Louis Sullivan’s autobiography, Breaking Ground, offers a valuable account of his professional achievements and a worthwhile look into the pitfalls facing black doctors and health care reformers in the mid-to-late twentieth century. Sullivan was born in Blakely, Georgia, in 1933. He earned his undergraduate degree from Morehouse College, went to medical school at Boston University and interned at Cornell’s New York Hospital. After completing his medical training, Sullivan accepted a haematology fellowship at Harvard’s Thorndike Laboratory and joined the medical school faculty at Boston University. There, he developed a national sickle cell anaemia programme dedicated to research, treatment and public awareness. In 1975, he accepted an appointment as the founding dean of the Morehouse School of Medicine and played a critical role in establishing the school as an accredited four-year institution. During this time, he came into contact with George H. W. Bush and, in 1988, joined the Bush Administration as Secretary of Health and Human Services. In this position, Sullivan led efforts to educate the public about HIV/AIDS and the dangers of tobacco use. He eventually returned to Morehouse as president of the medical school and lobbied successfully for what would become the National Institute of Minority Health and Health Disparities. Throughout his career, he worked to increase the presence of women and minorities in the medical profession. Breaking Ground downplays the impact of racial discrimination on Sullivan’s career but its influence is readily apparent. Outside his time at Morehouse, Sullivan was often the only black practitioner serving in the institutions where he trained and worked. He was one of only three black medical students enrolled at Boston University and the first black intern to serve at the Cornell Medical Center. While generally accepted by colleagues and professors, Sullivan repeatedly struggled to obtain housing and employment because of his race. After completing his residency, he received an invitation to join the medical faculty at Duke University but had his offer rescinded when administrators learned of his racial identity and expressed concerns about integrating faculty housing. Many of Sullivan’s research and political endeavours were also circumscribed by a cynical racial tokenism. His sickle cell anaemia programme relied heavily on resources from the Nixon administration, which funded the project to gain favour with black voters. Prior to his appointment as Secretary, Sullivan also accompanied Vice-President Bush on a diplomatic trip to sub-Saharan Africa. There, his primary role was to help the administration project an image of racial diversity. Sullivan identifies political partisanship, more than race, as the greatest hindrance to his work. Early on in his tenure as Secretary, he raised the ire of conservative anti-abortion activists by making unscripted comments about Roe vWade. He also faced stiff opposition from liberal reformers who viewed his policies as extensions of the Reagan era. Even within the Bush administration, Sullivan struggled to gain traction for his health care agenda. Describing himself as a political ‘mixed bag’ with both Republican and Democratic policy leanings—and insisting Bush was more open to issues of health awareness than Reagan—Sullivan explains that acute political factionalism was an unexpected obstacle that prevented him from connecting with potential allies and successfully navigating the landscape of health care reform. But while Sullivan presents himself as a political greenhorn, his party loyalties were often in conflict with his efforts to align with the tradition of civil rights activism. Most notably, his support for Clarence Thomas’ nomination to the US Supreme Court seems to undermine his stated commitment to gender equality and racial justice. It also flies in the face of his purported admiration for A. Leon Higginbotham, the Chief Judge of the Third Circuit Court of Appeals, who was considered by many to be a more worthy replacement for Thurgood Marshall. Sullivan regrets his endorsement, claiming he was deceived by Thomas. But he is also silent about the historic appointment of Jocelyn Elders, the first black US Surgeon General, and mentions none of the other black doctors, including Morehouse graduates, who assumed prominent roles under Democratic administrations. Coupled with a critique of the Affordable Care Act that reeks of partisan bias, his claims of political naiveté come across as somewhat disingenuous. Sullivan made noteworthy efforts to promote health awareness and diversify the medical profession. But, ultimately, Breaking Ground is an attempt to solidify his conflicted legacy. It offers some valuable observations about the history of African Americans in medicine and the political environment of health care reform under the Bush Administration. Interested readers, however, will find more nuanced historical analysis in the scholarly works of Vanessa Gamble, Darlene Clark Hine, Todd Savitt, Karen Kruse Thomas and Thomas Ward—as well as Marybeth Gasman’s history of the Morehouse medical school, which is co-written with Sullivan.1 Footnotes 1 Marybeth Gasman with Louis W. Sullivan, The Morehouse Mystique. Becoming a Doctor at the Nation’s Newest African American Medical School (Baltimore, MD: Johns Hopkins University Press, 2012). © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.
Social History of Medicine – Oxford University Press
Published: Feb 7, 2018
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