Twice as Hard

what organization did the author found and why?

"Minority Association of Rising Scientists (MARS). This organization aims to counteract the detrimental effects of implicit bias and imposter syndrome through programming that promotes community among students of color pursuing research careers. "

She felt targeted when she wanted to emter her lab but the cardkey did not work and a man who worked there questioned her even though she had her ID as a student

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What master did Jasmine pursue at Oxford University

As a Rhodes scholar, a master of philosophy - her dissertation was about social barriers preventing black women from entering medicine

Rebecca Lee Crumpler

First african american woman to become a physician in the US only 14 months after Lincoln signed the Emancipation Proclamation

allopaths, who did they compete with

regular physicians

"In 1800, approximately one hundred Edinburgh-trained physicians, plus the graduates from the three American institutions, constituted a medical elite.1 This group, combined with those who trained as apprentices, were described as the "regular physicians," or allopaths."

competed with homeopaths and eclectics

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James McCune Smith

The first African-American to earn a medical degree. Graduated from a school in Scotland. He practiced in New York.

What university did Smith get admitted to? Who did they not admit?

University of Glasgow; Women until 1892

David Jones Peck; how was he admitted to medical school?

The first Black man to graduate from an American medical school. He graduated from Rush Medical College in Chicago in 1847; the white students chose to keep him

Elizabeth Blackwell

First woman to receive a medical degree in the U.S. from Geneva Medical College

When Rebecca applied to medical school in 1860, how many women were physicians in the U.S?

300/54543, none black

Rudolf Virchow

proposed that new cells are formed only from cells that already exist, differed from common view that new cells came from a fluid called blastema

Louis Pasteur

proposed the germ theory of disease

Robert Kuch

applied the germ theory to find the agent of the deadly anthrax disease - Bacillus anthracis was the strand

Pasteur

"serendipitously immunized chickens against cholera. He accomplished this by inoculating the chickens with a live-attenuated version of Vibrio cholerae, the bacterium that causes cholera"

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calomel

a laxative; often used as a cure for intestinal worms, decreased in usage in 1870s

A Book of Medical Discourses: In Two Parts

only known medical book written by a 19th C AA woman

Mary Eliza Mahoney

first trained African American nurse in the US

American Medical Association

in 1901, when many doctors who considered themselves trained professionals the began forming local associations and societies such as this one, which was organized into a national professional society, including nearly 2/3 of all doctor, they called for strict scientific standards in practicing medicine, including 4 years of education and an exam to obtain their medical liscense

What is Flexer's criticism of training medical schools

too many doctors

What did Flexner believe about black physicians

they should only treat black patients

What illness did May suffer

osteomyelitis - bone infection, not forehead and swelling in arms and legs

what gen ed course did May take at Columbia as a music major?

biology with Dr. Jean Broadhurst, impressed with research paper and recommended her a career in STEM

What classes did Dr. Broadhurst encourage May to take

clinical pathology classes at a post graduate school in NY; less expensive and provided competition bc pathology rapidly expanding

What schools did Dr. Broadhurst encourage May to look into

allopathic -using more scientific research-informed therapies, homeopathy was losing its prominence

What condition did Columbia accept her for the medical class?

If she took a chemistry class over the summer

How did May's background in clinical pathology help her in med school?

"It afforded her skills that the typical medical student didn't have. For instance, she knew how to administer anesthesia to a patient, thanks to her experience giving anesthesia to animals"

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What recognition did Dr. May Chinn?

"Dr. May Chinn graduated from New York University Medical College in 1926 as the school's first African American woman graduate."

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What challenge did the doctors May worked for give her?

"They went as far as making her pay rent to stay in the building that housed the office even though she was doing them a favor. The Department of Health required a physician to be a resident on the property. "

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What patients did Dr. Chinn care for

Japanese and Black patients rejected for treatment by other people

Preparation for surgery by Dr. Chinn and Dr. Murray

"Depending on the size of the patient, the bed or an ironing board might be designated as the operating table. The presence of a coal stove was vital. The doctors would wrap up their dressings in newspapers and bake them in the oven. In less time than it took to bake a loaf of bread, the dressing was sterilized and safe to use. Then, Dr. Chinn or Dr. Murray would ask the family to show them to the washroom. The family's wash boiler, which usually washed clothes, could also disinfect their surgical instruments."

