Monthly Archives: August 2019

Desegregating Harlem Hospital: A Centennial

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This guest post is from Adam Biggs, faculty at the University of South Carolina Lancaster and panelist at the recent Academy Race & Health series event, “How Long Will We Wait? The Desegregation of American Hospitals.” Professor Biggs teaches courses in African American Studies and U.S. History, and his research explores the desegregation process at Harlem Hospital from 1919–1935.

“As I look back with charity at that period,” wrote Aubré Maynard in 1978, “I deplore the fact that I suffered more from the hostility and jealousy of some of my black colleagues than from the antipathy of whites, from whom I expected frank racial animosity.”[1] Lingering more than fifty years after he joined Harlem Hospital as one of its first black interns, Maynard’s feelings of resentment stemmed from acrimony that emerged during the desegregation process. After successfully overcoming white opposition, a heated debate broke out in Harlem over how best to utilize the facility in the interest of racial justice. But rather than a “magic bullet” for the problem of race, desegregation became a mirror of truth, exposing endemic obstacles to racial equality still deeply embedded within the medical profession and internalized within Harlem’s black medical community.

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Harlem Hospital ward, 1929. Image: Harlem Hospital records, 1887-1962, NYAM Collection.

Black civic activists had been advocating to desegregate New York’s municipal hospital system since the early 1910s.[2] But black practitioners would not gain entrance until the nation’s wartime effort placed a burden on medical staffing that could not be ignored. With a reluctant city administration, a small number of practitioners began acquiring low-level positions as early as 1917, and in August 1919, Louis T. Wright became the first black doctor to join the Harlem Hospital staff.[3] Continued advocacy over the next decade pushed the hospital to gradually incorporate black physicians and nurses into its ranks.

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Nurses of the class of 1929, Harlem Hospital, New York City. Image: Harlem Hospital records, 1887-1962, NYAM Collection.

This process, however, was not without challenges. For many of the established white staff, the presence of African Americans proved untenable. Shortly after their appointments, the hospital saw a mass exodus of white practitioners who transferred or resigned in protest. Many of those remaining displayed their discontent by acting with belligerence or passive aggression toward the new black hires.[4] Tensions reached a peak in 1927 when a hospital riot was barely averted after a junior white intern, dining in the cafeteria, threw water in the face of Aubré Maynard, a senior resident at the time.[5] Well publicized incidents such as this one amplified the hospital’s toxic racial climate and undermined the public’s trust.

In 1929, Mayor James Walker responded by reorganizing the municipal hospital administration. His reforms led to the dismissal of twenty-three white and two black physicians along with the appointment of twelve new black doctors and the promotion of Louis Wright to the Harlem Hospital board. Within a year, African Americans came to represent approximately forty percent of physicians on staff, making Harlem Hospital the first municipal institution of its kind to embrace the ideal of integration.[6]

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Louis T. Wright and colleagues at patient bedside, Harlem Hospital, New York, N.Y. From left to right: Dr. Lyndon M. Hill, Dr. Louis T. Wright, Dr. Myra Logan, Dr. Aaron Prigot, unidentified African American woman patient, and unidentified hospital employee. Image: Joe Covello (for Black Star), CC-BY SA 3.0

But, while meaningful, the celebration was short-lived. Conflicts soon emerged over who should receive the coveted appointments and whether to transform the hospital into a cutting-edge integrated research facility or an institution dedicated to the training of black personnel.[7] Harlem’s local black medical association, the North Harlem Medical Society, split in two between those supporting and those opposing the hospital administration.[8] Bitter rivalries formed between graduates of black medical programs and those from predominantly white medical schools.[9] Not isolated to Harlem, the conflict also attracted the attention of the national black press, the National Medical Association, and the NAACP. Prominent churches, political leaders, and labor organizations throughout the city got involved as well. Louis Wright became a focal point of contention. A representative of the hospital administration and graduate of Harvard Medical School, opponents labeled him an “Uncle Tom” while supporters characterized the attacks against him as petty envy.[10]

The conflict came to an end in March 1935 when a riot broke out in Harlem. E. Franklin Frazier, a prominent black sociologist, investigated the cause of unrest and determined the hospital’s perpetual discord was a contributing factor.[11] In the years that followed, Harlem’s medical community directed greater public attention toward matters of patient care.

