Made Men and American Skin

american skin

“We will take this ride…across this bloody river…to the other side”

American Skin, Bruce Springsteen

In the United States we are living within a very interesting system of evaluation of the human body where we are always witnessing the intersection of violence and the creation/recreation of identity at the level of the skin. In slavery, it was the pubic display of whipping marks and severed penises placed in the mouths of individuals who were lynched and hanged. In the prison industrial complex, the skin becomes a site for a new text that opposes and parallels the experiences of people who are imprisoned. This has transferred over into music and entertainment where rappers and basketball players – among many other people – are “tatted.” In the early 2000s, then commissioner David Stern ostracized NBA players (who were overwhelmingly Black) for their “ill-fitted” and “hip hop” style of dress. Dwayne Wade, a championship player who is Black, stated in an article that he credited David Stern for his improved dress.

My research over the last few years has focused on different aspects of healing. Within my emerging interest in healing, I have been concerned with how healing and violence intersect. Without fail, when you begin to discuss healing with Americans, their stories about why they need healing or why they choose to heal are related to some form of violence (that has happened or might happen). Meanwhile, the process of becoming healers may be wrapped in the acceptance of violence enacted upon themselves and others. In the case of recent events in Ferguson, Missouri, the epidemic of police violence against Black boys/men has helped reaffirm an impetus to help fix/heal/restore particular aspects of presentation in the United States so that injustices like Michael Brown’s murder do not continue to happen. (Recently, actor Wendell Pierce discussed how he prepares for a policeman to stop him so that he isn’t shot while being Black.)

Indeed, the death of Michael Brown and Eric Garner (and protests following acquittals of police responsible for their deaths) are parts of a LONG history of fire hoses, police dogs, whips, and other weapons aimed at non-White peoples in the United States. It has happened since the 1600s. Historically, violence against Black bodies occurred in “the streets” or in other public spaces (as opposed to much of the violence against Native Americans that took place in private boarding schools). Many historians describe 19th century slavery as it occurred within the gaze of White, Black, and Native American onlookers (Here is a link from the annals of UNC of Southern documents that illustrates the day to day life of plantation observation.)

But how do we articulate the vulnerability of the Black body despite where it is today?

A couple of days ago, Alpha Phi Alpha, a century old Black fraternity, celebrated its founder’s day. I’ve known men who pledged with this Black Greek organization. A couple of them – people I know well – suffered physical pain and humiliation at the hands of the fraternity. They were beaten with paddles. Some of their colleagues were branded with symbols of their loyalty to the fraternal organization. At the end of these initiation processes, they “crossed the burning sands” where humiliation and violence (among other rites of passage) culminated in their births into new “brotherhoods.”

Talk of personal suffering in these initiation practices is largely silenced. These men have been “made,” which is a status defined by the fact that a fraternity or sorority pledge (one who is attempting to join the fraternal organization) has made it through the process of initiation. Black Greek organizations are pervasively violent, as suggested by many stories of violent rituals on American college campuses (Link #1, Link #2Link #3).

Black fraternities aren’t alone in their violent practices. Fraternity hazing experiences define American youth culture across racial lines. I remember stories from a good friend at MIT – who was Korean American – about his biological brother at Dartmouth who was asked to prove his loyalty to the fraternity by allowing a fraternity “brother” to tie a brick to his testicles and drop the brick from a bridge. (A recent article from the Atlantic discusses these issues from the context of White fraternity life.)

Hank Nuwer, an officianado of “all things hazing,” documents myriad episodes of hazing throughout the United States. Most of these hazing rituals, his website suggests, take place in the middle of fraternity initiation where, for whatever reason, individuals are forced to endure something (some form of liquid poured into their mouth, beating with some device, public embarrassment, harassment of their genitalia, etc.). These hazing methodologies are often reminiscent of tactics used by the CIA to torture “terrorists.” White/Euro-American fraternity hazing first rose to prominence in the late 1800s, directly after the U.S. Civil War. According to Nuer, there was never a time when hazing was “legal” or “condoned.” According to his website, hazing is “nearly always against the rules.”

Indeed, what Nuwer’s research points to is the use of hazing in American college life as a preliminary step in more “adult” power broking in American society. In my writing about the cultures of healthcare (in an upcoming book) I discuss how transitions into power within healthcare hinge upon one’s acceptance of psycho-social violence against them in their training. Although, at times, physical violence defines hospital life. A lot of this power play, I suspect, begins within the backgrounds (college and otherwise) of the leaders within different fields in medicine.

Nevertheless, Nuer’s website is very interesting in its scope. According to his records, Black fraternities weren’t caught hazing – e.g. there weren’t incidents of hazing that turned into something “reportable” to authorities – until well after the Civil Rights movement. The first report involving a Black Fraternity, according to Nuer’s website, was at University of Virginia in 1992. (Although, I’ve heard of deaths of Black Greek pledges in the 1970s.) The person who died at UVA, Gregory Batipps, died while driving. His father, a physician, argued that he died because of exhaustion caused by hazing.

In the last 20 years, Black Greek hazing seems to have gotten worse. At each instance of hazing, Black Greek organizations and host universities come out and state, quite emphatically, that hazing is immoral and illegal. However, just below the surface, hazing remains critical in Black Greek life (although folks from the Black Greek world have argued that this shouldn’t be the case).

