Making a Place for Ourselves

Reviewed by: Making a Place for Ourselves: The Black Hospital Movement, 1920–1945 Edward T. Morman Vanessa Northington Gamble. Making a Place for Ourselves: The Black Hospital Movement, 1920–1945. Oxford: Oxford University Press, 1995. xviii + 265 pp. Ill. $45.00. Late-nineteenth-century American hospitals gave black health professionals virtually no opportunity to practice or be trained, and either excluded black patients or segregated them in inferior wards. Responding to this situation, African-American leaders in the 1890s began “making a place for themselves” by establishing black-controlled hospitals. The number of such institutions peaked in the 1920s and 1930s, a time when segregation was barely questioned and ambitious schemes were advanced for separate training and practice facilities. After World War II, with the triumph of integrationist ideology within the African-American community and the eventual end of formal legal barriers to black achievement, black hospitals lost their raison d’être and began to fade from the scene. Nonetheless, in the 1990s the realities of race in America continue to impose upon black health professionals the necessity of maintaining their own networks and associations. In this masterful contribution to the history of health care in the United States, Vanessa Gamble organizes the story of the black hospital around the [End Page 335] dialectic between separatism and integrationism, continually and convincingly reminding the reader that the two are not polar opposites in civil rights struggles. Thus, African-American physicians Daniel Hale Williams and Nathan Mossell established hospitals in Chicago and Philadelphia, respectively, not as a concession to the post-Reconstruction racial climate, but as an active protest against American racism. Later, in the 1920s, proponents of a “Negro Hospital Renaissance” (such as the National Medical Association, or Booker T. Washington’s followers at the Tuskegee Institute and elsewhere) frequently faced off against other African Americans—notably the NAACP, the established elites in Northern cities, and some graduates of “white” medical schools—who were more skeptical of the black hospital movement. Both sides, though, approved of Williams’s and Mossell’s ideal of a first-rate hospital, fully financed and controlled by African Americans, and excluding no patient or health-care worker on the basis of race. Gamble points out that this African-American analog to the Jewish hospital would not have signified an acceptance of segregation, but rather the utilization of separatism as a strategy toward integration. Unfortunately the limited financial resources of the black community made this ideal unattainable, and supporters of integration strongly opposed any other sort of black hospital—where standards might be relaxed, or the right of black professionals to train and practice purchased at the expense of accepting segregation. Gamble skillfully teases apart subtle differences in the paternalistic approaches to black health care of the Duke Endowment, the Rockefeller General Education Board, and the Julius Rosenwald Fund. She provides a balanced assessment of their activities, fully acknowledging their contributions to the health status of African Americans; but she omits a fuller explication of the vision of race embodied in the work of powerful white men (and their black and white lieutenants) at a time when challenges to segregation and white supremacist ideology came mainly from the NAACP, the political Left, and a small group of black and white academic social scientists and culture critics. She gives a tantalizing hint of what such an analysis would look like, by quoting Julius Rosenwald’s observation that “twelve million colored people constitute one of the great markets for American industry” (p. 107). On occasion, Gamble falls prey to too monolithic a view of black America. She expresses concern that white philanthropies effectively prevented “the African-American community” from “controlling and determining the role and function of some black hospitals” (p. 128). However, throughout the book she makes clear that the black community was home to a broad range of opinions on hospitals. How, then, could “the African-American community” as a whole exercise control over the hospital? This question really needs no answer since, as Gamble demonstrates, the key issue was really equal treatment—meaning full integration—of patients and medical personnel. To the extent that white philanthropies hindered this, they slowed progress toward a nonracial society—even

Health care · Ideology · Political science · Politics · Race (biology) · Sociology · Spanish Civil War · Gender Studies · Historical Psychiatry and Medical Practices · History · History of Medicine and Tropical Health · History of Science and Medicine · Law · Medicine · Gerontology