Help Me Out: Black Women's History

Feb 27 2012 Published by under [Etc]

Last night's Academy Awards featured stars in glittery gowns and lint-free tuxedos. My husband has a low tolerance for the show, so after I got my fill of red-carpet gowns and shoes, we watched a best-picture nominee and followed the prizes via twitter. Yes, my husband wanted to watch The Help.

Click for Source

I read it, loved it, and blogged it last summer. As the movie gained traction, I have heard more stories about my life in 1960's Houston, TX, including the day my mom  took me to the "colored" toilet in a shopping mall. She had a toddler who had to pee, and she saw a restroom marked for women. When she came out, apologetic store clerks told her the error of her ways. My own kids hear these stories and cannot believe that we ever allowed such stupidity.

I was really routing for both Octavia Spencer and Viola Davis to take home statuettes last night for their performances in the movie adaptation of this book (although Meryl Streep is fantastic in everything she does). Both women brought such depth and grace to these roles that even my husband was impressed by the movie. However, the twitter feed eventually lit up with complaints about these women playing maids in this day and age.

I wonder if these same folks bitch about those playing maids and footmen in Downton Abbey "in this day and age?"

My disclaimer follows:

If you have seen my photo, you know I am not African American; I have a proud insect ethnicity (WASP). I have felt like "the other" on occasion in my life. When I started out in medicine, everyone immediately assumed that any woman was a nurse. Now, when every medical show on television has multiple female physicians, this happens far less often. The nurses in these shows remain overwhelmingly women, though, reflecting the current reality. D00ds are still doctors till proven otherwise.

However, I may not be as sensitive to racial stereotypes since that has not been part of my experience.

The Help is a period piece, a story of a misguided time that we must not forget. It's the story of invisible women whose story becomes part of the record. I do not remember this sort of issue with Morgan Freeman playing a chauffeur in Driving Miss Daisy, another flick set in 1960's Mississippi (although that film came out during my fellowship when I had a two-year-old child and may have missed the controversy).

What do those who complain about these actresses playing maids want? Better roles for actresses of color? Hell, I would like to just say better roles for actresses in general (that could be another whole post).  Do they not want this story told? Because the world is better if we pretend this period never happened?

Or could this be another example of African American women being ignored? There's a museum for the men who waited on white people as Pullman porters and a book on the same. Should this work be adapted into a movie starring male actors, would they get put down for taking demeaning roles in a movie set in segregated US?

As I said in my original post:

The bottom line seems to be that housekeeping and childrearing remain undervalued. These chores require no specialized training, but they remain essential to our lives.

They are "women's work."

A male actor playing someone who takes on a demeaning job to support a family seems heroic. A woman playing a part where she cooks, scrubs floors, and raises others' children to achieve the same end...not so much. At least, for some. For me, the real value of The Help was making those women more than cardboard characters in the background. They were as brave and courageous as the men depicted during those same period dramas.

This week following the Oscars, we transition from Black History Month to Women's History Month. It's a great time to explore the contributions of black women to our world. And what a greater way to honor two amazing movie performances!

Even Meryl would approve as chair of the effort for the National Women's History Museum.

Share

13 responses so far

"You Don't Belong"

Sep 07 2011 Published by under Feminist Musings, Women in Science, [Science in Society]

The current issue of Nature Chemistry includes a commentary by Michelle Francl, Sex and the citadel of science. Click over and read it, if you can. Her thoughts on the lack of female achievement in science one hundred years after Marie Curie's second Nobel Prize provoked more thoughts on my part.

Click for source

Dr. Francl reviews her own story as well as the prevailing hypotheses to explain the lack of women scientists:

(1) the fraction of women who have the native intellectual capacity to do science, particularly at the highest levels, is much smaller than the fraction of men, (2) an inherent lack of interest among women in the hard sciences and engineering, and (3) societal and cultural biases that push women out of the pipeline and lead to the devaluation of the contributions of those who remain.

Data debunk the first two hypotheses, leaving us with societal and cultural biases that push women out of science. Of most interest to me were the discussions of architecture and color.

Built space is not neutral, as Winston Churchill noted, “we shape our buildings, and afterwards our buildings shape us”. As much as scientists use labs to create science, labs themselves create scientists.

