Speaker 1: Hi, I'm Aaron Welsh and this is this podcast will
Speaker 1: Kill You. Welcome to another episode in our mini series
Speaker 1: of bonus content that we've been putting out over the
Speaker 1: past few months. If this is your first time tuning in,
Speaker 1: these bonus episodes are a way of exploring more deeply
Speaker 1: some aspect of what Aaron and I talked about in
Speaker 1: our regular season episode the previous week. So, for instance,
Speaker 1: we followed up our multiple sclerosis episode with the bonus
Speaker 1: episode on the epstein bar virus, and our chlamydia episode
Speaker 1: with a bonus about other chlamydia species affecting koalas and
Speaker 1: other animals. The beauty of these bonus episodes is that
Speaker 1: we get to enlist the help of an expert and
Speaker 1: absolutely pepper them with questions, both on the topic of
Speaker 1: interest as well as their careers. I have really enjoyed
Speaker 1: putting these episodes together, and I've learned so much about
Speaker 1: an incredibly wide range of topics, and this particular bonus
Speaker 1: episode is no exception. Last week, Aaron and I told
Speaker 1: the story of tetanus, a deadly but fortunately vaccine preventable
Speaker 1: disease that is caused by this spore forming talks and
Speaker 1: producer anaerobic bacterial species Claustridium tetani. Most of you are
Speaker 1: probably familiar with tetanus, and, like me, have a healthy
Speaker 1: fear of stepping on a rusty nail. But what many
Speaker 1: of you may not know is just how prevalent neonatal
Speaker 1: tetanus used to be and still is today in places
Speaker 1: with limited access to vaccines. Neonatal tetanus usually occurs when
Speaker 1: the umbilical stump becomes infected with the tetanus bacterium, which
Speaker 1: can happen while cutting the cord with a non sterile tool,
Speaker 1: for example. And if you haven't listened to the tetanus
Speaker 1: episode yet, I recommend that you stop here, go listen
Speaker 1: to it, and then come back to this episode. But
Speaker 1: I'll give a quick recap here anyway, just to kind
Speaker 1: of preface what we'll be talking about in this bonus episode.
Speaker 1: While discussing the history of tetanus. Last week, I spent
Speaker 1: a fair amount of time talking about neonatal tetanus among
Speaker 1: enslaved people in the American South Before the Civil War.
Speaker 1: Neonatal tetanus in the South was an extremely prevalent and
Speaker 1: deadly infection, said to be responsible for up to two
Speaker 1: thirds of the deaths among infants born to enslaved people,
Speaker 1: and this led to it having a reputation of being
Speaker 1: a disease of the South, especially of enslaved people, and
Speaker 1: last week I asked whether it was indeed a quote
Speaker 1: disease of fatal frequency solely of the South, or whether
Speaker 1: northern physicians simply weren't looking for it as much. I
Speaker 1: used the example of neonatal tetanus in the South during
Speaker 1: this time to illustrate two different themes. One is that
Speaker 1: you have to consider the focus of medical studies as
Speaker 1: a factor of time and place. Southern doctors were more
Speaker 1: likely to observe neonatal tetanus because they were employed by
Speaker 1: enslavers to monitor the health of enslaved people, whereas Northern
Speaker 1: doctors lacked both the reason to look for this disease
Speaker 1: as well as the opportunity, for lack of a better word,
Speaker 1: to observe it in a larger group of people, especially
Speaker 1: those whose consent was not or could not be given.
Speaker 1: And the other theme is how the institution of slavery
Speaker 1: is one example of a structure that led to physicians
Speaker 1: making observations of populations rather than individuals, giving them a
Speaker 1: bird's eye view of how disease spreads, and this is
Speaker 1: what basically led to the birth of epidemiology. These two
Speaker 1: themes are not at all of my own creation, but
Speaker 1: rather feature extensively in the latest book by my guest
Speaker 1: for this episode, doctor Jim Downs. Doctor Down's book Maladies
Speaker 1: of Empire, How Colonialism, Slavery and War Transformed Medicine is
Speaker 1: a new and necessary re examination of how we tell
Speaker 1: the story of the origins of epidemiology. Did this field
Speaker 1: come about during a London caller epidemic with John Snow
Speaker 1: in the broad Street pump? Or did it emerge in
Speaker 1: army hospitals, on slave ships and within colonies as physicians
Speaker 1: collected information or outright exploited non consenting subjects. Doctor Downs
Speaker 1: joins me in this bonus episode to explore some of
Speaker 1: the ideas presented in his fantastic book, and I cannot
Speaker 1: wait to dive in. So let's just take a quick
Speaker 1: break here and then we'll get started.
Speaker 2: My name is Jim Downs. I'm the author of Maladies
Speaker 2: of Empire, How Colonialism, Slavery and War Transform Medicine. I
Speaker 2: am currently the Guilder Lherman National Endowment for the Humanities
Speaker 2: Professor of History and Civil War Studies at Gettysburg College.
Speaker 1: Awesome, thank you so very very much for joining me today.
Speaker 1: I am so excited to discuss your book because I
Speaker 1: feel like it fits in really well with a lot
Speaker 1: of the themes that we discuss on the podcast, especially
Speaker 1: the importance of placing our understanding of medical or scientific
Speaker 1: developments in this broader historical context. So let's get into
Speaker 1: that context. In your book, you explore how colonialism, slavery,
Speaker 1: and war during the period of the seventeen fifties through
Speaker 1: the eighteen sixties led to this huge shift in medicine.
Speaker 1: People began to study populations rather than individuals, essentially kicking
Speaker 1: off the field of epidemiology. Can you explain what it
Speaker 1: is about this period that led to this revolution in thought?
Speaker 2: Right, So the key word there would be populations. So
Speaker 2: doctors had studied patients since the beginning of time, and
Speaker 2: there have also been scores of doctors throughout the early
Speaker 2: modern period even before then that also studied populations. But
Speaker 2: what you see happening beginning in seventeen fifty five is
Speaker 2: the rise of studies of populations, and that's not coming
Speaker 2: purely out of a medical question. It's coming out of
Speaker 2: the biggest social transformations of the mid eighteenth century, namely
Speaker 2: the rise of the slave trade and then the expansion
Speaker 2: of colonialism and the growth of empire. And then both
Speaker 2: of those forces kind of coalesce by the mid to
Speaker 2: the mid nineteenth century with the rise of war, the
Speaker 2: Crimean War and the Civil War, which again battlefields become
Speaker 2: laboratories in which populations are again studied. So ultimately it's
Speaker 2: the ways in which imagine the slave trade is about
Speaker 2: the movement, the violent, brutal transport of enslaved Africans to
Speaker 2: the Caribbean, to North America, to South America, and it's
Speaker 2: all done for economic purposes, but it ultimately created major
Speaker 2: medical crises, and so there were doctors deployed on those
Speaker 2: ships to care for the crew. But ultimately they realized
Speaker 2: that so many people were becoming sick and dying on
Speaker 2: those ships that they began this massive effort to study
Speaker 2: the spread of epidemics. And what I also noticed, and
Speaker 2: this is what I think separates my work from maybe
Speaker 2: someone who's found the doctor from thirteenth century Venice, is
Speaker 2: that these doctors are all tied together through a military
Speaker 2: network and the military is a massive bureaucracy, and the
Speaker 2: military demands these physicians to document their observations and to
Speaker 2: keep records. So now up happening is doctors are now
Speaker 2: in contact with what's happening on various slave ships throughout
Speaker 2: the Atlantic. They're trading information, they're developing preventative protocols, they're
Speaker 2: coming up with treatments. Whereas before there was no real mechanism,
Speaker 2: there was no real umbrella to knit these doctors together.
