Tag Archives: African American

Specific Reasons for Overrepresentation of COVID-19 in African Americans

Introduction

We’ve previously quantified the overrepresentation of COVID-19 in African Americans. This Straight, No Chaser offers a few specific reasons for those disparities. We hope policy makers and public health professionals continue to identify and address these root causes of medical and social determinants of health. These are among the main reasons for the vicious health care disparities now being revealed.

Individual Reasons for the Overrepresentation of COVID-19 in African Americans

  • Clustering in America’s most populous cities
  • Disproportionately poor
  • Disproportionately represented in front line “essential” jobs (janitors, cashiers, bus drivers, etc.)
  • Greater presence of preexisting conditions
  • Inadequate housing and higher representation in homeless population
  • Increased neighborhood risks (exposure to pollutants and toxins, less green spaces, less healthy food options, less safety), many of which lead to lowered immunity
  • Less access to care (health facilities are less available in African American communities)
  • Less access to testing (testing facilities are less available in African American communities)
  • Need to utilize public transportation (representing 25% of users)
  • Overrepresentation in the incarcerated population
  • Unequal levels of care received due to an “empathy gap” by physicians caring for African Americans
  • Perceived criminalization (yes, the perception of Blacks wearing masks actually is inhibitive to the use of personal protective equipment in the community)

These conditions don’t excuse the presence of disease or absolve individuals from exerting their best efforts toward health self-empowerment. However, it helps to appreciate factors that stack the deck for or against specific groups of individuals. Furthermore, doing so allows health professionals to create and adjust plans accordingly. Stay safe.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being filled at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

African American COVID-19 Outcomes are Disproportionately Bad

Introduction

Very few states have been collecting COVID-19 demographic data based on race. When you look at the data, it’s apparent why some may not wish to be confronted with that information. We’ve already discussed how African Americans are set up for horrific outcomes due to this pandemic. African Americans fit the high-risk profile in numbers disproportionate to the greater population. They have increased incidences of diabetes, chronic heart disease, chronic lung disease and HIV. As you may be aware, along with being elderly and having other causes of lower immunity, these conditions constitute the most significant risk factors for poorer outcomes with COVID-19 infection.

African Americans are also subject to poorer outcomes due to social determinants of disease. In each of the major considerations: impediments in accessing care, having equal quality of care, and baseline economic status allowing the navigation of costs of care, African Americans are less well off than the general population.

African American COVID-19 Outcomes in Selected Locations

Here are a few data points that show just how dangerously and disproportionately COVID-19 is affecting the afro-descendent community.

  • In Chicago’s Cook County, African American residents make up 23% of the population. Unfortunately, they account for 58% of the COVID-19 deaths. According to data from the Cook County Medical Examiner’s office, half of the deceased lived in Chicago. Furthermore, the majority of African American COVID-19 patients who died had underlying health conditions, including respiratory problems and diabetes. Eighty-one percent had hypertension (high blood pressure), diabetes or both.
  • However, it’s not just an issue in Chicago. Statewide, the number of African American residents throughout with COVID-19 is also disproportionately high. African Americans account for 38 percent of the confirmed cases in Illinois while only being 14% of the population. The state has not released a racial breakdown for deaths, although Illinois is one of the few states that keeps COVID-19 data with a racial breakdown. 
  • As of April 2nd, African Americans were almost half of Milwaukee County’s 945 cases. They were 81% of its 27 deaths. Milwaukee County’s population is 26% black. 
  • According to the Michigan Department of Health and Human Services, as of April 2nd, African Americans made up 35% of the state’s overall confirmed cases. They accounted for 40% of Michigan’s 417 deaths related to COVID-19. In Michigan, the state’s population is 14% black.
  • Louisiana has not published case breakdowns by race, but 40% of the state’s deaths have happened in Orleans Parish, where the majority of residents are black. New Orleans has emerged as one of the nation’s hotspots for COVID-19.

Other Examples of Disparities

  • Other concerns have been expressed without the data to precisely quantify them. Disproportionality in African American having access to tests with the same systems have been reported. Temporary COVID-19 treatment facilities have tended not to go up in areas accessible to African American communities. The $2 trillion stimuli bill was passed after stripping affirmative action guidelines promoting fairing in the business procurement process, making it less able for Black businesses to get opportunities to fund and fashion culturally specific solutions. The explosion in unemployment also disproportionately affected African Americans. These social determinants of health matter.

