operating the cameras and working to collect all the questions, your help is appreciated, couldn't have done it without you. hope to see you back here real soon. >> booktv on c-span2 every weekend with the latest nonfiction books and authors, comes from these television companies who support c-span as a public service. >> reporter: up next booktv haps monthly "in depth" program with medical ethicist harriet washington, the monopolies: the shocking corporate takeover of life itself--and the consequences for your health and our medical future" and recently published carte blanche about nonconsensual medical testing on member to be with missouri, african americans and prisoners. >> host: harriet washington, you write that at age 10 hours schweitzer, out of your life, out of my life, change your life. how did that happen?

>> guest: i discovered that particular book and began reading others and i was struck by his spirit, how he melded his christian beliefs, most of all a life devoted to service. i just found that incredibly compelling, he is a totally enchanting. as i get older, my admiration of him continued unabated but i became a little bit more nuanced, people get began pointing out things about his behavior and character which added up to the fact that he was not perfect any more than the rest of us are perfect but coming to that realization was quite a journey for me because at first i had intolerance of

any evidence of being less then perfectly actuated by his spirit of service and i began to realize he is a human being as we all are and it is important to not expect perfection because one is destined to be disappointed but to appreciate people who achieve great things, inspired untold members of other people to also pursue an agenda for their lives. loved him, still love him, he embodies the spirit of medical science perfectly. >> professionally where did that book and your own persona lead you? >> even before i found that book i think i was probably inspired by the film the nonstory starring audrey hepburn but very different from other rules, she wasn't -- he was in mind, a deeply conflicted by her political

beliefs and passion and torn between being a good none, a quiet none and being a healer. that inspired me. it inspired me to become a physician. i did well in high school, won the prizes, when things came to a rude halt when i entered college at 16 years old and was told university, forget medicine, that's not a realistic goal for you. i was told by several people there are no african-american women doctors. it is not going to happen for you. of course that was a lie but i believed it because i had never seen one. instant derailing, i was young and used to being encouraged in an academic environment so i sort of acceded to what they told me and i would never do

that today, but it was painful for me and more so because i realized it wasn't only my story, it was happening to a lot of people. >> you write, harriet washington, during your career as a medical researcher someone said to you, quote, girl, black people don't get organs, they give organs. >> guest: yes. the worst parties in large part he was right. >> host: what is the back story? >> guest: i was managing a poison control center, teaching in upstate new york, i loved the job. we were given file cabinets by radiology, emptying it out and saw other files that had been forgotten in the cabinet and being me, i read every one.

i was appalled to discover, the files of african-americans who need kidney transplants, seem to be treated differently. the social profile of the black patients had the word negro very prominently written on every page of the social profile, to make no mistake that you were working on a black person and they mostly seemed thinner. i found two files that seems identical, about the same age, elderly gentlemen in kidney failure but both had been employed, they both had families, the things people look for in terms of social support, physical and financial ability and the white patient was sick, filled with testaments for his determination to live and

everything needed to buttress his claim to an organ. the black person was thinner, had a single line. the treatment goal was to help him prepare for his imminent demise. it was signed by a physician that i knew. a kind airtight man, embodied the same qualities i first admired in albert schweitzer. i was so disappointed to. of course that was not proof race was a large determining factor but it certainly was evidence, talked to someone who worked on that unit. just this summer i reviewed a book called the organ thieves which an author talked about one of the first organ

transplants, from a black man into a white man. he detailed the history, some accurately some not. basically he illustrated, other black people, their bodies were used to procure organs, the same thing happened in this country, happening in south africa, i remember as a high school student hearing the christian bernard and his success at heart transplants no one talked about the fact that these organs were going into white people from black people in a country where apartheid was the law. it was that disparity. in some cases it still is. "medical apartheid: the dark history of medical