Speaker 2: And one of the things I'll say before, because I
Speaker 2: could talk about this foreveryone, ever and ever, one of
Speaker 2: the things that blows my mind is someone living in
Speaker 2: the twenty first century was that the creation of what
Speaker 2: we understand is the American Medical Association is a relatively
Speaker 2: new phenomena. It was around, it gets developed in the
Speaker 2: eighteen forty, so prior to the creation of those professional networks,
Speaker 2: Sure there were societies, Sure there was a circulation of
Speaker 2: some journals, but really the military creative bureaucracy that allows
Speaker 2: for the studies of populations that leads to the development
Speaker 2: of epidemiology.
Speaker 1: It's incredibly fascinating, and I don't think I had a
Speaker 1: true appreciate for just how much bureaucracy did in terms
Speaker 1: of the creation of epidemiology. And I also want to
Speaker 1: talk about a couple other tools that are key in
Speaker 1: studying the spread of disease and populations, and that is
Speaker 1: statistics and mapping, And can you talk about how those
Speaker 1: two tools were involved also in these aspects of colonialism, slavery,
Speaker 1: and war.
Speaker 2: So between seventeen fifty and eighteen fifty, this is a
Speaker 2: century prior to the development of germ theory and the
Speaker 2: discovery of microbes and to the understanding really of how
Speaker 2: bacteria leads to the spread of disease and even to
Speaker 2: how virus leads to the spread of disease. So oftentimes
Speaker 2: all doctors could do was count. They could count, and
Speaker 2: this goes true for the cases of field hospitals. They
Speaker 2: could count the number of people that are am in it,
Speaker 2: the number of people who die, of people who are released.
Speaker 2: So statistics emerges as a way of trying to create
Speaker 2: a rational order to respond to what seems to be
Speaker 2: really irrational, and that is the rapid morbidity immortality. So
Speaker 2: that's part of what happens. The other part of it
Speaker 2: is that colonialism is obviously very much invested in numbers,
Speaker 2: and so there's already a built in investment in cataloging
Speaker 2: things and thinking about things in terms of numbers. There
Speaker 2: is an early science before statistics call nosology, which is
Speaker 2: a sort of branch of science that develops that again
Speaker 2: draws on quantitative and empirical analysis. So you see that
Speaker 2: at work within the medical records. But the other part
Speaker 2: of this really fascinating is that if you think about empire,
Speaker 2: empires require maps. Empires require maps to not only track voyages,
Speaker 2: but also as a way to assert power over particular geography.
Speaker 2: And so mapping is integral, it's essential to colonial and
Speaker 2: imperial endeavors. And so these maps are already situated. When
Speaker 2: an epidemic blows up, it's just coloring in the map,
Speaker 2: it's filling out the map, it's using the map to
Speaker 2: tell a different story. So today when we're thinking about
Speaker 2: outbreaks of COVID, and we're thinking about mapping and surveillance
Speaker 2: and all of these are important, critical hallmarks of epidemiology
Speaker 2: and necessary for us to understand how disease spreads the genealogy.
Speaker 2: The origin of that mapping practice, whether or not it's efficacious,
Speaker 2: originates with colonialism and empire.
Speaker 1: And the history of medicine in general, I feel like
Speaker 1: is often told as this series of discoveries and accomplishments,
Speaker 1: right with the leading protagonist as the scientist logic triumphing
Speaker 1: over superstition. But as much as we may like to
Speaker 1: pretend that there's a natural, orderly progression in medical knowledge,
Speaker 1: the truth is that it's driven by many different factors,
Speaker 1: in part by shifting incentives and opportunity. So can you
Speaker 1: talk a bit about how colonialism, slavery, and war incentivized
Speaker 1: understanding the spread of disease while also providing opportunities for
Speaker 1: physicians to study these populations of disenfranchised or oppressed individuals
Speaker 1: in a way that they hadn't been able to previously.
Speaker 2: Right, So, just to put it, like, just to give
Speaker 2: a concrete example to sort of answer your question, one
Speaker 2: of the chapters of the book looks at an explosion
Speaker 2: of what they don't know at the time. They call
Speaker 2: it fever, but it eventually this is like the sort
Speaker 2: of mystery of the chapter, so they don't know what
Speaker 2: it is. It ultimately is yellow fever. And so an
Speaker 2: outbreak of yellow fever happens and the ship there was
Speaker 2: a British vessel, and it was policing the coast to
Speaker 2: West Africa for any signs of the international slave trade. Ultimately,
Speaker 2: the ship stops at Cape Verde just as a holding
Speaker 2: place before it makes his trip voyage back to London.
Speaker 2: When it stops, when it eventually arrives in London, everyone says,
Speaker 2: this ship is infected with yellow fever and you need
Speaker 2: to be quarantined. And there's explosive debate about lockdowns and
Speaker 2: about quarantine, about all of the things that I was
Speaker 2: writing about in twenty seventeen, which I thought like people
Speaker 2: are never going to understand, Like they're not going to understand.
Speaker 2: I was like literally in a coffee shop in New
Speaker 2: York being like, how do I I can't call the
Speaker 2: chapter quarantine. No, I just want to get that and
Speaker 2: like the year twenty twenties, like hold my beer, like
Speaker 2: guess you have no idea what's coming. So ultimately what
Speaker 2: happens is there's a question of like, well, how did
Speaker 2: this originate? Where did it originate? And so the British military,
Speaker 2: the British and the government send a doctor to Cape Verde,
Speaker 2: and when he arrives there, he begins this massive effort
Speaker 2: to interview all of the p people on the island.
