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James McCune Smith and Medicine’s Racist Legacy

“The autopsy revealed no physical findings that support a diagnosis of traumatic asphyxia or strangulation. Mr. Floyd had underlying health conditions including coronary artery disease and hypertensive heart disease. The combined effects of Mr. Floyd being restrained by the police, his underlying health conditions and any potential intoxicants in his system likely contributed to his death.”—Charging document, Derek Chauvin

 These past few weeks have reminded me powerfully of the work of James McCune Smith, the first African American to earn an M.D.. Smith thought he would deploy his hard-earned scientific training easing the pain of the sick in his community. Instead, he spent much of his life demonstrating that their pain wasn’t self-inflicted. Born in 1813 to a self-emancipated mother, Smith earned his medical degree at the University of Glasgow (no American university would admit him) and returned in 1837 to a hero’s welcome.

 Within a year of his return from medical school, James McCune Smith found himself reading a physician’s report that would strike 2020 readers of George Floyd’s state autopsy as distressingly familiar. In 1836, a few white New Yorkers opened an orphanage for Black children, the first of its kind in the city. In its first year of operation, nine children out of the sixty-four housed there died–a shocking mortality rate, even by nineteenth-century standards. Dr. MacDonald, who was the presiding physician at the Asylum, was a member of the American Colonization Society, an organization that argued, among other things, that Black people were physically ill-suited to flourish on American soil. In 1837, the physician published a report, ostensibly to explain the deaths of so many children under the Asylum’s care. The report insisted that these deaths were attributable, not to mismanagement or neglect, but to the “peculiar constitution and condition of the colored race.” In MacDonald’s medical opinion, these children were doomed before they ever stepped foot in the asylum, for the sin of being “the offspring of unhealthy parents.” In response, Dr. Smith wrote a lengthy reply in an 1839 edition of the Colored American, insisting that racism, rather than heredity, was to blame for the deaths of so many Black people in the city.

 [If Black people succumbed to health problems]  “it cannot be the result of any ‘peculiarity of constitution,’” Smith argued, “but rather of that legalized curse which drives [the] colored mind to prey upon itself – that hell-born prejudice which shuts out from its proper sphere the patriotic intellect of colored men, in crushing whom the state suicidally destroys the hardiest frames with which she is blessed.”

 The 1840 Census leveraged the weight of the United States government to promote the fiction that the suffering African Americans endured was somehow the fault of their genetic makeup rather than the result of racist structures. The census statistics seemed to indicate that freedom was literally toxic to black people, suggesting that the further African Americans lived in the free North, the more likely they were to suffer from a physical or mental disability. The further the census takers went into the deep South, on the other hand, the healthier African Americans were reported to be.

 James McCune Smith once again drew on his training as a physician, and his skill as a statistician to set the record straight by publishing in both medical and public venues. He determined that the census’s sunny report on the relative health of enslaved people was actually a byproduct of slavery’s deadly effects. In other words, slavery’s violence reduced the odds that people would live long enough to suffer from the disabilities associated with advanced age. In an article published in the February 23rd edition of The Liberator, Smith took care to precisely number the lives of those that slavery had taken. According to his calculations, the Census revealed that 179,085 enslaved men had died early deaths,  “MURDERED by the system of slavery.”  What mockery it is,” he added, “to talk of the kindness of masters in taking care of aged slaves when Death has relieved them of so large a share of the burden!”

 This nineteenth-century tendency to pathologize Black bodies in order to render racist acts of violence into inevitable acts of nature resonates in the twenty-first-century data—and the national response to it—detailing the disproportionate suffering the COVID 19 epidemic has wrought on African American communities.  Here again, the effects of racism are held up as freestanding evidence, while the causes are waved away as somehow irrelevant. In an April 2020  NPR interview, Senator Bill Cassidy was asked whether one could separate the underlying health conditions that plagued the Black community from a history of unequal healthcare treatment. The Senator dismissed the suggestions as “rhetoric.”  “As a physician, “ he said, “I’m looking at science. . .  I don’t want to seem insensitive at all  . . .  But as a physician, I approach it more – OK, what is the physiology?” 

