Black Health Care, Black Art: A Texas Perspective
Galveston, Texas, may best be remembered as the provenance of Juneteenth. However, in the universe of Black history, the island city also serves as an obscure yet poignant touchstone for an inquiry into Black health care. Galveston won the site of the state’s first medical school — the University of Texas Medical Branch (UTMB)—opened in 1891. Their “negro” department of the hospital attracted Black people in need of medical attention from as far away as Houston, presumably until the first better appointed Black hospital in the city—Houston Negro Hospital—was built 1927. It was also in Galveston that the second organization of Black medical professionals in the nation — the Lone Star State Medical, Dental, and Pharmaceutical Association— was established in 1886. As an anthropologist concerned with paradigms of health, these early trajectories of Black medicine in Galveston, and more broadly in Texas, provide historical reference points for beginning to think through the socio-cultural context and texture of Black health care— a paradigm of care I observe as a blend of science, politics, and art.
This past year’s COVID-19 pandemic brought historical racial inequities in health and health care into high relief. According to the American Public Media Research Lab, Black Americans along with Pacific Islanders and Indigenous people experienced the highest death tolls from COVID-19. The Centers for Disease Control point to how social determinants such as discrimination, poverty, housing, occupation, and limited access to healthcare contributed to these populations’ susceptibility to the virus. Over a century earlier, Dr. Henry E. Lee in his 1915 essay in The Red Book of Houston connected poor housing, food, sanitation to Houston’s Black population’s vulnerability to diseases such as typhoid fever, cholera, and tuberculosis. The social determinants of health have formed a critical persistent part of the complex ecology of Black health, that include the racially-motivated ways the medical establishment in the US looks upon Black patients. Part of my exploration of Black health care—which I use interchangeably with Black medicine for convenience’s sake—is to not only recognize the longstanding health needs of the Black population and the political mobilization of Black people around healthcare, but how Black physicians like Dr. Lee, conceptualized, and practiced their medicine and healing work.
The origins of UTMB in Galveston offer a lesser-explored place to investigate early Black health care. When the medical school opened, Black patients were treated in a separate “large frame building in the backyard” of Sealy, the city hospital.1 In the antebellum period, enslaved people made up as much as 16 percent of the city’s population, with enslaved men often labored at the international port as longshoremen and cotton jammers, and enslaved women as domestic workers.2 Archival research might confirm the types of care Black residents received in the midst of their exacting lives in addition to discovering whether Black residents also helped construct and maintain the medical buildings. With the Great Storm (hurricane) of 1900 came the construction of a separate and new “negro hospital” in 1902, funded by a private donation. This became the first state hospital for Black people and was later replaced in 1937 with a larger one that eventually closed in 1958. While the storm’s aftermath created a new Black facility, environmental historian Andy Horowitz contends it also revealed the “ongoing human disaster of racialized terror” endured by Black residents including physical violence and political disenfranchisement. This racial climate raised questions about the health risks and medicine, allopathic and otherwise, used to treat, heal, and protect Black people, during this period on the island.
The research of Daina Berry, Deidre Cooper Owens, and Harriet A. Washington for example, present a historical background for this type of exploration. Their work has unfurled the brutal histories of Black people’s treatment as medical subjects during the nascency of the medical field in the US. More in-line with the focus of this essay, the scholarship of Vanessa Northington Gamble, David McBride, and Thomas J. Ward Jr., has detailed some of the histories of Black medicine, laying out how Black people have cared for Black people, and giving special attention to Black medical care in southern states. In applying an anthropological lens, this scholarly body (more comprehensively captured in Johnson, Mitchell, and Nuriddin’s syllabus) creates a foundation for contemplating the labor, approach, and craft, as well as the human relations that comprised Black health care, particularly across Texas.
UTMB was not an option for aspiring Black doctors in the late 19th or early 20th centuries. Until widespread integration of medical schools, Black people received their medical training predominately at historically Black schools: Meharry Medical College (est. 1876) and Howard University Medical School (est. 1868) are among the better known and still operational of the at least fourteen Black medical schools founded in the 19th century. Meharry medical graduate (1886), Dr. Monroe Alpheus Majors (1864–1960) was the first Black Texan to obtain a medical degree and one of the founders of the Lone Star State Association previously mentioned. An outspoken advocate of the Black community, Majors’s medicine included a lifetime of political, social, and educational work on behalf of Black people and their care. In Galveston, Mary Madison’s (ca.1820–unknown) value as a free Black nurse gained her permission to reside in Texas from the state legislature. The Stanton brothers, born in the late 19th century, and also Meharry graduates, opened their practice on the island in the early 20th century, tending to the Black population. These Texas forerunners played invaluable roles in the treatment, care, and proverbial uplift of their communities. Witnessed in the lives of the first Black doctors in the US, the practice of Black health care, especially in southern states, took shape around the political, social, and therapeutic commitments connected to the diverse needs of Black people. Black doctors fundamentally understood Black health as intimately connected to society’s wellbeing.
Oral histories from Black practitioners in 20th century Texas offer a qualitative resource for beginning to understand the art of healing within Black medicine. The treasure I encountered is the University of Houston’s public history archive on African American healthcare and hospitals, which offers a wealth of information about the progression of Black doctors and their communities in Houston and beyond. Through oral histories, the words paint pictures of how Texas became a hub of early Black medicine in the South, including its ties to Galveston. Recorded from approximately 2005–2007, the videos and transcripts relay the strategic and emotional work of integrating white spaces all the while attending daily to the therapeutic demands of an underserved population. Although my engagement has been preliminary, a perceptible breathing paradigm of healing medicine lives in these accounts.
Take that of Dr. Edith Irby Jones (1927–2019), the first Black graduate of the University of Arkansas Medical School (1948), the first woman elected president of the National Medical Association (1985), and a doctor who operated a private practice in Houston’s historically Black 3rd ward beginning in 1962. At the time of her 2005 interview, she was still practicing. Jones stands out for her leadership, civil rights work, and her commitment to serving those most in need. But many other Black physicians in Texas animate the care that occurred through their hands, within their communities, and the field of medicine, locally, statewide, and nationally.
Describing her contribution to the Houston community, Dr. Edith Jones said on record:
It’s maybe my persistence, to see that the needs of the poor have been met, and met with dignity….particularly Blacks, where they were seen in a different room, where they had to come through a different door, when they were seen that they did not get the same kinds of adequate medical care that others were being given, and that’s the paid against the unpaid, primarily. I think maybe my being here, in these situations, has meant to those who could not speak for themselves, or felt they could not speak for themselves, that they had a voice in me.
Here, Dr. Jones speaks of humanizing care. Black medicine, Jones’ words suggest, has not only been about the care of the physical body, but also the emotional, intellectual, and psychic bodies that have borne the long history of racism and other de-humanizing social forces. She, like others recorded, understood medicine as a layered practice of comprehending how Black people and society at large were affected differently by these social determinants of health, and she responded by educating and creating access for patients and doctors alike. Her work was not driven by a curative model so much as a sustained effort to help heal Black folks and cultivate Black wellbeing. To this end, the voices of Black physicians and their patients, past and present, from Galveston to other parts of Texas, are invaluable resources that give texture and shape to this lineage of care and its art.