Latent resentment, however, lingered for decades. In 1952, despite an illustrious career, when Wright was nominated for the National Medical Association’s distinguished service award, he received only one vote.[12] Public doubts about black doctors and Harlem Hospital also persisted. Maynard lamented that accepting black doctors onto its staff had the ironic side-effect of diminishing the hospital’s reputation among Harlem residents.[13] Local political figures and New York’s medical community held similar doubts. In 1958, when Martin Luther King, Jr., was taken to Harlem Hospital for emergency care, one nurse in attendance recalled, “a lot of time was wasted while they argued.…They didn’t want to take him to the black hospital.”[14]

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Coretta Scott King in children’s ward of Harlem Hospital with flowers sent to Martin Luther King, Jr., September 1958. Image: Harlem Hospital records, 1887-1962, NYAM Collection.

More than a celebratory centennial, the story of desegregation at Harlem Hospital raises meaningful questions about how best to address the problem of race in medicine. The conflicts that emerged within Harlem’s black medical community were not peculiar racial idiosyncrasies but, rather, emblematic of unresolved tensions evident in the profession at large and unaddressed in the hospital reforms. Desegregation proved not to be a miracle cure but instead led to a renewed call for black doctors to further interrogate the deeply embedded, protean forms of racial exclusion that endured in their profession and American society. Today, it reminds us that even watershed victories require continued vigilance and an unyielding commitment to the pursuit of racial justice.

References

[1] Aubré de L. Maynard, Surgeons to the Poor: The Harlem Hospital Story  (New York: Appleton-Century-Crofts, 1978). 51.

[2] Michael L. Goldstein, “Black Power and the Rise of Bureaucratic Autonomy in New York City Politics: The Case of Harlem Hospital, 1917–1931,” Phylon 41, no. 2 (1980): 191.

[3] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 18-25.

[4] Louis Tompkins Wright. “I Remember….” In Louis T. Wright Papers, Box 130-1, Folder 12. Manuscript Division, Moorland–Spingarn Research Center, Howard University, n. d. p. 93–94; Maynard, Surgeons to the Poor: The Harlem Hospital Story: 23.

[5] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 43.; “Barely Avert Riot at Harlem Hospital,” New York Amsterdam News, 6 July 1927, 1, 2.

[6] “Harlem Hospital Staff Is Reorganized, Giving Place to Nineteen Negro Doctors.” New York Age, 22 February 1930, 1.

[7] Ibid.

[8] “Doctors Quit North Harlem Society to Form New Medical Body; Old Body Repudiated,” New York Age, 24 May 1930, 1, 3.

[9] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 53.

[10] “Plan City Hall March in Fight on Hospital,” New York Amsterdam News, 8 March 1933, 1, 2; Vanessa Northington Gamble, Making a Place for Ourselves: The Black Hospital Movement, 1920–1945 (New York: Oxford University Press, 1995), 58–66.

[11] Charles V. Hamilton, Adam Clayton Powell, Jr.: The Political Biography of an American Dilemma (New York: Cooper Square Press, 2002). 55–63.

[12] W. Montague Cobb, “Louis Tompkins Wright, 1891–1952,” Journal of the National Medical Association 45, no. 2 (1953): 3.

[13] Maynard, Surgeons to the Poor: The Harlem Hospital Story: 81–82.

[14] Ebony Magazine. “[IN MY LIFETIME] Goldie Brangman on Saving Martin Luther King’s Life.” 2016.

How Long Will We Wait? A Recap of Our Latest Race & Health Series Event

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This guest post is by Dr. Danielle Laraque-Arena, the 2019 Scholar in Residence at the New York Academy of Medicine. She is the tenured Professor of Pediatrics, Psychiatric & Behavioral Sciences, Public Health & Preventive Medicine at SUNY Upstate Medical University (UMU), the Former President of UMU, and moderated the Race & Health Series event, “How Long Will We Wait? The Desegregation of American Hospitals” on July 10, 2019.