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How did the doctors find adequate light

brought office lamps with batteries

Teamwork of Dr. Chinn and Dr. Murray

"Whenever a patient needed a blood transfusion, Dr. Chinn and Dr. Murray worked together against the clock. Dr. Chinn would conduct blood counts, blood typing, and urinalysis in a makeshift lab she had built in her home. Then they would prepare the blood donor, who oftentimes was a family member or a neighbor. Relying on direct transfusion, the doctors needed only a few small needle pokes for the blood to flow from the donor to the recipient. Dr. Chinn and Dr. Murray could complete the entire transfusion process within twelve hours."

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What was a concerning trend in Dr. Chinn's patients?

They were wasting away from cancer

What was one technique Chinn learned from Memorial Hospital

biopsy

"One of the techniques that she learned was how to collect a biopsy—a tissue sample. She started obtaining biopsies from the patients she suspected might have cancer. Then, she sent the samples to the diagnostic section of Memorial Hospital. These samples would typically have been refused because she was a black physician, but she had a connection on the inside: some of the white male physicians at the hospital were her former classmates. They would accept her samples and analyze them for her. After Dr. Chinn had been doing this for about twelve years, black male physicians and white physicians finally started to recognize her expertise. They began referring their patients to her for biopsies. She would send the samples to Memorial with her name attached to them"

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Which doctor contacted Chinn to offer her a job as a physician in her clinic?

Dr. L'Esperance

What was Dorthy not given when she was born?

a birth certificate, because she was black

How many people in Dorthy's medical class were women?

5/143

What were female students like Dorthy excluded from?

"When Dorothy started medical school, she held the logical expectation that her professors would give her medical training in exchange for the high tuition payments. Instead, the Tufts medical professors neglected Dorothy and the other female students. For the first three years, the instructors acted as if they didn't exist. Whether in a large auditorium with all their classmates or in smaller learning groups, the women were always passed over when opportunities for individual learning arose. When a woman raised her hand in class, lecturers pretended they couldn't see her. Anytime there was an opportunity for a student to give a presentation, male students were the only ones selected.

This gender-based exclusion persisted in the clinics. When students began to practice delivering diagnoses at the bedside, a necessary skill to be a competent physician, none of the five women were permitted to give the diagnosis. They were even relegated to clinical experiences that aligned more with a nursing curriculum, such as the bandage clinic or the foot-soaking clinic. "

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What opportunity were provided to the class of Dorthy in her 3rd year?

"That year, their medical class had the opportunity to receive clinical training at Massachusetts General Hospital"

"Every Friday afternoon, from one to five, the students would crowd into the hospital's amphitheater and watch as a well-regarded physician presented complex clinical cases."

What did the women decide to do in their own hands?

"They agreed to meet every Friday and Saturday to discuss cases from five foreign medical journals that they deemed important: from Vienna, Paris, Berlin, England, and Scotland. They would explain the different clinical cases and the medical teams' therapeutic approaches. By sampling such a large array of cases, the women were more than prepared for the sessions at Mass General Hospital, as well as those in their clinics."

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Failure of the professor to embarrass the 5 women

"The case bore a strong resemblance to a case from the Vienna journal article that the five women had reviewed a couple of weeks earlier."

"Dorothy stood tall, as the only black woman in a room full of white men who refused to treat her as an equal. Then she gave a case summary that was impossible to ignore. She went through each diagnosis that was high on her team's differential, laid out the clinical findings that supported a given diagnosis, and pointed out any evidence that would persuade her against a particular diagnosis. After providing thorough arguments against various diagnoses, Dorothy delivered her final diagnosis. The professor—who was not expecting the women to figure out the correct diagnosis—stood with his mouth opened, in shock. "

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Twice as Hard

Jasmine Brown

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How did the 5 women graduate?

top 9, Dorthy was 1st/143

Dr. Boulding's residency

"She was referred to Dr. William A. Warfield Jr., the superintendent of the hospital. Dr. Warfield was impressed by Dr. Boulding's credentials and interview, so he offered her a residency position at Freedmen's Hospital. Dr. Dorothy Boulding began her residency training in the summer of 1924."