The concept of a perfect storm ignores the fact that there’s nothing perfect about it to its recipients. A certain degree of willness ignorance about public health challenges tends to exist at the onset of major catastrophes. Let’s not allow that to define the experience of African Americans during this already devastating pandemic. It’s long been said that when White Americans catch a cold, Black American get pneumonia. Given the devastation occurring across America, let’s be mindful of the still disproportionate effects that occur in this demographic.

Need Masks?

The CDC now recommends everyone wear masks. Courtesy of SI Medical Supply, you have an option to provide 3-layer facial masks for your family and loved ones. You can now obtain a pack of 15 for $35, including shipping and handling. These are the recommended masks. Importantly, getting this product does not deplete the supply needed by first responders and medical personnel. Orders are now being accepted at www.jeffreysterlingmd.com or 844-724-7754. Get yours now. Supplies are limited.

Follow us!

Feel free to #asksterlingmd any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample what you can get from http://www.docadviceline.com. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2020 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: Saluting African-American Healthcare Pioneers

Here’s a quote that I enjoy:

“History favorably remembers those that do things first and those that do things exceedingly well.”

                                                                                                                                                –Anonymous

On this next to last day of Black History month, allow me to use our little corner of the world to recognize and pay tribute to a few of the many African-Americans whose work has impacted the lives of millions around the globe. Even if you are not familiar with these individuals or their work, learning about their existence and pioneering endeavors may prove meaningful.
Dr. James McCune Smith (1813-1865), the first Black to hold a medical degree

Smith_JamesMcCune_2x2

James McCune Smith (1813 – 1865) was the first African-American to hold a medical degree, having graduated at the top in his class at the University of Glasgow, Scotland. He was also the first African-American to own and operate a pharmacy in the United States. He has been most well-known for his leadership as an abolitionist, and, along with Frederick Douglass, he helped start the National Council of Colored People (1853), the first permanent national organization for Blacks. Douglass said that Smith was “the single most important influence on his life.”
James Derham (1762-1802?), the first recognized Black physician in the U.S.

drjamesderham

James Derham, the first recognized Black physician in the United States, was born a slave in Philadelphia. Owned by a number of physicians, Derham ended up in New Orleans with a Scottish physician who hired him in 1783 to perform medical services. When he turned 21, he bought his freedom, went to New Orleans and established his own medical practice. In 1788, he was invited to Philadelphia to meet Dr. Benjamin Rush, one of the signers of the Declaration of Independence. Rush was so impressed with Derham’s success in treating diphtheria patients that he read Durham’s paper on the subject before the College of Physicians of Philadelphia.
In 1789, Durham returned to New Orleans, establishing his legend; he saved more yellow fever victims than any other physician in colonial Philadelphia. During an epidemic that killed thousands, he lost only 11 of 64 patients. He moved back to New Orleans and was lauded by prominent local doctors. Despite his demonstrated expertise and his flourishing practice, his practice was restricted in 1801 by new city regulations because he did not have a formal medical degree and was unable to get formal training. He disappeared after 1802, and his fate was unknown.
Dr. David Jones Peck (1826-1855), the first Black to graduate from an American medical school

davidjonespeck

Between 1844 and 1846, David Peck studied medicine under Dr. Joseph P. Gaszzam, a white anti-slavery doctor in Pittsburgh. He then entered Rush Medical College in Chicago in 1846, three short years after the institution opened. Upon graduation in 1847, Peck became the first Black man to graduate from an American medical school.
In 1849, Peck established his practice in Philadelphia. Peck’s medical practice, however, was not successful. Few doctors recognized his status, referred patients to him or consulted with him. He returned to Pittsburgh in 1850. Peck was notable in having toured Ohio with William Lloyd Garrison and Frederick Douglass, promoting abolitionist ideals. Peck moved to Nicaragua in early 1852 where he was killed in 1855.
Dr. Daniel Hale Williams (1858-1931), physician, pioneer of heart surgery and founder of National Medical Association