We must attempt to understand what this fairly contemporary emergence of Black hazing means within the broader landscape of violence against Black peoples in the United States. One might suggest that Black hazing is “kids being kids” in a college environment where Black folks can finally be “normal.” If this is the case, I might make an argument that, in a post-Civil Rights era, Black families and communities continue to adopt White/Euro-American frameworks of “crossing over” into their cultural spaces.

To begin to have this conversation, we must discuss the genealogy of Black Greek life. Let’s use Alpha Phi Alpha for example. Alpha Phi Alpha parades its “7 Jewels” around as the apostles of its brotherhood. The “7 Jewels” were 7 men who, according to Alpha Phi Alpha advertisements, founded the fraternity at Cornell University in 1906. When I was a student at MIT, university parties hosted by Black and Latino students would often include men who pledged Alpha Phi Alpha during their tenure at colleges in Boston. They would often shout “O…6” as a form of reverence for their founding as a study group at Cornell University in 1906.

This beginning must be critically examined. In 1906, the “7 jewels” were connected to organizations like “Jack and Jills” and variations of the Freemasons and Eastern Stars. This Black bourgeoisie (as I call it) first took root in the aftermath of the U.S. Civil War. The first “Black U.S. Senator” was a man named Hiram Revels. His story is a story that I don’t have time to talk about here, but I will assert that he was related to Native Americans in North Carolina who, at the point of Reconstruction after the U.S. Civil War, could not provide Hiram with the proper infrastructure to advance in American politics. Hiram became well known over a decade in which he became the face of Black politics. So, by 1906, the “7 Jewels” weren’t creating some revolutionary method for Black men to survive. They were part of an already established Black political system…a system that hid as much as it helped clarify.

We can’t dissolve or elide this conversation about Black elitism as we begin to understand the plight of mostly poor Black men in Ferguson and elsewhere. The proliferation of Black Greek life over the last century is a symbol of a major shift in American life toward the “haves” and “have nots” in Black America. Tyler Perry, in fact, has a television show with this very title. His show, which is featured on Black Entertainment Television (BET), includes one or two White characters. However, its premise is to depict how American Black communities are divided into the haves and have nots….into the wealthy and the poor…into the connected and disconnected. Many folks in Black Greek life call their “connections” a form of organization. I suggest that they are part of a storied history of indisputable self-segregation of Black peoples. (To help contextualize this frame of reference, please read much of the history about the debate between – in fact, the hatred between – Marcus Garvey and “light skinned” Black leaders like WEB DuBois and Thurgood Marshall.)

Indeed, Black collegiality and fraternity became the language of post Civil Rights America. Recently, Bill Cosby has faced an onslaught of accusations regarding his alleged role in the rape of several women since the 1970s. These new images of Cosby offset the wholesome American image that he created in his hit 1980s television program, the Cosby Show, in which he featured a family, led by a doctor and lawyer, which had major relationships with Historically Black Colleges and Universities. On many episodes, Cosby sported sweatshirts and t-shirts from institutions like Howard, Spellman, and Tuskegee. Meanwhile, many folks pondered why Bill Cosby never let his fictional children interact with or talk about the other, less privileged parts of New York outside his upper-class neighborhood in Brooklyn in the middle of the Crack epidemic and Reagan’s “War on Drugs.” (Here is the link to a great article on Cosby, race, and class…where a great book from 1992 – Enlightened Racism – is referenced.)

So as we ponder the nature of violence against the preciousness of life for which we write out hashtags such as #blacklivesmatter, we must not forget to ask “what’s the matter?” with these same lives. The cultural conditions of privileged Black lives may hide what would, in the “streets,” seem like injustice and immorality. There are dozens of stories – from the 1990s, 2000s, and now the 2010s – of rampant violence against Black men and women within the elite space of the university vis-à-vis Black Greek life (as evidenced in three links above). Perhaps folks feel like the tradition of the university, as an already privileged space, doesn’t allow them to question how violence and re-segregation occur in today’s university. But this conversation is vital.

I’m left with this sour question: isn’t it a bit ironic that most Black fraternity violence began to take place after the end of American segregationist policies?

Perhaps the Black Greek paddle is the university’s version of the police baton or 9mm. I can’t imagine what must be going through the head of an 18 year old African American kid at Cornell University today? He already feels like White people think he shouldn’t be there – heck, some Black folks probably think he doesn’t need to be there – and it is suggested that he can’t really succeed unless he partakes in fraternal rituals. In these rituals, his skin may be (and often is) exposed in his attempt to be accepted. Is there safety in this acceptance? Well, I’m sure there is some perception of safety. But skin doesn’t lie. Like on the plantation, the public value of abuse cannot be underestimated. Back then, society covered up the immorality of the abuse of Black men and women by referencing scripture and law. Today, I’m persuaded that violence among privileged Black youth in college is seen as more of an accessory. It is not. It’s systemic. It is here to stay. It speaks of deep seeded political and economic issues.

Nevertheless, brute acts against the Black body are worn as trophies.

So we must ask what the skin means in today’s conversation about systemic abuse, institutional racism, and the reality that perception is more critical than ever before. You know your racialized body is perceived in certain ways. The perception is that you can’t get out of those systemic racial perceptions unless some smaller community perceives you as loyal. Then, in being “made,” you hide particular marks and reveal others. All of them – the ones you want and the ones you don’t want – are part of that “bloody river” that we are still traveling across. They are part of all violence against Black peoples. May we obtain bravery to acknowledge this.

