Special Episode: On the Origin of Epidemiology

our regular season episode the previous week. So, for instance, we followed up our multiple sclerosis episode with the bonus episode on the epstein bar virus, and our chlamydia episode with a bonus about other chlamydia species affecting koalas and other animals. The beauty of these bonus episodes is that we get to enlist the help of an expert and absolutely pepper them with questions, both on the topic of

interest as well as their careers. I have really enjoyed putting these episodes together, and I've learned so much about an incredibly wide range of topics, and this particular bonus episode is no exception. Last week, Aaron and I told the story of tetanus, a deadly but fortunately vaccine preventable disease that is caused by this spore forming talks and producer anaerobic bacterial species Claustridium tetani. Most of you are probably familiar with tetanus, and, like me, have a healthy

fear of stepping on a rusty nail. But what many of you may not know is just how prevalent neonatal tetanus used to be and still is today in places with limited access to vaccines. Neonatal tetanus usually occurs when the umbilical stump becomes infected with the tetanus bacterium, which can happen while cutting the cord with a non sterile tool, for example. And if you haven't listened to the tetanus episode yet, I recommend that you stop here, go listen

to it, and then come back to this episode. But I'll give a quick recap here anyway, just to kind of preface what we'll be talking about in this bonus episode. While discussing the history of tetanus. Last week, I spent a fair amount of time talking about neonatal tetanus among enslaved people in the American South Before the Civil War.

Neonatal tetanus in the South was an extremely prevalent and deadly infection, said to be responsible for up to two thirds of the deaths among infants born to enslaved people, and this led to it having a reputation of being a disease of the South, especially of enslaved people, and last week I asked whether it was indeed a quote disease of fatal frequency solely of the South, or whether

northern physicians simply weren't looking for it as much. I used the example of neonatal tetanus in the South during this time to illustrate two different themes. One is that you have to consider the focus of medical studies as

a factor of time and place. Southern doctors were more likely to observe neonatal tetanus because they were employed by enslavers to monitor the health of enslaved people, whereas Northern doctors lacked both the reason to look for this disease as well as the opportunity, for lack of a better word, to observe it in a larger group of people, especially those whose consent was not or could not be given.

And the other theme is how the institution of slavery is one example of a structure that led to physicians making observations of populations rather than individuals, giving them a bird's eye view of how disease spreads, and this is what basically led to the birth of epidemiology. These two themes are not at all of my own creation, but rather feature extensively in the latest book by my guest

for this episode, doctor Jim Downs. Doctor Down's book Maladies of Empire, How Colonialism, Slavery and War Transformed Medicine is a new and necessary re examination of how we tell the story of the origins of epidemiology. Did this field come about during a London caller epidemic with John Snow in the broad Street pump? Or did it emerge in army hospitals, on slave ships and within colonies as physicians

collected information or outright exploited non consenting subjects. Doctor Downs joins me in this bonus episode to explore some of the ideas presented in his fantastic book, and I cannot wait to dive in. So let's just take a quick break here and then we'll get started.

that context. In your book, you explore how colonialism, slavery, and war during the period of the seventeen fifties through the eighteen sixties led to this huge shift in medicine. People began to study populations rather than individuals, essentially kicking off the field of epidemiology. Can you explain what it is about this period that led to this revolution in thought?

purely out of a medical question. It's coming out of the biggest social transformations of the mid eighteenth century, namely the rise of the slave trade and then the expansion of colonialism and the growth of empire. And then both of those forces kind of coalesce by the mid to the mid nineteenth century with the rise of war, the Crimean War and the Civil War, which again battlefields become

laboratories in which populations are again studied. So ultimately it's the ways in which imagine the slave trade is about the movement, the violent, brutal transport of enslaved Africans to the Caribbean, to North America, to South America, and it's all done for economic purposes, but it ultimately created major medical crises, and so there were doctors deployed on those

ships to care for the crew. But ultimately they realized that so many people were becoming sick and dying on those ships that they began this massive effort to study

the spread of epidemics. And what I also noticed, and this is what I think separates my work from maybe someone who's found the doctor from thirteenth century Venice, is that these doctors are all tied together through a military network and the military is a massive bureaucracy, and the military demands these physicians to document their observations and to keep records. So now up happening is doctors are now in contact with what's happening on various slave ships throughout

the Atlantic. They're trading information, they're developing preventative protocols, they're coming up with treatments. Whereas before there was no real mechanism, there was no real umbrella to knit these doctors together.