daniel hale william

Daniel Hale Williams was born in Hollidaysburg, PA, and he earned his M.D. from Northwestern University in 1883. He organized the Provident Hospital and Training School for Nurses in 1891, the first black-owned hospital in the United States.
In 1893, Williams performed the first successful closure of a wound of the heart and pericardium (the layer immediately surrounding the heart). President Cleveland appointed him surgeon in chief of Freedmen’s Hospital, Washington, D.C. During his five-year tenure there, he reorganized the hospital and established a training school for African-American nurses.
Williams helped form the National Medical Association in 1895, though African-Americans were denied membership at that time. He was a charter member of the American College of Surgeons, being the first and only Black member for many years. From 1899 until his death, he was professor of clinical surgery at Meharry Medical College, Nashville, TN.
Mary Eliza Mahoney (1845-1926), groundbreaking nurse

marymahoneylg

America’s first Black professionally trained nurse, Mary Eliza Mahoney, was born in Dorchester, Massachusetts. She graduated from the New England Hospital for Women and Children Training School for Nurses in 1879, having worked there for 15 years before being accepted into its nursing school.
After gaining her nursing diploma in 1905, Mahoney worked for many years as a private care nurse, serving as director of the Howard Orphan Asylum for Black children in Kings Park, Long Island, NY. In 1896, Mahoney was one of the original members of a predominantly white Nurses Associated Alumnae of the United States and Canada, which became the American Nurses Association (ANA) in 1911. In 1908, she was cofounder of the National Association of Colored Graduate Nurses (NACGN).
Dr. Charles R. Drew (1904-1950), physician, pioneer of blood transfusions

Charles_Drew

Charles Richard Drew was born in Washington, D.C. As a surgeon and a professor at Howard University, he developed a means of preserving blood plasma for transfusion. During World War II he headed the program that sent blood to Great Britain. Among his noteworthy accomplishments, Drew started and was the first Director of the American Red Cross Blood Bank.
Dr. Louis Sullivan (1933- ), Physician and 17th Secretary of the U.S. Department of Health and Human Services

SullivanLouis

Louis W. Sullivan was born in Atlanta, Georgia. Sullivan earned his medical degree, cum laude, from Boston University in 1958. Dr. Sullivan held positions at Harvard Medical School and other facilities. In 1967, he founded the Boston University Hematology Service at Boston City Hospital and later was director of the Boston Sickle Cell Center.
Dr. Sullivan left Boston in 1975 to become the founding dean and director of the Medical Education Program at Morehouse College. In 1985, the Morehouse School of Medicine was fully accredited as a four-year medical school. In 1989, Dr. Sullivan took a leave of absence from Morehouse to become the 17th Secretary of Health and Human Services. As Secretary, Dr. Sullivan championed causes among vulnerable populations. He was a strong advocate for increased medical research pertaining to racial and ethnic minorities and the illumination of racial healthcare disparities.
Dr. Ben Carson (1951- ), Groundbreaking neurosurgeon

Carson Scholars Fund

Dr. Carson is a contemporary addition to this list because of his achievements, including successfully detaching twins conjoined at the head in 1987 and his groundbreaking surgery on a twin suffering from an abnormal expansion of the head — conducted while the baby was still in the mother’s uterus. Dr. Carson has performed operations which have greatly expanded scientific knowledge of the brain and its functions. Dr. Carson was the youngest and long-time director of pediatric neurosurgery at Johns Hopkins Hospital in Baltimore. His clinical expertise in treating rare neurological conditions is unquestioned and largely unparalleled. 
Congratulations to these and the many other who are pioneers and leaders. Let’s support and encourage the many who continue this proud tradition.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Syphilis Prevention, Treatment and the Tuskegee Experience

Introduction

tuskegeesyphilis4
Syphilis should be a word derived from something meaning horrible. In an earlier post, we reviewed the rather horrific progression of the symptoms of syphilis. An additionally horrible consideration is that treatment is so very easy once identified. Of course, that’s not the most horrific aspect of the disease. Read on.

Looking back retrospectively, advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. However, as discussed in the post discussing the symptoms of syphilis, remember that treating syphilis at any point can prevent the most severe complications that lead to death. Which brings us to Tuskegee – and keep in mind this is Straight, No Chaser.

The Tuskegee Experiments

tuskegee

In the early 1930s, the US Public Health Service working with the Tuskegee Institute in Alabama began a study to evaluate the effectiveness of current treatments for syphilis, which at the time, were thought to be at least as bad as the disease. The study was conducted on 600 Black men, who were convinced to participate in the study with the promise of free medical exams, meals and money for burial, ‘if’ it was necessary.