Word on the Street: Ferguson and UVA in our crosshairs

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Lee Baker, professor at Duke University, describes the distinction between sociology and anthropology. He states that, in the early 20th century, anthropology was distinguished from sociology by an understanding that anthropologists study people and things that are “out of the way.” Sociology, he argues, studies things “in the way.”

Indeed, sociology must be praised for its ability to stand in the gap for peoples who are overtly oppressed and ostracized within the United States. However, although aloof, anthropology has been wise to maintain the importance of ensuring that stories of human tragedy and suffering throughout the world are parts of larger narratives of sociality that span human experience. Anthropologists study race, indigeneity, gender, and other universal human ideas across national lines and within a largely global and trans-human context. That is why, at the beginning of most introductory anthropology classes, you will probably see videos of some ape or gorilla along side stories of far away lands. Anthropology, by and large, is the stranging (“queering” is a popular term today) of most anything. Anthropologists make things strange so that, in that strangeness, we can begin new conversations about human realities.

That’s why I’m interested to hear how anthropologists respond to the current proliferation of events in Ferguson, MO and the strange ways that the ebbs and flows of violence (between police and black men, for example) dance with other major events in the early 21st century in the United States. Watching the news media in these last two weeks, for example, we have heard very little about the “war on terror.” In fact, in the midst of the tension in Ferguson, the U.S. Secretary of Defense left his office.

We also haven’t heard from alternative places of oppression. For example, we don’t see signs in the midst of the Ferguson riots from “Gays for Ferguson.” We don’t see rallies of Native Americans against the rage of police terror against Black men in Ferguson and in many other cities across the United States (although much of this violence mirrors what was happening to Native Americans up until the 1990s). We don’t see hospitals in America placing posters on their doors asking for there to be “Justice for Mike Brown”, even though practically every hospital argues that it is the site and source of “health” and “wellness” for its clientele. (Walgreens…is the “corner of happy and healthy” in Ferguson?)

Where is the unification between different oppressed peoples? Well, different types of oppression often have dissimilar access to “the system.” My friend texted me a great quote from a radio station in Southern California in the midst of the Ferguson Riots: “White rage is in the system. Black rage is in the streets.” This is excellent! But I would modify it a bit. Certain people are able to “rage” in the system. Other people are forced to rage in the streets. We can’t always base this location of rage on race or other normalized categories. For example, we know, post-Katrina, that certain Black peoples had access to certain resources and influence when other poor Black peoples became victims of chronic displacement.

Nevertheless, it seems like West Florissant isn’t the only street in America that is being defaced in protest. Lakota youth in the Dakotas and Lumbee youth in North Carolina are patrolling their community spaces with spray paint and guns. Protestors at the University of Virginia march down fraternity row to bring attention to rape.

And it is important to see how tentacles of “the system” reach into “the streets” during these moments. In Ferguson, police, missionaries, and humanitarians are face to face with the realities of the urban ghetto everyday. Deans at America’s universities attempt to preserve fraternity life while they assuage raped women after decades of silence. What we see in the streets of Ferguson – as evidenced by the decoration of local police and military as peacekeeping forces (see picture above) – is a conversation between the streets and the system. What we see in the streets in the University of Virginia – as evidenced by strange gestures toward the safety of female students – is a conversation between the streets and the system.

Battling against Molotov cocktails that are thrown from “agitators” that look for a place to express grievances. Defending the reputation of UVA against Rolling Stone articles that shed light on fraternity row and the legacy of oppression at UVA. The streets are alive and well.

We do need to save Black men from the terror of police in their neighborhoods. We do need to save vulnerable women from being raped in fraternities. However, I would argue that post-Reaganomics frameworks about the need to fix the streets dismiss the extreme value of the streets. The streets in Ferguson remain a space where White power, cloaked as militarism, is continuously identified (the amount of video footage of police brutality on the internet is astounding!). The streets of UVA remain a place where White power, cloaked as “liberal arts,” is questioned like never before.

So as we wonder why Ferguson was the wick that ignited an explosion of protests across the United States, perhaps we should consider what we (anthropologists) don’t understand about the importance of the streets around and between our academic homes. Sociologists get it a little better than we do sometimes. However, sociologists can profit from conversations with us. As they (sociologists) are more inclined to be “in the streets,” we (anthropologists) can help them become more conscious of the topography.

Beware the military industrial complex

“Beware the military industrial complex”…these were the words of President Eisenhower in one of his last televised speeches. Today, these words are truer than ever…and they are shown to be prophetic in the strangest of ways. Here was a post that I placed on Facebook during the height of the crisis in Ferguson, MO. My references to “Lumberton” and “State Trooper Covington” make sense to folks from the community I grew up in:

8/21/14:

Just a thought before I get some rest. Today has been tough intellectually. How do we describe the chaos and turmoil that faces us in the next few weeks?

In particular, I’m concerned with the future of policing. Back in the 90s, police officers were, for the most part, an eclectic bunch. I remember the band that the Lumberton police used to have. They were diverse. State Trooper Covington (whose son, I believe, became a trooper) was known as a career trooper. Many police officers were like this.