The Race & Health Series, a powerful series of presentations, was initiated early this year, envisioning a more just society, reviewing key lessons of the past, evaluating current status of health equity, and engaging in robust dialogue with the community on the social, economic, and systemic issues that keep all people from enjoying a healthy life. The first presentation in this series reviewed the history of the Tuskegee Syphilis Study and posed the question of whether Tuskegee could happen again. The second presentation, “How Long Will We Wait? The Desegregation of American Hospitals,” was prefaced by a showing of the documentary film, Power to Heal: Medicare and the Civil Rights Revolution, followed by a community-engaged discussion of the implications of the film for our current-day realities.

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The Academy Library displayed archival Harlem Hospital photos in the lobby.

Barbara Berney, Ph.D., M.P.H. produced the documentary film. Dr. Berney, a distinguished scholar in public health, environmental justice and the US healthcare system, joined us from the shores of California. Barbara was joined by Professor Adam Biggs, an American historian from the University of South Carolina. The two scholars spoke to the diverse audience of about 300 people from the Harlem area, New York City, and New York State at large. They took us on a historical journey of the deeply segregated United States of the Jim Crow period. Their focus was on recounting the impact of Jim Crow state and local laws that dictated every aspect of life for black Americans following Reconstruction. During this period, segregation was mandated in all public facilities such as restrooms, restaurants, hotels/motels, schools, and hospitals. Professor Biggs highlighted the period from 1919–1935, focusing on the desegregation of Harlem Hospital. The audience, many of whom work or have worked at Harlem Hospital, were on the edge of their seats for this important discussion.

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The author (left) with panelists Barbara Berney and Adam Biggs.

The background analysis of the Jim Crow period led to a focused discussion regarding the segregation of American hospitals and the dire conditions of health care for black Americans. The response from black physicians, the formation of the National Medical Association, the advocacy efforts of the NAACP, and the force of the conviction of people of conscience throughout the United States led to the partnering of the American government under John F. Kennedy and then Lyndon B. Johnson with activists, to begin to transform the landscape of American life and politics. The palpable national tone of the bitter struggles of the Civil Rights movement—with activities such as voter registration in the southern states that often led to the murders of civil rights activists—was ever real for many who in the audience had lived through those dark days.

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Audience members at the panel discussion respond to the speakers’ powerful remarks.

In fact, among the attendees were individuals such as Phyllis Cunningham and Roger Platt, both of whose efforts were shared in the film. I had the honor of working with both Phyllis (nurse, activist) and Roger (internist, hospital inspector) during my 24 years in the Harlem area, but had renewed respect when I witnessed—as demonstrated in the film—their immense courage during the dangerous times of the 60’s. Others featured in the film included David Satcher, M.D., Ph.D., former U. S. Surgeon General. I had the pleasure of speaking with Dr. Satcher a number of times. He spoke of the achievements of the Civil Rights movement, the passage of Medicare, and the continued aspiration for universal access for all: recognizing that health care is a right and not a privilege.

The film also reviewed the passage of the Civil Rights Act of 1964 and of Medicare in 1965. The intersection of these two landmark events leveraged their collective impact to amplify the message that health care is a human right. At the time of the passage of the Medicare legislation, the persistence of the “separate but equal” effect of Hill-Burton Act, providing for hospital construction, was alive. As Johnson noted, a hammer was needed to propel the desegregation of hospitals, and this was done by having the receipt of federal dollars in support of the care of the elderly be contingent upon desegregation of hospital services. The key lesson was that incremental progress, as had been imperfectly done in education, would not yield the fundamental results needed in health care. Civil rights were to be baked into the administrative process. Desegregation occurred through the brute application of the principle “follow the money.”

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Audience members lined up to ask questions at the end of the discussion.

The two-hour session engaged questions from the audience. Individuals lined up to ask the obvious: How do we learn from the courage of those who achieved so much in the past decades? Does such courage exist today? What was the effect of desegregation on the elimination of health disparities—and by implication, is desegregation sufficient? The importance of history, the importance of courage under fire, and the lifelong commitment to social justice and health justice was clear from the engagement of the audience and the resounding voices of our distinguished panel.

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