Speaker 2: And basically what he's doing is contact tracing, and he's
Speaker 2: drawing on the narratives and the testimonies of mostly enslaved
Speaker 2: and colonized washerwomen because they had been dealing with the
Speaker 2: quote dirty linen and this could be potentially infectious. Now
Speaker 2: what's fascinating is these women had no idea he was coming,
Speaker 2: but they understood the incubation period. They had already mapped
Speaker 2: where it spread from one place to another. They had
Speaker 2: sort of figured out this house got infected, but this
Speaker 2: house didn't get infected. And he puts together their story
Speaker 2: and he produces what I call the largest inventory of
Speaker 2: a patient narrative of black people in the nineteenth century. So,
Speaker 2: to go back to your question, we often say he's
Speaker 2: the hero. He figured this out, he traced it, and look,
Speaker 2: he did a lot of work. The point is to
Speaker 2: not discredit his work. But the point is, as many
Speaker 2: medical anthropologists have said, as many people interested in narrative
Speaker 2: medicine talking about it's about centering the patient narrative, that
Speaker 2: his knowledge, his ideas could not exist without their contribution.
Speaker 2: And so when doctors eventually figured out it was yellow fever.
Speaker 2: It wasn't just from mc williams identification of pathology. It
Speaker 2: was about washerwomen noticing the black vomit and to know,
Speaker 2: wait a second, I know these people are sick, but
Speaker 2: there's something's up here. The vomit's black, and not to
Speaker 2: just say oh, they ate something bad, like they were
Speaker 2: noticing the symptoms and then it becomes codified through his
Speaker 2: formal publication. And so my work is to try to say,
Speaker 2: how does the experience of colonialism and slavery and war
Speaker 2: create create new opportunities of knowledge production, and how can
Speaker 2: we also acknowledge patient's contribution to science.
Speaker 1: Right exactly, And because it's not just about these individuals
Speaker 1: that formerly hadn't been recognized as the sources of information
Speaker 1: themselves and like local knowledge, but also the individuals themselves
Speaker 1: whose bodies gave up this information. And so how do
Speaker 1: we incorporate that more into storytelling of the history of
Speaker 1: science and medicine.
Speaker 2: So I think it is just the word you said,
Speaker 2: they're storytelling. It's about how we narrate the story. So
Speaker 2: a colleague of mine who's a pre eminent historian of
Speaker 2: medicine whose name I won't say, but he's really smart,
Speaker 2: and he's written about the Cape Verdet incident. I actually
Speaker 2: uncovered it in the archive in twenty thirteen, and I
Speaker 2: was sitting on it because it takes a while to
Speaker 2: work on a book, and so that was going to
Speaker 2: be one chapter, and I was working on other chapters
Speaker 2: in the meantime. He uncovered it as well, and he
Speaker 2: wrote a chapter on it. But he turned the doctors
Speaker 2: into the protagonist in the story. I turned the washerwomen
Speaker 2: into the protagonist's story. Neither one of us is right
Speaker 2: at history as an interpretation, but it's about how we
Speaker 2: tell the stories. In his account, these women don't even
Speaker 2: appear in my account. They've been lifted off the page
Speaker 2: as purely just informants and cast as important contributors to
Speaker 2: the development of knowledge. And so that's how I think.
Speaker 2: That's what I think the answer is. It's talking about
Speaker 2: why and how the patients matter. There's also a new
Speaker 2: book called Medical Bondage by Deirdre Cooper Owen about the
Speaker 2: rise of gynecology in the American South that developed as
Speaker 2: a result of Jay Mary and Sims' experiments on enslaved women. Again,
Speaker 2: Deirdre Cooper Owen, a very good friend of mine, a
Speaker 2: very good colleague. Is not saying that Sims isn't important.
Speaker 2: She's actually putting in the context of many other doctors
Speaker 2: that were like Sims. But she's also giving voice and
Speaker 2: giving textual space in the man Your Script to the
Speaker 2: enslaved women not just as objects of study, but rather
Speaker 2: as interlockertors, as people who were there and who were
Speaker 2: possibly know we're contributing to this new development of ideas.
Speaker 2: Sometimes I feel like, think it's a really academic and
Speaker 2: people are like, yeah, that sounds like really cool, but
Speaker 2: I don't see it working out. And then I have
Speaker 2: one word for you, A loss of taste, of smell
Speaker 2: and taste. When the COVID pathology first came out, and
Speaker 2: I was one of the people who first got COVID
Speaker 2: in March of twenty twenty, I was actually flying from
Speaker 2: LA to New York. I felt a little tired, but
Speaker 2: I thought it was jet lag. I felt a little nauseous.
Speaker 2: I thought it was like something that in the airport.
Speaker 2: I noticed immediately I lost my sense of taste and smell.
Speaker 2: It was not reported as part of the pathology. It
Speaker 2: wasn't until Kelly Ripper on Our Morning Joe It's read
Speaker 2: an article in the New York Times, and all my
Speaker 2: friends in LA were like, Jim Kelly Rippa. Its article time.
Speaker 2: And so the question becomes, how did the loss of
Speaker 2: taste and smell become part of the pathology of COVID?
Speaker 2: And it became part because patients started reporting it and
Speaker 2: doctors did not dismiss it as silly. I'm sure a
Speaker 2: bunch did, right, but a bunch didn't, And so then
Speaker 2: it becomes recognized as a hallmark of it. So, in
Speaker 2: other words, when I say recognizing patients, we have to
Speaker 2: say that we are in a process of recognizing patient
Speaker 2: narratives even today. So it's it's not just an academic
Speaker 2: theory that sounds good, it's actually how we understood what
Speaker 2: COVID is and how we're going to understand what long
Speaker 2: COVID is as well. Right, it's going to be patients
Speaker 2: reporting and doctors then going through that material and making
Speaker 2: sense of it and saying, okay, this works, that doesn't work.
Speaker 2: But the patient is important. The patient is a is
Speaker 2: an architect of knowledge in this in these.
Speaker 1: Moments, absolutely, and I feel like the shifting definitions of
Speaker 1: disease are the boundaries around disease classification are always changing,
Speaker 1: and it's a topic that we've talked about before on
Speaker 1: the podcast in the context of symptoms versus signs, signs
Speaker 1: being things doctors can observe, symptoms being things that patients report,
Speaker 1: and how that shift of being able to measure these
Speaker 1: signs like temperature or heart rate, that kind of took
Speaker 1: the attention away from the patient. And I feel like
Speaker 1: it's all still, but it's still happening, like we're still
Speaker 1: we still don't do a great job of it. But
Speaker 1: one of the things I thought was really interesting in
Speaker 1: your book is that it kind of went up into
Speaker 1: right before germ theory became a thing started, and yet
Speaker 1: still there were these hypotheses, or these prevailing notions of
Speaker 1: the way disease spread, namely in miasma theory or contagion theory.
Speaker 1: Can you talk about how those two prevailing thoughts influenced
Speaker 1: this birth of epidemiology.