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what valuable experience did Dr. Boulding have?

"One aspect of her clinical training involved serving with the crews of Freedmen's ambulances in the late 1920s. Her ambulance was frequently called to care for people who had been wounded in street fights or domestic disturbances in southeast Washington. Due to redlining, many of the African Americans from low-income backgrounds were segregated to this area. During this time, Dr. Boulding saw more than just broken bones. She saw the challenges that the community faced, which improved her understanding of the people's social needs."

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How was the Southeast Settlement House born?

Dr. Boulding's experience of the aggression of an officer for a starving black boy left at home stealing milk for him and his starving brother

Alpha Kappa Alpha Sorority

1st sorority for black college-educated women in 1908

Disease in Bolivar County

black men suffered from syphilis; U.S. Public Service selected Bolivar County for the infamous Tuskegee experiment

many suffered from dysentery and tuberculosis

Success of the Alpha Kappa Alpha's Mississippi Health Project

"Alpha Kappa Alpha's Mississippi Health Project provided immunizations against diphtheria and smallpox to more than 14,000 children. It also treated thousands of adults for diseases that plagued the Bolivar community, such as malaria and syphilis. The black sharecroppers in the county also suffered from extreme malnutrition, so the team spent extensive time teaching families how to use their limited food supplies to correct malnutrition.16 Dr. Ferebee's contribution to the health project garnered her support within the sorority, and in 1940, she became the Supreme Basileus (a.k.a. the national president) of Alpha Kappa Alpha Sorority, a role she held until 1951. She was the organization's first and only Supreme Basileus to date who was a physician."

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Loving v. Virginia (1967)

State prohibition against inter-racial marriage violates equal protection

Dr. Edwards' residency application to Margaret Hague Maternity Hospital

"She submitted her residency application to the Margaret Hague Maternity Hospital in 1936. Having already worked at the hospital for five years, she was confident about her chance of being accepted; the other doctors knew her personally, and they knew she was a talented and hardworking physician. So when she received their decision on her residency application, she was shocked. Rejection."

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Dr. Lena Edwards' recognition

"Dr. Lena Edwards completed the residency program and passed the qualifying exams, making her one of the first African American women to be a National Board-certified obstetrician-gynecologists in the US.13 She used these credentials to secure a position as a gynecologist in the hospital's surgical department."

had a role model of a dentist dad

membership of International College of Surgeons

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Dr. Edwards' treatment of patients

"She had studied German, French, and Spanish when she was younger, and she used those skills to help bridge the cultural gap. Just by taking the time to sit down with the women and speak to them to the best of her ability, Dr. Edwards made medicine more accessible for people right in her neighborhood."

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Work at Margaret Hague Maternity Hospital

360 maternity cases and 100 hundreds per year

hospital in Hereford

"Aware of the hospital's predicament, Dr. Edwards leveraged its need when negotiating her position. She was able to acquire full privileges to practice at the hospital as an attending physician, allowing her to build a clientele list that she could use as she prepared to build a maternity clinic nearb"

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Who joined the St. Joseph's mission

Dr. Edwards -"She resigned from her lecturer post at Howard and moved to Hereford, Texas, to join the St. Joseph's Mission. She felt particularly compelled to join this mission because it served Mexican migrant farmworkers who played a crucial role in putting food on many Americans' tables, and yet were "treated worse than their cattle" in American society.18 The mission sought to provide medical care"

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What honor did Dr. Lena Edwards receive

Presidential Medal of Freedom

Marie Metoyer

1st AA female graduate of Weill Cornell, became a family doctor for 15 years, obstetrics and gynecology

"Once her children were all grown up and out of the house, Dr. Metoyer and her husband, Victor, moved to Manchester, New Hampshire. She practiced medicine there, becoming New Hampshire's first African American female psychiatrist, until she retired at seventy. She was also one of the first African Americans to practice psychiatry in Vermont."

