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Abraham Flexner and the Flexner Report

2020-07-08 | 🔗

The Flexner Report in the early 20th century is often credited with changing the medical field and shaping what medical education looks like today. But this document negatively impacted medicine in the black community. 

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This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
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I heart, radio, hello, unwelcome upon tat. Somehow we try and I'm Tracy Wilson Tracy one of the topics that come up a couple of times for me in recent weeks, as I've just been doing. My own reading related to racial injustice is the flexible report, and this is for there was issued in the early twentieth century. It is often credited changing the medical field in shaping what medical education looks today. I also found one article that said it's the most overrated document in medical history. It made me laugh a bit no good, but there are also aspects of this document that really need to be discussed in terms of how they impacted the black community. So we're gonna talk about this one in three parts. First, we're gonna talk about Abraham flex nerve for whom the report is named and who made report and then we're going to take him
the general impact of the flexible report on medicine. And finally, we will talk about how this affected black medical school specifically, and it is a lot to unpack and I hope we manage to do it just as with anything related to any of these topics, a person's biography, the history of any given field Emma history of how things impacts racial injustice, lake you're, always more nuances than we could ever packing doing episode, but we're hoping we hit all of the the prominent and pertinent points guy. If you listen to the pod cast saw bones, they didn't episode, which I guess at this point will be a few weeks ago. That was about
racism in medicine, and it it alludes to this without going into too much detail about it. If you, if you listen to our show in that show, these are sort of the complement one another they do. They do. We didn't plan that it has happened so the starts with Abraham Flex, inner and Abraham Flex, nor was born in Louisville Kentucky on November Thirteenth eighteen, sixty six have father more its flex, inner and his mother s, her Abraham or german jewish emigrants Morris had a hat ass an Esther worked as a seamstress. The flexible family was large, Abraham was their six child and they ultimately had nine more it's enough were able to build up their finances with the plan, not that they were
I've lavishly, but that every one of their sons- and there were seven of them- would attend college. But that plan fell apart when the eighteen seventy three panic hit and they lost their savings. But Abraham did manage to go to college. He attended Johns Hopkins University and the funds came from his brother, Jacob. The span of the ages of the flax nor children meant that Jacob was already established by the time Amber him graduated from high school. The money he was making. As a drugstore owner was put towards Abrahams tuition yeah, they definitely always prioritized. The education is where they put their money. Abraham earned his ba in eighteen. Eighty six and his hope had been to go into a postgraduate programme, but there was not enough money for that and though he did to secure a fellowship, none materialised. So went home to Louisville to start his career for the next four years. Flaxen or worked as a high school teacher heading up. The latin and greek classes at Loo will high school
but during that time he was developing another idea because he thought there was a better way to structure education Idea manifested as an experimental school inflection are founded that school in eighteen. Ninety that's cool was simply called mister. Exeter School, and it was incredibly progressive. The structure probably see no structure at all to traditional educators flex. Nor did away The idea of a set curriculum students didn't have exams, and they did not receive grades. The vision of Lechner had for the school was custom, tailored education to prepare Stewed for higher learning,
and a lot of his students got into very good schools. So this was a very successful model. The flax in our family continued to value education and help one another in that regard. One of the personal benefits for ever him, flexor and creating his school was that he could enroll his brother Simon there and get him into Johns Hopkins. He was also able to paper Simons tuition. Abraham also helped his sister Mary. He paid her way up red meat, this marks an expansion of the families plan to not only educate the men of the family, but also the women in education for women, with something that Abraham supported throughout his life. One of the former pupils in nurse preparatory school. A young woman named an Crawford, also became an important part of Abrahams. Life after graduating Anne had become a teacher she'd attended, Vassar in which he finished those steady. She started working there at the school and she also had started to pursue a career as a playwright, apron