Speaker 2: Yeah, So one of the things to think about is that,
Speaker 2: so my asthma theory would just be people would notice
Speaker 2: everyone's getting sick and they don't understand how, and they
Speaker 2: can see it as a contagious phenomenon. They could say, well,
Speaker 2: this person got sick then that person got sick. So
Speaker 2: they believe in Godasian and then they're like, well, where's
Speaker 2: the origin, and so they would turn to rotten vegetation, corpse, unsanitary,
Speaker 2: like an unsanitary mass of trash, and they would say,
Speaker 2: from that unsanitary massive trash, there would be these poisonous
Speaker 2: vapors emanating from it, and these poisonous vapors are moving
Speaker 2: through the air, and that's what's getting people sick. And
Speaker 2: then people said, no, I don't think so, and so
Speaker 2: colonialism becomes another important testing ground to figure that out.
Speaker 2: One of the places is in a Malta, which is
Speaker 2: in the center of the Mediterranean, and it's an important
Speaker 2: quarantine hub. It's an important quarantine hub for ships going
Speaker 2: from Europe to the Middle East. It's an important hub
Speaker 2: from North Africa to Europe. And so what happens is
Speaker 2: you have two populations of people that begin to be studied,
Speaker 2: Muslim migrants and washerwomen. And the first is like the
Speaker 2: washer women are sort of like they come up in
Speaker 2: the Cape Verdi chapter and they come up here again.
Speaker 2: And as a historian, I thought when I saw them
Speaker 2: at Cape Verdie, I thought, oh, it was interesting. It's important.
Speaker 2: When I saw them again in Malta, I was like,
Speaker 2: these are an important group of people that are central
Speaker 2: to the development of knowledge and medicine during this period
Speaker 2: and have not really been cast as leading thinkers or
Speaker 2: leading actors. And so what happens is the ship's go
Speaker 2: into port, the ship's quarantined, it's isolated, no one can
Speaker 2: come on and off. They have to wait two weeks
Speaker 2: in order for whatever's there to eventually not be there.
Speaker 2: And so these washerwomen ultimately are going on the ship
Speaker 2: to collect the dirney linens and then return the linens,
Speaker 2: and some doctor recognizes they're not becoming sick, and so
Speaker 2: automatically this sort of like they become the subjects to
Speaker 2: actually prove that contagion doesn't work, and they become the
Speaker 2: subjects for doctors to launch these massive investigations into what
Speaker 2: causes people to become sick, because it can't just be
Speaker 2: it can't be miasma and it can't be contagion. And
Speaker 2: so the washerwomen are definitely part of the medical treatise.
Speaker 2: But the other major group are Muslim migrants. Muslims who
Speaker 2: are returning from the annual pilgrimage the haj are in ships,
Speaker 2: they're in Egypt, they're in Malta, they are in other places.
Speaker 2: And again going back to your first question, it's a population.
Speaker 2: They start realizing that these ships are quote and infected,
Speaker 2: they say they're infected, they place them into quarantine, and
Speaker 2: then they realize plague or cholera or another epidemic is
Speaker 2: not spreading it, so that the sort of it sort
Speaker 2: of undermines this argument that contagion is there. And again,
Speaker 2: think about it, like if you're in a small town
Speaker 2: or you're in a big city and you're trying to
Speaker 2: figure out if contagient works, there's no real mechanism to
Speaker 2: actually figure it out. But think about how colonialism around
Speaker 2: the sort of movement of Muslims creates a massive bureaucracy
Speaker 2: within those ports that allows doctors to record copious information
Speaker 2: about who's on the ships, what they're doing on the ships,
Speaker 2: if they're and how they're being under constant surveillance. And
Speaker 2: so all of a sudden, now these are major test
Speaker 2: subject populations that begin to undermine contagion theory and lead
Speaker 2: to epidemiology, meaning leading to a more investigative method of
Speaker 2: understanding outbreak. And so just one of the points that
Speaker 2: happens is that these doctors are stationed all throughout the world,
Speaker 2: these British doctors. They're in the Ports and Malta, they're
Speaker 2: in Jamaica, they're in the Caribbean, they're in India, they're
Speaker 2: in South America. And what happens is when they return
Speaker 2: to London, they say, we've learned a lot and they
Speaker 2: create the Epidemiological Society in eighteen fifties. So that the
Speaker 2: actual deployment of these physicians throughout the Empire and their
Speaker 2: arrival back to London to create the epidemiological field proves
Speaker 2: how this was a global practice and it grew out
Speaker 2: of these key moments.
Speaker 1: And that's kind of where the classic story of epidemiology
Speaker 1: usually begins, right with John Snow and the Broad Street
Speaker 1: pump in the London cholera epidemic of the eighteen fifties.
Speaker 1: But that story, as you point out in your book,
Speaker 1: is really only a small piece of the puzzle of
Speaker 1: how epidemiology truly began. So how do you think that
Speaker 1: story should be told today and where does John Snow
Speaker 1: fit into it?
Speaker 2: What I would say is the story of John Snow
Speaker 2: and the origins of epidemiology is that he remains a
Speaker 2: really important critical figure in tracing the origin of cholera
Speaker 2: to the water pump. That is absolutely his discovery, and
Speaker 2: he ought to be lauded for that. What I would
Speaker 2: add is that he is not a lonely pioneer, sort
Speaker 2: of courageously going into the poor neighborhood in London to
Speaker 2: search for the cause of cholera, what caused it to spread.
Speaker 2: He's part of a larger cohort of physicians, and he's
Speaker 2: part of a group of doctors who've been studying the
Speaker 2: origins of epidemics from the eighteen thirties, eighteen forties and
Speaker 2: even earlier. And so the story that I spoke about
Speaker 2: earlier about John McWilliam going to Cape Verde to study
Speaker 2: the origin at yellow fever, he and John Snow rubbed
Speaker 2: shoulders to the Epidemiological Society. They knew each other. So
Speaker 2: McWilliam actually goes first. McWilliam goes to Africa first, and
Speaker 2: he does the interviews first, he creates maps first, he
Speaker 2: does the investigations first. So John Snow is actually following
Speaker 2: in the footsteps of imperial doctors who walked through the
Speaker 2: West coast of Africa to uncover the spread of cholera.
Speaker 2: Yet he is actually part of a larger movement of
Speaker 2: physicians who have begun this practice of investigating the cause
Speaker 2: and spread of disease, And so he's not a lonely pioneer.
Speaker 2: He's among a whole group. So while his discovery that
Speaker 2: cholera is related to the water is genius, his methods
Speaker 2: he learned from other He learned from other doctors. And
Speaker 2: that's some thing that I think needs to be recognized
Speaker 2: within public health textbooks and so forth, that there was
Speaker 2: this whole group of people who actually were doing those methods.
Speaker 2: But here's the point. Their methods did not develop purely
Speaker 2: out of laboratory science. Their methods developed because slavery and
Speaker 2: colonialism had made populations available. So when we think about
Speaker 2: their methods, it's not just to say, hey, snow has
Speaker 2: these methods. His methods came out of his slavery and colonialism,
Speaker 2: and it came out of the ways in which those
Speaker 2: institutions created built environments that allowed doctors to study people.
Speaker 2: So that's the piece that really needs to be sort
Speaker 2: of underscored.