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Dr. Edwards concerns

"With so many medical specialties, Dr. Edwards felt that many doctors were losing sight of the whole picture. This could cause patients with complex illnesses to bounce between multiple medical providers without the treatment they needed, because the specialized physicians weren't seeing the ways that different symptoms were connected. "

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"A patient may go to their gastroenterologist, a doctor who specializes in the digestive system, to check on their gallstones. With so much focus on their gallbladder and bile duct, they may forget the recurrent bouts of itching that began the week before. But itching can be a sign that the flow of bile in the biliary tract is obstructed by gallstones, which can be life threatening."

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Edith's early struggles

watching her dad die after being bucked from his horse

What happened a few weeks after Mattie's father died

a typhoid outbreak; plagued the Irby family and Edith took on tasks to help her siblings

Juanita Irby's symptoms of typhoid

"Juanita had numerous bouts of bloody diarrhea. She was hemorrhaging in some part of her intestines. Once the family noticed this, someone ran to the doctor's office and begged for his help. But he was busy. He had already made an appointment with one of Edith's neighbors. Their money commanded more attention than a girl experiencing a medical emergency did."

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Edith's Easter sacrifice

Her mother Mattie resewed her only dress to fit Edith so she had a dress to wear to present a speech at a Sunday church school convention

How was Edith able to pay for her college tuition at Knoxville College?

only had 60/300 dollars for tuition; met the president Dr. Imes and served as the assistant secretary's secretary

What were Edith's studies at Knoxville College

triple major in biology, physics, and chemistry

what did medical application submissions cost?

5-10 dollars

how did Edith strengthen her medical application?

took a course on clinical psychology at Northwestern University

Edith's acceptance into med school

"Edith graduated from Knoxville College in the spring of 1948, when racial segregation still permeated the education system in the Jim Crow South. If an African American from the South wanted to earn an undergraduate or professional degree, they usually had to attend one of the historically black colleges and universities, or an integrated school in the North. Never had a black person attended a predominantly white medical school in the South. Edith's decision to enroll at the University of Arkansas School of Medicine would make her the first."

also accepted to University of Chicago and Northwestern med schools

was able to pay for it because of her community's contributions

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social isolation at University of Arkansas

Edith was forced to eat at a room in the library due to segregation and use her own toilet

how have medical school costs changed

$500->400,000

The Bates and civil advocacy for Edith

"Daisy and L. C. Bates also invited Edith into their home. Every weekend, the couple played poker, and when Edith was able to take a break from her studies she would go to play poker with them, instead of spending the weekends alone. During these games, she met many of Little Rock's black elite. She became known as a socialite and was invited to many parties, where she was introduced to the world of advocacy. The Bateses were heavily involved in the civil rights movement, and as Edith learned and became more involved herself, she was even invited to speak at various advocacy events.

One of the more significant events she attended was hosted by the National Association for the Advancement of Colored People (NAACP), in New Orleans. She was asked to give a speech at the event, alongside Thurgood Marshall, the lawyer who would successfully argue before the US Supreme Court in the Brown v. Board of Education case as the legal counsel for the NAACP and in 1967, become the first African American associate justice of the Supreme Court."

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Dr. William Montague Cobb

physician-scientist and 1st AA to earn PhD in anthropology

Dr. James B. Jones, married to Edith

"He was the first African American to earn a PhD at the University of Washington in Seattle.2"

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What medical procedures did Dr. Chenault teach Edith

how to work on gallbladders and appendicitis

Edith residency accomplishment

"She then began a pediatrics residency at a hospital in Hot Springs, Arkansas, making her the first African American to do so."