in fell in love and they were married and eighteen. Ninety eight may eventually had to gene and Eleanor in nineteen o for an adapted. The novel, MRS wigs of the cabbage patch, which is a comedic story about an impoverished southern family, into a Broadway play. Mrs wig ran from September third, one thousand nine hundred and four to January 19th, five at the Savoy theater, and it was a success. The income from ants work on the show made it possible for Abraham to enroll at Harvard to get his master's degree in psychology. He closed his school to do that. He also spent a year in Germany as part of his studies again. Bank through his wife success in the theater that time spent in Germany made flex nerd deeply aware of what he saw as the failings of the education system back home and as a result, in one thousand nine hundred and eight, he researched and wrote an assessment of higher education in the United States titled the American College, a criticism based on his work exam,
colleges and identifying what he sighs the problems at the single school level, as well as systematically flex narrow, was commissioned by the Carnegie Foundation for a new project. He was asked by the President of the Carnegie Foundation for the advancement of teaching that was Henry Smith. The Pritchett to apply that same critical and analytical I to the medical institutions, specifically in the United States and Canada. There were a hundred and fifty five medical schools in his survey here he took two years to basically travel around and visit all these schools and do his assessment and then in nineteen ten flexing, are completed. His report, which was titled medical education in the United States and Canada, and when this report came out, it had a massive impact on medical education in North Amerika. A lot of the schools that flexible had found lacking closed as a consequence of its publication others were completely overhauled and essentially rebuilt from the ground up and we're gonna talk more
bout. All of that in just a moment following the medical school report Flex near produced a report at the behest of the Rockefeller Foundation, examining the sex work field in Europe and how it was regulated. It was the first of many very reports that for nor would compile for the foundation, but though he had moved on to other projects like that, flexor did not just drop his medical report and then move on with his wife. He actually dedicated himself to him moving medical education, specifically in nineteen thirteen. Following his report on european sex work, flexible became the secretary to the Rockefeller foundations, General Education Board. There, this time in his role. He worked on a number of other research and reporting projects, as we mention, but he also made sure that money from private donors was allocated to medical education and improving some of the problems he had discovered while working on his nineteen
report in nineteen, twenty one, Abraham flexing wrote a memo for the Rockefeller Foundations Board, which was titled the usefulness of useless knowledge and memo evolved in it became a lecture, and then, eighteen years after he initially wrote it, it was published in Harpers magazine and that piece of writing opens with the following paragraph quote: is it not a curious act that in a world steeped in irrational hatreds which threaten civilization itself, men and women, old and young detached themselves wholly or partly the angry current of daily life, to devote themselves to the cultivation of beauty to the extension of knowledge to the of disease to the amelioration of suffering. Just as though fanatics were not so, tediously engaged in spreading pain, ugliness and suffering the world
has always been a sorry and confused sort of place. Yet poets and artists and scientists have ignored the factors that would, if attended, to paralyse them from a practical point of view. Intellectual and spiritual life is on the surface, a useless form of activity in which men indulge because they procure for themselves greater satisfactions than are otherwise obtainable. In this paper. I shall concern myself with the question of the extent to which the pursuit of these useless satisfactions proves unexpectedly, the source from which undreamed of utility is derived. One of the things that flex nor touches on in this writing is the unintentional outcomes of pursuits that were of pure intent. He specifically mentions how the advancement of the cruelty of warfare was fuelled by scientists.
