Harriet Washington's Medical Apartheid is a provocative assimilation of facts and inferences that speak to the shadows in American medical history and illuminate its past in chilling detail. Much more than a catalogue of past abuses and strongly resistant to blaming explanations, this text is gritty, nuanced and well worth a careful reading.
My interest in conducting this review was initially rooted in a desire to read and comment on what I was sure to be at least an informative elucidation of the racial injustices in American medicine. However, I was especially drawn to the idea that I could be a part of introducing this work to the psychoanalytic community, a group of individuals uniquely equipped to interpret its meaning and complexities and put this understanding to good use. My reading of the text was infl uenced by many factors, most obvious are the factors related to my personal identifi cations with the subject matter. As a black woman psychiatrist born and raised in South Jersey, I have taken on many roles, and experienced a range of assumptions and projections from others about who I am and what I am capable based superfi cially on my racial identifi cation. Although the weight of assumptions and projections are not unique to African Americans, this country has continued to struggle with issues of race, and has great diffi culty reconciling past realities with present and future possibilities. At the individual level, African Americans are heterogeneous in terms of the ability to withstand negative projections based on race, yet when this occurs in the context of the doctor-patient relationship, the ethical implications are profound. This is not a comfortable topic, and the drive towards denial and repression are strong. Medical Apartheid serves as a mechanism for uncovering our shameful past so that we may uncover, recover and truly heal.
The history recounted in Medical Apartheid is alarming, compelling, troubling and disconcerting. In warding off my own denial, I read a few chapters at Book review and commentary 354