And one of the things I'll say before, because I could talk about this foreveryone, ever and ever, one of the things that blows my mind is someone living in the twenty first century was that the creation of what we understand is the American Medical Association is a relatively

new phenomena. It was around, it gets developed in the eighteen forty, so prior to the creation of those professional networks, Sure there were societies, Sure there was a circulation of some journals, but really the military creative bureaucracy that allows for the studies of populations that leads to the development of epidemiology.

So statistics emerges as a way of trying to create a rational order to respond to what seems to be really irrational, and that is the rapid morbidity immortality. So that's part of what happens. The other part of it is that colonialism is obviously very much invested in numbers, and so there's already a built in investment in cataloging

things and thinking about things in terms of numbers. There is an early science before statistics call nosology, which is a sort of branch of science that develops that again draws on quantitative and empirical analysis. So you see that at work within the medical records. But the other part of this really fascinating is that if you think about empire, empires require maps. Empires require maps to not only track voyages, but also as a way to assert power over particular geography.

And so mapping is integral, it's essential to colonial and imperial endeavors. And so these maps are already situated. When an epidemic blows up, it's just coloring in the map, it's filling out the map, it's using the map to tell a different story. So today when we're thinking about outbreaks of COVID, and we're thinking about mapping and surveillance and all of these are important, critical hallmarks of epidemiology and necessary for us to understand how disease spreads the genealogy.

The origin of that mapping practice, whether or not it's efficacious, originates with colonialism and empire.

in part by shifting incentives and opportunity. So can you talk a bit about how colonialism, slavery, and war incentivized understanding the spread of disease while also providing opportunities for physicians to study these populations of disenfranchised or oppressed individuals in a way that they hadn't been able to previously.

West Africa for any signs of the international slave trade. Ultimately, the ship stops at Cape Verde just as a holding place before it makes his trip voyage back to London. When it stops, when it eventually arrives in London, everyone says, this ship is infected with yellow fever and you need

to be quarantined. And there's explosive debate about lockdowns and about quarantine, about all of the things that I was writing about in twenty seventeen, which I thought like people are never going to understand, Like they're not going to understand. I was like literally in a coffee shop in New York being like, how do I I can't call the chapter quarantine. No, I just want to get that and like the year twenty twenties, like hold my beer, like

guess you have no idea what's coming. So ultimately what happens is there's a question of like, well, how did this originate? Where did it originate? And so the British military, the British and the government send a doctor to Cape Verde, and when he arrives there, he begins this massive effort to interview all of the p people on the island.

And basically what he's doing is contact tracing, and he's drawing on the narratives and the testimonies of mostly enslaved and colonized washerwomen because they had been dealing with the quote dirty linen and this could be potentially infectious. Now what's fascinating is these women had no idea he was coming, but they understood the incubation period. They had already mapped where it spread from one place to another. They had sort of figured out this house got infected, but this

house didn't get infected. And he puts together their story and he produces what I call the largest inventory of a patient narrative of black people in the nineteenth century. So, to go back to your question, we often say he's the hero. He figured this out, he traced it, and look, he did a lot of work. The point is to

not discredit his work. But the point is, as many medical anthropologists have said, as many people interested in narrative medicine talking about it's about centering the patient narrative, that his knowledge, his ideas could not exist without their contribution. And so when doctors eventually figured out it was yellow fever.

It wasn't just from mc williams identification of pathology. It was about washerwomen noticing the black vomit and to know, wait a second, I know these people are sick, but there's something's up here. The vomit's black, and not to just say oh, they ate something bad, like they were noticing the symptoms and then it becomes codified through his

formal publication. And so my work is to try to say, how does the experience of colonialism and slavery and war create create new opportunities of knowledge production, and how can we also acknowledge patient's contribution to science.

in the meantime. He uncovered it as well, and he wrote a chapter on it. But he turned the doctors into the protagonist in the story. I turned the washerwomen into the protagonist's story. Neither one of us is right at history as an interpretation, but it's about how we tell the stories. In his account, these women don't even appear in my account. They've been lifted off the page as purely just informants and cast as important contributors to

the development of knowledge. And so that's how I think. That's what I think the answer is. It's talking about why and how the patients matter. There's also a new book called Medical Bondage by Deirdre Cooper Owen about the rise of gynecology in the American South that developed as a result of Jay Mary and Sims' experiments on enslaved women. Again, Deirdre Cooper Owen, a very good friend of mine, a very good colleague. Is not saying that Sims isn't important.

