1619 · The New York Times

How the Bad Blood Started

September 14, 2019·39 min·3 clips

600 Tuskegee men were promised free care while researchers spent 40 years watching untreated syphilis kill them.

1. 1619's episode "How the Bad Blood Started" examines the roots of racial health care inequality in the United States. 2. Host Nikole Hannah-Jones interviews reporter Janine Interlandi, and the episode closes with a short story read by its author, Yaa Jessie. 3. The core question is how a health care system built on exclusion and underfunding left Black Americans distrustful of doctors and worse off than white Americans by nearly every measure. 4. The host opens with a personal story about her Uncle Ed, a roofer who lost his job-based insurance right as his back pain worsened. 5. A free clinic denied him an X-ray or CT scan because he had no insurance and sent him to a chiropractor instead. 6. After a chiropractic visit ended with an audible "pop" in his back, an ER doctor finally scanned him and found cancer that had metastasized throughout his body. 7. The terminal diagnosis made him eligible for federal disability insurance, the very coverage he needed months earlier, and he died at 50, two weeks after his grandniece was born. 8. Interlandi then traces the story back to 1865 and Rebecca Lee Crumpler, one of only 300 women and the sole Black woman among the era's roughly 54,000 U.S. doctors. 9. Crumpler went south to Virginia to treat the newly emancipated through the Freedmen's Bureau Medical Division, the nation's first federal health care program. 10. She found hospitals so underfunded that Bureau officials, fearing dependency, denied requests for more doctors, blankets, and quarantine space, and one hospital in North Carolina was ordered burned down rather than treated for smallpox. 11. In response, Crumpler wrote "A Book of Medical Discourses in Two Parts," addressed directly to Black mothers and nurses on how to treat themselves. 12. The episode jumps to Truman's 1947 State of the Union call for national health insurance, which the American Medical Association crushed with a hundred million pieces of literature branding it "socialized medicine." 13. Montague Cobb, a Howard University anatomy professor and later head of the National Medical Association, spent decades campaigning against hospital segregation, citing cases like a Black man pulled off an examining table at Atlanta's Grady Memorial Hospital once staff realized he wasn't white. 14. Cobb's testimony helped tie the 1965 Medicare bill to the Civil Rights Act's ban on federal funding for segregated institutions. 15. Within four months of Medicare's passage, nearly 3,000 hospitals desegregated rather than lose federal funds. 16. The episode notes that disparities persist today: Black women are three times more likely to die of pregnancy-related causes, and twelve times more likely to die in childbirth in New York City, than white women. 17. The interview segment is conversational and historical, moving chronologically from 1865 through the 1960s with archival audio of Truman and Cobb. 18. The closing segment shifts to literary narration, with Yaa Jessie reading her short story connecting the Tuskegee syphilis study to a mother's anxieties about her son's safety in a hospital. 19. Listeners interested in American history, health policy, or the origins of racial health disparities would find this episode most rewarding. 20. Listeners looking for lighter or unrelated entertainment content would likely skip this episode.

As heard by us

A family memory opens into the long history behind Black Americans' fear of medical institutions.

The episode traces how distrust around Black medical care becomes more than a feeling. It begins close to home, with the host's memory of Uncle Eddie: the jokester who called the host Bird, gave shelter after fights with the host's father, and wore red from head to toe at…

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Press play when you want a family bond to open into the history behind medical fear.

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