The study was initially meant to last 6 months, but at some point a governmental decision was made to continue the study and observe the natural progression of syphilis until all subjects died of the disease, with a commitment obtained from the subjects that they would be autopsied ‘if’ they died. There were several problems with this decision.

  • None of the patients participated under informed consent. They believed they were being treated as opposed to being observed and having medicine withheld while they were being allowed to die. In other words, the subjects were not aware of the purpose of the study.
  • Penicillin was established as a true, rapidly effective treatment for syphilis and the standard of care by 1947. The study continued 25 years beyond this treatment option being available.
  • Efforts by concerned individuals failed to end the study for 5 years prior to a whistleblower going to the press in 1972. The study was ended in a day.

Aftermath

The aftermath of the study includes the following:

  • Reparations averaging a mere $15,000 per individual were given ($9M total) as well as a formal apology, delivered by President Clinton. Yep, the victims received the equivalent of $15,000 per person on average for 40 years of carrying syphilis 25 years after there was a known cure, after infecting wives and unborn children in several documented cases.
  • Strict requirements for protocols for human study (i.e. Institutional Review Boards) were implemented for the first time.

It shouldn’t surprise anyone that many African-Americans remain distrustful of governmental public health efforts to this day; for many, this study continues to be the reason while vaccination isn’t optimally taken advantage of (e.g. HPV) and why organ donation rates are so relatively low in the African-American community. Even though this posture contributes to the adverse health outcomes that exist in the African-American community, it isn’t hard to see why the fear and distrust exists.

Let’s bring this full circle. When it comes to syphilis, prevention is best, and full treatment is available. At the very least, I certainly can say you’ve been warned. Folks have given their lives to make your warning possible. I welcome your questions and comments.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: Saluting African-American Healthcare Pioneers

Here’s a quote that I enjoy:

“History favorably remembers those that do things first and those that do things exceedingly well.”

                                                                                                                                                –Anonymous

On this next to last day of Black History month, allow me to use our little corner of the world to recognize and pay tribute to a few of the many African-Americans whose work has impacted the lives of millions around the globe. Even if you are not familiar with these individuals or their work, learning about their existence and pioneering endeavors may prove meaningful.
Dr. James McCune Smith (1813-1865), the first Black to hold a medical degree

Smith_JamesMcCune_2x2

James McCune Smith (1813 – 1865) was the first African-American to hold a medical degree, having graduated at the top in his class at the University of Glasgow, Scotland. He was also the first African-American to own and operate a pharmacy in the United States. He has been most well-known for his leadership as an abolitionist, and, along with Frederick Douglass, he helped start the National Council of Colored People (1853), the first permanent national organization for Blacks. Douglass said that Smith was “the single most important influence on his life.”
James Derham (1762-1802?), the first recognized Black physician in the U.S.

drjamesderham

James Derham, the first recognized Black physician in the United States, was born a slave in Philadelphia. Owned by a number of physicians, Derham ended up in New Orleans with a Scottish physician who hired him in 1783 to perform medical services. When he turned 21, he bought his freedom, went to New Orleans and established his own medical practice. In 1788, he was invited to Philadelphia to meet Dr. Benjamin Rush, one of the signers of the Declaration of Independence. Rush was so impressed with Derham’s success in treating diphtheria patients that he read Durham’s paper on the subject before the College of Physicians of Philadelphia.
In 1789, Durham returned to New Orleans, establishing his legend; he saved more yellow fever victims than any other physician in colonial Philadelphia. During an epidemic that killed thousands, he lost only 11 of 64 patients. He moved back to New Orleans and was lauded by prominent local doctors. Despite his demonstrated expertise and his flourishing practice, his practice was restricted in 1801 by new city regulations because he did not have a formal medical degree and was unable to get formal training. He disappeared after 1802, and his fate was unknown.
Dr. David Jones Peck (1826-1855), the first Black to graduate from an American medical school

davidjonespeck

Between 1844 and 1846, David Peck studied medicine under Dr. Joseph P. Gaszzam, a white anti-slavery doctor in Pittsburgh. He then entered Rush Medical College in Chicago in 1846, three short years after the institution opened. Upon graduation in 1847, Peck became the first Black man to graduate from an American medical school.
In 1849, Peck established his practice in Philadelphia. Peck’s medical practice, however, was not successful. Few doctors recognized his status, referred patients to him or consulted with him. He returned to Pittsburgh in 1850. Peck was notable in having toured Ohio with William Lloyd Garrison and Frederick Douglass, promoting abolitionist ideals. Peck moved to Nicaragua in early 1852 where he was killed in 1855.
Dr. Daniel Hale Williams (1858-1931), physician, pioneer of heart surgery and founder of National Medical Association