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Edith's birth

"As the hours of labor passed, complications emerged. Maybe her delivery was prolonged, or her baby was in the breech position, his feet facing downward—which is dangerous in a vaginal delivery. Whatever the reason, the doctors decided it was necessary for Edith to have a C-section instead of the natural birth that she had hoped for. A C-section is a major surgery that requires postoperative care. It's associated with serious postoperative risks, such as intense pain, wound separation, infection, and even deep vein thrombosis, which can be deadly.26 To prevent some of these negative outcomes, women are supposed to be monitored in the hospital for at least twelve hours after the procedure."

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Edith's son procedure

"Her medical knowledge became useful when it was time to circumcise her son, Gary. While she was still recovering from her surgery, Edith taught her husband how to perform a circumcision. Using sterile surgical instruments from the hospital, he completed the procedure on his newborn son on the family's kitchen table."

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how many times more are black women likely to die from pregnancy-related causes than white women

3 times

Dr. Irby Jones' education and accomplishments

became 1st black woman intern and 2nd physician in the internal medicine program in the Baylor College of Medicine Affiliated Hospitals

completed rest of residency (3 months) at Freedman's Hospital

"In 1962, Dr. Irby Jones took the bold step of establishing a private practice in inner city Houston to serve people who didn't have any other access to healthcare, using $17,000 that a local businessman loaned her to open the clinic. At the time, there were only two other black women physicians practicing in Houston: Dr. Thelma Patten Law and Dr. Catherine Roett-Reid.31 Dr. Irby Jones's clinic helped fulfill her childhood dream of serving people regardless of their ability to pay. She upheld this mission throughout her medical career, expanding her work beyond the US through her involvement in international clinics in Haiti, Mexico, Cuba, China, the Soviet Union, and throughout Africa.

She also advocated for underserved communities through her involvement in organized medicine. In 1985, Dr. Edith Irby Jones became the first woman to serve as president of the National Medical Association, which had been founded in 1895 to support African American physicians who had been excluded from the first medical association in the US"

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Joycelyn's baby brother's symptoms. What did the doctor do

"when her baby brother became gravely ill. His abdomen was distended, looking like a grown man's beer belly would after the man had downed a case of Budweiser. He was experiencing a dull pain, which grew worse in tandem with his waistline. He felt nauseous and didn't want to eat, and his forehead was burning hot to the touch. But the most concerning sign of all was that he was the only one in the family who was sick. With the common cold or food poisoning, the whole family would have become ill. This time, it was just the brother."

"the child likely had a dangerous infection in the lower right quadrant of his abdomen, but the doctor didn't have much time to address the issue. He hurriedly sliced open the boy's abdomen and inserted a drainage tube. Yellow-tinged creamy pus quickly drained out. This invasive procedure came with some serious health risks. If Joycelyn's brother had been white, he would've been admitted into the hospital to be watched by a medical team to ensure that nothing went wrong. But the affiliated hospitals refused to treat black patients, so this sick child was sent back home."

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What did Joycelyn's brother likely have?

"Dr. Elders believed that her younger brother had had appendicitis. She believed his appendix had ruptured and caused peritonitis, an infection in his peritoneum, which is a serous membrane that lines the abdominal cavity. This kind of infection can be fatal."

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What did Dorthy Gaston (Marilyn Gaston's mom) suffer?

fainted on a dry day; suffered from anemia, a low blood cell count b/c of worsening cervical cancer - her brain didn't receive enough oxygen because of low red blood cell and hemoglobin counts, causing her to faint

what did Marilyn study at Miami University?

zoology

What problem did Marilyn face from her white male classmates?

sexual harassment

what hospital did Marilyn choose and why?

"After earning her medical degree, Dr. Marilyn Gaston (she had married by then) left Ohio briefly to complete her pediatric internship year at Philadelphia General Hospital. She strategically chose the hospital because it shared many of her values. As the first government-sponsored hospital in America dedicated to caring for the poor, it was a charity hospital that treated the sick and mentally ill while also providing housing and food for the homeless.9"

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Dr. Gaston and the baby at the hospital

The baby boy had a red and swollen hand, flailing incessantly - Dr. Gaston assumed it was assumed and blamed the mother but it was sickle cell disease from a blood smear - red blood cells with crescent moon shapes; also disproportionately affected AA's

tokenism

the practice of making only a perfunctory or symbolic effort to do a particular thing, especially by recruiting a small number of people from underrepresented groups in order to give the appearance of sexual or racial equality within a workforce.