Who were often working, they thought for the betterment of mankind as a nineteen. Twenty were on Abraham Flex, nerve found himself at odds with other members of the education Board at the Rockefeller Foundation, and this led to him currently being pushed out of the organization in nineteen, twenty eight and one thousand nine hundred and twenty nine Abraham Flexner, was approached by philanthropists, siblings, Louis and Caroline Bamberger. The band thought they could use their wealth to establish a new medical school in Newark, New Jersey, and they wanted flex as an adviser on the project. But what's your pointed out that newer had neither a teaching hospital nor a top notch university, both of which were vital to the success of a medical school and I am flexor was really thinking of a different sort of project and he was able to convince the bamberger that they should instead invest in his idea, and they did with a gift of five million dollars
Wexner envisioned what he would later call an educational utopia that offered the greatest minds a place where they could be driven entirely by their curiosity and sew in nineteen thirty Flexner found at the institute for Advanced Study in Princeton, New Jersey and service director there. Until one thousand nine hundred and thirty nine its mission stated quote, the institute is pledged to assemble a group of scientists and scholars who, with their pupils and assistance, may devote themselves to the task of pushing beyond the present limits of human knowledge and a training. Those who make carry on in the sense. What's there was to attract some of the biggest names to his institute, including Albert Einstein, who joined in nineteen thirty three in the years since its founding the institute has had as members or as faculty. Thirty four. Nobel laureates forty two fields: medalists an eighteen able prize laureates
in addition to Einstein, notable names on that list include Robert Oppenheimer and previous podcast. Subject, John VON Norman, we're going to cover the end, the Flexures life and the impact of his work on medical education, but were due for a quick break to have a word from our sponsors this episode is brought. You buy indeed, what is it twenty mean for small businesses, you have to do more with less the tar suddenly. Every single higher is critical, but there are fewer resources to find the right. People, indeed, is to help India Com is the number one job site in the world because indeed gets you the best people fast. Like other sites. Indeed give you full control and payment flexibility over your hiring. You only pay what you need. You can pause your account at any time, and there are no long term contracts plus indeed provides powerful tools to make your search that much. Here with seventy percent of online job seekers visiting indeed each month. Indeed, is
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a review of how schools ran in different countries, titled universities, American English, german flaxen, a retired as director at the institute and nineteen thirty nine. After an internal conflict in which the school was accused of allowing an anti semitic climate at play- Stan School that they routinely worked with, nay, were allowing that climate to hinder the work of a lot of the professors as tensions among the scholars leadership war on flexible retired in the autumn of nineteen, thirty nine, although he was in his seven these who stay very busy after believing the institute consulting on various projects and writing several books, including his autobiography biography during and after war to several of Abraham siblings, died by the end of the nineteen, forty
only Abraham and his sister Gertrude were still living out of the nine flexor siblings. At the same time, his wife, Anne had gradually developed vascular dimension in ninety forty seven Anne had declined so seriously that she was taken to erode island sanitarium there are two daughters, frequently visited her and they updated their father, but Abraham never saw him again. He had not coped with her illness well and could not bear to have the person that he had been so close to no longer recognize him. He later told friends that he had actually had a breakdown during this time, as he recovered from this significant change as life flex, nor moved to a hotel near central Park and enrolled in classes at Columbia. He opted for classes and lit sure and history and nineteen fifty one. The New York Times read an article about the eighty five year old flex, inner educational reformer taking classes alongside coeds a quarter, his age, an died, sure
before Abrahams ninety s birthday, which once again sent him into a dark period and as was slowly returning to his old self. His daughter Jean convinced him to leave New York and move to false church Virginia, which is where she lived so that he could be near her any
two years they are enjoying a very active social life and visiting the museums of near by Washington DC regularly before his death on September, twenty first nineteen, fifty nine. So moving on to his report about medical schools, as we mentioned, flaxen are covered a hundred and fifty five schools and nineteen ten report, and in researching that report, he had visited each school and written, detailed and comprehensive notes about their entrance requirements, faculty funding, laboratories and connections with affiliated hospitals and the five decades before has research. Massive advances in science and medicine had been made, but because there was no comprehensive guidance for how medical schools operated, a lot of them are still teaching out of date, information basically telling future doctors stuff that wasn't believed maturity more. This is, in large part
