Guest contributor: Chris Ciocchetti*
Teaching about race and medicine can be lonely.
When I created my course in bioethics at Centenary College over ten years ago, I knew more about what I didn’t want to do than what I wanted to do: I wanted to talk about race and medicine; I didn’t want to tack on a section about race after the “main work.” I believed that students most needed to see how race pervades the decisions made by patients, providers, and administrators in our healthcare system. I wanted them to ask the question habitually, “How is race affecting this situation?”
Without external training, I relied on several approaches that have grown popular in the last decade. I took students to the Martin Luther King Health Center and Pharmacy for some place-based learning. In class, they were assigned roles at a fictional clinic and asked to decide how to address AIDS and HIV in the community. This made them into active learners and required them to synthesize what we had learned. Meanwhile, the national discussion about how we teach race in schools was undergoing a dramatic transformation.
Needless to say, it was a lot to process (for me and my students), and I often second-guessed my teaching choices. Students are passionate, so I’ve had to learn to help them manage their passionate ideas and combine passion with critical discussions and problem-solving. As teachers, we never want to push students into resignation and indifference about the problems that matter to their communities.
Today, I host a Race and Medicine Teaching Circle for colleagues at Centenary College and other colleges in the region and beyond. On the third Friday of each month, colleagues from around the country helped each other rejuvenate our collective work. Among many things we discuss together are issues of practical pedagogy. We started the conversation about creating a welcoming classroom by critiquing an article from the National Education Association (NEA), “10 Principles for Talking About Race in School.” We discussed when and how to bring our personal experiences into the conversation. (The answers will be different for everyone, but it helped to hear how others used personal disclosure and when they found that it distracted from the lesson.) We share articles that we’ve used in our courses, including essays about epistemic injustice, systemic racism, and racism in earlier pandemics. We share teaching materials, assignments, and ideas to frame the issues for students—but most important, we support each other as we find ways to improve.
One important discussion was about avoiding “elite capture,” a process that philosopher Olúfẹ́mi Táíwò defines as the moment when “political projects can be hijacked in principle or in effect by the well positioned and resourced, while the fundamental structure of the social order—and its attendant inequalities—remains unchanged.” This discussion left us with more questions than answers, but it helped to know others struggled with the same issue.
In the Teaching Circle, we concluded the 2022-2023 academic year with a challenging topic that was meaningful to all of us: how to obtain and maintain support for teaching about race from your department and institution. I have realized that I’m not alone in this challenge—colleagues from across the Teaching Circle network are all struggling to receive more permanent support for our work while working to retain the critical edge necessary to address the legacies of slavery as it pertains to race, health, and medicine.
Academic communities often think that teaching about race should be done only after the “real work” is finished. But at least once per month, I have enjoyed talking with a group of people who don’t see it that way. Perhaps more than anything, the Teaching Circle gives me hope for what a passionate community of scholars and practitioners can achieve across the country.
* Chris Ciocchetti is Beaird Chair of Philosophy at Centenary College of Louisiana in Shreveport, LA. Centenary is a Regional Collaboration Partner of the CIC Legacies of Slavery network. The views expressed here are not necessarily those of the college or CIC.
The Race and Medicine Teaching Circle is committed to meeting again throughout the 2023-2024 academic year. Instructors from other CIC member colleges and universities are warmly invited to join the Teaching Circle if they want to learn more about race and medicine or want to explore new ways to teach about the multiple legacies of American slavery. The first meeting of the Teaching Circle this year will be on September 15, 2023, at 3:00 p.m. CST. Please email Chris Ciocchetti at cciocchetti@centenary.edu for further details or with any questions about this initiative.
Recommended Readings from the Teaching Circle
Descriptions added by the Legacies of Slavery editorial team.
Joe R. Feagin and Zinobia Bennefield, “Systemic Racism and U.S. Healthcare,” Social Science & Medicine 103 (2014): 7-14. https://doi.org/10.1016/j.socscimed.2013.09.006
Using systemic racism theory to examine contemporary research about health disparities, Feagin and Bennefield call for a radical restructuring of the healthcare system in order to address issues of racially exploitative medical and public health practices informed by “institutionalized white socioeconomic resources, discrimination, and racialized framing from centuries of slavery, segregation, and contemporary white oppression.”
Vanessa Northington Gamble, “‘There wasn’t a lot of comforts in those days’: African Americans, Public Health, and the 1918 Influenza Epidemic,” Public Health Reports 125, suppl. 3 (2010): 113–122. https://journals.sagepub.com/doi/abs/10.1177/00333549101250s314
Gamble offers a brief history of African American health since emancipation, situating health disparities within the contexts of racist medical and scientific theories, political disempowerment, and segregated healthcare systems. Turning to the era of the Spanish Flu, she notes that “Contradicting prevailing theories about African Americans’ increased susceptibility to disease, it appears that during the 1918 epidemic the incidence of influenza was lower in … African American communities, [but] it still overwhelmed their medical and public health resources.”
Nancy K. Bristow, “‘It’s as Bad as Anything Can Be’: Patients, Identity, and the Influenza Pandemic,” Public Health Reports 125, suppl. 3. (2010): 134–144. https://journals.sagepub.com/doi/abs/10.1177/00333549101250S316
Bristow uses primary sources to offer a people’s history of the pandemic, focusing on the intersections of gender, race, and culture that made it easier for an unprecedented disease to overrun both the public and private healthcare systems. She also argues—with prescience, in light of the COVID pandemic—that “Americans can learn from [the 1918 pandemic influenza], guarding against identity-based discrimination and acknowledging … the grief and loss fellow citizens suffered.”
Ian James Kidd and Havi Carel, “Epistemic Injustice and Illness,” Journal of Applied Philosophy 34, no. 2 (2017): 172-190. https://doi.org/10.1111/japp.12172
This article examines structural inequalities in the American healthcare system through the philosophical lens of epistemic injustice, “[identifying] negative stereotypes and structural features of modern healthcare practices that generate them.” The authors also suggest possible solutions to health disparities by race—starting with a recognition of the problem and a critical analysis of stereotypes and ending with a total reformation of contemporary healthcare.