In the last decade, this model has changed. We have a generation of young men (and women, possibly) who have been tasking away in the heat of the Middle East. They are crafted soldiers,meticulously groomed for global combat. These folks are steadily becoming the face of our domestic safety. They bring with them expertise and flexibility. They also bring with them great pain.

Many are hurt because they have lost a decade of their life in the midst of vipers and sand storms. They have seen death and mayhem. And they come to the US (their home) and they seek the fulfillment of that mission.

I’m afraid – seriously afraid – that their wrapping up of their careers in roles as domestic keepers of the peace is not easily separated from their roles as global soldiers. I don’t know if they have been/can be given the space to make a transition from soldier to peace officer.

This is pressing me, obviously, after what we have witnessed in Missouri. There are a multitude of homemade videos that show policemen who too easily use military tactics on US citizens. This makes some of us think that they are evil. I suggest that we may want to consider them under the influence of their captivity in global warfare.

Just a thought. It would be nice to hear them talk about it.

I’m writing some stuff about the current era of medicine. Like these soldiers turned cops, healthcare professionals often have a hard time making transitions into being healers. They have undergone so much pain (medical education isn’t pretty) that they enter medicine with indifference and animosity.

We must heal those people in charge of our healing – cops, doctors, pastors, etc – lest they continue to act inappropriately.
Yes, cops in St. Louis have murdered just like doctors error in their medical practice. Both situations are the condition of deep, historical pain. We must try to fix this.

Who’s saving your child’s life? (or, Why Native American mascots must end)

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Dan Snyder, the current owner of the Washington “Redskins,” defends his team’s mascot in very bipolar ways. On one hand, he states that the Redskins mascot is just a symbol…doing no harm to anyone. Days later, he states, in very emotional rhetoric, that his dad spent months (if not years) seeking the right image among tribes in the Western United States to make the current image of the Redskin on his team’s helmet. Dan Snyder’s racism – yes, Dan Snyder is racist – is bipolar because it attempts to offer up the extremely emotional and the extremely indifferent (simultaneously!) all for the purposes of maintaining status quo.

The fact is, mascots dehumanize the people that they represent. In one way, mascots misrepresent the dead. They aren’t historically accurate.  In another way, mascots take living people out of our collective senses of reality. They make some living people obsolete and unimportant. 

The sports culture in America is on a mission to be victorious and maintain team pride (read: national pride) for the sake of a paying public. That’s why many folks in Washington DC and other large sports cities describe their areas as “Redskins Nation” and “Red Sox Nation” (for examples). These teams, in their aiming for victory, help perpetuate a psychological hunt. This isn’t lost on older Americans, many of which were born and raised in the early to mid-20th century when sports and war were simultaneous. A great book titled SHOWDOWN by Thomas Smith discusses how Americans clothed themselves in the veneer of Redskins (and Cowboy) fandom while the United States was at the brink of nuclear warfare with Russia and in the middle of the war over Black civil rights.

Recently, both Mike Ditka (famed Chicago Bears coach) and Ted Nugent (a formerly popular musician) have stated explicitly that Native American activists are in the way. While Nugent told Native Americans in the Great Plains that they should “go back where they came from,” Mike Ditka has stated with certainty that activists against the use of the “Redskins” mascot by the NFL are out of their mind. Both men make Native Americans out to be antagonists of a nationalistic, sports-centered ethos. In their minds, this is America, and it will always be America…and Native Americans ought not mess with that. 

Stephen Carter, a faculty member in the Law program at Yale University, wrote an article (link here) titled “Hail to the Lumbee” that suggested that we might consider changing the Washington DC football mascot name from “Redskins” to “Lumbee.”  I thought it was ironic that Stephen Carter is Black. I know the Ivy League system quite well. His role as a Black faculty member at Yale is surprising in its own right. Beyond that, however, I am surprised by his use of his role as a Yale faculty member to provide propaganda for a major news outlet without any interrogation of where and for whom he writes. I was surprised that he, a Black faculty member in the Ivy League, would be insensitive to the racial plight of Native American people.

Mr. Carter’s article showing up in the Chicago Tribune is possibly purposeful. Chicago is in the state of Illinois. The University of Illinois has made it no secret that they are protecting the “Chief Illiniwek” mascot for their mostly White alumni base. The Chicago Blackhawks organization has, overwhelmingly, ignored how its use of the Blackhawks logo helps celebrate a quite brutal history of Indian genocide and removal in the Chicago region. The Chicago Blackhawks fan base is multi racial….and you should not be surprised to see people from the nation of India wearing tshirts and other garb that have the word “Indian” and pictures of feathers on them. It shows how the colonial conquest of Columbus has been fulfilled. 

I think about the arguments that are made by pro-Redskins folks about why we should allow the continued use of the “Redskin” as a sports mascot. Their arguments, often, discuss how Native mascots are used to honor the “bravery” or “history” of Native American people in the United States. Mr. Carter, in his article in the Chicago Tribune, states that this should be considered as we continue to use Native American mascots.  In his description of why the Washington mascot should be changed to a Lumbee, he writes about how Lumbee people are brave, smart, savvy, determined, etc. He discusses their education and political determination. Mr. Carter goes as far as using the example of Sean Locklear, a Lumbee Indian football player. Sean Locklear, he suggests, played for the Washington Redskins for a number of years. So, in Mr. Carter’s opinion, we should take that as an affirmation that Sean Locklear (and his people) would endorse such a move to make Lumbee people a mascot. 

