Deirdre Cooper Owens is telling the stories of the past that can point us in the right direction in the future.
Her book, “Medical Bondage: Race, Gender, and Origins of American Gynecology,” lays groundwork for understanding how structural racism was seeded in health care and how it continues to play a role in the health outcomes of minorities to this day, including in the COVID-19 pandemic that is disproportionately affecting Black and Hispanic communities.
Cooper Owens, the Charles and Linda Wilson Professor in the History of Medicine and director of the Humanities in Medicine program at the University of Nebraska–Lincoln, sat down for a conversation with Nebraska Today to discuss her scholarship, the past and present of health care in the United States, epidemics, and what comes next.
You joined the faculty in the fall of 2019. What brought you to Nebraska?
You know, it was really a wonderful career opportunity. On a personal level, how many black women are heads of humanities departments? There are literally two of us in the United States and also two black women faculty members who are endowed professors in the history of medicine. I thought, ‘what a wonderfully progressive opportunity for the Midwest to make this kind of move outside of a metropolis like Chicago or Detroit.’ But also, the ways that Nebraska is trying to center humanities — particularly with all of the discussions around STEM — sometimes the medical humanities is forgotten. Yet, it has such a big impact on society. It was a wonderful opportunity, I think professionally and personally, for me to come here.
Having been here a little over a year, as the director of the Humanities in Medicine program, what opportunities do you see for growth there?
What we’re trying to do is raise our profile nationally, with other medical humanities programs. Beyond that, I want to be able to institution-build, so that in a number of years, I would love to have postdoctoral fellowship opportunities and hire more faculty members, but right now, we don’t have the hard money for these positions. One of the most promising things about heading up this department and doing the kind of work that intersects with history, race and racism, and gender, and all of these things, is, in the moment of this pandemic, people have really been looking to the medical humanities and folk who do the history of medicine to be able to provide context for where we are at this moment. People really want to understand this moment, in a way that doesn’t make them feel like this is new and exceptional. If we’ve been here before, how do we move ahead? Medical humanities experts have thankfully been able to do that in this particular moment.
Is there a particular course you really love teaching?
Oh, my gosh, yes, I love the History of American Medicine. I’m able to really rely on my expertise. And, in the years to come, when my course load increases a little bit, I would love to teach graduate students who are also interested in comparative histories of race and medicine and the impact it has on our society.
What spurred you to become a historian of medicine?
Until probably three and a half years ago, I was really afraid to take on the label of historian of medicine, because I thought, ‘I do U.S. history. I do slavery. I do women’s history, and that’s it.’ I used medicine as a lens to understand all of these people and the country.
It felt weird to me to call myself a historian of medicine, but I realized I was doing a different kind of history of medicine. I wasn’t writing about a disease. I wasn’t writing about a famous person. I wasn’t writing about a hospital or institution. I was really writing about the patients, and that was something that typically had not been done in the history of medicine. It took a long time for me to adopt that, but now, it’s interesting. I do other things, too. I can talk about more things than that, but I absolutely love it.
Your book, “Medical Bondage,” was published in 2017, which received a lot of acclaim. Were there reactions that surprised you?
I would say in terms of the response, it’s been really positive. In some ways, it was shocking.
I was living in New York at the time. And there was this huge controversy surrounding the removal of a statue of James Marion Sims, known as the father of American gynecology (and one of the doctors researched in the book who performed medical experiments on enslaved and poor women). I joke that I went from an assistant professor at Queens College who taught African American history, to the country’s foremost expert on James Marion Sims. What was happening? At first, I wanted to stay in my safe place as an academic. I don’t want to have these political opinions about whether the statue should stay or be removed. But the public really wanted to know. They wanted context.
Then the book got a second breath of life from birth workers — primarily midwives and doulas — who found out about the book and they were like, ‘wait, we didn’t learn this in school.’ And now, the third iteration is medical colleges and schools of nursing. I have done probably more Grand Rounds than I can count. These medical residents are really interested in how do we come to a maternal health crisis for black women and black birthing people? Why is this so reminiscent of the 19th century? They’ve been looking to my work to fill the gaps.
