When we think of notable civil rights issues in medicine, the best-known cases might be Henrietta Lacks, whose cells were taken without consent for research, or the participants of the Tuskegee Syphilis Study who were subject to unethical experiments.
These are important events that changed the course of medicine, but they’re also examples in which Black people were unknowingly harmed as patients. Vanessa Northington Gamble, a physician and researcher at George Washington University, wants us to know more stories of Black people actively resisting racism within medicine.
STAT spoke with Gamble about a new paper she published on Herman A. Barnett III, a Black veteran who desegregated the University of Texas Medical Branch in Galveston in 1949. Technically, Barnett was admitted to the school on a contract basis — to uphold racial segregation, the university leadership planned to build an entirely separate medical school for Black students where Barnett would be required to transfer. But that school was never built, and Barnett graduated from UTMB in 1953.
The conversation has been edited for length and clarity.
I’d love to start with how you came across Barnett’s story and what interested you about it.
I’m very interested in the medical civil rights movement, because there’s not a lot written about civil rights activists in medicine, be it in hospitals, medical societies, or in this case, medical schools.
I wrote about the desegregation of the University of Arkansas School of Medicine. That medical school desegregated in 1948. And there were no troops, there were no lawsuits, there were no jeering mobs. And the woman who desegregated that school, her name was Edith Irby, later Edith Irby Jones. Arkansas did not fight it. On the other hand, in Barnett’s case, there’s Texas not only fighting it, but it wanted to build its own separate medical school for Black people.
One of the things that fascinated me about Texas is that it was the only place where they appropriated the money for the separate medical school. North Carolina wanted to do it. They passed legislation, but they didn’t appropriate the money. So Texas was different. There’s a couple of reasons that medical school was never built, the main being that after World War II, their medical education became so expensive.
Even though Barnett was a part of the school, and he did well, there was still segregation. He had to sit at a desk by himself. He could only see patients at the Black hospital.
The other part about Dr. Barnett’s story that’s connected to the broader civil rights narrative is that he was a vet. He had been a Tuskegee airman. So one of the major narratives of the civil rights movement and the medical civil rights movement was: here were these people who had fought, had served their country, and could not get into, say, a veteran’s hospital.
Barnett had already been admitted to a few medical schools outside of Texas when he applied to UTMB and agreed to be a plaintiff in a lawsuit with the National Association for the Advancement of Colored People if he was not accepted. What made him the right candidate for a potential lawsuit? Of course, he didn’t end up being one because he was accepted, but what sort of sacrifice was he making by being willing to do that?
They couldn’t have any excuses. They couldn’t say he was not qualified. He had qualifications that matched and exceeded white applicants. There was no question that Barnett should be admitted to the University of Texas Medical branch. The same was true with Edith Irby Jones. They were extraordinarily qualified.
But it’s not just the academic qualifications. They also had to have a certain mental stamina, too. They did not know what would happen when they got to school. Were they going to be jeered at? Or was there going to be violence? One of the things that many people don’t know about Rosa Parks is that it wasn’t just that one day she decided, I’m not going to get up. It was that she had been trained, that she was a civil rights activist. There had been trainings about what to do if somebody is up in your face. And so the NAACP needed someone who had the intellectual capabilities but also had the stamina. Barnett was someone who saw himself as an activist. I didn’t have the room to write about this but there was somebody who they had tried to get before Barnett. But he actually decided not to do it. He was not sure that he could deal with the pressure.
But I think Dr. Barnett saw more of a sacrifice in going to Chicago or going to Nashville. If he went out of state, he was going to be away from his family. He was going to be away from his support system. He was going to be away from his church. Also, there was a strong belief that he was a Texan. He was a citizen of Texas, his family paid taxes in Texas. Why should he be denied an opportunity that his white classmates could have?
There’s a quote you found in your research, where somebody joked, “What was the state going to do when a Negro applied for a medical education — build him a whole medical school?” And then that’s exactly what UTMB tried to do. What can we learn today from this story?
One of the things we can learn from this story is the importance of community and community activism in helping American medicine live up to its ideals. It was not the Association of American Medical Colleges, it was civil rights activists and students pushing for this. So I think that it calls for a broader history of medicine.
The other thing for me is that a week or two before this article came out, a white student sued the Texas medical schools because he did not get in. And so for me, it reminds us that we need to continue to be vigilant about these issues, about diversifying medicine — that it was not that long ago when many of these institutions first started admitting African Americans. This reminds me that it’s still a battle that I think we need to be vigilant about.
How does the continued lack of opportunities for Black physicians and clinicians affect patient care? And how might that be related to the fact that desegregation of medical schools took so long and so much effort?
One of the things that you saw going on in Texas, is that you have a civil rights organization basically saying that one of the ways we think our health status could be improved is with more Black physicians, but also saying that the state has a role in providing more Black physicians; that Texas should be should be providing opportunities for African Americans.
There still are so few Black physicians and especially Black male physicians. I strongly believe it affects the quality of care that African Americans get. And at the same time, I don’t want to let white physicians off the hook. Because most Black people in this country, as long as I live, will probably get their care from a white physician.
Why do you think there isn’t much writing or discussion about the medical civil rights movement?
One of the things about the desegregation of professional schools that I don’t think is widely known is that there were these court cases that predated Brown v. the Board of Education of Topeka. There was a push to desegregate professional and graduate schools before elementary schools, before public schools. The predominant narrative of the history of the civil rights movement in education has been focused on Brown v. Board of Education of Topeka.
It’s only been more recently that there are scholars in the history of medicine who are looking at medicine in terms of civil rights. One of the things I’m really interested in is having a narrative where Black people were resisting, where Black people stood up. And I think this is an example where African Americans in Texas were saying, we are Texas citizens. We deserve the right to go to school in Texas.
You are the first woman and first African American to hold your faculty position at the George Washington University, as the University Professor of Medical Humanities. What does it mean to you to be both the first woman and first African American to hold your position, over half a century after Irby and Barnett were beginning to desegregate medical institutions?
Well, when I was on the faculty at the University of Wisconsin Medical School, I was the first Black woman ever on the medical school faculty. Dr. Barnett went to medical school in 1949, and here we are over 70 years later, still talking about the firsts. It shows how much more work we have to do. And part of my work is that, I might be the first, but I have not done my job if I’m the last.