In attempting to comprehend the idiocy of Carter, Ditka, and Nugent, it is apparent that they see racial segregation and racism as systemic and systematic processes that only affect Black and White peoples in the contemporary world. They live in a faux-tolerant society that would never tolerate a football team that celebrates the bravery of Black slaves. (I can see it now, a bright green and red helmet with a black man emasculated under chains).  Americans can’t (or don’t) comprehend that the “Redskin” and every other Native American mascot is a token of American victory over the Native american body and mind. While the White pattern of thought is to say that Native American people were brave, we know that Native American men often posed with government photographers after months and years of accepting the conditions of war. They were handed medals, which were dual symbols. On one hand they symbolized “peace.” On the other hand, they were an inverted trophy, given from the victor to the loser in colonial battle. 

Indeed, what is forgotten in all the debates about the Redskins mascot is how we tend to glamorize the assassinated, the victimized, and the publicly shamed. We think that Black Americans shouldn’t riot like Malcom X. We think that Martin Luther King provided a better example of how the racially oppressed should act. With the CIA and and every other soul stealing spy agency on his back, Martin Luther King was depicted as a stoic martyr. Similarly, sports fans, when questioned about the use of the Redskin, state that he (the “Redskin”) represents the brave Indian…the one who was proud of his fight until the end.

In the meantime, little Black boys and little Indian boys don’t carry with them the same stoic looks. They are often angry and hostile, and their disruptions as living peoples is anything but acceptable within American society. They are often told that their “attitudes” and demeanors ought to be more respectful and pleasant to look at. 

Yet, what if that little boy is smart and able to make his way through medical school? (I’m keeping the gender theme going here because the Washington “Redskin” is male.) When working in DC two years ago, I tended to ask many of my colleagues (in a local hospital) about their appreciation of the Redskins. Many of my Black colleagues would easily put me off by stating that they were “part Indian.” My White colleagues would easily put me off by stating that “history” was “too big” to change. I asked them if their token Indianess or their incomprehension of history could make sense of a Native American doctor coming into a Washington DC hospital. “What would happen to them?” I would ask. “Could they be Native American and be a doctor?”

I said to one of my colleagues, “Try to understand what would happen if a Lumbee man was a doctor in the DC area and had a child patient ask them what they were. Consider what may happen if that Lumbee doctor said ‘Native American.’ Then the child said, ‘like the Indian man on the helmet.’ Then think about the way that this doctor would be perceived. We hope that the Lumbee doctor would break stereotypes. However, it seems more plausible that the child wouldn’t be able to comprehend a ‘real’ and ‘live’ Native American when all they know is Black and White fans at Redskins games dressing up in faux feathers and face paint on Sunday afternoons.”

This was my example…and it depended on my breaking the Native American doctor out of the feathers and stoic face…out of the death and disfigurement…and making him important within the context of treating a child in an emergency room situation. To exist as real people, Native Americans can’t continue to exist on a helmet or jersey. They can’t be stoic. They must be allowed to live in the here and now as fully animate and comprehendible human beings.

They may be saving your child’s life. 

 

Healing the Healers

This past winter, a train in Chicago derailed because the conductor suffered sleep deprivation. One of my colleagues at the Chicago Medical School (part of Rosalind Franklin University of Medicine and Science) stated that this should not be frowned upon: “Physicians and medical students work with no sleep. But you still want them to save your life.” I paused for a second. “You are really going to make that argument?” I asked. “Of course,” she responded, “you expect the healer to treat themselves as if they don’t matter…as if their lives aren’t important.”

The conductor of the Chicago train did not simply have little sleep. For example, she may have been working three jobs to pay enormous debt and care for a sick mother. Similarly, derailments in medicine aren’t simply caused by miscommunication in a particular situation or other transitory social factors. Incidents, tragedies, and insufficiencies in medicine are often part of deep histories and complicated cultural conditions.

In the last decade, the concept of “Social Medicine” has gained traction. Within the standard model of “Social Medicine,” healthcare professionals are asked to interact with patients and healthcare subjects in a way that allows the healthcare professional to “assimilate” these interactions into the worldview of the healthcare professional.[1] In other words, doctors, nurses, and most everyone else in healthcare are asked to be culturally competent, sensitive to a patient’s social context, and open to alternative ways of thinking about the health of a human being.

It strikes me, however, that there is very little conversation within “Social Medicine” about who these healthcare professionals are. Where do they come from? What makes them tick? How are they made unhealthy within their journeys into medicine?

Medical schools continue to be places of status and privilege. Certain students have certain resources, connections, and privileges that other students do not. These resources, connections, and privileges are often generated through particular communities, clubs, and racial affinity groups that other students are not members of. Students who lack relationships within these communities, clubs, and racial affinity groups often endure alienation before and during medical school. Additionally, medical schools tend to emphasize certain learning skills, often as a means to prepare students for standardized testing, which do not usually align with medical students’ personal learning styles. Their personal learning styles are often products of cultures and heritages that are otherwise applauded by administrators at many medical schools as “diverse.”

Medical schools praise a small cohort of “diverse” students who make it through numerous obstacles on their ways to becoming physicians. The presence of these students in medical schools is supposed to illustrate a changed political and social climate where the best physicians are being trained. But why is this diversity important?