as the faculty at many medical schools consisted largely of practising physicians who were teaching exactly as they had been taught without updating that information with the changing times. Bacteria ology diagnostic developments and surgical techniques we're all rapidly, changing fields, and if a school wasn't keeping up the doctors they train. We are in danger of offering their patients poor or David care at best dangerous their lives at worst. Thick compounds that problem there were lot of new medical schools, opening with totally varied standards for entry when Flex Inner published a study. Seventy four percent of a medical schools that were open required only a high school education for admission. Some are willing to accept high school equivalency certificates, which meant that there was really no clear standard. Only a fifth of the schools required two or more years of college prior to
tree many worrisome, essentially profit driven businesses, Abraham Flex nearer was also very frank in his report about how little the public really knew about the workings of any given medical school. He wrote in introduction, quote educational institutions, particularly those which are connected with it, major a university are peculiarly sensitive to outside criticism and particularly to any statement of the circumstances of their own conduct or equipment which seems to them unfavourable in compare sin with that of other institutions. As a rule, the only knowledge which the public has concerning an institution of learning is derived from the statements given out by the institution itself. Information which, even under the best circumstances, is coloured by local hopes, ambitions and points of View
flexor, felt that this work was vital and important to be doing. Writing that the information in it was of importance not just to medical practitioners, but to quote every citizen of the United States and Canada Abraham Flex. Inner building on standards that were already in place in Germany established standards of evaluation for the medical schools in his study and then judged each one against those criteria, and we should know that was not the first person to do this. In the United States, the Association of American Medical colleges, founded in eighteen, seventy six and consisting of twenty two member schools had agreed on curriculum standards to provide uniformity and medical education that had happened after an assessment of the state of medical education. They m c, continued to grow and re evaluate, and the years between its founding influx nurse report, the American Medical Association had similarly started issuing reports on the status of medical educate
When is early as one thousand eight hundred and forty eight and some of the criteria that use were present in Flexner's evaluation system as well, but neither of these had oversight overall, medical schools that was an option on a set of birds all of flex. Nurse work was aimed at determining in his opinion whether a school was able to effectively teach it students, modern medicine the model that he drew up for what this look like included, admittance requirements of college level, biology, chemistry and physics courses, a curriculum with both
sure and lab teaching of anatomy pathology, bacteria ology in pharmacology, among other courses, access to teaching hospitals for hands on experience, salaried faculty, who were exclusively working in teaching and research, not practising doctors who just taught on the side flex inner laid out his findings state by state and school by school. He was detailed calling out if he had found dirty labs are lax standards. He criticised the way the days were scheduled at schools and how exhausted students were often sitting through hours of dull lecturers by parttime faculty, because he was an outsider, an education reformer rather than a member of the medical community. His assessment was without preconception and it was brutally honest, offering the general public a startling look at the way people who cared for their health were being educated flex, inner advocated for state licensing boards to take a more assertive role in modernizing medicine by refusing to
licence graduates from schools that were not up to standards and he will is that a lot of schools were not up to standards in the end, He recommended that one hundred twenty of the one hundred fifty five he reviewed for the report should be closed. That Commendation was based on his assessments that their standards are very poor and that they were not keeping up scientifically and thus were creating poorly educated doctors who lacked up to date, knowledge in their field, which was something he saw it as a completely obvious danger to pump health, canadian schools. We should mention fared much better than their. U S counterparts overall. Only once Will they are made Flexures list of closing recommendations? It was not clothes though they
I have a little bit of a review of their curriculum in their standards and changed up a little many of the schools in the. U s that he recommended be closed did Claire's. Within a decade there were only half as many medical schools as there have been when Flexures report was published. There's that had remained had reformed their standards in their courses and lab work in clinical teaching had been significantly changed and, in most cases, modernized for all of the change that was catalyzed by the report. Flexor became famous as an educator nor a former we're going, pause here before we dig into the ramifications of Flexures work for black medical school. Specifically. So here in the meantime, are some of the sponsors that keep stuff you missed in history class. Going support for stuff. He missed in history class comes for our friends at rocket mortgage by loans home today is so much more than it was yesterday, but it rocket mortgage home is still about you during
