Cover image for Dying in the city of the blues : sickle cell anemia and the politics of race and health
Dying in the city of the blues : sickle cell anemia and the politics of race and health
Wailoo, Keith.
Personal Author:
Publication Information:
Chapel Hill, NC : University of North Carolina Press, [2001]

Physical Description:
ix, 338 pages : illustrations ; 24 cm.

Format :


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RA645.S53 W35 2001 Adult Non-Fiction Central Closed Stacks

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This groundbreaking book chronicles the history of sickle cell anemia in the United States, tracing its transformation from an "invisible" malady to a powerful, yet contested, cultural symbol of African American pain and suffering.

Set in Memphis, home of one of the nation's first sickle cell clinics, Dying in the City of the Blues reveals how the recognition, treatment, social understanding, and symbolism of the disease evolved in the twentieth century, shaped by the politics of race, region, health care, and biomedicine. Using medical journals, patients' accounts, black newspapers, blues lyrics, and many other sources, Keith Wailoo follows the disease and its sufferers from the early days of obscurity before sickle cell's "discovery" by Western medicine; through its rise to clinical, scientific, and social prominence in the 1950s; to its politicization in the 1970s and 1980s. Looking forward, he considers the consequences of managed care on the politics of disease in the twenty-first century.

A rich and multilayered narrative, Dying in the City of the Blues offers valuable new insight into the African American experience, the impact of race relations and ideologies on health care, and the politics of science, medicine, and disease.

Author Notes

Keith Wailoo is professor of social medicine and history at the University of North Carolina at Chapel Hill.

Reviews 3

Publisher's Weekly Review

From slavery onward, diseases real and imaginary have played significant and complex roles in race relations. Wailoo, professor of social medicine and history at UNC-Chapel Hill, focuses on one disease, sickle cell anemia, in one city, Memphis, to fashion a compelling demonstration of how powerful and significant this underappreciated interaction between illness and race has been, in particular tracing a cycle of ignorance of illness and suffering among blacks, to recognition of the reality of sickle cell disease and back to a disregard for black pain and suffering. American discovery of sickle cell anemia in 1910 was followed by decades of obscurity (some doctors simply denied its existence). But a 1934 report that Memphis led the nation with an 11% infant mortality rate was a difficult turning point, eventually leading to medicine displacing cotton as the city's prime economic focus. From the 1940s to the 1970s, there was a growing acknowledgement of sickle cell disease and an increase in medical services provided to the African-American community (though, according to Wailoo, treating sick black children was an easier racial accommodation on the part of the white establishment than acknowledging issues of black power), culminating in the 1972 Sickle Cell Control Act that brought Memphis $500,000 for research. This high point of celebrity and sympathetic visibility contrasted sharply with the 1990s, when medical authorities began again to question the reality of pain inflicted on sufferers by the disease - due, according to the author, to the establishment's increasing focus on treatment costs and the resurgence of stereotypes about blacks and drug use, in particular (unwarranted) fears that prescribing painkillers would lead to drug addition. This unassuming masterpiece of revelation focuses on a new, more precise lens on the intersection of race, illness and politics. (Mar.) (c) Copyright PWxyz, LLC. All rights reserved

Library Journal Review

Wailoo (social medicine, Univ. of North Carolina-Chapel Hill) sets forth a history of sickle cell disease (SCD) from the academic perspective of social medicine. In this overly detailed, scholarly examination, Wailoo investigates the entire spectrum of the social, cultural, scientific, economic, political, and, most especially, racial aspects of the disease. He unifies and focuses his narrative on the underlying health history of black Americans from slavery through current-day managed care and the rise of SCD from near-invisibility to a major national medical research effort. In Wailoo's comprehensive telling, the story of SCD in Memphis is the definitive story of race and health in the United States. It is a fascinating narrative based on scholarly hypotheses that bear hints of an academic dissertation. Nonetheless, the book is recommended for academic, medical, and larger public libraries because Wailoo makes clear how SCD and all the issues surrounding it reflect societal crises at the intersection of black culture and American health politics. James Swanton, Harlem Hosp., New York (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