Speaker 1: One thing I was thinking about was how these early epidemiologists,
Speaker 1: or the people that we would now reflect back on
Speaker 1: and call early epidemiologists. How did they view themselves? Did
Speaker 1: they view themselves as physicians? Did they view themselves as
Speaker 1: practicing a new kind of science? Like when did that
Speaker 1: recognition sort of shift or take place?
Speaker 2: It's interesting, that's a great question. And I think that
Speaker 2: they view themselves as physicians. They understood that. I mean,
Speaker 2: most of them are doctors. They're not the way that
Speaker 2: we would think of someone who was semester's of public
Speaker 2: health as an epidemiologist today. And I think they see
Speaker 2: themselves as beginning a new science, beginning a new form
Speaker 2: of information gathering and knowledge production. And I think that's
Speaker 2: in part because they create the Epidemiological Society. I mean,
Speaker 2: it's really interesting if I could critique my own book,
Speaker 2: you know. Look, I mean I was so into the
Speaker 2: source of so into the stories. There are so many
Speaker 2: things that I kind of thought, Okay, I have to
Speaker 2: hit this, I have to do that. After publishing the book,
Speaker 2: I'm like, wow, I could have really just did an
Speaker 2: entire chapter in the Epidemiological Society. But it seemed to
Speaker 2: me like it was such an obvious piece. But that
Speaker 2: was just me being so in my head and thinking,
Speaker 2: like everybody knew this, and everybody doesn't know this, and
Speaker 2: so the reality of it is is for them to
Speaker 2: actually create a society signals that they see their work
Speaker 2: as different from typical patient care, clinical practice, and that
Speaker 2: they see their work as sort of embarking on a
Speaker 2: new mode of scientific inquiry.
Speaker 1: So you talked about how, you know, bureaucracy, statistics, mapping,
Speaker 1: how all of those tools were really important in creating
Speaker 1: this notion of epidemiology and this new way of seeing things.
Speaker 1: But without something like journalism, perhaps would it have stayed
Speaker 1: a little bit more closely enveloped in colonialism, or in slavery,
Speaker 1: or in wartime.
Speaker 2: Right, So that's a great question. So one of the
Speaker 2: things I noticed is that the Crimean War figures into
Speaker 2: the book as its own chapter, in large part because
Speaker 2: the Crimean War is often considered one of the first
Speaker 2: major wars and my major modern wars, and that is
Speaker 2: to say that it was one of the first times
Speaker 2: you had British journalists deployed to the battlefield and were
Speaker 2: reporting back exactly what was happening. And one of the things,
Speaker 2: and I talk about this in the book, one of
Speaker 2: the journalists is talking about combat but also talking about
Speaker 2: the high rates and morbidity and mortality among the British
Speaker 2: troops and the British public would have known about unsanitary
Speaker 2: conditions in prisons, they would have known about them in hospitals,
Speaker 2: which at the time were not for middle class people.
Speaker 2: They were basically sheltered for the poor and dispossessed. So
Speaker 2: they may have thought about hospitals as dirty places. They
Speaker 2: may have thought about prisons as incubators for medical disorders,
Speaker 2: but those were populations of people they really didn't care about.
Speaker 2: Now that they've sent their sons, their fathers, their husbands,
Speaker 2: their brothers to the war and they're actually becoming sick
Speaker 2: and dying in the hospital, then it's like, wait a minute,
Speaker 2: you're basically exposing hospitals as these unsanitary places, and people
Speaker 2: are now becoming invested in why, and so that's in fact,
Speaker 2: that's what sort of inspires Florence Nightingale, who is a
Speaker 2: major figure in the book, to lead a corps of
Speaker 2: nurses to Crimea. And when she gets there, she does
Speaker 2: care for the wounded soldiers. She does, you know, put
Speaker 2: bandages on them and provides comfort and does all of
Speaker 2: this other stuff. But she's also very much interested in
Speaker 2: why more soldiers are becoming sick and dying in British
Speaker 2: hospitals and noticing they're not becoming sick and dying in
Speaker 2: the French and the Russian hospitals. And so she becomes
Speaker 2: what I think is she becomes an epidemiologist in many respects,
Speaker 2: and within the nursing literature and among some schools of
Speaker 2: public health she's recognized for her contributions, but by and large,
Speaker 2: within the larger history of medicine, she's recognized as a
Speaker 2: pioneering nurse, but not as a pioneering epidemiologist. And when
Speaker 2: she returns back to London to crime from Crimea, she
Speaker 2: meets with Queen Victoria and with Prince Albert in their
Speaker 2: Scottish home, which I actually think if you watch Dalton
Speaker 2: NAVI it's like in Navanda, that's when they go. Anyway,
Speaker 2: So she meets there, so we're just trying to create
Speaker 2: some images and he based Albert says, listen, I have
Speaker 2: a tutor, and he's a statistician, and so he teaches
Speaker 2: her statistics. And so this goes back to your earlier
Speaker 2: question about statistics as a sort of way of understanding
Speaker 2: and measuring epidemics. She becomes inducted into the National Statistics Academy.
Speaker 2: She's one of the women, if not the first I
Speaker 2: and so she's a leading thinker. And of course I
Speaker 2: want to say this too, just she's a problematic person
Speaker 2: in lots of ways. There's a lot of literature coming
Speaker 2: out about how she's racist, she's a white supremacist, she's
Speaker 2: all of those things. But my argument is that she's
Speaker 2: also leading the field of epidemiology, and both things can
Speaker 2: be true. She can be a white superreminisist and she
Speaker 2: could be a statistician.
Speaker 1: We've talked a lot about these early physicians, early epidemiologists
Speaker 1: observing groups of people without their consent or without or
Speaker 1: observing people who can't or have not given their consent.
Speaker 1: But it's not just about observation a lot of the time.
Speaker 1: Sometimes it is outright, you know, exploitation, and so the
Speaker 1: dehumanization extends even further. And there's one example in particular
Speaker 1: that I'm thinking of that you discussed in your book
Speaker 1: involving smallpox, and I was wondering if if you could
Speaker 1: describe this instance for our listeners and also share your
Speaker 1: thoughts on why so many examples of exploitation like this
Speaker 1: seem to have been largely erased from medical history.
Speaker 2: Okay, so just first, I mean a lot of the
Speaker 2: stories of exploitation have been embrased, in large part because
Speaker 2: the notion of sort of medical ethics is not really
Speaker 2: a thing bioethics that I really think, until the mid twentieth century,
Speaker 2: So that's part of it. A lot of this comes
Speaker 2: out of the Nuremberg Trials, and that sort of begins
Speaker 2: a public conversation about what the boundaries of doctors and
Speaker 2: with the boundaries of scientific practice, etc. One of the
Speaker 2: things that I study, and I study at both in
Speaker 2: this book and in my first book, Sick from Freedom,
Speaker 2: is the fact that most people don't know this. And
Speaker 2: this is the sort of like mind blowing thing that
Speaker 2: I sort of uncovered without being sepphagrandizing. But it was
Speaker 2: just really like going through sitting in Washington, DC, reading
Speaker 2: medical records and finding references to smallpox and being like,
Speaker 2: wait a minute. I study Civil War, I study the Reconstruction.