Dr. Francl discusses the difficulties of being "vertically challenged," at least in comparison to the typical male scientist for whom lab benches, podiums, and even lecture hall chairs have been designed. As I sit in a standard office chair writing this with my feet on a riser and the chair in its lowest position, I understand her views. I am average height for a US woman; I have friends who must special order chairs! Consider how awkward things can be if a woman failes to wear a jacket with pockets for a seminar. She has no place to put the microphone power pack during her talk. As Dr. Francl points out:

Ginger Rogers may have had to do everything Fred Astaire did backwards and in high heels, but a female speaker who forgets to don something with pockets or lapels may find herself having to do what her male colleague does, but with both hands tied up.

Are any of these things game-ending? No, but each is a subtle reminder that we women "don't fit" the standard.

Color provides other cues, with children as young as three years understanding the association of pink with girls. Dr. Francl Googled images for "chemistry laboratory" and sorted by color; six-fold more equipment appeared in blue, green, or other earth colors than in "girly" pastels. The shift to real lab equipment typically occurs in middle school, about the time that girls lose interest in math and science. Color provides one more subtle cue that these things are not feminine.

Dr. Francl admits that each of these feels trivial alone, but provides an analogy that illustrates the cumulative risk of such things on girls:

Of course, chemists regularly separate closely related materials, by simply repeating the separation process many times on a chromatographic column. The ability to chromatographically resolve two samples depends not only on the selectivity of the process, but on the number of theoretical plates. Think about the number of times a child encounters the standard gender colour-coding scheme every day — the number of theoretical plates is extraordinarily high.

So what can we do to assure that all capable individuals of both sexes can achieve their potential in science?

We may not be able to avoid the gender-linked colour-coding imposed by the larger society, but we can be more attentive to the spaces we create in which we do and talk about science, as well as the materials we use to do it. Even small tweaks in the conditions under which a chromatography column is run can affect the separation.

Don't dis the pink telescope or the lavendar microscope. That may be what it takes to get a girl hooked on science early.

Share

8 responses so far

What I Am Reading: Chimera Version

Mar 15 2011 Published by under [Medicine&Pharma], [Science in Society]

Click to Pre-order at Amazon

One of the joys of my blogging life is getting to read books before they are officially published. This year, the Science Online swag bag included Blood Work: A Tale of Medicine and Murder in the Scientific Revolution, a book that kept me occupied for a few days. Science? Check. Medicine? Check. Murder mystery? Check.

Holly Tucker, a faculty member of Vanderbilt University,  weaves a number of historical and political intrigues into a story of medical experimentation that results in murder.

The saga proceeds in the 1600s. French and British physicians and scientists race to learn new facts about anatomy and physiology. Great rewards awaited the first to publish (gee, does that sound familiar?), and governments (royalty) began to fund academies to help assure the place of their investigators in the race for knowledge. Within France, where the murder in question occurs, political clashes between a private academy begun by Henri-Louis de Montmor and that funded through the crown, as well as the Parisian medical establishment versus other schools within the country, complicate the interpretation and dissemination of experimental data (once again, sound familiar?).

The primary character, Jean-Baptiste Denis, longs to make his mark in Parisian society, despite being an upstart of lesser birth trained outside of the Parisian school. He becomes convinced that transfusion will provide transport for his social goals, and begins experiments with dog-to-dog blood transfers. These procedures are described in excruciating detail -  after all, there was no anesthesia, so dogs were muzzled and tied to tables for the procedure. Anticoagulation was unknown, so blood had to be transferred directly from one dog to the other without storage, and the transfer took place through small metal stems and quills. The donor dog underwent cut-down to access an artery, and that dog's blood pressure drove the blood into the recipient's vein, also accessed via a cut-down. Going from a large dog to a small one seemed to work better, and the small dog often seemed "livelier" after the procedure. The donor dog? Not so much.

He then wanted to proceed to animal-to-human transfusion. This proposition scared folks, not because of the issue of transfusion reactions not yet described; no, people were terrified that they could become physical chimeras. Receive the blood of a calf, and you might wake up with the face of a cow. The artwork in the book shows these amazing chimera images!

Click for Source

Denis eventually found "volunteers" for his experiments, the first a desperately ill 16-year-old boy who the barber-surgeons had bled more than 20 times. For his donor, he chose a sheep. What could be more helpful than the blood of the lamb, the symbol of Jesus' sacrifice? The boy felt better the next day, apparently cured of his two month fevers. Denis then persuaded a butcher, perhaps the one who provided the lamb, to undergo the procedure. He also did well and took the lamb home for supper.