Choice Review

Wailoo's choice of Memphis as the setting for this detailed historical account of the African American experience with a specific disease in the political, social, and economic context in which health care is provided to the citizens of this country enabled him to present an informative, though unsettling, scholarly account of the African American life experience throughout the 20th century. Wailoo (Univ. of North Carolina at Chapel Hill) traces sickle cell anemia from its lack of recognition and identification as a possible molecular problem to its political significance through decades of abundant funding for research, achievement of "celebrity status" arising from attention by numerous celebrities, and the impact of managed care on treatment of this disease. By looking at the attention paid to health care, race relations, and the socioeconomic aspects of Memphis, he has provided great insight to the history of race relations in this country and its impact on health care. An extensive listing of references, organized by chapter, is included at the end of the book. Sources include a variety of written materials as well as interviews with people directly involved with the search for a means of treating this hereditary disease. Graduate students; faculty; researchers; professionals. V. B. Byers emerita, SUNY Upstate Medical University



Introduction Pain and Suffering in Memphis Throughout history, numerous diseases have been used to draw attention to the African American body and to represent particular aspects of the "African-American condition." In the 1850s southern physician Samuel Cartwright invented "dyaesthesia Aethiopis," a disorder that he claimed caused "obtuse sensibility of the body" and insensitivity "to pain when subjected to punishment" in slaves. The "disease" was a convenient invention, for it could be used to highlight just how different enslaved blacks were from their white owners. Biological difference could be used to excuse plantation whippings and to explain the excessive brutality of slavery.[1] Throughout the nineteenth and twentieth centuries many other conditions, syndromes, and pathologies among blacks--from tuberculosis to venereal disease--have been used similarly to moralize about African American status, sexuality, intelligence, education, or economic condition. Whether these discussions focused on what we term "real" pathologies or invented ones, the discourse of "Negro disease" has always reflected deeper moral quandaries in society. Were black people degraded by or biologically suited to slavery? Was black sexuality a danger to whites and to society? Were black people sicker because they were innately different, or because they were kept socially unequal in America? The stories of particular maladies have been mined and interpreted throughout history because they appear to provide the answers to such questions. The discourse of black disease has often been stigmatizing and controversial, but occasionally narratives of black pathology have also been uplifting. In 1930, for example, a blues guitarist with the stage name of Memphis Minnie brought an obscure disorder into public light, seeking to sow the seeds not of fear or revulsion but of compassion toward ailing African Americans. In her "Memphis Minnie-jitis Blues," the artist Lizzie Douglas sang: My head and neck was painin' me Feel like my back would break in two My head and neck was painin' me Feel like my back would break in two Lord I had such a mood that mornin' I didn't know what else there was to do.[2] In the lyrics that followed, Douglas sang of the excruciating pain of meningitis, the diagnostic confusion of the doctor, and the enduring faith of her companion. The lyrics dramatized a common, often epidemic, disorder in the South, asking the listeners for sympathy and understanding. Depending on the time, the context, and the interpreter, the performance of pathology could point in many different directions. The conception of "racial diseases" has provided physicians, patients, and performers ample, ever-changing material for debating race relations in America. From tuberculosis to venereal disease to meningitis to AIDS, the ways in which diseases are defined, characterized, and dramatized provide a window on social relations and social values. Read the complete introduction . Excerpted from Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health by Keith Wailoo All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.

Table of Contents

Acknowledgmentsp. vii
Introduction. Pain and Suffering in Memphisp. 1
1 Conjurors of Health in the New Southp. 25
2 Race Pathologies, Apparent and Unseenp. 55
3 Remaking Jim Crow Medicinep. 84
4 The Commodification of Black Healthp. 107
5 Sickled Cells, Black Identity, and the Limits of Liberalismp. 137
6 Promising Therapy: Government Medicine on Beale Streetp. 165
7 Pain and Policy at the Crossroads of Managed Carep. 197
Conclusion: Race against Diseasep. 225
Notesp. 235
Primary Sourcesp. 327
Indexp. 329