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go to Mazda, USA, dot com, slash I heart and don't forget to explore their strongest financing options. Before we talk about the effects of the flax and a report on the black population, in the U S and its medical schools, we should give a brief sense. What's going on in that space prior to nineteen, ten, the first black man in the? U S to receive a medical degree was David J Pack. He received a degree from rush medical school in Chicago in eighteen, forty seven. As a note, he was not the first black doktor in the. U S, that's usually cited as former
Liam slaves, James Durham. He was born in one thousand seven hundred and sixty two and learned medicine through an apprenticeship in the thirteen years after packs graduation, there were a handful of other black men students who graduated with degrees in the: U Dot S nine medical school, to establish that they would admit black students by one thousand eight hundred and sixty, including the medical School of Harvard of Harvard University Bowdoin Medical School in Maine and the medical school of the University of New York in the late 1860's, the first medical school for black students open that was Howard University Medical School in Washington DC and it open in eighteen. Sixty eight, eight years later, my Harry Medical College opened in Nashville Tennessee from eighteen. Seventy six to nineteen o for another. Six black medical schools opened including letter in medical school, which became Shaw University in Raleigh North Carolina, New Orleans University, Medical College, Knoxville College Medical Department
Knoxville Medical College Chattanooga, National Medical College and University of West Tennessee College of Physicians and surgeons the schools listed there are ones that were open. When Flexner compiled a report, there had been others that had folded before the one thousand. Nine hundred and eight research started that included Lincoln University in Oxford, Pennsylvania, which it opened at one thousand, eight hundred and seventy closed. For years later straight University Medical Department was established in New Orleans in eighteen, seventy three, but was display. One thousand eight hundred and seventy four Hannibal Medical College of Memphis Tennessee that open in eighteen. Eighty nine be closed. In eighteen. Ninety six Louisville State University Medical Department ran from eighteen ninety nine to one thousand nine hundred and three Chattanooga National Medical College closed in one thousand. Nine hundred and four five years an operation. The medical society of the District of Columbia was founded in eighteen, seventeen that society was for whites only
the American Medical Association was founded in eighteen, forty seven and though black doctors applied to become members for years they were denied entry. Rina come back to the AMA and just a bit the medical tyrannical. Society was founded as a black medical society in eighteen. Eighty four, because of the impossibility that black doctors faced gaining admittance to those established groups The National Medical Association was founded in eighteen. Ninety five for black doctors. For the same reason, it was not Till the nineteen fifties that black doctors had gained admittance to medical societies in most states in the midst of this clear division and racism, but flexible report was released.
Flexible had often been lauded for his role as a reformer and as we discuss reform did need to happen. He was obviously blunts and often scathing in his critics of individual schools and the schools for blackmail. Students were no different. In his report. He wrote quote of the seven medical schools for negroes in the United States five or at this moment in no position to make any contribution of value. While he praised both Howard and my Harry is worth developing, the rasper deemed basically useless. This assessment did not take into account the fact that black medical schools charged much lower tuition than white schools had fewer endowments and were operating on much narrower margins. In his assessment he wrote quote the Negro needs schools rather than many schools. He went on labourer that it was important for black doctors to be well educated. He understood that black doctors would see to the health of the black population and since the black population was a part of the larger hole,
their care was important, but the language that flex nor used throughout this section where he talked about all of this, is a very mixed bag. He simultaneously speaks of the rights and contributions of black people, but also asserts that it is best of black doctors. Take care of their own. People and offers the teaching of hygiene as one of the most important duties of black doctors and nurses, rather than lifesaving skills, which is just inherently racist. Every black medical college that flex near called out as sub par closed. The first four had shut their doors by nineteen fourteen a fifth closed and nineteen fifteen. The last from the last with the Medical Department of the University of Tennessee lasted until nineteen twenty three Howard and Mary remains, and they still do the Charles ART.