I strongly believe that the contemporary call for diversity is a passive response to urgency for authentic communication in healthcare. At Rosalind Franklin University of Medicine and Science (RFUMS), my home university, I advise and mentor students who are at the beginning of medical school. In this role, I recognize that students coming into medical school from various backgrounds often prepare for their roles as future physicians as if they are neutral positions from which they may begin to decipher the peculiarities of the lives of their patients. But I find that I must consistently persuade my students that their care of patients takes place within highly social contexts. It’s not as if social conditions stop affecting the health of the patient once they enter a hospital or physician’s office. It’s not as if the physician somehow turns off their biases and intuition. Who and what stands before a patient – in the form of a physician or other healthcare provider – helps determine a patient’s health.

Recognition of these truths is empowering. It makes it OK for a physician to be able to speak from their wealth of experiences and not be silenced by an unwarranted objectivity that places biases, non-medical intuition, and general senses of heritage on the periphery of medical care. But to be comfortable speaking in these ways as physicians, students must begin their medical training in the midst of difference and debate that only comes from bringing students from different vantage points and learning styles into medical school.

In that context, medical school admissions becomes a critical point of reflection in the medical educational process. When I first arrived at RFUMS in 2013, I attended a meeting about a Supreme Court case related to university admissions. One of our university administrators stated that use of any racial quota had become illegal. I told this person that I would never suggest a racial quota. Rather, I suggested, we ought to emphasize a connection between certain communities that are defined by certain healthcare disparities and the students who are most likely to research, treat, and eliminate these disparities. To make these changes means that we have to reconsider how medicine is kept alive in its current formations.

I lived in North Carolina for much of my life. My home community – the Lumbee Indian Tribe – prides itself on a long history of creating doctors. As a youngster, I knew that there were two medical schools that “we” attended if we wanted to go to medical school: UNC-Chapel Hill and East Carolina University. Other medical schools were off limits, it seemed, because “we” weren’t educated at these schools. Wake Forest University School of Medicine, in Winston Salem, North Carolina, is a great example. This university was well known for its history of admitting and educating several generations of physicians (sometimes 4 or 5 generations!) within White families in North Carolina. Years later, when some of my undergraduate classmates from MIT began reporting on their experiences applying to and attending various medical schools, it became very obvious that Wake Forest School of Medicine is not alone in its affinity for students who come from families of physicians.

Medical universities such as Wake Forest understand that they will not have to extend extra resources to students from these “legacy” families because there are mechanisms built within these families that guarantee success in medical school. Historically, “legacy”- which might be described as familial and community propulsion into and through a particular situation – has overwhelmingly helped White students. In recent decades, the “legacy” system is mirrored in a small number of American Black families and in some South Asian communities.

This presses us to consider a very important anthropological concept: recognition. I often think about how a baby stares at a human face. From a very young age, they look at faces in order to establish trust. They do not lose that mechanism for building trust on their journey to adulthood. Humans see faces. Humans learn to trust people in particular moments of identification. And to think that this somehow stops within medicine is absurd.

Thus, we must prepare our students as if they will be recognized beyond the authority of their white coats.[2] There is an assumption within medical education that physicians are people who are legitimate simply because they have finished the academic work necessary to claim an identity as MD or DO. No, healing, like any human action, is context specific. It is culturally situated. It depends on the person being healed, and the person healing. Therefore, medical universities must create educational programs aimed at placing patients with particular cultural needs in contact with healthcare providers who possess particular cultural backgrounds.[3] To create these new programs, however, medical schools must identify and equitably address gaps in status and wealth between students.

This brings us back to economics. The people who likely have the most affinity for particularly underserved populations tend to be the most vulnerable students in medical school classes. Some medical students (usually those described as “diverse”) move through their education against the grain of a historic trend of students advancing into important social positions who are connected to a wealth of resources. If you listen to students who are not “connected,” their stories are often similar. Not only are they often not wealthy, they often possess educational backgrounds that were not supportive of their long-term achievements. Their families and communities care for them, but these families and communities tend to understand very little about the conditions of a medical student’s life. As a result, we should not be surprised if these same students are torn between medical specialties that allow them to practice with their communities and other possibly more lucrative, possibly more alienating medical specialties. Pressure is placed on medical students by other members of the medical community (including their classmates) to seek out the most profitable specialty as a demonstration of machismo and prestige. Still other students begin to look at their careers in medicine as a mechanism to truly deal with a legacy of poverty and disenfranchisement.

On that note, it is saddening to see that some of our students are educated in poverty. How does this poverty look? Many “diverse” students must pay attention to families and communities that pull at them for help in the midst of heavy medical school course loads. Additionally, the $20,000/year stipend from their gargantuan medical school loan does not make up for deep, historic poverty. As a result, they may not be able to afford the study aids necessary for successful completion of medical school practicums.

These are frightening propositions. There is an economic force – which helps energize the “legacy” that I mentioned earlier – that creates a scenario in which simply matriculating into medical school isn’t enough. The medical school of the future must incorporate a new type of community in which future physicians are valued, protected, listened to, and enabled to educate one another on the truths that come from the collaboration of different peoples within the university.

