Black Bodies, Black Pain: (In)difference, Disparities in Medical Care, and the Legacy of Dysaesthesia Aethiopis

“If you are silent about your pain, they’ll kill you and say you enjoyed it.” – Zora Neale Hurston

A study by Dr. Robert Fortuna of the University of Rochester has found that Black children brought to the ER for stomach pain and cramps were less likely to be prescribed pain medicine than white children with the same complaints. In an earlier study, he found similar patterns in the treatment of adults across racial and class lines; that is, patients of color (particularly Black patients) and/or patients from low-income households were less likely to be prescribed strong pain medications such as opioids. This possibly speaks to the ways that racism and classism structure healthcare disparities, and the way that the medicalization of Black (and brown) bodies has served to further deny our lived experiences and capabilities to feel pain.

Another study, conducted by Anthropology student, Jason Silverstein found that white-identified subjects, when shown pictures of white subjects in pain versus Black subjects in pain, perceived Blacks as feeling less pain. This is hardly surprising in light of a history of the medicalization of Black bodies. For example, J. Marion Sims, a white man experimented on the enslaved African woman we know as “Anarcha” 30 times between the years 1845 and 1849 (in addition to experimenting on the bodies of enslaved African women by the names of Betsy and Lucy and 8 unnamed others), making advances in the study of gynecology.

Two years later, U.S. physician Samuel Cartwright (who also proposed that “drapetomania” was a mental illness afflicting enslaved Blacks, which caused them to desire to run away) used the term “Dysaesthesia Aethiopis” to refer to the supposed insensitivity of Black bodies to pain. The cure, according to Cartwright was the cleansing of Black skin, the beating of still-wet Black skin, and (forcible) hard labor under the sun.

“The best means to stimulate the skin is, first, to have the patient well washed with warm water and soap; then, to anoint it all over in oil, and to slap the oil in with a broad leather strap; then to put the patient to some hard kind of work in the sunshine.” (quoted from, Arthur L. Caplan, James J. McCartney, and Dominic A. Sisti (2004). Health, Disease, and Illness: Concepts in Medicine. Washington, D.C.: Georgetown University Press. p. 35)’

Since then, Cartwright’s supposed illnesses “drapetomania” and “dysaesthea Aethiopis” have been debunked as racist pseudoscience, but their legacy continues on in the form of diagnoses and treatments that place the blame for the effects of social ills and structural inequalities on the brown, poor individuals. It continues in the convergence of the medicalization and criminalization of Black, brown, poor, queer and disabled bodies.

In previous work, I’ve emphasized the central role that the exploitation of Black and brown bodies has played in medical advances. Whether it’s the Tuskegee Syphilis Experiment (1932, 1947) or the use of Puerto Rican women as unconsenting subjects to birth control testing by Drs John Rock and Gregory Pincus, whose experiments were funded by the U.S. government (1954-55). Black and brown bodies have historically been subjected in the name of scientific and medical advances. In the 1950s in St. Louis, Missouri, the U.S. Army conducted experiments wherein they released airborne chemical compounds (zinc cadmium sulfide) into schools and housing projects in majority-Black areas of the city (termed “a densely populated slum district” in the memorandums) to test the effectiveness of the compound in delivering doses of radiation among large populations (the result is that residents have suffered from bone, liver and lung cancers.)

…but whose blood is spilled most?

Yes, “we all bleed the same color,” but some of us bleed more. Here, I emphasize the importance of being critical of these liberal flourishes that elide constructed differences and demand homogeneity where there is none. We can conflate equality and sameness, but that won’t change the (often denied) lived realities of those harmed by structural and interpersonal racism, classism, ableism, heterosexism, transphobia, homophobia…

Related Reading:

• Smedley, Stith, and Nelson (eds), (2003) “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” (book preview)
• American Medical Association, “Segregation, Civil Rights, and Health Disparities: The Legacy of African American Physicians and Organized Medicine, 1910-1968” (a brief timeline of Black American contributions to medical care and research)
• Dr. Samuel Cartright (1851), “Diseases and Peculiarities of the Negro Race”
• Allan Brandt, “Racism and Research: The Case of the Tuskegee Syphilis Study” (link to accessible PDF)
• Durrenda Ojanuga (1993), “The Medical Ethics of the ‘Father of Gynaecology,’ Dr. J. Marion Sims” (link to accessible PDF)
• The Anarcha Project: Sims and the Medical Plantation (performance art, poetry, resistance)

I’d also recommend the work of Dr. Alondra Nelson (Body and Soul: The Black Panther Party and the Fight against Medical Discrimination) and Dr. Dorothy Roberts (Killing the Black Body: Race, Reproduction, and the Meaning of Liberty) on Black bodies, racism, medicalization, criminalization and the medical industry.