Medical school, in LOS Angeles, was the next predominantly black medical school to open that in happen until nineteen sixty sex, you listen to our episodes on Brown. We board, like that, seems late in the creation of a medical school, but that school was founded like specifically to respond to two medical access needs within the black community, the net was WAR House School of Medicine in Atlanta and nineteen. Seventy five, so the narrowing of options for prospective black doctors left a huge care gap for the black community, many but Joe physicians were excluded from educational opportunities due to location, which meant that the care of black patience was often old out by white doctors who, even in the best of circumstances, met their duties with inherent racial bias and, as we have just on the show before there were definite racist abuses of power in the medical system, and this has had far
teaching and ongoing consequences. A panel was assembled by the American Medical Associations Institute for ethics into that, on five to examine the history of racism in the medical profession. One of their findings was that the Carnegie Foundations Project for which they hired flex inner that had been sponsored by the EIA may as well, although that hadn't been disclosed at the time flex. Nurse line of good schools, rather than many schools, have ensured that medicine Sayd segregated and that community who needed doctors, the most were just left without them. Yet there are some question marks that continue about. Whether or not someone associate with the AMA was actually with him on some of those school visits and at some point in history he said That person was with him and then later on, he was ignored in internet like they met me, they are like it. It's shifted so don't really know if there was even more hands on direction of that report in that regard or not.
Picture on the now defunct black med schools by Doktor Earl H, hardly of Washington DC was published in the jury of the National Medical Association in September of two thousand six in n, it doctor Harley summarised how black medical schools, which always been smaller, with a higher percentage of graduates going into medicine, for underserved communities have continued to face obstacles in the century. Since Flexures report rating quote one of the greatest challenges of today's black medical schools is economics. Black medical schools find it difficult to compete with well funded majority universities of the long standing commitment to train african arrogance such as the University of Michigan. The result may be the siphoning of well qualified, highly competitive african american students who choose quote rich schools for pragmatic economic reasons. This places an extra burden on today's black medical school of appealing to a higher social calling as they seek to fulfil their historic missions.
The search for greater endowments to become more attractive? They must continue to position cells as the training grounds for those who will serve the underserved so thus brings up a natural question, flex, no real the disproportionate impact of his report on black men, students and doctors and patients. He spoke at length about race throughout. Has life. But what were his intentions with us? One thousand nine hundred and ten report. I mean, apart from his attentions the effect that we just mentioned. Yeah. But we do know what his mindset was and their different schools of thought on it. You can talk to a lot of people and they will give you completely different answers for whether or not they thought that there was racism in the mix or affliction are really understood this. He did oh, that he was limiting the scope of black medicine. He said so in his report, although it is part of a rather idealist passage that reads quote the up: building of how
Bird and Mohira will profit the nation much more than the inadequate maintenance of a larger number of schools. They are. Course unequal to the need, an opportunity, but nothing will be gained by satisfying the need or of rising to the opportunities through the survival of feeble ill equipped institutions, quite regardless of the spirit which animates the promoters. One thousand nine hundred and thirty Flexner wrote a letter to the trustees of his institute for advanced studies in which he advocated against discrimination, quote. It is fundamental in our purpose and are expressed desire that, in the appointments to the staff and faculty, as well as in the admission of workers and students, no account shall be taken directly or indirectly of race, religion or sex res feel strongly that the Spirit Characteristic of America at it snow.
Above all, the pursuit of higher learning cannot admit of any conditions as to personnel other than those designated to promote the objects for which this institution is established, and particularly with no regard whatever to accidents of race, creed or sex. It appears that reflects nurse progressive ideas about equality, particularly in relation to race, probably came from his childhood in Louisville one biographer, who is very sympathetic to Flex Neuro Thomas Naval Bonner, made the case in his book about Flex, knew that Abraham was growing up in Louisville Kentucky. It was a time when well There was certainly nothing akin to equality. There were more services and opportunities for the cities black community than in a lot of other places. There were a dozen schools for black students there Abraham was growing up and professional training schools in teaching medicine and law were available to block incidents and the flex nurse who were not wealthy lived in a neighborhood where they had black neighbours Abraham.