She's actually putting in the context of many other doctors that were like Sims. But she's also giving voice and giving textual space in the man Your Script to the enslaved women not just as objects of study, but rather as interlockertors, as people who were there and who were possibly know we're contributing to this new development of ideas. Sometimes I feel like, think it's a really academic and people are like, yeah, that sounds like really cool, but

I don't see it working out. And then I have one word for you, A loss of taste, of smell and taste. When the COVID pathology first came out, and I was one of the people who first got COVID in March of twenty twenty, I was actually flying from LA to New York. I felt a little tired, but I thought it was jet lag. I felt a little nauseous. I thought it was like something that in the airport. I noticed immediately I lost my sense of taste and smell.

It was not reported as part of the pathology. It wasn't until Kelly Ripper on Our Morning Joe It's read an article in the New York Times, and all my friends in LA were like, Jim Kelly Rippa. Its article time. And so the question becomes, how did the loss of taste and smell become part of the pathology of COVID? And it became part because patients started reporting it and doctors did not dismiss it as silly. I'm sure a bunch did, right, but a bunch didn't, And so then

it becomes recognized as a hallmark of it. So, in other words, when I say recognizing patients, we have to say that we are in a process of recognizing patient narratives even today. So it's it's not just an academic theory that sounds good, it's actually how we understood what COVID is and how we're going to understand what long

COVID is as well. Right, it's going to be patients reporting and doctors then going through that material and making sense of it and saying, okay, this works, that doesn't work. But the patient is important. The patient is a is an architect of knowledge in this in these.

the attention away from the patient. And I feel like it's all still, but it's still happening, like we're still we still don't do a great job of it. But one of the things I thought was really interesting in your book is that it kind of went up into right before germ theory became a thing started, and yet still there were these hypotheses, or these prevailing notions of the way disease spread, namely in miasma theory or contagion theory.

Can you talk about how those two prevailing thoughts influenced this birth of epidemiology.

this person got sick then that person got sick. So they believe in Godasian and then they're like, well, where's the origin, and so they would turn to rotten vegetation, corpse, unsanitary, like an unsanitary mass of trash, and they would say, from that unsanitary massive trash, there would be these poisonous vapors emanating from it, and these poisonous vapors are moving

through the air, and that's what's getting people sick. And then people said, no, I don't think so, and so colonialism becomes another important testing ground to figure that out. One of the places is in a Malta, which is in the center of the Mediterranean, and it's an important quarantine hub. It's an important quarantine hub for ships going from Europe to the Middle East. It's an important hub

from North Africa to Europe. And so what happens is you have two populations of people that begin to be studied, Muslim migrants and washerwomen. And the first is like the washer women are sort of like they come up in the Cape Verdi chapter and they come up here again. And as a historian, I thought when I saw them at Cape Verdie, I thought, oh, it was interesting. It's important.

When I saw them again in Malta, I was like, these are an important group of people that are central to the development of knowledge and medicine during this period and have not really been cast as leading thinkers or leading actors. And so what happens is the ship's go into port, the ship's quarantined, it's isolated, no one can come on and off. They have to wait two weeks in order for whatever's there to eventually not be there.

And so these washerwomen ultimately are going on the ship to collect the dirney linens and then return the linens, and some doctor recognizes they're not becoming sick, and so automatically this sort of like they become the subjects to actually prove that contagion doesn't work, and they become the subjects for doctors to launch these massive investigations into what causes people to become sick, because it can't just be

it can't be miasma and it can't be contagion. And so the washerwomen are definitely part of the medical treatise. But the other major group are Muslim migrants. Muslims who are returning from the annual pilgrimage the haj are in ships, they're in Egypt, they're in Malta, they are in other places. And again going back to your first question, it's a population.

