Content Warning: The source material and this guide include discussions of racism, eugenics, and medical experimentation.

Harriet A. Washington opens her book, Medical Apartheid, with a description of two images of James Marion Sims—a 19th-century surgeon celebrated for his development of cures for gynecological diseases. First, Washington describes a statue honoring Sims located in New York City by the New York Academy of Medicine. Then, Washington describes a painting that depicts Sims right before conducting experimental surgery on Betsy, an enslaved woman, without anesthetics or Betsy’s consent. For Washington, these contrasting images of Sims—“one benign, one malevolent” (2)—provide a framework for understanding the racial divide in American medicine that Medical Apartheid explores.

Washington argues that a “medical apartheid” (20) exists within America, with African Americans receiving far worse treatment and care than their white counterparts. African Americans have higher rates of numerous diseases, including cancer and AIDS, and have far lower life expectancies than white Americans. Further, African Americans are diagnosed with mental health disorders far more frequently than whites. African Americans frequently mistrust the largely white US medical establishment, believing they receive worse treatment or outright abuse at the hands of doctors. In turn, white doctors have frequently viewed Black people as “noncompliant” patients who refused to follow treatments due to baseless fears.