Denis immediately reported his success, and then decided to go for the big-time. Antoine Mauroy, once a valet, now roamed the streets of Paris raving, an infamous mad man. Denis planned to transfuse the blood of a calf into Mauroy to attempt to heal his illness. The transfusion reportedly quiets his troubled soul, and he returns to his wife, Perrine, a calmer, saner husband. After a few weeks, she returns to Denis requesting another treatment because Mauroy's ravings have returned. Denis obliges, and a few weeks later, Antoine is dead.

I love mysteries, and I love biomedical science, so the book resonated with me. My favorite parts were some of the anecdotes illustrating various points, especially those that involved kidney disorders. I am, after all, a nephrologist.

Animals and their parts were common folk remedies of the time. Below follows a cure for kidney stones:

In the month of May distill Cow-dung, then take two live Hares, and strangle them in their blood, then take the one of them, and put it into an earthen vessel of a pot, and cover it well with mortar made of horse dung and hay, and bake it in an oven with household bread and let it still in an oven two or three days, until the hare be baked or dried to powder; then beat it well and keep it for your use. The other Hare you must flew, and then take out the guts only; then distill all the rest, and keep this water; then take at the new and full of the moon, or any other time, three mornings together as much of this powder as will lie on six pence, with two spoonfuls of each water; and it will break any stone in the kidneys.

Now that makes remembering to take a once-a-day pill seem easy.

I also loved learning that urine can be used as invisible ink!

Blood Work provides an interesting trip into the history of medicine and its scientific roots. The book becomes available on March 21.

Share

No responses yet

Meeting the Devil You Don't Know

Dec 16 2010 Published by under Uncategorized, [Medicine&Pharma]

The Bad Boy (click image for source)

This morning I dragged myself out of bed and through the wintery slush to fulfill my teaching attending duties. Approximately once every 18 months, each of the attending physicians in our pediatrics program must sit in on a conference while the residents present a case and work through it. Today's case provided a sense of nostalgia, but not in a good way.

A 15 month-old boy was admitted with a febrile illness, including nausea, vomiting, refusal to walk, and crossed eyes. His exam revealed irritability and a stiff neck, consistent with the diagnosis of meningitis. A spinal tap showed thousand of white blood cells and bacteria - what lay people would call pus.

The bacteria responsible: Haemophilus influenzae.

When I trained in pediatrics, we saw cases of haemophilus meningitis on a regular basis. For today's house staff, this case is very unusual because the incidence has decreased by 99% since the introduction of regular immunizations in 1988, the year I finished training.

Haemophilus meningitis, while curable, can result in permanent hearing loss (20%) or other neurologic problems. Even with antibiotics, 3 to 6% of cases prove fatal.

Turns out one of this child's older siblings had a fever and irritability after a round of vaccination, so the family decided not to allow further vaccinations of any of their children.

Now that they have seen meningitis first-hand, and an early, fairly mild case at that, the kids are all getting their shots.

There are good reasons we have spent loads of time and effort developing immunizations. Biomedical researchers did not target "trivial" diseases. The defeat of Haemophilus meningitis has occurred in my professional lifetime, and it is nothing short of a miracle.

I just hope others who read this will think long and hard before refusing a medical miracle for their own children. I would hate to see another case anytime soon, especially a bad one.

Share

One response so far

Continuing Medical Education: Where Have We Been?

Sep 09 2010 Published by under Continuing Development, [Education&Careers], [Medicine&Pharma]

Modern medical education in the US began a century ago with the publication of the Flexner report which condemned the "system" of the time for excessive commercialization, unstandardized curricula, and lack of efficacy for actual patient care. This document led to radical reforms and regulation of medical education, the end result of which is today's system.

Around the same time, practitioners began to make note of efforts to provide ongoing education. The first documented continuing medical education (CME) program was the "Blackburn Plan." Weekly one-hour sessions taught basic science and treatment techniques to general practitioners with the opportunity for questions and answers. Sounds a bit like current grand rounds to me - except without PowerPoint.  The first medical school to open a dedicated CME unit was the University of Michigan, and they were one of the original "regional centers" for coordinating CME programs in the 1930's. Others included Albany and Tufts. Regional medical schools and their teaching hospitals provided ongoing programs for the smaller hospitals and practitioners in their locale. The first recorded "center" for CME arose in 1936 at the University of Minnesota.

After World War II, new technologies made advances in CME delivery possible, including color television (1948), telephone conferences (1951), and two-way radio (1956). As technology provides new toys, CME takes advantage of them. How many webinars and other online "learning opportunities" happen everyday? Difficult to answer, but my google search produced 7,850,000 results for "CME online courses."