They start realizing that these ships are quote and infected, they say they're infected, they place them into quarantine, and then they realize plague or cholera or another epidemic is not spreading it, so that the sort of it sort of undermines this argument that contagion is there. And again, think about it, like if you're in a small town or you're in a big city and you're trying to figure out if contagient works, there's no real mechanism to

actually figure it out. But think about how colonialism around the sort of movement of Muslims creates a massive bureaucracy within those ports that allows doctors to record copious information about who's on the ships, what they're doing on the ships, if they're and how they're being under constant surveillance. And so all of a sudden, now these are major test subject populations that begin to undermine contagion theory and lead to epidemiology, meaning leading to a more investigative method of

understanding outbreak. And so just one of the points that happens is that these doctors are stationed all throughout the world, these British doctors. They're in the Ports and Malta, they're in Jamaica, they're in the Caribbean, they're in India, they're in South America. And what happens is when they return to London, they say, we've learned a lot and they

create the Epidemiological Society in eighteen fifties. So that the actual deployment of these physicians throughout the Empire and their arrival back to London to create the epidemiological field proves how this was a global practice and it grew out of these key moments.

He's part of a larger cohort of physicians, and he's part of a group of doctors who've been studying the origins of epidemics from the eighteen thirties, eighteen forties and even earlier. And so the story that I spoke about earlier about John McWilliam going to Cape Verde to study the origin at yellow fever, he and John Snow rubbed shoulders to the Epidemiological Society. They knew each other. So

McWilliam actually goes first. McWilliam goes to Africa first, and he does the interviews first, he creates maps first, he does the investigations first. So John Snow is actually following in the footsteps of imperial doctors who walked through the West coast of Africa to uncover the spread of cholera. Yet he is actually part of a larger movement of physicians who have begun this practice of investigating the cause and spread of disease, And so he's not a lonely pioneer.

He's among a whole group. So while his discovery that cholera is related to the water is genius, his methods he learned from other He learned from other doctors. And that's some thing that I think needs to be recognized within public health textbooks and so forth, that there was this whole group of people who actually were doing those methods. But here's the point. Their methods did not develop purely out of laboratory science. Their methods developed because slavery and

colonialism had made populations available. So when we think about their methods, it's not just to say, hey, snow has these methods. His methods came out of his slavery and colonialism, and it came out of the ways in which those institutions created built environments that allowed doctors to study people. So that's the piece that really needs to be sort of underscored.

in part because they create the Epidemiological Society. I mean, it's really interesting if I could critique my own book, you know. Look, I mean I was so into the source of so into the stories. There are so many things that I kind of thought, Okay, I have to hit this, I have to do that. After publishing the book, I'm like, wow, I could have really just did an entire chapter in the Epidemiological Society. But it seemed to

me like it was such an obvious piece. But that was just me being so in my head and thinking, like everybody knew this, and everybody doesn't know this, and so the reality of it is is for them to actually create a society signals that they see their work as different from typical patient care, clinical practice, and that they see their work as sort of embarking on a new mode of scientific inquiry.

reporting back exactly what was happening. And one of the things, and I talk about this in the book, one of the journalists is talking about combat but also talking about the high rates and morbidity and mortality among the British troops and the British public would have known about unsanitary conditions in prisons, they would have known about them in hospitals, which at the time were not for middle class people. They were basically sheltered for the poor and dispossessed. So

they may have thought about hospitals as dirty places. They may have thought about prisons as incubators for medical disorders, but those were populations of people they really didn't care about.

Now that they've sent their sons, their fathers, their husbands, their brothers to the war and they're actually becoming sick and dying in the hospital, then it's like, wait a minute, you're basically exposing hospitals as these unsanitary places, and people are now becoming invested in why, and so that's in fact, that's what sort of inspires Florence Nightingale, who is a major figure in the book, to lead a corps of nurses to Crimea. And when she gets there, she does

care for the wounded soldiers. She does, you know, put bandages on them and provides comfort and does all of this other stuff. But she's also very much interested in why more soldiers are becoming sick and dying in British hospitals and noticing they're not becoming sick and dying in

the French and the Russian hospitals. And so she becomes what I think is she becomes an epidemiologist in many respects, and within the nursing literature and among some schools of public health she's recognized for her contributions, but by and large, within the larger history of medicine, she's recognized as a