daniel hale william

Daniel Hale Williams was born in Hollidaysburg, PA, and he earned his M.D. from Northwestern University in 1883. He organized the Provident Hospital and Training School for Nurses in 1891, the first black-owned hospital in the United States.
In 1893, Williams performed the first successful closure of a wound of the heart and pericardium (the layer immediately surrounding the heart). President Cleveland appointed him surgeon in chief of Freedmen’s Hospital, Washington, D.C. During his five-year tenure there, he reorganized the hospital and established a training school for African-American nurses.
Williams helped form the National Medical Association in 1895, though African-Americans were denied membership at that time. He was a charter member of the American College of Surgeons, being the first and only Black member for many years. From 1899 until his death, he was professor of clinical surgery at Meharry Medical College, Nashville, TN.
Mary Eliza Mahoney (1845-1926), groundbreaking nurse

marymahoneylg

America’s first Black professionally trained nurse, Mary Eliza Mahoney, was born in Dorchester, Massachusetts. She graduated from the New England Hospital for Women and Children Training School for Nurses in 1879, having worked there for 15 years before being accepted into its nursing school.
After gaining her nursing diploma in 1905, Mahoney worked for many years as a private care nurse, serving as director of the Howard Orphan Asylum for Black children in Kings Park, Long Island, NY. In 1896, Mahoney was one of the original members of a predominantly white Nurses Associated Alumnae of the United States and Canada, which became the American Nurses Association (ANA) in 1911. In 1908, she was cofounder of the National Association of Colored Graduate Nurses (NACGN).
Dr. Charles R. Drew (1904-1950), physician, pioneer of blood transfusions

Charles_Drew

Charles Richard Drew was born in Washington, D.C. As a surgeon and a professor at Howard University, he developed a means of preserving blood plasma for transfusion. During World War II he headed the program that sent blood to Great Britain. Among his noteworthy accomplishments, Drew started and was the first Director of the American Red Cross Blood Bank.
Dr. Louis Sullivan (1933- ), Physician and 17th Secretary of the U.S. Department of Health and Human Services

SullivanLouis

Louis W. Sullivan was born in Atlanta, Georgia. Sullivan earned his medical degree, cum laude, from Boston University in 1958. Dr. Sullivan held positions at Harvard Medical School and other facilities. In 1967, he founded the Boston University Hematology Service at Boston City Hospital and later was director of the Boston Sickle Cell Center.
Dr. Sullivan left Boston in 1975 to become the founding dean and director of the Medical Education Program at Morehouse College. In 1985, the Morehouse School of Medicine was fully accredited as a four-year medical school. In 1989, Dr. Sullivan took a leave of absence from Morehouse to become the 17th Secretary of Health and Human Services. As Secretary, Dr. Sullivan championed causes among vulnerable populations. He was a strong advocate for increased medical research pertaining to racial and ethnic minorities and the illumination of racial healthcare disparities.
Dr. Ben Carson (1951- ), Groundbreaking neurosurgeon

Carson Scholars Fund

Dr. Carson is a contemporary addition to this list because of his achievements, including successfully detaching twins conjoined at the head in 1987 and his groundbreaking surgery on a twin suffering from an abnormal expansion of the head — conducted while the baby was still in the mother’s uterus. Dr. Carson has performed operations which have greatly expanded scientific knowledge of the brain and its functions. Dr. Carson was the youngest and long-time director of pediatric neurosurgery at Johns Hopkins Hospital in Baltimore. His clinical expertise in treating rare neurological conditions is unquestioned and largely unparalleled. 
Congratulations to these and the many other who are pioneers and leaders. Let’s support and encourage the many who continue this proud tradition.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight No Chaser: Saluting African-American Healthcare Pioneers

Here’s a quote that I enjoy:

“History favorably remembers those that do things first and those that do things exceedingly well.”