Later in his wife that he and his siblings often played with the black children in their neighbourhood, and this experience may have left a complex, nor a little idealistic about the realities of life for the black families that he knew and socialized with two Hammett seemed obvious that any other kids you played with could grow up to do the same kinds of jobs that he and his siblings could do. But it seems that you didn't really come to terms with the fact that there were plenty of other people who didn't see things this way. He acknowledged during his lifetime that he didn't realize that the black students he had known growing up we're so deeply disadvantaged until later and his life when he was real. Urging and analyzing educational institutions after his retirement from the institute, both before and after world war to flex, there was pretty outspoken against prejudice he made a radio broadcasts in which he stated his disappointment. That democracy hadn't brought more equality to the relationship between races after the war he spoke about how
or behind England, the. U S was in terms of both religious and racial prejudice, but his feelings about prejudice are complicated. I also say that An interesting note about England and the? U S in terms of re, I feel like flex near always. Compared the? U S, two european countries he had visited and he always found the? U S lacking by comparison, but some of that is definitely a rose coloured glass, a situation get yeah. I don't. I don't know when he made that statement, but something that's gonna come up at an episode. We're gonna record shortly is like about racism in England. Specifically, anyway, back to the subject at hand, does feelings about prejudice are complicated,
although he had been raised by devout jewish parents Abraham and whose siblings all drifted away from the jewish faith and they considered themselves secular Jews. When he encountered answers Anti Semitism, he tended to presume the person involved was ignorant instead of malicious and he just breasted often went on with his life, but he was in a position to be able to do that. Anti Semitism. Doesn't seem too, materially impacted his career or his life. Yet this is definitely one of those cases where I think he doesn't realise that he would you know, enjoying a certain degree of privilege to be able to be like? Oh you don't like me. Ok, I still have plenty of opportunities which is not how it works for everybody, the true depths of racism.
The black community was clearly a blind spot in his work and that left a lasting legacy on both black physicians and patients. That is still felt. He just thought that medical schools and other institutions of higher learning should be admitting students, regardless of their sex, color or religion, but he didn't seem to recognise that there is a whole world of obstacles that had to be addressed to get to the point We're students who were white or weren't male could even be applying to medical school when alone gets through the admission process. And in a way it fuck me, while I was researching this, that his own idealism put him in this situation, not dissimilar to the scientists that he once wrote about her accidentally advanced technologies of warfare in his work for school reform. The already disadvantaged black schools simply could not keep pace with standards that required money and resources they simply didn't have, and white schools were still not often admitting black medical students. The debate over Flexures intentions continues among medical
Torrents and if you start digging, you'll find people who think of him as everything from a benevolent paternalism. We ve talked about a lot of those on the show to inherently racist talked about a lot of those two then this this latter part is due to the discussion of hygiene as a primary focus for black. Does and there are examples of leaders from both Macsharry and Howard, using similar language regarding the need for hygiene. Instruction is an important part of the service of black factors. They predate flex nerves report by a couple of years, and this is on its This inherently racist, those leaders who also said that that was an important part of a black doctors training were also white, but it also suggests a flexible statements were echoes school, stated missions rather than stand alone, judgments that he made and there is
so at an interesting possibility, as discussed in a twenty eleven article in the journal of the history of medicine and allied sciences by leaning, Miller and Richard and wise that this language was actually part of carving out a public health role for the physicians from these schools. In an effort to garner support for the schools across racial lights in the statements from a hairy and Howard in nineteen o, seven and nineteen o eight that we're talking about those sentiments of high Jeanne being the highest need, are followed by mentions of how obvious it is, thus that these institutions should be supported, and there are some indicators that a number of medical schools, black and white were already in an economic tailspin before Flexures report was released. Some of that was because there were already efforts to try to meet the guidelines that had been issued by the am ay and the financial burdens of doing that. Just prove to be too much to allow for sustainability. While