pioneering nurse, but not as a pioneering epidemiologist. And when she returns back to London to crime from Crimea, she meets with Queen Victoria and with Prince Albert in their Scottish home, which I actually think if you watch Dalton NAVI it's like in Navanda, that's when they go. Anyway, So she meets there, so we're just trying to create some images and he based Albert says, listen, I have a tutor, and he's a statistician, and so he teaches

her statistics. And so this goes back to your earlier question about statistics as a sort of way of understanding and measuring epidemics. She becomes inducted into the National Statistics Academy. She's one of the women, if not the first I and so she's a leading thinker. And of course I want to say this too, just she's a problematic person in lots of ways. There's a lot of literature coming out about how she's racist, she's a white supremacist, she's

all of those things. But my argument is that she's also leading the field of epidemiology, and both things can be true. She can be a white superreminisist and she could be a statistician.

dehumanization extends even further. And there's one example in particular that I'm thinking of that you discussed in your book involving smallpox, and I was wondering if if you could describe this instance for our listeners and also share your thoughts on why so many examples of exploitation like this seem to have been largely erased from medical history.

So that's part of it. A lot of this comes out of the Nuremberg Trials, and that sort of begins a public conversation about what the boundaries of doctors and with the boundaries of scientific practice, etc. One of the things that I study, and I study at both in this book and in my first book, Sick from Freedom, is the fact that most people don't know this. And this is the sort of like mind blowing thing that

I sort of uncovered without being sepphagrandizing. But it was just really like going through sitting in Washington, DC, reading medical records and finding references to smallpox and being like, wait a minute. I study Civil War, I study the Reconstruction. I don't know anything about this. I've never heard it. I checked all the indexes of the major books. No one has mentioned it. By taking all of these records

from the military that have created this bureaucracy. I pieced together the fact that at the moment of emancipation, over sixty thousand formerly enslaved people died of smallpox, and no one has sort of talked about that. Now, if you think about it, it's actually not that surprising because during the Civil War more soldiers died from disease than from battle.

So again, when we think of the Civil War, we think of it, you know, the heroic, noble death at the Battle of Gettysburg or at the Battle of Antietam. We don't realize that most people, most soldiers died not from battlefield wounds or battlefield combat. They died from infectious disease. Because there's no such thing as germ theory. They died from GI problems, they died from pneumonia, etc. So the

smallpox epidemic fits within that context really well. And so when smallpox began to spread among Confederate or Union troops, there were two ways of doing two ways of responding. The first was they could fall back on the century law belief of quarantining people, just literally taking someone who was infected and isolating them, and that would prevent the virus from spreading. The second was there was this whole

question about vaccination versus oculation. An inoculation was a practice developed here in the United States in the seventeenth century when an enslaved person told Cotton Mather, Hey, listen, I know there's a smallpox epidemic, and smallpox basically produce a vesicle and in it it gets filled with limph, a fluid.

He said, if you cut open the vesicle and then you cut open someone who's vulnerable their arm, and you take the limph from their arm and you put it into the arm of someone who is vulnerable, they can develop a mild version of the infection and then clear it. Vaccination is the same practice, but you use cowpox, and there's a whole history of that. So during the war, they're trying to get their hands on cowpox, but it's hard to transport cowpox, you know, during a battlefield on

a piece of glass. It's not happening, okay, And so that's not working. So they go to this thing of like, all right, let's go back to armed arm inoculation. But in the process that they're conferring, they're not conferring immunity. They're actually you know, transmitting things like syphilis and other bloodborne diseases and other problems. And so again, the Confederacy has a military bureaucracy, so the doctors are now able to say, out of eighty troops, these are the five

cases that have worked. These are the twenty that haven't worked. These are the fifteen they've done X. Prior to that, these physicians were isolated. They didn't really there wasn't a small box epidemic in the South before the war. They didn't know what worked. They didn't know what what could work, or what didn't work or could whatever. Here's the thing. Someone says, we can't use the soldiers because it's causing

more problems. Let's turn to enslaved infants and children, because they fell back on this pro slavery parable that enslaved people were in an idyllic countryside. They were in a very comfortable position, they were healthy, they were the happy slave. And so the Confederacy basically deploys physicians throughout the South to go and purposely infect children and even better, infants

because they're even purer with smallpox. Then they would come back two or three weeks later, they would check if their body had in fact taken the virus and if they had started to produce the lymph, and they would take the limp and then use it to give it to white people as a form of vaccination. Now this is a really interesting point because I've studied smallpox for over fifteen years. It's not in the literature, it's you know,