The American Medical Association (AMA) has long advocated CME via its Physician Recognition Award (PRA); the AMA/PRA Category 1 Credit(TM) is the coin of the realm for CME in the US, a currency established by the AMA in 1968. Even before this level of involvement, the AMA tracked CME in the US. In 1946, 47 medical schools offered 491 courses. By 1966, CME no longer belonged to medical schools but to sponsors, of which there were 252 offering more than 1600 courses. Over the next 10 years these numbers doubled again (with 554 sponsors offering 5,000 approved courses), and more than 9,000 offerings from more than 1,000 sponsors by the mid-1980s. Tracking down current numbers can be challenging, given the explosion of offerings available through various venues now.

The funding of CME also changed over time as providers have moved from schools to sponsors. Today direct commercial support provides 38% of the $2,184,353,716 in CME income taken in by nationally certified providers. Advertising and exhibits at activities provides another 13% of the total, according to the 2009 report of the Accreditation Council for Continuing Medical Education. This commercial support of CME raises concerns about conflict of interest and the nature of CME as a marketing activity. Even though efforts have been made to resolve these issues, the monetary support from drug and product manufacturers remains a concern.

Even with all the money and gizmos that go into today's CME, most programs remain similar to the "Blackburn" courses at the turn of the last century. Most states require some level of CME attendance for maintaining a medical license; however, the rationale behind CME choices and the efficacy of many programs remains unknown. In other words, we have no evidence that current CME improves physician knowledge, let alone patient outcomes! I suspect many physicians choose CME as much for convenience of the offering or the location of the course as for their educational interest and needs.

CME research can only be aided by the recent call for change from the Institute of Medicine of the National Academies. Redesigning Continuing Education in the Health Professions (released December 4, 2009) calls for more research into effective ongoing professional development examining practice improvement and patient outcomes as end-points. Its authors and others in the CME community feel the time may be right to form a national continuing education institute to coordinate such efforts and to shift funding from commercial sources.

More reading:

Image adapted from PhotoXpress.

Share

No responses yet

What I'm Reading: Gaslight Mysteries

Aug 15 2010 Published by under What I'm Reading, [Etc]

Every December my spouse prowls local bookstores for holiday gifts. On Christmas morning, I never know if I will open one huge box or many small packages, but I know I will get books.

My  hubster looks for new mystery series for me. This past year I received 6 of the 12 Gaslight Mysteries by Victoria Thompson; the other 6 now reside on my Kindle, and all have been read in order. Over a period of 6 weeks. Yes, I loved them.

The protagonists of the series include Sarah Brandt, a midwife in New York City in 1896 who rejected her wealthy Knickerbocker family and supports herself with her profession following the death of her idealistic physician husband. While delivering a baby, she encounters an Irish detective, Frank Malloy, in the first book. The victim turns out to be from a wealthy family, and Sarah's "interference" in the investigation proves indispensable in solving the crime. Malloy has issues of his own; the police force has been rocked by Theodore Roosevelt's efforts to introduce professionalism and remove the bribes and corruption that have characterized the force. "Uncle Teddy," as Sarah calls him, has also brought Jews and Italians onto the force amid controversy.

Of course, as a former romance novelist, Thompson allows the "rich girl" and "completely unsuitable boy" to be attracted to each other. Malloy's wife has died in childbirth, so he has a negative reaction to the midwife, even as he is tempted to sneak a peak at her ankles. Then Sarah visits his home where she learns that his son survived the delivery that killed his wife. She eventually figures out that the child is deaf, not retarded, and helps the detective find schooling for him, as well as a surgeon who can repair the little tyke's club foot. Over the course of the dozen books and multiple crimes, the pair become more attracted and involved. Remember, this is 1896- no bodice-ripping in these books, although I keep hoping!

The crimes in the first books were not challenging for a modern (warped?) reader, but puzzling out the killer has been more difficult with each mystery. The development of Coney Island, various immigrant neighborhoods, Victorian fascination with the occult, and the eugenics movement have figured into the cases. The latest volume, Murder on Lexington Avenue, features the debate between signing or solely lip-reading for deaf communication.

The Gaslight Mysteries provide perfect escapism for the beach or airport- not great literature, but great fun.

Share

One response so far

Bad Behavior has blocked 365 access attempts in the last 7 days.