Sunday, January 10, 2016

Freedmen’s Hospital

By Yanglu Chen, Princeton University, New Jersey, United States

The name itself, Freedmen’s Hospital, betrays a sense of bitter conflict: that there existed men unfreed, and they were not treated here – and that even the freed men had only this hospital. In fact, Freedmen’s Hospital in Washington D.C. was the first of its kind because it provided medical care to former slaves, eventually becoming the major hospital for neighboring African American communities.1 It opened in 1862, in the midst of the American Civil War, as thousands of African Americans rushed toward the North for freedom.

The next year, Freedmen’s Hospital was briefly headed by Lieutenant Colonel Alexander T. Augusta, MD, making Augusta the first African American hospital administrator in U.S. history.2 Augusta had also made history in other ways: as the first commissioned African American surgeon in the military during the Civil War and as the first African American to serve on the faculty of a U.S. medical school, Howard University.1 Just a couple years later, in 1868, the hospital became a teaching hospital for the Howard University Medical School, although the U.S. government continued to manage it. It was not until much later, in 1961, that John F. Kennedy officially transferred the hospital to Howard University.1

In 1909 Freedmen’s Hospital was relocated to a new building at Bryant and 6th street.3 It was this 278-bed state-of-the-art building that attracted famous figures such as Charles R. Drew, M.D., a surgeon, hospital administrator, and professor at Howard University, known for research that led to the development of blood banks.2 Drew was an activist who protested the Red Cross’s segregation of blood donations and petitioned the American Medical Association to revise membership requirements, knowing that this prejudice barred qualified African Americans from receiving specialty training and advancement in the medical field.4 Even so, his greatest ambition was to train young African American surgeons according to rigorous standards of excellence; he saw surgery as a “discipleship.”5

In one speech, Dr. Drew reported that between 1932 and 1942, the number of African American graduates from medical schools was cut by half even as the African American population increased.6 He attributed this disparity to the unaffordable cost of medical school for poor African Americans and “the widespread policy of exclusion” at medical schools and clinical facilities.6 The Freedman’s Hospital, besides providing much-needed healthcare for many African Americans, was a major training ground for young and aspiring African American doctors. Freedmen’s paved the way for later hospitals and medical colleges such as George W. Hubbard Hospital (Nashville), Provident Hospital (Chicago), and Frederick Douglass Memorial Hospital (Philadelphia).

While much progress has been made, even in the modern era the proportion of African Americans represented among M.D.’s is reported to be about half the proportion of African Americans represented in the U.S. population.7 Many argue that having more minority doctors would enhance the field of medicine because underrepresented minorities are more likely to return to and serve underserved communities.7 Minority doctors can also encourage cultural understanding and patient-physician connection, since research shows that race and ethnicity play a role in patient comfort and participation.8 The denial of care to African American men in the Tuskegee Syphilis Study is just one example of how cultural distrust of physicians has been bred.9 Other studies have shown that African Americans generally receive less treatment than white Americans, especially for conditions with fewer objective measures,10 although it is difficult to attribute these disparities to cultural differences or biases in the healthcare system alone.

In the history of hospitals, there are many “firsts”: the first hospital, first pediatric hospital, first hospital with anesthesia, and so on. However, Freedmen’s hospital should be thought of as more than just a “first.” All things considered, Freedmen’s should not be a glorified example, for many of its white and black hospital administrators were engaged in misconduct and malpractice scandals between 1872 and 1910.2 Ultimately, Freedmen’s is significant because it forces us to ask ourselves difficult questions: questions that touch on the representation of all minorities in our medical schools and hospitals, as well as racial disparities in physician-patient interactions. True, they have been asked for generations, but neither have they been fully resolved.

In 1975, yet another reincarnation of the hospital was built on Georgia Avenue, which continues Freedmen’s Hospital’s legacy today as Howard University Hospital.1 The older two buildings now house the School of Communications, College of Nursing, and College of Allied Health Services of Howard University.2

“Pioneers in Academic Surgery - Opening Doors: Contemporary African American Academic Surgeons.” Exhibitions. Accessed December 26, 2014.
“Freedmen’s Hospital/Howard University Hospital (1862) | The Black Past: Remembered and Reclaimed.” Accessed December 26, 2014.
“Historic Medical Sites in the Washington, DC Area - Howard University Hospital.” Digital Library Collections. Accessed December 26, 2014.
“ ‘My Chief Interest Was and Is Surgery’ –Howard University, 1941-1950” The Charles R. Drew Papers. U.S. National Library of Medicine, accessed December 26, 2014.
Drew, Lenore R. “Address given by Lenore (Robbins) Drew to medical students.” Speech, Howard University. Moorland-Spingarn Research Center. Charles R. Drew Papers, After 1950. U.S. National Library of Medicine. last modified December 8, 2010. Accessed December 26, 2014.
Drew, Charles R. “Scholarship, Named in Honor of Dr. Drew, Presented to Student Eligible to Study Medicine at Tufts, Boston University, or Harvard.” Speech, Temple of Israel Brotherhood, Boston, Massachusetts, March 21, 1946. U.S. National Library of Medicine, last modified December 15, 2010. Accessed December 26, 2014.
“Why We Need More Minority Doctors.” Commonhealth, February 9, 2012.
Cooper-Patrick L, Gallo JJ, Gonzales JJ, and et al. “Race, Gender, and Partnership in the Patient-Physician Relationship.” JAMA 282, no. 6 (August 11, 1999): 583–89. doi:10.1001/jama.282.6.583.
Grace, Darrell L. “Overcoming barriers in treating African-Americans.” AOA Health Watch. January 2011. 10.
Tamayo-Sarver, Joshua H., Susan W. Hinze, Rita K. Cydulka, and David W. Baker. “Racial and Ethnic Disparities in Emergency Department Analgesic Prescription.” American Journal of Public Health 93, no. 12 (December 2003): 2067–73.
Saha S, Komaromy M, Koepsell TD, and Bindman AB. “Patient-Physician Racial Concordance and the Perceived Quality and Use of Health Care.” Archives of Internal Medicine 159, no. 9 (May 10, 1999): 997–1004. doi:10.1001/archinte.159.9.997.
Todd, K. H., C. Deaton, A. P. D’Adamo, and L. Goe. “Ethnicity and Analgesic Practice.” Annals of Emergency Medicine 35, no. 1 (January 2000): 11–16.

YANGLU CHEN is an undergraduate studying Chemistry at Princeton University. She has interned in virology, oncology, immunology, and genomics at Fox Chase Cancer Center, Rockefeller University, and the National Institutes of Health.



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