                                                                                                                                                –Anonymous

On this last day of Black History month, allow me to use our little corner of the world to recognize and pay tribute to a few of the many African-Americans whose work has impacted the lives of millions around the globe. Even if you are not familiar with these individuals or their work, learning about their existence and pioneering endeavors may prove meaningful.
Dr. James McCune Smith (1813-1865), the first Black to hold a medical degree

Smith_JamesMcCune_2x2

James McCune Smith (1813 – 1865) was the first African-American to hold a medical degree, having graduated at the top in his class at the University of Glasgow, Scotland. He was also the first African-American to own and operate a pharmacy in the United States. He has been most well-known for his leadership as an abolitionist, and, along with Frederick Douglass, he helped start the National Council of Colored People (1853), the first permanent national organization for Blacks. Douglass said that Smith was “the single most important influence on his life.”
James Derham (1762-1802?), the first recognized Black physician in the U.S.

drjamesderham

James Derham, the first recognized Black physician in the United States, was born a slave in Philadelphia. Owned by a number of physicians, Derham ended up in New Orleans with a Scottish physician who hired him in 1783 to perform medical services. When he turned 21, he bought his freedom, went to New Orleans and established his own medical practice. In 1788, he was invited to Philadelphia to meet Dr. Benjamin Rush, one of the signers of the Declaration of Independence. Rush was so impressed with Derham’s success in treating diphtheria patients that he read Durham’s paper on the subject before the College of Physicians of Philadelphia.
In 1789, Durham returned to New Orleans, establishing his legend; he saved more yellow fever victims than any other physician in colonial Philadelphia. During an epidemic that killed thousands, he lost only 11 of 64 patients. He moved back to New Orleans and was lauded by prominent local doctors. Despite his demonstrated expertise and his flourishing practice, his practice was restricted in 1801 by new city regulations because he did not have a formal medical degree and was unable to get formal training. He disappeared after 1802, and his fate was unknown.
Dr. David Jones Peck (1826-1855), the first Black to graduate from an American medical school

davidjonespeck

Between 1844 and 1846, David Peck studied medicine under Dr. Joseph P. Gaszzam, a white anti-slavery doctor in Pittsburgh. He then entered Rush Medical College in Chicago in 1846, three short years after the institution opened. Upon graduation in 1847, Peck became the first Black man to graduate from an American medical school.
In 1849, Peck established his practice in Philadelphia. Peck’s medical practice, however, was not successful. Few doctors recognized his status, referred patients to him or consulted with him. He returned to Pittsburgh in 1850. Peck was notable in having toured Ohio with William Lloyd Garrison and Frederick Douglass, promoting abolitionist ideals. Peck moved to Nicaragua in early 1852 where he was killed in 1855.
Dr. Daniel Hale Williams (1858-1931), physician, pioneer of heart surgery and founder of National Medical Association

daniel hale william

Daniel Hale Williams was born in Hollidaysburg, PA, and he earned his M.D. from Northwestern University in 1883. He organized the Provident Hospital and Training School for Nurses in 1891, the first black-owned hospital in the United States.
In 1893, Williams performed the first successful closure of a wound of the heart and pericardium (the layer immediately surrounding the heart). President Cleveland appointed him surgeon in chief of Freedmen’s Hospital, Washington, D.C. During his five-year tenure there, he reorganized the hospital and established a training school for African-American nurses.
Williams helped form the National Medical Association in 1895, though African-Americans were denied membership at that time. He was a charter member of the American College of Surgeons, being the first and only Black member for many years. From 1899 until his death, he was professor of clinical surgery at Meharry Medical College, Nashville, TN.
Mary Eliza Mahoney (1845-1926), groundbreaking nurse

marymahoneylg

America’s first Black professionally trained nurse, Mary Eliza Mahoney, was born in Dorchester, Massachusetts. She graduated from the New England Hospital for Women and Children Training School for Nurses in 1879, having worked there for 15 years before being accepted into its nursing school.
After gaining her nursing diploma in 1905, Mahoney worked for many years as a private care nurse, serving as director of the Howard Orphan Asylum for Black children in Kings Park, Long Island, NY. In 1896, Mahoney was one of the original members of a predominantly white Nurses Associated Alumnae of the United States and Canada, which became the American Nurses Association (ANA) in 1911. In 1908, she was cofounder of the National Association of Colored Graduate Nurses (NACGN).
Dr. Charles R. Drew (1904-1950), physician, pioneer of blood transfusions

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Charles Richard Drew was born in Washington, D.C. As a surgeon and a professor at Howard University, he developed a means of preserving blood plasma for transfusion. During World War II he headed the program that sent blood to Great Britain. Among his noteworthy accomplishments, Drew started and was the first Director of the American Red Cross Blood Bank.
Dr. Louis Sullivan (1933- ), Physician and 17th Secretary of the U.S. Department of Health and Human Services