discussion of Flexner's intentions and the real ramifications of his work continues. The AMA, following the findings of their ethics Council, did issue a public apology in two thousand. I quote for its past his of racial inequality toward african american positions and shares its current effort to increase the ranks of minority physicians and their participation in the air. The organization also announced a number of programmes aimed at encouraging minorities to pursue careers in medicine. This is one of those cases where we're still untangling all the tendrils of all these influences on the medical field. That will probably continue for you to come. I wanted to close with another quote from Flexures usefulness of useless knowledge. Personally remain in a state of conflict about the man and his work. It's like I wanted
ordered idealist. Who wants to make things better, but not one that idealism blind you so much that you end up hurting people, but when I came across this passage while I was researching, it really hit me in its pertinent to our world today and he wrote quote- the justified outcry of those who, through no fault of their own, are deprived of opportunity and a fair share of worldly goods therefore diverts an increasing number of students from the studies which their fathers pursue. To the equally important and no less urgent study of social, economic and governmental problems. I have no quarrel with this tendency. The world in which we live, is the only world about which our senses can testify unless it is
a better world, a fairer world. Millions will continue to go to their graves, silent, saddened and embittered than does the complicated, flexible report yeah I've. I think it's worth knowing that like there's that there's a question sometimes where it seems like people are kind of asking, was racist or was he operating from best intentions and it can be without rating guy he's operating from his best intentions, like still racist. There, like it's impossible to grow up in a position of privilege in a racist society that is threatened all through with many layers of racist MIA of racism and like to be racist, like it is a lie on effort to undo Isle of theirs thinking patterns, no matter how well intended you are you. I mean it's. It's
things when you read his writing. Heat so clearly believes that lake, if we just shut of a bad black medical school. These two good ones are gonna, be so good that then we can information? Everyone will be great. It's like he's missing. So much of the puzzle dead, like I again in an ideal world sure, but let it yeah he's he's complicated. I have complicated feelings about him. The adolescent I do it's much less complicated at the very, very lovely listener mail. From our listener crystal who writes history of science, top here's my dream, which I liked, because its wine to shreds Holly and Tracy. I'm writing the sale of your podcast. I've always enjoy learning about history, and you make it easy to listen to you over the past few months have been catching up with you going through your catalogue of twenty nineteen. I'm a scientist working in a lab in Canada, doing research with insects, and I just love when you do podcast on science related to
x. I particularly like the mention of Thomas say from the new harmony episode as he was an entomologist suggest and tax, honest and I will no more about the lives of these people from the past. In my I've been able to help digitize historical insect specimen records, the sound so cool and I am always amazed when I find collection labels that say the specimen was collected during world war- one or war to what were these sites he's doing during these difficult times and why were they continuing their research and not involved in particular wartime efforts? I also thoroughly enjoyed learning about changing whew, whom I had never heard about before. She was a pioneer in physics and is certainly inspired me as a women scientists. Please share more of these kinds of stories. Lastly, I just finished listening to your episode on the discovery of helium. Again I just love hearing about top like this. The I wanted to read this in part because it ties in a little bit too flexures discussion of how, in that that's seemingly useless knowledge become
useful. He talks about how sometimes scientists just step away from the realities of current events to continue to do their work, but I can't speak specifically to those specimen collectors that got those insects. Although again that sounds super interesting. So thank you so much crystal. I love that you were in science and that there's entomology happening under your hand, we proceeded and were grateful to be alone with you and some of that journey. If you would like to write to us, you can do so at history, pike, ass, tat, I heard radio dot com. You can also find as pretty much everywhere and social media as missed in history and if you like to subscribe this super easy to do, you can do that, and I heard you up on Apple pie, CAS or wherever it is. You listen stuff. You must, in history class the production of I heart, radio for more planned cats. For my,
radio, either by her radio, have added mankind's or wherever you listen to your favorite shows. What, if you could make yourself happy every day in every aspect of your life, is away percent of American seated grateful people are happier and more satisfied and their onto something find out appreciating your spouse changes the neurons of your brain, and why saying thanks helps you succeed, discover
You can use gratitude to sleep better and lower your blood pressure and stress levels. Amazingly, gratitude works to improve your mood, no matter what's going on in the world, so even if you're feeling a little grumpy these days, you can start changing your perspective and feeling more positive about yourself, your friends, your family and even here job and finances. I'm Janis Kaplan join me for the gratitude diamonds. Every Monday to Friday, on these Iheart radio Apple Pie castle. Ever you get your PA guests,
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