Speaker 2: I don't know anything about this. I've never heard it.
Speaker 2: I checked all the indexes of the major books. No
Speaker 2: one has mentioned it. By taking all of these records
Speaker 2: from the military that have created this bureaucracy. I pieced
Speaker 2: together the fact that at the moment of emancipation, over
Speaker 2: sixty thousand formerly enslaved people died of smallpox, and no
Speaker 2: one has sort of talked about that. Now, if you
Speaker 2: think about it, it's actually not that surprising because during
Speaker 2: the Civil War more soldiers died from disease than from battle.
Speaker 2: So again, when we think of the Civil War, we
Speaker 2: think of it, you know, the heroic, noble death at
Speaker 2: the Battle of Gettysburg or at the Battle of Antietam.
Speaker 2: We don't realize that most people, most soldiers died not
Speaker 2: from battlefield wounds or battlefield combat. They died from infectious disease.
Speaker 2: Because there's no such thing as germ theory. They died
Speaker 2: from GI problems, they died from pneumonia, etc. So the
Speaker 2: smallpox epidemic fits within that context really well. And so
Speaker 2: when smallpox began to spread among Confederate or Union troops,
Speaker 2: there were two ways of doing two ways of responding.
Speaker 2: The first was they could fall back on the century
Speaker 2: law belief of quarantining people, just literally taking someone who
Speaker 2: was infected and isolating them, and that would prevent the
Speaker 2: virus from spreading. The second was there was this whole
Speaker 2: question about vaccination versus oculation. An inoculation was a practice
Speaker 2: developed here in the United States in the seventeenth century
Speaker 2: when an enslaved person told Cotton Mather, Hey, listen, I
Speaker 2: know there's a smallpox epidemic, and smallpox basically produce a
Speaker 2: vesicle and in it it gets filled with limph, a fluid.
Speaker 2: He said, if you cut open the vesicle and then
Speaker 2: you cut open someone who's vulnerable their arm, and you
Speaker 2: take the limph from their arm and you put it
Speaker 2: into the arm of someone who is vulnerable, they can
Speaker 2: develop a mild version of the infection and then clear it.
Speaker 2: Vaccination is the same practice, but you use cowpox, and
Speaker 2: there's a whole history of that. So during the war,
Speaker 2: they're trying to get their hands on cowpox, but it's
Speaker 2: hard to transport cowpox, you know, during a battlefield on
Speaker 2: a piece of glass. It's not happening, okay, And so
Speaker 2: that's not working. So they go to this thing of like,
Speaker 2: all right, let's go back to armed arm inoculation. But
Speaker 2: in the process that they're conferring, they're not conferring immunity.
Speaker 2: They're actually you know, transmitting things like syphilis and other
Speaker 2: bloodborne diseases and other problems. And so again, the Confederacy
Speaker 2: has a military bureaucracy, so the doctors are now able
Speaker 2: to say, out of eighty troops, these are the five
Speaker 2: cases that have worked. These are the twenty that haven't worked.
Speaker 2: These are the fifteen they've done X. Prior to that,
Speaker 2: these physicians were isolated. They didn't really there wasn't a
Speaker 2: small box epidemic in the South before the war. They
Speaker 2: didn't know what worked. They didn't know what what could work,
Speaker 2: or what didn't work or could whatever. Here's the thing.
Speaker 2: Someone says, we can't use the soldiers because it's causing
Speaker 2: more problems. Let's turn to enslaved infants and children, because
Speaker 2: they fell back on this pro slavery parable that enslaved
Speaker 2: people were in an idyllic countryside. They were in a
Speaker 2: very comfortable position, they were healthy, they were the happy slave.
Speaker 2: And so the Confederacy basically deploys physicians throughout the South
Speaker 2: to go and purposely infect children and even better, infants
Speaker 2: because they're even purer with smallpox. Then they would come
Speaker 2: back two or three weeks later, they would check if
Speaker 2: their body had in fact taken the virus and if
Speaker 2: they had started to produce the lymph, and they would
Speaker 2: take the limp and then use it to give it
Speaker 2: to white people as a form of vaccination. Now this
Speaker 2: is a really interesting point because I've studied smallpox for
Speaker 2: over fifteen years. It's not in the literature, it's you know,
Speaker 2: it's not really anywhere. The use of children to harvest
Speaker 2: vaccine matter was not invented, however, by the Southern doctors.
Speaker 2: This is a practice that happens throughout Europe. As I
Speaker 2: mentioned in the book, King Carlos of Spain wants to
Speaker 2: get people vaccinated in Mexico, so he infects a bunch
Speaker 2: of orphans in Spain, puts them on a boat, sends
Speaker 2: them to Mexico. Once they're in Mexico, he infects another
Speaker 2: group of orphans sends them to Vietnam. I mean, this
Speaker 2: is the trafficking of children. I just gave a talk
Speaker 2: recently at the University of Virginia and medical historian said,
Speaker 2: I have a case. It's eighteen ten the orphans in England,
Speaker 2: the same thing was happening. So this is a widespread
Speaker 2: practice around vaccination and a time when we didn't have
Speaker 2: medical ethics. It was, it was it was these kinds
Speaker 2: of things were I think more common than not. Now
Speaker 2: here's what's really interesting to me as a historian. It's
Speaker 2: often so the now, it's often so commonplace, there isn't
Speaker 2: the need to write it down. So it's like they
Speaker 2: don't think they need to write down like these kinds
Speaker 2: of things. And so what happens is during a war,
Speaker 2: the bureaucracy ends up capturing a lot of stuff. It
Speaker 2: ends up serving as a net, and all of a sudden,
Speaker 2: you're like, wait a minute, why is this doctor being
Speaker 2: sent out and this other doctor is telling forty other
Speaker 2: doctors to do it. Wait, it's in the command, it's
Speaker 2: in the order. It's like there's lots of medical practices
Speaker 2: and lots of medical ideas that aren't articulated, but they're
Speaker 2: just understood.
Speaker 1: Fascinating. We're going to take a quick break here, and
Speaker 1: when we get back, I want to shift to talking
Speaker 1: about what it's like to actually be a historian and
Speaker 1: some of the other areas that you're interested in. Welcome
Speaker 1: back everyone. I have really been enjoying chatting with doctor
Speaker 1: Jim Downs about how important it is to recognize the
Speaker 1: role that slavery, colonialism, and war has played in the
Speaker 1: development of epidemiology as a science. But now we're going
Speaker 1: to turn to some more personal questions. Besides the origin
Speaker 1: story of epidemiology, what other areas have you worked on?