it's not really anywhere. The use of children to harvest vaccine matter was not invented, however, by the Southern doctors. This is a practice that happens throughout Europe. As I mentioned in the book, King Carlos of Spain wants to get people vaccinated in Mexico, so he infects a bunch of orphans in Spain, puts them on a boat, sends them to Mexico. Once they're in Mexico, he infects another group of orphans sends them to Vietnam. I mean, this

is the trafficking of children. I just gave a talk recently at the University of Virginia and medical historian said, I have a case. It's eighteen ten the orphans in England, the same thing was happening. So this is a widespread practice around vaccination and a time when we didn't have medical ethics. It was, it was it was these kinds of things were I think more common than not. Now

here's what's really interesting to me as a historian. It's often so the now, it's often so commonplace, there isn't the need to write it down. So it's like they don't think they need to write down like these kinds of things. And so what happens is during a war, the bureaucracy ends up capturing a lot of stuff. It ends up serving as a net, and all of a sudden, you're like, wait a minute, why is this doctor being sent out and this other doctor is telling forty other

doctors to do it. Wait, it's in the command, it's in the order. It's like there's lots of medical practices and lots of medical ideas that aren't articulated, but they're just understood.

to turn to some more personal questions. Besides the origin story of epidemiology, what other areas have you worked on?

to rationalize and explain the spread of HIV? And what I learned was that policymakers, newspaper journalists, public health people, doctors saw HIV, the explosion of HIV in the early eighties, and we're like, what caused this? And they immediately turned to sex culture. And while that's true to a point,

it's not in another way. And what it's done is it's actually turned the seventies into one note and it's failed to see that in the nineteen seventies, for instance, there was the creation of the first ever gay church, actually was in nineteen sixty seven. Like I never knew gay people create their own church, their own synagogues, own

prayer groups. So there's this whole religious movement that develops out of the seventies because you couldn't necessarily go to a gay bar, you could go to a prayer group. You could, you know, So that was interesting. They created you know, we talked about HIV AIDS. We talk about the political networks that got the word out. It came out through the volunteer press, It came out from newspapers that gay men and lesbians and trans people created for themselves.

And they weren't I tell my students this all the time, Like they couldn't put it on their resume, like you people have all these activities, or like I'm putting on my restumes, like this doesn't go in the resume, Like they would get fired if it was on their resume. So they create a whole newspaper culture and they you know,

so there's the first ever gay bookstore was created. And so I grew up at a time in the nineties where there were feminists and gay bookstores all those A lot of those have basically died, But in the seventies those were another site of community building and community spaces

long before you had community centers. So when people say it's just the bars and the bath houses in the beaches where gay people were coming together, I'm like, no, there's churches, there's bookstores, there's community centers, and both can be true. There can be lots of sex, and there

could be that. But the point that I came at it from a medical perspective, which was really important, especially as a gay man, was that we got to stop this narrative about HIV spreads because of problemscuity HIV spreads. If you come in contact with the virus, you could have lots of sex with lots of different people and never catch HIV. You could have be completely monogamous and on your wedding night with another man have sex for the first time and be exposed to it and that's

it and it's not. So I'm trying to like really dispel those kinds of rumors and myths in the book and really point to the ways in which gay people try to create a sense of culture in order to create a sense of community.

was in college at University of Pennsylvania. Uh, a friend of mine said, do you want to volunteer at the Gay Community Center, And essentially we went there on Wednesday night and all of these men who had left Philadelphia or died of HIV stuffed all their belongings from the seventies into paper bags. And the Gay Community Center, the William Way Center was at the time dealing with runaway youth, dealing with helping trans people, HIV testing, dry queen bingo,

but had to reality. Knew that they had to keep their history because the major libraries and archives in the Philadelphia area, which is like the hub of history, as a major historical hub weren't taking them, and so everything was like stuffed into an attict. And I started looking at these documents, and I wasn't a librarian, but just

writing down what I saw. And I learned that that's also what happened in New York and in other places, other gay places, And so it was coming in contact with those sources and coming in contact with that history and understanding that history is doing political work. That's what

sort of really got me interested. And then when I was in graduate school, I read a lot of literature by black women and slave narratives, and so I started researching the history of slavery, and I again uncovered all of these major records about the period immediately following slavery, which we call emancipation, and I just thought, wow, that has to be told. It was the medical stuff, mostly because most of the history is about the important moments citizenship, suffrage.