Very simply, a future with “Social Medicine” means that the healers must be healed. We must address the social conditions of medical professionals before they can adequately address the social conditions of their patients. We must be honest about how particular parts of medical education in the United States are diseased. We must use “Social Medicine” as a harsh light that reveals and heals in the selection and creation of the physician

[1] Kothari, K. The Case for Social Medicine. JAMA. 24 June 2014

[2] Over the past decade I have worked in pharmacy as a “pharmacy technician.” I

once heard an executive for Walmart’s Wellness division tell a pharmacy student

(at the store for a volunteer health day) that she should have confidence by saying:

“You wear the White coat, not that person you are helping. You are the authority.

You are the expert. Act like it.”

[3] Some notable exceptions include The University of Minnesota’s Medical School at

Duluth and East Carolina University, both of which have shown a major

commitment to educating Native American physicians.

Protecting Tobacco Road

UNC football

There are four major universities in North Carolina: N.C. State, UNC, Duke, and Wake Forest. These universities make up “Tobacco Road.” However, I think “Tobacco Road” extends beyond these four schools to include those universities that have constructed sports powerhouses on top of legacies of racial subjugation. In many ways, the “masters” or “planters” of the old plantation have been replaced by university administrators.

I began thinking about this in recent weeks in the aftermath of the UNC reading scandal. At the center of this story is a certain conversation about race. Most of the athletes implicated are Black. The Black Studies Department at UNC was a major part of the miseducation of UNC athletes. Additionally, surrounding UNC athletics, there is an oligarchy that will not give up power over the racialized body.

Let’s talk about how this system is protected.

I loved attending UNC basketball games as a graduate student between 2007 and 2012. However, I realized that social and racial hierarchy defined the Dean Smith Center (where the UNC basketball team plays). After standing in line for 2 hours to get a decent seat in the student section of the Center, and upon taking my seat in the student section, I observed the “wine and cheese” club. The members of this club walk out onto the floor minutes before tip off.  The rumor is that they enjoy wine and cheese before home basketball games. These “wine and cheese” members are special donors who have a special relationship with UNC athletics. They are overwhelmingly White (I think I saw a Black person one time). Most are over 40 of age. Yet, on this floor and on the football field, Black athletes formed the nucleus of the game. Black bodies were, overwhelmingly, the objects of sports spectacle.

UNC, like all of the universities on Tobacco Road, is part of a ‘crib to professional sports’ pipeline where Black athletes are often not expected to achieve core competencies in the University. I have to admit that N.C. State and Duke seem to not fit this mold so much. They push their students to take legitimate classes and some of them graduate in 3 or 3.5 years. Nevertheless, mostly Black players in most of these universities go from playing under the control of White university administrators to being the property – literally, the “property” – of White owners in the NBA or NFL. (Have you ever watched an NFL combine? They resemble slave markets.)

It is important for us to consider how this economy of athletics in American universities is aided in quite substantial ways by the racial segregation that still defines life in the U.S. South.  In past decades, UNC students have begged university administrators to remove the secrecy about the conditions of racial servitude at UNC. The University proudly displays two statues very close to one another in the main courtyard beside Franklin Street in Chapel Hill. One statue is a confederate soldier: “Silent Sam.” Another statue, titled the “Unsung Founders Memorial,” incorporates tiny figures of Black people holding a slab of granite. It supposedly pays homage to the history of the work that Black folks (slaves and non-slaves) did to make the university. But it is 10% the height of Silent Sam. It is relatively invisible.

This secrecy and invisibility doesn’t just define UNC. I interviewed for a faculty job at University of South Carolina a year or so ago. I was overcome by the fact that the campus is an old Southern plantation. The University President stays in a house in the middle of the campus that is akin to a plantation “big house.” A local hotel – where interviewees stay during their interviews – proudly displays a diagram of the plantation farms that surrounded the University of South Carolina over 150 years ago. When I asked faculty and Administrators at the University of South Carolina about this proud display of the plantation landscape, they dismissed me entirely.

In conversations with barbers in Winston Salem, North Carolina, I heard many stories about how police around Wake Forest University protected a line between poor Black communities and the overwhelmingly White student population of Wake Forest. Speaking about growing up around Wake Forest University, a local barber told me that “they would patrol that intersection at Cherry Street…if you went left…(onto what is now University Parkway)…you would be stopped…no questions asked.”

photo

He and his fellow Black barbers grew up in a particular type of segregation. They could go practically anywhere they wanted to…but just not there.

The “patrolling” of these universities is a significant area of inquiry, especially in the aftermath of several murders in and around UNC. After the murder of UNC student Eve Carson in March 2008, the UNC community reacted with feelings of great fear. News specials showcased Eve Carson, a White female, as an angelic figure. UNC community, in particular, emphasized her role as student body president and lost gift to society. Even after police discovered that one of the men who murdered Carson (both men were Black) was responsible for murdering Duke graduate student Abhijit Mahato, a citizen of India, it was Eve’s image that defined a culture of fear, vigilance, and healing in central North Carolina.

I returned to these quagmires after the murder of Faith Hedgepeth in Chapel Hill in 2012. Hedgepeth’s murder did not drum up the same sense of concern as Carson’s death did in earlier years. Hedgepeth – a UNC undergrad, a Native American, and a future doctor – still lies in limbo. Her murderer has not been found. Some people question if justice was sought for Faith Hedgepeth like it was sought for Eve Carson.