Speaker 2: Yeah, I'm really I'm really interested in the history of
Speaker 2: gender and sexuality. That's always been a big pe. I
Speaker 2: have a book called stand by Me, The Forgotten History
Speaker 2: of Gay Liberation, and there is a medical narrative to it,
Speaker 2: and that's basically that when we think about the seventies,
Speaker 2: we think about it, at least for white gay men,
Speaker 2: as this huge orgy, and it's like, how much of
Speaker 2: that is true and how much of that was used
Speaker 2: to rationalize and explain the spread of HIV? And what
Speaker 2: I learned was that policymakers, newspaper journalists, public health people,
Speaker 2: doctors saw HIV, the explosion of HIV in the early eighties,
Speaker 2: and we're like, what caused this? And they immediately turned
Speaker 2: to sex culture. And while that's true to a point,
Speaker 2: it's not in another way. And what it's done is
Speaker 2: it's actually turned the seventies into one note and it's
Speaker 2: failed to see that in the nineteen seventies, for instance,
Speaker 2: there was the creation of the first ever gay church,
Speaker 2: actually was in nineteen sixty seven. Like I never knew
Speaker 2: gay people create their own church, their own synagogues, own
Speaker 2: prayer groups. So there's this whole religious movement that develops
Speaker 2: out of the seventies because you couldn't necessarily go to
Speaker 2: a gay bar, you could go to a prayer group.
Speaker 2: You could, you know, So that was interesting. They created
Speaker 2: you know, we talked about HIV AIDS. We talk about
Speaker 2: the political networks that got the word out. It came
Speaker 2: out through the volunteer press, It came out from newspapers
Speaker 2: that gay men and lesbians and trans people created for themselves.
Speaker 2: And they weren't I tell my students this all the time,
Speaker 2: Like they couldn't put it on their resume, like you
Speaker 2: people have all these activities, or like I'm putting on
Speaker 2: my restumes, like this doesn't go in the resume, Like
Speaker 2: they would get fired if it was on their resume.
Speaker 2: So they create a whole newspaper culture and they you know,
Speaker 2: so there's the first ever gay bookstore was created. And
Speaker 2: so I grew up at a time in the nineties
Speaker 2: where there were feminists and gay bookstores all those A
Speaker 2: lot of those have basically died, But in the seventies
Speaker 2: those were another site of community building and community spaces
Speaker 2: long before you had community centers. So when people say
Speaker 2: it's just the bars and the bath houses in the
Speaker 2: beaches where gay people were coming together, I'm like, no,
Speaker 2: there's churches, there's bookstores, there's community centers, and both can
Speaker 2: be true. There can be lots of sex, and there
Speaker 2: could be that. But the point that I came at
Speaker 2: it from a medical perspective, which was really important, especially
Speaker 2: as a gay man, was that we got to stop
Speaker 2: this narrative about HIV spreads because of problemscuity HIV spreads.
Speaker 2: If you come in contact with the virus, you could
Speaker 2: have lots of sex with lots of different people and
Speaker 2: never catch HIV. You could have be completely monogamous and
Speaker 2: on your wedding night with another man have sex for
Speaker 2: the first time and be exposed to it and that's
Speaker 2: it and it's not. So I'm trying to like really
Speaker 2: dispel those kinds of rumors and myths in the book
Speaker 2: and really point to the ways in which gay people
Speaker 2: try to create a sense of culture in order to
Speaker 2: create a sense of community.
Speaker 1: Yeah, that's really fascinating, And is this something that you
Speaker 1: always wanted to research, Like when you were a kid,
Speaker 1: did you want to grow up to become a historian?
Speaker 1: Like what did you become interested in these in these fields? Yeah?
Speaker 2: So I think when I was a kid, I wanted
Speaker 2: to be in a rapper slash actress more powerful than
Speaker 2: three cleopatras. That's Lauren Hill. No, I wanted to be
Speaker 2: I wanted to become an I wanted to become an actor,
Speaker 2: I think, I mean mostly then. It was when I
Speaker 2: was in college at University of Pennsylvania. Uh, a friend
Speaker 2: of mine said, do you want to volunteer at the
Speaker 2: Gay Community Center, And essentially we went there on Wednesday
Speaker 2: night and all of these men who had left Philadelphia
Speaker 2: or died of HIV stuffed all their belongings from the
Speaker 2: seventies into paper bags. And the Gay Community Center, the
Speaker 2: William Way Center was at the time dealing with runaway youth,
Speaker 2: dealing with helping trans people, HIV testing, dry queen bingo,
Speaker 2: but had to reality. Knew that they had to keep
Speaker 2: their history because the major libraries and archives in the
Speaker 2: Philadelphia area, which is like the hub of history, as
Speaker 2: a major historical hub weren't taking them, and so everything
Speaker 2: was like stuffed into an attict. And I started looking
Speaker 2: at these documents, and I wasn't a librarian, but just
Speaker 2: writing down what I saw. And I learned that that's
Speaker 2: also what happened in New York and in other places,
Speaker 2: other gay places, And so it was coming in contact
Speaker 2: with those sources and coming in contact with that history
Speaker 2: and understanding that history is doing political work. That's what
Speaker 2: sort of really got me interested. And then when I
Speaker 2: was in graduate school, I read a lot of literature
Speaker 2: by black women and slave narratives, and so I started
Speaker 2: researching the history of slavery, and I again uncovered all
Speaker 2: of these major records about the period immediately following slavery,
Speaker 2: which we call emancipation, and I just thought, wow, that
Speaker 2: has to be told. It was the medical stuff, mostly
Speaker 2: because most of the history is about the important moments citizenship, suffrage.
Speaker 2: So I think it was like for me the sources,
Speaker 2: it's always the documents. I mean, I don't necessarily, I
Speaker 2: mean I might have lots of different questions, I might
Speaker 2: have been interested in lots of different things, but what
Speaker 2: actually leads to the creation of a book is always
Speaker 2: going to be some kind of record, some kind of
Speaker 2: document that I don't think has been told.
Speaker 1: What have you encountered as some of the biggest misconceptions
Speaker 1: about being a historian When someone you when you introduce
Speaker 1: yourself and you say, I'm a historian, what are some
Speaker 1: of the questions you get and the misconceptions you find?
Speaker 2: Okay, first of all, I don't. Yeah, I get questions
Speaker 2: all the time, like they think I said I'm a historian.
Speaker 2: I'm not Wikipedia or Google. They always like like oftentimes
Speaker 2: they have questions and they're so they're so there's such
Speaker 2: strange questions and it's like but they already know the answer.
Speaker 2: They just want It's like Final Jeopardy. It's like every
Speaker 2: time I meet somebody, it's like Final Jeopardy. They're like,
Speaker 2: do you know, And I'm like, yeah, I actually don't
Speaker 2: feel history questions like don't want to get So that's
Speaker 2: one of the I think this is like one of
Speaker 2: the misconceptions I think doing podcasts like, I was trained
Speaker 2: by Eric Pohoner, I was trained by African American scholars.
