The Author of Blacks in Medicine on Race, Racism, and Health Outcomes
The following is an excerpt from a June 2020 article republished with the permission of GOOP.Black Americans are disproportionately infected with and dying from COVID-19. In a report from the largest health care system in Louisiana, 70 percent of the people who were killed by COVID-19 were Black, even though Black people make up only 31 percent of the system’s population. In his recent book "Blacks in Medicine," Richard Allen Williams, MD, the founder of the Association of Black Cardiologists, discusses the health of Black Americans from the point of view of doctors and patients and digs deep into the history that’s led to today’s disparities. (Williams is also currently a clinical professor of medicine at the David Geffen School of Medicine at UCLA.)
His history of Black medical practitioners in the U.S. is fascinating and disturbing, starting with the remarkable contributions that Black people made to medicine even while enslaved. Here, Williams explains how a long tradition of discrimination and racial segregation has resulted in inequality in health outcomes for Black people in the U.S. And he tells us why he’s hopeful for the future.
GOOP: A powerful letter of yours was published in the Los Angeles Times on June 2, 2020. Can you tell us about the events of the ’70s and ’80s that you wrote about?
Dr. Williams: I was the assistant medical director at the brand-new Dr. Martin Luther King Medical Center in Los Angeles, having just come across the country from Harvard Medical School, where I had completed my cardiology fellowship. I came into a hospital that was built on the ashes of the Watts uprising. I saw a great deal of police brutality going on, especially toward the Black population. A number of Black men were dying from what is called the chokehold, a carotid restraint method administered by police, which was highlighted most recently in the death of George Floyd in Minneapolis. This restricts blood flow to the brain and also can cause a drop in blood pressure and heart rate such that the individual dies.
I noted that sixteen men had died from the chokehold in a few months. Twelve of those sixteen gentlemen were Black. So I was amazed when I got a call from police chief Daryl Gates asking me if I agreed that the susceptibility, as he put it, of Black people to this chokehold was due to a weakness in their anatomical structure. He was basing this request on a book that I had written, "The Textbook of Black-Related Diseases," which described differences in health care delivery and responses to medications being different for Black people than for White people.
I refuted this vehemently and called a press conference. This issue came to the attention of the Los Angeles police commission and it led to a banning of the chokehold in the city of Los Angeles. What George Floyd experienced was not something new, and this problem could very easily be eliminated. All that is needed is for mayors and police commissions to say that no longer will the chokehold be accepted. I was at a meeting with assemblyman Mike Gipson, who has sponsored a bill for the purpose of banning the chokehold throughout the state of California. Governor Newsom has promised to sign it.
GOOP: You went through your medical training in the ’60s. How did the civil rights movement impact your career in medicine?
Dr. Williams: I was involved in petitions to open up Harvard Medical School to a greater degree of diversity. I was the first Black postgraduate trainee at Harvard Medical School in its entire history. I was surprised when I learned that and started a push for change that was very successful. I teamed up with the dean of the medical school, Robert Ebert, for a rather unusual get-together, so to speak, with members of the Black Panther party and Black Muslims. We had a historic meeting in Roxbury at a Muslim temple. The dean of the medical school came, and I presented the case that Harvard wasn’t admitting any Black people into its medical training programs and was not turning out any Black doctors into the community. We got Harvard to contribute a large amount of money for me to start a recruitment drive, which I went on throughout the country, recruiting Black medical students and interns and residents to apply to Harvard. We started admitting our first residents and interns during the time I was in my training program there. In 2004, I was given a lifetime achievement award by Harvard for the efforts that I had made in opening the institution up to diversity.
GOOP: How well represented are Black medical doctors in the US now?
Dr. Williams: The number of Black doctors in this country is about 6 percent of the total, which is ridiculous because approximately 13 percent of the population is Black. That’s something that I’m working very diligently on now, with efforts to get Black students into medical school, as well as providing scholarship funds. I’ve established seven scholarships to fund Black students going into medicine.
GOOP: You wrote "The Textbook of Black-Related Diseases" in 1975 — what was the impetus at the time?
Dr. Williams: I wanted to do something significant in regard to what I had found were severe medical problems with my people, with Black people. And that’s when I discovered that there was really no literature on the medical problems of Black people. It was assumed either that Black people should be treated the same as White people or that Black people did not have a need for treatment for certain conditions. At that time, heart attacks and hypertension were not thought to be problems that Black people suffered from. I decided that none of that was true and that we had to start to bring the truth to light. Dr. George W. Thorn, my boss at Brigham and Women’s Hospital, encouraged me to write a pamphlet about it, which grew into an 850-page book, "The Textbook of Black-Related Diseases," published in 1975. I don’t know whether I would’ve had much of a chance to get published without his help because there wasn’t much interest in a book like that at the time.