Black and Blue. John Hoberman
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by health professionals.”119
Physicians' sense of entitlement to privacy in their professional conduct is not limited to American practitioners. Most British physicians, too, expect to be left alone to manage race relations on their own terms. The following anecdote is instructive in this regard. After hearing a South Asian medical student speak on the needs of minority ethnic children in the National Health Service (NHS), the speaker's white peers “reacted negatively: 'He's off again!' some said. Others felt insulted that I could even consider that they would ever discriminate against anybody. Some groaned that they wanted a 'serious medical topic,' which to them this wasn't. Most saw it as a political statement, bearing no relationship to their future in medicine.” And some white doctors extend the same racial privilege to white patients. A South Asian doctor in Birmingham “provoked outrage when he planned to screen his prospective patients for racist views.”120 Encounters with racist patients have long been part of being an African American physician.
The task of understanding how doctors think and feel about race is also made more difficult by the fact that the accumulated survey data about racial attitudes focuses on attitudes toward economic status, social policies, and other sociological topics. Opinion surveys of racial attitudes typically measure respondents' attitudes toward affirmative action, economic status, the state of race relations, voting rights, educational achievement, enforcement of civil rights laws, sources of inequality, the effects of interracial contact, or “the racial healing process.” These data, too, present collective information about attitudes and pose few questions that are directly relevant to the medical setting. Questions focusing on racial stereotypes of laziness and intellectual inferiority would be relevant to studying the attitudes of doctors who may doubt the willingness of black patients to understand and follow their instructions. But doctors also deal with the intricacies, and the intimate aspects, of human bodies that do not figure in published survey data. The sociologists and political scientists who produce most of these studies do not include the questions about anatomical or physiological traits that could illuminate how medical students or doctors might think about their black patients.
In fact, it is unlikely that social scientists would see any reason to pose such questions, given the widespread and mistaken assumption that biological fantasies about racial difference are largely extinct. Second, many social scientists conducting research on race would feel uncomfortable about posing such questions. The days when whites refused to share the same swimming pool water with black bathers are gone, and modern people feel an understandable reluctance to revisit the primal fears that insisted on this sort of biological quarantine from racial aliens. Yet the biological level is precisely where we must go to explore the racial fantasies of medical personnel. There are even some survey data that can help us reassess the assumption that biological racism is a thing of the past. For example, a political scientist's 2004 study of support for the Mississippi state flag found that a biologically themed “old-fashioned” racism was far more prevalent among college students than he and others had expected it to be. “Old-fashioned” racism in early twenty-first-century Mississippi included the belief that “differences that exist between Blacks and Whites are attributed to God's divine plan”—implying a belief in the polygenist doctrine of separate creations—and that blacks and whites should not intermarry, thereby mingling their racially distinct genomes.121 In fact, many years of social conditioning have made race biological thinking a fundamental aspect of how we continue to think about racial differences, even if understandable (and generally commendable) social pressures keep most of these ideas from circulating widely in our public media.
Social scientists' lack of interest in investigating biological fantasies about racial differences has been matched by a similar disinterest on the part of journalists, with a few exceptions. A Washington Post-ABC News poll reported in 1981, for example, that close to one-quarter of white adults still regarded blacks as inferior human beings, a judgment that suggests a belief in genetic inferiority.122 A National Opinion Research Center study released in 1990 reported that 56 percent of whites believed blacks were “violence-prone,” although the idea of a biological basis for this trait was not explored.123 (A suspected biological trait was explored at the New York State Psychiatric Institute during the period between 1993 and 1996, when 100 black and Hispanic younger brothers of juvenile delinquents were given the subsequently banned diet drug fenfluramine “to test a theory that violent or criminal behavior may be predicted by levels of certain brain chemicals.”124) In October 1963, only months after Dr. Martin Luther King's March on Washington, Newsweek reported that 71 percent of whites thought that black people “smell different”125—a biological fantasy about black bodies that can be traced back to the racist plantation physician Samuel Cartwright.126 Our problem is to relate such findings to how doctors think and behave. For example, if about a quarter of white Americans believe black people are somehow inferior, is there any reason to assume that about a quarter of America's physicians are somehow immune to this sort of racial thinking?
PLAYING ANTHROPOLOGIST
An embarrassing and revealing episode involving racial misbehavior by a physician was the 2000 scandal that engulfed Dr. William (Reyn) Archer III, an obstetrician-gynecologist and the son of a powerful Republican congressman, who was appointed Texas health commissioner by Governor George W. Bush in 1997. Over the next three years, Dr. Archer made a number of eccentric and controversial statements, public and private, on such topics as the emasculating effects of birth control and Hispanic attitudes toward marriage. The end came when he told an African American doctor of internal medicine that she was “too smart in a way,” and that using one's intellect to get ahead was “what white people do.” Then, playing anthropologist, he observed that her light-colored skin placed her in an African American “elite.”127 It turned out that Dr. Archer had once said “that he likes to look at health and other problems with an anthropologist's eye, examining the customs, behavioral issues and cultural values that might be contributing factors.”128 The racially eccentric conversations of the highest-ranking physician in Texas were made public only because they were secretly tape-recorded by the black female physician to whom he directed his remarks. The medical profession did nothing to dissociate itself from this authoritarian personality or his primitive racial fantasies. Dr. Archer's urgent need to play racial anthropologist finally led to his resignation from public office in late 2000, but the Texas chapter of the American Medical Association played no role in removing him from public office.129
The ironic aspect of this awkward and protracted drama is that physicians should, in fact, take an “anthropological” interest in the backgrounds, habits, and life circumstances of their patients for the purpose of giving them well-informed care. But there is a crucial difference between the amateur cultural anthropology that acquaints the physician with the lives of his patients and the amateur racial anthropology that searches for racial essences and becomes fixated on apparent racial differences that can inspire both voyeuristic fascination and misleading fantasies in white observers.
What we may call “playing anthropologist” also occurs outside the doctor's office. Young African American women, for example, have told me of being approached in public places by white male strangers who proceeded to comment on the anatomy of their heads or bodies. The comments made by these men were not overtly lewd or hostile, but rather expressed an “anthropological” curiosity about black women. They also demonstrated a willingness to treat black women as if they were specimens on display, another ritual that was common in the nineteenth century. In this sense, “playing anthropologist” involves both a curiosity about the anatomy of the racial alien and a sense of entitlement that confers a right to examine her body for evidence of racial difference.
These inquiring approaches to black women are attempts to answer what the African American journalist Susan Richardson calls “black questions” from complete strangers. She found it frustrating that “after so many centuries in this country, my people were still a mystery to many whites. I have friends who belligerently refuse to answer questions about our curly hair, the variation in our skin color from chocolate to 'high yella' and our culture, especially when they are asked if we are related to the exotic peoples in National Geographic.”130 Troubling encounters with racially curious whites are among the emotional “micro-aggressions”