So I think it was like for me the sources, it's always the documents. I mean, I don't necessarily, I mean I might have lots of different questions, I might have been interested in lots of different things, but what actually leads to the creation of a book is always going to be some kind of record, some kind of document that I don't think has been told.

time I meet somebody, it's like Final Jeopardy. They're like, do you know, And I'm like, yeah, I actually don't feel history questions like don't want to get So that's one of the I think this is like one of the misconceptions I think doing podcasts like, I was trained by Eric Pohoner, I was trained by African American scholars. I was trained to bring what I've learned to the public. I was not trained to sit in a circle with other academics or in front of a big lecture hall

and show people how smart I was. I was trained to say, you learn this, and you have a responsibility to get out there and to change the conversation. And you don't do it by being aloof and being lofty and being you do it by being real. And so like my my advisor, Eric Bohoner, like constantly was publishing in the nation. He's still alive, he's still doing lots of work. He's like he always makes his work really accessible. So and he never really he never sat us down

and was like you need to do this. It was by example, and it was like I remember once he was kind of late for class at NBC News, was like in the courtyard and he was like, I got to do something on air Johnson today I got. I'm like He's on TV, and I was like checking my hair and makeup. I'm like, am I am background? But like I And then within African American studies and being part of that field, in that world, there is a

deep commitment among many to make knowledge accessible. So I think what most historians don't know is that most people don't know. It's like I a lot of us spend a lot of time doing this work, doing podcasts, tweeting, writing articles for the mainstream press, making the information available.

provide historical consultation to the entertainment profession. And so there's lots of people out there that are making documentaries that are in desperate need of historians to service consultants. There's lots of people who are making feature length films and are doing series that are looking for historical consultants, and so I think that's like one of the other ways lots of other historians traditionally go into museum work and

other forms of public history. But increasingly, I mean, I think that historians are really good at learning how to read and write. And so one of my colleagues at History Studio, Eric Armstrong Dunbar, is an executive producer on this show Gilded Age, and the Gilded Age is a period piece is HBO. But she's brilliant, Like if she reads the script, she knows how to identify, you know, what is a good storyline, what is right? And do you know what? She appears at the end of the episode.

She's the first historian ever to testify and to frame an episode. Normally it's just like the actors and the actresses and maybe the showrunners. She's framing it for the American public, and so she's actually changing and expanding the role of historians by actually getting on there, getting to the public and saying, this is what this episode meant, This is what it meant to be a black person in the Guilded Age. These are the kinds of indignities

they face. These were also the opportunities they confronted. Because a lot of times it's very easy to say as a historian, oh, yes, black people suffer from discrimination, Yes, but sometimes that obscures all of the major things they did. And what Dunbar says at the end of that episode is they created an entire publishing industry. There was a huge black newspapers. They have the whole industry of black newspapers that were developing during this time. So I think

there's a lot that historians can do. I just think it's about people may not come to you as a historian bch. You have to come to them, and you have to pitch them and you have to show what you can do, and then you know, hopefully that that'll change more as we progress, So we'll see.

it's surprising. But if you place it in historical context, you say, wow, it's actually part of a larger pattern. I mean, this actually happened during the Civil War. White people didn't care that black people were dying a smallpox. This actually happens before and even now with HIV. HIV is no longer The largest growing group of people to contract the HIV in the United States are not gay

white men. They are black, cisgender women in the South, and yet it's people don't think about it as much anymore. So It's like when you think about history, it actually can illuminate patterns and it could actually help you better analyze and examine a particular issue.

slavery and War Transformed Medicine. I'll post a link to the book as well as to doctor Down's faculty page on our website This podcast will kill You dot com. Also on our website are the sources for all of our episodes, transcripts, Quarantinian Placeberrida recipes, our bookshop, dot org, affiliate account, Goodreads list, links to music by Bloodmobile, links to merchan, Patreon, and so much more. Listen, follow and leave us a review on Amazon Music, Apple Podcasts, or

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very much. We have got a brand new episode on a brand new topic coming out next week, so until then, keep washing those hands, um