In terms of the publishing, most books by an academic press sell 300 to 400 copies. I’m now over 8,000. For me, it’s not about selling books. I’m more interested in, what does this say for scholars who are coming along who want to write histories that they see have a resonance for contemporary society? They want to write about slaves. They want to write about immigrants. They want to explore these kinds of histories of marginalized people. For me, it leaves an imprint. The press now knows people are really interested in these kinds of histories. There are people who are really interested in the history of gynecology, not because it’s the history of gynecology, but what does this say about a current crisis that so many people are facing? That’s why it’s important that something like this does so well.
Speaking of racism in medicine, this pandemic seems to have put a very bright spotlight on systemic racism in health care. From a historian’s perspective, is this going to be a catalyst for change?
Yeah, I think so. Although this has been ongoing for a really long time, I am, I would say, optimistic about a transformation happening.
A year or so ago, I was giving a talk in Iowa at Simpson College. I was in the lobby of the hotel, catching the shuttle, and I had the hotel copy of USA Today. On the front page was a story about the black maternal health crisis. That would have never been on the front page of a major newspaper five years ago, and so people are paying attention.
I’ve done interviews in Turkey, Germany, with the BBC, ABC News, all on race and structural racism in medicine. Even reporters are becoming more precise and accurate with the language. What does anti-blackness look like? Or, what does racism look like? What does sexism look like? What does classism look like? Once we start naming the things that actually create these negative social determinants of health, then we can start to face the problem. How does the impact of poverty, or how does one process racism, physiologically? How does that then affect the ways in which your body processes these things? Or what if someone has a bias against you? What if you aren’t able to articulate language in a particular way, and so if someone is condescending to you, and that manifests in terms of stress, now there’s low-level inflammation that happens. All of these things are not necessarily based on whether one is Black or white, or Chinese, or Chippewa, but it’s really based on the structures that our society has created.
With the work of reproductive justice activists, in particular, and what has now been intersecting with the epidemiology of this pandemic, it’s really beginning to make change. I’m really, really grateful Lincoln has even declared medical racism as a public health crisis. That’s pretty progressive, being that the CDC hasn’t even made that declaration. So, yes, I’m hopeful.
There are new calls for us to really take to heed of what medical racism does. Often, and this is a really distressing fact, when I show the documentation, and I provide the evidence that the black maternal health crisis in the 21st century rivals the numbers during the age of slavery, most people are shocked. For those stats to still be the same for Black mothers and Black birthing people, I think it’s a crisis that we’re going to have to take very seriously. We know what these medical crises cost our country billions of dollars that we don’t actually need to be spending if we could just save their lives and the lives of their children.
What I am thankful and hopeful about is that medical institutions, medical organizations, like the American College of Obstetricians and Gynecologists are finally saying, ‘okay, we have to change this, because the numbers are dismal. We should not be the most dangerous country in the developed world for women of color to have children.’ They’ve been hard at work at trying to reverse those numbers.
What is your next research project?
I am working on two projects, both in the history of medicine.
The more fun project, for me, is really understanding Harriet Tubman as a disabled person. Most people know of Harriet Tubman as one of the conductors on the Underground Railroad and all of her work with the Civil War as a soldier who helped free over 750 slaves in the raid in South Carolina. But they often don’t know that she suffered a traumatic brain injury as an adolescent.
In today’s age, we might look at her askance because of some of the things that she said right? She would get these vivid visions, these hallucinations, where she would have conversations with God, seeing colors that didn’t exist in real life. The effects of her condition led her to make those multiple trips back to her former plantation to free almost 100 slaves, but also when she was married and enslaved in her early 20s, she never had a child for all the years that she was married. And that’s pretty uncommon. We’ll never know for sure. She was illiterate — she didn’t leave a body of written work — but I think knowing this information helps to raise questions around infertility.
It helps to raise questions around the ways that men and women responded to Tubman as a disabled person, which was something she was very transparent about. And yet, the most powerful white men in the country asked her to lead a raid during the Civil War. She did amazing things.
The second project that’s going to take a really long time is one where I’m looking at slavery and mental illness. And I’m looking at it from the colonial period all the way to the 19th century. What did it look and feel like for people living during that time to be considered? There was a kind of violence that we can’t imagine. People were killed publicly. There were lynchings. I mean, I can’t imagine seeing that now. How does one live through this and maintain a grasp of sanity? What does insanity look like? What got me on that path was the first hospital that was built in the United States was one for the mentally ill.