks were from their white owners. Biological difference could be used to excuse plantation whippings and to explain the excessive brutality of slavery.[1] Throughout the nineteenth and twentieth centuries many other conditions, syndromes, and pathologies among blacks—from tuberculosis to venereal disease—have been used similarly to moralize about African American status, sexuality, intelligence, education, or economic condition. Whether these discussions focused on what we term "real" pathologies or invented ones, the discourse of "Negro disease" has always reflected deeper moral quandaries in society. Were black people degraded by or biologically suited to slavery? Was black sexuality a danger to whites and to society? Were black people sicker because they were innately different, or because they were kept socially unequal in America? The stories of particular maladies have been mined and interpreted throughout history because they appear to provide the answers to such questions.

The discourse of black disease has often been stigmatizing and controversial, but occasionally narratives of black pathology have also been uplifting. In 1930, for example, a blues guitarist with the stage name of Memphis Minnie brought an obscure disorder into public light, seeking to sow the seeds not of fear or revulsion but of compassion toward ailing African Americans. In her "Memphis Minnie-jitis Blues," the artist Lizzie Douglas sang:

My head and neck was painin' me
Feel like my back would break in two
My head and neck was painin' me
Feel like my back would break in two
Lord I had such a mood that mornin'
I didn't know what else there was to do.[2]

In the lyrics that followed, Douglas sang of the excruciating pain of meningitis, the diagnostic confusion of the doctor, and the enduring faith of her companion. The lyrics dramatized a common, often epidemic, disorder in the South, asking the listeners for sympathy and understanding.

Depending on the time, the context, and the interpreter, the performance of pathology could point in many different directions. The conception of "racial diseases" has provided physicians, patients, and performers ample, ever-changing material for debating race relations in America. From tuberculosis to venereal disease to meningitis to AIDS, the ways in which diseases are defined, characterized, and dramatized provide a window on social relations and social values.

Read the complete introduction.

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Table of Contents

Acknowledgments
Introduction. Pain and Suffering in Memphis
1. Conjurors of Health in the New South
2. Race Pathologies, Apparent and Unseen
3. Remaking Jim Crow Medicine
4. The Commodification of Black Health
5. Sickled Cells, Black Identity, and the Limits of Liberalism
6. Promising Therapy: Government Medicine on Beale Street
7. Pain and Policy at the Crossroads of Managed Care
Conclusion. Race against Disease
Notes
Primary Sources
Index

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