According to Cassidy’s formulation,  African American “physiology” stands on its own, riddled with problems that either occur spontaneously or are self-inflicted. The Surgeon General of the United States addressed the racial disparity in COVID-19 outcomes by instructing Black people to avoid “alcohol, tobacco, and drugs,” advice that is seldom heard in COVID 19 warnings aimed at the general public, but that echoes the Minnesota coroner’s suggestion that “possible intoxicants” might have somehow led to George Floyd’s death, rather than Chauvin’s knee pressing on his windpipe. 

As Ibram X. Kendi has written, “According to this logic, racism is not murderous; black people are killing themselves.”    

James McCune Smith did not rest solely on scientific data to prove that “hell-born prejudice” was, to use Kendi’s term, murderous. He spent his life seeking to create conditions in which Black people could enjoy health and prosperity. By 1846, he had become the presiding physician of the New York Colored Orphan Asylum, the same institution that had employed a white physician to explain away the deaths of nine Black children in their care a generation earlier. Under his supervision, the Asylum flourished and even added a hospital wing. During his time there, the Asylum supported and educated hundreds of children, who were invited to display their learning at cultural institutions like New York’s glittering Crystal Palace.

 White New Yorkers met this proof of Black excellence with violence. During the Draft Riots of 1863, white men, outraged by the prospect of being called to fight in the Civil War, took their rage out on the Black inhabitants of the city. The Asylum was razed to the ground, as were churches and individual dwellings. For three days, dozens of Black men, women, and children were chased through the streets, beaten and murdered, because White New Yorkers were upset about being drafted into a war caused by slavery’s incalculable violence. The mob in New York was not alone in blaming African Americans for the bloodshed of the Civil War. In 1862, Abraham Lincoln invited Black leaders to the White House and told them that their very existence was to blame for the conflict: “But for your race among us there could not be war,” he told the delegation, “although many men engaged on either side do not care for you one way or the other. Nevertheless, I repeat, without the institution of Slavery and the colored race as a basis, the war could not have an existence.” Notably, Lincoln’s wording elided the centuries of abduction, rape, and murder that had led African Americans “to be among us.”

 Mere months after white rioters burned his beloved Asylum to the ground, Dr. Smith witnessed another day marked by thousands of New Yorkers thronging the streets. This time, however, the city had gathered to cheer the sight of armed and uniformed Black men, who had finally been allowed to enlist as a New York Union regiment. On March 5th, 1864, the Tribune reported a “vast crowd of citizens of every shade and every phrase of social and political life” filling Union square and surrounding streets—every “door, window, veranda, tree and house-top was peopled with spectators” applauding Black soldiers marching off to New Orleans.

 James McCune Smith later recalled the emotional whiplash that accompanied the celebration. For Black people, he wrote, who had “been mobbed, hunted down, hung from the lamp-posts or trees, their dwellings sacked and destroyed, their orphan children turned from their comfortable shelter which was destroyed by fire” now to be “cheered along the same streets” was a turn of events that “put ordinary miracles in the shade.” As the streets of New York and hundreds of other cities across the globe continue to fill with people protesting racist violence, it is tempting to imagine that we are again at such a miraculous moment. I hope so.

 And yet.  Even that moment of recognition in the streets of 1864 New York was a brief celebratory pause in a Civil War that cost more American lives than any other conflict. Then, as now, governmental insistence that acts of murder are actually self-inflicted wounds amounts to nothing less than what James McCune Smith would deem national suicide, in which the US destroys the best of the citizens “with which she is blessed.”


Anna Mae Duane is an Associate Professor of English at the University of Connecticut. She has written a dual biography of James McCune Smith and Henry Highland Garnet.  twitter @annamaeduane


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