Moving beyond apologies


St. Louis Today News
New York, NY

August 17, 2008

When Leslie F. Bond graduated from the University of Illinois in 1948, there were only two medical schools in the nation that would admit him: Howard University in Washington, D.C., and Meharry Medical College in Nashville, Tenn.

That was how the medical establishment wanted it. Beginning in 1910, the American Medical Association limited its accreditation of medical schools for black students to two.

Dr. Bond attended Meharry, where his father, Dr. Henry W. Bond, also had studied and earned his medical degree.

When Dr. Leslie F. Bond graduated from Meharry in 1952 and began his medical residency, there were few areas in St. Louis where he was permitted to buy a home. By 1952, some restaurants in some parts of town would serve him a meal, although he still couldn't "get a seat in the balcony of the theaters along Grand Avenue," he recalls.

But Dr. Bond also recalls that he received superb medical training at St. Louis' public Homer G. Phillips Hospital, which employed black and white doctors and treated black patients. He speaks with reverence about the physicians who were his clinical instructors, with excitement about the training he received in internal medicine and general surgery and with pride about Homer G. Phillips as a place for great young doctors, whatever their skin color.

Last month, the American Medical Association issued a public apology for its "history of racial discrimination against African-American physicians." Dr. Ronald M. Davis, the AMA's immediate past president, catalogued a series of "dishonorable acts of omission and commission" in a commentary published in the Journal of the American Medical Association.

He described how the association tolerated "openly practiced racial exclusion" in state and local medical associations, how its membership rolls separated physicians according to race, how the association stood mute during the debate over the Civil Rights Act of 1964 and how it was slow to oppose construction of segregated hospital facilities.

"The medical profession, which is based on boundless respect for human life, had an obligation to lead society away from disrespect of so many lives," Dr. Davis wrote. "The AMA failed to do so."

The victims of this discrimination, as the AMA now acknowledges, were "the generations of African-American physicians excluded from the mainstream of American medicine and the patients whose needs went unmet because of this exclusion."

Dr. Bond adds another significant point: It was not just people of color who were cheated.

Training at Homer G. Phillips Hospital was highly sought not just by young black doctors, but also by white doctors training at Barnes and Jewish Hospitals. All of them cared deeply about medicine and knew that at Homer G. Phillips they would have the opportunity to observe and learn from medical professionals whose skills and savvy transcended any limitations of the facilities.

But the white medical establishment kept this wealth of medical talent confined and constricted to the detriment of the white establishment itself, as well as its patients.

In the late 1960s, black physicians started to join the staffs of St. Louis' "white" hospitals, but old prejudices died hard. Dr. Bond remembers when, as a staff physician at one of these hospitals, he had to tell a mother that her child had died. The mother instinctively reached for Dr. Bond, a soft-spoken man, for support and began to cry on his shoulder.

The hospital's religious director was standing nearby and immediately intervened, frantically pulling the distressed woman away from the black doctor who was comforting her. The religious director's racial fears denied the woman the consolation she needed because she was white.

Dr. James M. Whittico also graduated from Meharry Medical College and trained at Homer G. Phillips Hospital. Except for two years of military service in the Pacific during World War II, he has been practicing medicine in St. Louis since 1940. He still sees patients and has staff privileges at St. Mary's Health Center.

Dr. Whittico says he "holds no animosity, personally" for the AMA's exclusionary practices and that, "doctor to doctor," he had good relations with white peers, even during times of segregated practice.

He points to Dr. Robert Elman and Dr. William Danforth at Washington University and Dr. Valle Willman at St. Louis University as prominent examples of white physicians who used their prestige to elevate professionalism above race and place a high priority on improving race relations.

The role the AMA should have played is no mystery to Dr. Whittico. "It should have acted strictly from a medical standpoint and broadened participation to all within the profession," he says.

Dr. Whittico recently returned from the annual meeting of the National Medical Association, the professional association of black physicians of which he is a past president. The colleagues with whom he spoke about the AMA apology were cautious, he says. "They want to accept it, but they want to think about how to accept it."

There is much to think about, and plenty of work ahead.

The AMA statement itself acknowledged that medical care of African-Americans "remains largely segregated, which contributes powerfully to racial disparities in care." It noted that, although African-Americans represented 12.3 percent of the United States population in 2006, they made up just 2.2 percent of the nation's physicians and medical students slightly less than the 2.5 percent they represented in 1910.

"The story of African-Americans and organized medicine is still being written," the AMA statement concluded, which means that organized medicine has a chance to move from formal apology to constructive deed, this time with no excuse for failure.


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