All of these issues point us toward a serious conversation about our different human values within American society. We often don’t want the things that pull at our heart strings and our senses of pride to be challenged. We don’t want to think that our universities are running modern day plantations. We don’t want to consider how the UNC community did not bemoan the death of Hedgepeth like it bemoaned the death of Carson.

In recent weeks, Mary Willingham, the tutor who broke the story of UNC’s unwillingness to ensure the educational standards of mostly Black athletes, has come out and stated that she will accept the backlash for speaking out about the conditions of oppression that defines UNC athletics. However, we must think beyond this particular story. We must attempt to define the powerful fist that came down on Willingham’s head. And we must ask several questions:

- How does this fist mirror the silence around the murders of particular people?

- How does this fist uphold the image of others?

- And, maybe more importantly, why and for whom is Tobacco Road protected?

Now Available at Walmart

A recent article in the Indian Country Today discusses the fact that Walmart will sell Native Threads clothing. One quote from this article sticks out like a sore thumb. It comes from the CEO, Randy Bardwell:

Native Threads is different because we aren’t a tribally operated business and we don’t have financial backing from tribes…We are a true entrepreneurship and went out to find money from the private sector as most entrepreneurs would.

As a Lumbee Indian, I always second guess my use of the word “tribe” in describing my membership to a Native American community. Back home (in the Lumbee community), when people say “tribe”, they reference some political/governmental entity that does not encompass the experiences of everyday life. I’ll be writing more on that in my upcoming book on Lumbee healing. However, for now, let’s start with the principle that the notion of tribe is very unsustainable as scholars of Native American envision it.

Why am I talking about this now? Well, along with the recent article on Native Threads, I found out that Mike Green, a highly regarded White historian of Native America, died recently. During graduate school at UNC, I encountered Professor Green many times. I remember one of my most troublesome encounters was after a presentation before a colloquium of Native American Studies scholars at UNC. I don’t remember what I was presenting (this was in the middle of my graduate career, which is always a place where you are constantly developing your argument), but I had made a statement to the effect that we must stop regarding Native Americans as simply tribes. Green, who walked in late, heard this statement. He raised his hand immediately after I was finished and said “If Natives don’t exist in tribes, how do they exist?” I smiled – I could feel my teeth gleaming – and I answered in a way that historians probably hate: “Historians started this tribal paradigm, now someone else must clean it up.” Yes, I know anthropologists love tribes – we study them all over the world – but ask a historian to explain Native America and they are always searching for a tribe. It’s almost as if, within history, all of these tribes are the actors.

You miss the individuals. You miss agency.

Whether in academia or outside academia, everyone identifies Native America through a tribal context. And I can understand how this is empowering. To keep the wannabes out, you have to set up particular barricades. I do it myself. I get people all the time who email me with inquiries about my take on Lumbee history and genealogy, and I am aware that I cannot fully open up to them. Why? Because there are things that only we know, and there are things that I share. I have to be careful about how I share.

But it should be no secret that for years Native American people have been traveling in and out of Native American communities, and the impetus within academia and U.S. society has been placed on preserving the tribe from which they come or within which they find a community. But what happens when Native Americans leave? Seriously, does the tribe somehow still own them? Or, maybe more accurately, does the tribe sit as the indefinite originator of authenticity?

For many, many Native Americans, the “tribe” isn’t the world. It’s an important component of the Native American world, but it isn’t the Native American world.

One of the most troublesome parts of the U.S. past is the fact that the Trail of Tears left many Native Americans while it took away so many other Native Americans. The Cherokee Tribe, as a massive economical force, carried a federal target on their backs because they stood in the way of American expansion and utilization of land in the U.S. South. On the other hand, from Georgia to Virginia, Native Americans thrived until the Civil War. Out West, tribes became codified by the Federal Government. Choctaw, Cherokee, Osage – – they all became these cartoonish elements through which the U.S. Federal Government and everyday citizens could put Indian people in their place. Back East, Lumbee people continued to regard Cherokees and other removed tribes as pitiful and in need of help. There is a long history of Lumbee aid to Native Americans out West (which I am writing about in my upcoming book).

But as we witness the political debacle that is tribal politics in the Lumbee community and beyond, we must remember and appreciate how Native American people have been the ultimate hustlers (to use a term commonly used in the United States today). Name an industry – from early colonial carpentry, to alcohol distribution, to healthcare in the 21st century – Lumbee people and members of other Native American communities have been highly agentive in these industries. They have been major players in these economies in these particular historical periods. They were and are entrepreneurs. They haven’t had tribal backing. Why would they want it today?

Now, this isn’t to say that they don’t want the Native community to support them. No, much of their success has been within Native communities. However, the “tribe” hasn’t been a central component in their success. Native Threads has amassed a great clientele at Native American conventions like the Gathering of Nations. Spaces and places like this are where Native American entrepreneurs bloom and showcase the power of Native American community that isn’t tribally centered.

However, I think that this approach to appreciating Native American agency doesn’t only provide a nice sound bite, it bucks against the “nation building” and anti-colonial rhetoric that defines the center of Native American, American Indian, and Indigenous studies today. It allows the Native American physician to see themselves as credible and abled caretakers of communities beyond their own. It sets up a scenario for a TV show in the future about Native American housewives (I’m just saying!!).

This is the beginning of an important conversation that breaks us from impoverished pictures of Native people. It demystifies Native American conditions, especially within the tribe. It makes Walmart a much more interesting space of inquiry.