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Louis W. Sullivan was born in Atlanta, Georgia. Sullivan earned his medical degree, cum laude, from Boston University in 1958. Dr. Sullivan held positions at Harvard Medical School and other facilities. In 1967, he founded the Boston University Hematology Service at Boston City Hospital and later was director of the Boston Sickle Cell Center.
Dr. Sullivan left Boston in 1975 to become the founding dean and director of the Medical Education Program at Morehouse College. In 1985, the Morehouse School of Medicine was fully accredited as a four-year medical school. In 1989, Dr. Sullivan took a leave of absence from Morehouse to become the 17th Secretary of Health and Human Services. As Secretary, Dr. Sullivan championed causes among vulnerable populations. He was a strong advocate for increased medical research pertaining to racial and ethnic minorities and the illumination of racial healthcare disparities.
Dr. Ben Carson (1951- ), Groundbreaking neurosurgeon

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Dr. Carson is a contemporary addition to this list because of his achievements, including successfully detaching twins conjoined at the head in 1987 and his groundbreaking surgery on a twin suffering from an abnormal expansion of the head — conducted while the baby was still in the mother’s uterus. Dr. Carson has performed operations which have greatly expanded scientific knowledge of the brain and its functions. Dr. Carson was the youngest and long-time director of pediatric neurosurgery at Johns Hopkins Hospital in Baltimore. His clinical expertise in treating rare neurological conditions is unquestioned and largely unparalleled. 
Congratulations to these and the many other who are pioneers and leaders. Let’s support and encourage the many who continue this proud tradition.
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Straight, No Chaser: Syphilis Prevention, Treatment and the Tuskegee Experience

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Syphilis should be a word derived from something meaning horrible. In an earlier post, we reviewed the rather horrific progression of the symptoms of syphilis. An additionally horrible consideration is that treatment is so very easy once identified. Of course, that’s not the most horrific aspect of the disease. Read on.
Looking back retrospectively, advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. However, as discussed in the post discussing the symptoms of syphilis, remember that treating syphilis at any point can prevent the most severe complications that lead to death. Which brings us to Tuskegee – and keep in mind this is Straight, No Chaser.
In the early 1930s, the US Public Health Service working with the Tuskegee Institute in Alabama began a study to evaluate the effectiveness of current treatments for syphilis, which at the time, were thought to be at least as bad as the disease. The study was conducted on 600 Black men, who were convinced to participate in the study with the promise of free medical exams, meals and money for burial, ‘if’ it was necessary.
The study was initially meant to last 6 months, but at some point a governmental decision was made to continue the study and observe the natural progression of syphilis until all subjects died of the disease, with a commitment obtained from the subjects that they would be autopsied ‘if’ they died. There were several problems with this decision.

  • None of the patients participated under informed consent. They believed they were being treated as opposed to being observed and having medicine withheld while they were being allowed to die. In other words, the subjects were not aware of the purpose of the study.
  • Penicillin was established as a true, rapidly effective treatment for syphilis and the standard of care by 1947. The study continued 25 years beyond this treatment option being available.
  • Efforts by concerned individuals failed to end the study for 5 years prior to a whistleblower going to the press in 1972. The study was ended in a day.

The aftermath of the study includes the following:

  • Reparations averaging a mere $15,000 per individual were given ($9M total) as well as a formal apology, delivered by President Clinton. Yep, the victims received the equivalent of $15,000 per person on average for 40 years of carrying syphilis 25 years after there was a known cure, after infecting wives and unborn children in several documented cases.
  • Strict requirements for protocols for human study (i.e. Institutional Review Boards) were implemented for the first time.

It shouldn’t surprise anyone that many African-Americans remain distrustful of governmental public health efforts to this day; for many, this study continues to be the reason while vaccination isn’t optimally taken advantage of (e.g. HPV) and why organ donation rates are so relatively low in the African-American community. Even though this posture contributes to the adverse health outcomes that exist in the African-American community, it isn’t hard to see why the fear and distrust exists.
Let’s bring this full circle. When it comes to syphilis, prevention is best, and full treatment is available. At the very least, I certainly can say you’ve been warned. Folks have given their lives to make your warning possible. I welcome your questions and comments.
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