What job did Dr. Gaston for Doleres' community

pediatrician

Dr. Gaston's clinic funding

"One photo was so striking, it became impossible for people to turn their backs on the cause. A little boy sat on a cheap foldable chair in the middle of an empty court, located across the street from numerous worn"

"buildings. Next to him stood a hunched Dr. Gaston as she tried to tune out external street sounds to listen to his heartbeat through her stethoscope. Simultaneously, she strained her eyes to examine him. The sole source of light was a loose-hanging lamp that fought against the dark of night closing in on the scene."

founded the Lincoln Heights Health Center in Oct 1967 - 1st community health center in Ohio

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when a patient need to sit upright at Dr. Gaston's clinic for a breast or stomach exam what did the nurses do?

On the second floor, When a patient needed to sit upright, the nurses would stack fluffy pillows against the bedframe to provide support for the patient's back. They could relax against the pillows as a doctor conducted a breast or stomach exam. All they had to do was lean forward off of the pillows when the doctor needed to press the smooth drum of their stethoscope against the thoracic portion of the patient's back to listen for the sound of the patient's lungs and check for signs of pneumonia and other lung diseases."

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What did the kitchen serve as?

the center lab to test urine or blood samples

what did the basement serve to do?

give patients a free dental exam

What did people of sickle cell disease ask for and experience

Had extreme pain when sickle cell red shaped cells cluster together and obstruct blood flow to the chest, abdomen, or both parts of the body and needed opioids to lessen the pain: led to stigmatization of AA's to be addicted to opioids

what did the vulnerability of sickle cell disease relate to

having AIDS at the height of AIDS epidemic

age expectancy of sickle cell diseased people

1960s-1970s: didn't live past 20 usually s

struggles of sickle cell disease

"these patients struggled with crippling pain and increased susceptibility to infections. Oftentimes, they lost their lives to multiorgan failure, or stroke, when obstruction of blood flow (from aggregation of their sickled red blood cells) became too severe"

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What funding of the Ohio state department go to more

cystic fibrosis, not much for sickle cell disease to study mechanisms or potential treatments

which president focused on sickle cell anemia disease prevention

Richard Nixon

criticism of the medical community

" dissatisfaction had increased considerably in 1970, when Dr. Robert B. Scott published an article in the Journal of the American Medical Association documenting the scant funds allocated by the US National Institutes of Health (NIH) for sickle cell anemia research, as compared to funding for research on other genetic disorders such as cystic fibrosis, which primarily impacted white Americans."

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Genetics of sickle cell disease

"It is an autosomal recessive disease, meaning that a patient with sickle cell disease has two copies of a mutated gene—one copy from each parent. Given the short lifespans of sickle cell disease patients in the 1980s, the people with the pertinent mutation who lived into their reproductive years were usually carriers of the sickle cell gene, not people with the disease.29 They had only one copy of the mutated gene and were said to have sickle cell trait. People with sickle cell trait didn't have any symptoms, and they had normal lifespans. Many people with sickle cell trait never knew they had this mutation until screening for sickle cell disease became more prevalent."

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What income waged gap did Dr. Gaston face?

white male with same job made $20,000 more than her

why did children with sickle cell likely die at age 4

"She noticed a worrying trend of babies with sickle cell disease dying before they reached age four. For these children, the sharp edges of their sickle-shaped red blood cells damaged their spleens to the point of dysfunction. This left the children defenseless against life-threatening encapsulated bacteria, such as Streptococcus pneumoniae and Neisseria meningitidis. Dr. Gaston had witnessed tragic scenes of babies with sickle cell disease arriving at the ER with fever only to be declared dead less than nine hours later."

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