Medicine and slavery went hand-in-hand. But what was the nature of this vile partnership? In Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840 (UNC Press, 2017), Rana Hogarth shows that familiar histories, though excellent, fail to explain how and why medicine and slavery became fused in the first place.

No doubt, defenders of slavery used medicine to justify the corrupt practice once it was under threat. But Hogarth shows how science and medicine grafted during times and in places where slavery was secure—where white elites had no need to justify the violent practice with medical ideas because slavery was taken for granted. How and why did medicine and slavery fuse, Hogarth asks, in the Atlantic World of the newly invented United States and ascendant imperial Britain? Understanding the answer helps us grasp the valences and impacts of racialized national and social identities, then as well as today.

White physicians inflated their value—financial as well as reputational—by locating medical reasons for already existing racist tropes. Circa 1800, white physicians were a disreputable and loosely aligned lot. They had many rivals (Black healers), rich skeptics (plantation owners), and no professional organization until the mid-nineteenth century under which they could rally. Before then, a wide-spread, active white belief in an innate difference between Black and white bodies was the foregone conclusion that white physicians worked to explain in order to appear of use. White physicians in the English-speaking Caribbean developed medical theories of innate difference in the etiology, progress and experience of illness in Black and white bodies—evidence to the contrary be damned. As a consequence, they ignored immense Black suffering, exposed Black workers to deadly diseases, and policed Black people through the hospital system, all the while seeing Black people as appropriate for service in the military and as objects for teaching dissection, that is to say, in projects of imperial and professional expansion.

Medicalizing Blackness broadens the story of medicine in the Atlantic World with a lens that perceives more than the institution of slavery. It also demonstrates the emergence of the Caribbean as a locus—not an outpost—of trustworthy medical knowledge circulated through an array of genres, including journals articles, plantation guides, hospital advertisements, and other media of “textual subjugation” that Hogarth reads with great insight. In short, medicine needed the racist logics of slavery in order to gain power before slavery needed racist medicine to defend its own might.

July 2022 marks the fiftieth anniversary of the exposure of the abusive and unethical Tuskegee Syphilis Experiments in the US media. Engaging the roots of white supremacist ideas and practices is essential for better understanding and for stronger political action against racism, as important fifty years ago as it is in our ongoing racialized pandemic.

This interview was a collaborative effort among Professor Laura Stark  and students at Vanderbilt University in the course “American Medicine & the World.” Please email Laura with any feedback on the interview or questions about the collaborative interview process: [email protected].

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