Speaker 2: I was trained to bring what I've learned to the public.
Speaker 2: I was not trained to sit in a circle with
Speaker 2: other academics or in front of a big lecture hall
Speaker 2: and show people how smart I was. I was trained
Speaker 2: to say, you learn this, and you have a responsibility
Speaker 2: to get out there and to change the conversation. And
Speaker 2: you don't do it by being aloof and being lofty
Speaker 2: and being you do it by being real. And so
Speaker 2: like my my advisor, Eric Bohoner, like constantly was publishing
Speaker 2: in the nation. He's still alive, he's still doing lots
Speaker 2: of work. He's like he always makes his work really accessible.
Speaker 2: So and he never really he never sat us down
Speaker 2: and was like you need to do this. It was
Speaker 2: by example, and it was like I remember once he
Speaker 2: was kind of late for class at NBC News, was
Speaker 2: like in the courtyard and he was like, I got
Speaker 2: to do something on air Johnson today I got. I'm
Speaker 2: like He's on TV, and I was like checking my
Speaker 2: hair and makeup. I'm like, am I am background? But
Speaker 2: like I And then within African American studies and being
Speaker 2: part of that field, in that world, there is a
Speaker 2: deep commitment among many to make knowledge accessible. So I
Speaker 2: think what most historians don't know is that most people
Speaker 2: don't know. It's like I a lot of us spend
Speaker 2: a lot of time doing this work, doing podcasts, tweeting,
Speaker 2: writing articles for the mainstream press, making the information available.
Speaker 1: Yeah, it's so crucial, and it's something that I think
Speaker 1: not every graduate degree affords you, right, not everyone gets
Speaker 1: that sort of training. And what other opportunities are out
Speaker 1: there for someone with a PhD or a master's in history.
Speaker 2: I think there's a lot. I mean, I think there's
Speaker 2: a lot in terms of just one of the great
Speaker 2: things about being a historian is you really learn how
Speaker 2: to read search and you learn how to write, so
Speaker 2: that kind of goes into lots of other fields. I
Speaker 2: also should just give a sort of shout out to
Speaker 2: a company that I'm a partner of, which is called
Speaker 2: History Studio, and what we do at History Studios we
Speaker 2: provide historical consultation to the entertainment profession. And so there's
Speaker 2: lots of people out there that are making documentaries that
Speaker 2: are in desperate need of historians to service consultants. There's
Speaker 2: lots of people who are making feature length films and
Speaker 2: are doing series that are looking for historical consultants, and
Speaker 2: so I think that's like one of the other ways
Speaker 2: lots of other historians traditionally go into museum work and
Speaker 2: other forms of public history. But increasingly, I mean, I
Speaker 2: think that historians are really good at learning how to
Speaker 2: read and write. And so one of my colleagues at
Speaker 2: History Studio, Eric Armstrong Dunbar, is an executive producer on
Speaker 2: this show Gilded Age, and the Gilded Age is a
Speaker 2: period piece is HBO. But she's brilliant, Like if she
Speaker 2: reads the script, she knows how to identify, you know,
Speaker 2: what is a good storyline, what is right? And do
Speaker 2: you know what? She appears at the end of the episode.
Speaker 2: She's the first historian ever to testify and to frame
Speaker 2: an episode. Normally it's just like the actors and the
Speaker 2: actresses and maybe the showrunners. She's framing it for the
Speaker 2: American public, and so she's actually changing and expanding the
Speaker 2: role of historians by actually getting on there, getting to
Speaker 2: the public and saying, this is what this episode meant,
Speaker 2: This is what it meant to be a black person
Speaker 2: in the Guilded Age. These are the kinds of indignities
Speaker 2: they face. These were also the opportunities they confronted. Because
Speaker 2: a lot of times it's very easy to say as
Speaker 2: a historian, oh, yes, black people suffer from discrimination, Yes,
Speaker 2: but sometimes that obscures all of the major things they did.
Speaker 2: And what Dunbar says at the end of that episode
Speaker 2: is they created an entire publishing industry. There was a
Speaker 2: huge black newspapers. They have the whole industry of black
Speaker 2: newspapers that were developing during this time. So I think
Speaker 2: there's a lot that historians can do. I just think
Speaker 2: it's about people may not come to you as a
Speaker 2: historian bch. You have to come to them, and you
Speaker 2: have to pitch them and you have to show what
Speaker 2: you can do, and then you know, hopefully that that'll
Speaker 2: change more as we progress, So we'll see.
Speaker 1: That's that is so cool. I've got one last question
Speaker 1: for you, and that I'll let you go, and that
Speaker 1: is when someone asks you why it's so important to
Speaker 1: know history or learn history, what do you tell them?
Speaker 1: What's your answers?
Speaker 2: It's about learning how to frame and learning how to
Speaker 2: frame a contemporary issue. So NBC News just broke a
Speaker 2: story yesterday that came out of UGT University of Georgia,
Speaker 2: a study that white people don't really care about COVID
Speaker 2: because they've heard it only affects black people. And so
Speaker 2: you know, we can talk about the merits of the
Speaker 2: study or not. The point is, if you read this
Speaker 2: article in isolation, you can either just say it's rubbish
Speaker 2: and push it aside, or you can just say, oh,
Speaker 2: it's surprising. But if you place it in historical context,
Speaker 2: you say, wow, it's actually part of a larger pattern.
Speaker 2: I mean, this actually happened during the Civil War. White
Speaker 2: people didn't care that black people were dying a smallpox.
Speaker 2: This actually happens before and even now with HIV. HIV
Speaker 2: is no longer The largest growing group of people to
Speaker 2: contract the HIV in the United States are not gay
Speaker 2: white men. They are black, cisgender women in the South,
Speaker 2: and yet it's people don't think about it as much anymore.
Speaker 2: So It's like when you think about history, it actually
Speaker 2: can illuminate patterns and it could actually help you better
Speaker 2: analyze and examine a particular issue.
Speaker 1: Thank you so much, doctor Downs for taking the time
Speaker 1: to chat with me today. I can already tell that
Speaker 1: this is a conversation that is going to stick with
Speaker 1: me for a very long time. And if you listeners
Speaker 1: would like to learn more about some of the things
Speaker 1: that we talked about today, do yourself a favor and
Speaker 1: go check out doctor Down's book Maladies of Empire, How Colonialism,
Speaker 1: slavery and War Transformed Medicine. I'll post a link to
Speaker 1: the book as well as to doctor Down's faculty page
Speaker 1: on our website This podcast will kill You dot com.
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Speaker 1: you to our fantastic, generous patrons. We appreciate you so
Speaker 1: very much. We have got a brand new episode on
Speaker 1: a brand new topic coming out next week, so until then,
Speaker 1: keep washing those hands, um
Speaker 2: Um