experimentation on black americans from colonial times to the present," you quote martin luther can from 1965, quote, injustice in health is the most shocking and inhumane civil rights abuse. what was he referring to? >> guest: exactly that. doctor king had many concerns. we typically understandably hear about he was equally concerned about economic disparities and healthcare allocation which he was prescient enough to recognize the systemic program before many other people did. if you go back to a lot of accounts during that time you sometimes find papers denouncing, that were overly racist but turning a blind eye to their own racial disparities but doctor king's view was broader than that. he saw what was happening, the

political and economic and health struggles of people in this country were bound to gather, inextricably linked and also how profoundly cruel that was, dictate a person its entire life, being determined by their race or the fact that they were for it. "medical apartheid: the dark history of medical experimentation on black americans from colonial times to the present" is a bestseller. you talk about doctor james marion sims. who was that? >> guest: i talk about doctor sims early in the introduction. he's important to me, so well epitomized a classic figure in american medicine. in american medicine we decided certain people are medical heroes. these are the people who achieved a great things but when we use the term hero we

are not concerned how they achieve these things, only that we think they achieve them because sometimes we are wrong, sometimes we ascribe the achievements to the wrong person but a perfect example too of a doctor viewed 1-way by whites and one way by blacks. many white people viewed him, praised him as someone who treated alike & slaves, elected him president of the american medical association and for a lot of white women he was viewed for a long time, they were told to view him as a savior. he was able to cure devastating complication called physical vaginally fistula. it is a horrible complication that results in a woman being incontinent of urine and feces and living her life in perpetual pain and infection, a horrible situation.

doctor sims learned how to close these fistula surgically but he did it predicated on the abuse of african american women, took black women, only black women and experiment on them for years trying different ways, closing their fistulae which meant he was experimenting doing surgery, that were painful and distressingly intimate, they lived as white women did and having someone operating on your genitalia frequently and in front of witnesses, doctor sims would invite friends and other doctors come and watch him work so he was abusing these black women, night white women, by subjecting them and it is horrible what happened but it is also horrible the way american medicine society in general treated this behavior. even today you will find people defending doctor sims by

claiming he used no anesthesia but there was no anesthesia then. they are wrong, there was. today one would have to test it and it would be written up in medical journals but during the victorian era, the nineteenth century the practice was to experiment. try things out. asking the patient yes or no if they were white but not asking the patient if they were black, simply procuring a person, buying, selling, renting, borrowing from their slaveowner, simply doing what you want to do with their bodies. two different views of doctor sims, from black women enslaved by him and forced into painful distressingly intimate surgeries and white women, the horrible consequence of

childbirth. something one finds repeatedly if you look at the four centuries of history. in american medicine you find the bodies of black people appropriated and used in service of other people, white people, an opportunity to say yes or no. >> host: you write in apartheid: the dark history of medical experimentation on black americans from colonial times to the present" the dearly held precepts of scientific racism sound nakedly racist, absurd or both today. in the eighteenth and nineteenth centuries scientific racism was simply science and it was promulgated by the best minds, the most prestigious institutions of the nation. what is the role of the prestigious institutions? >> these men, they were all men, their role was among other things to not only solve medical problems, but to tell

the world, americans and the world who african-americans were. you had swiss naturalist at harvard, one of the best-known scientists in the world, one -- the group of scientists who examine african-americans and made certain proclamations about them, that african-americans have different bodies than white americans. black people belong to a different species. they weren't truly homo sapiens, they represent a missing link between animals and human beings, black people didn't feel tame away whites did because their nervous systems were so primitive. simply unable to register pain or anxiety or develop heart disease which back then was ascribed often to anxiety. african-americans were profoundly different beings.

not just people with different skin color or hair texture, these were beings who were not really human and had diseases white people never had. a deficiency disease was found to be in infectious disease black people had because they were dirty basically. even vesicle angela fistula, the complication doctor sims experimented on, affected more slave women than white women and the reason with slave women were sexually profligate and dirty. the reason given for a lot of illness like malaria, yellow fever, they proclaimed black people didn't die from yellow fever the way white people did and suffered less from malaria. the theories were really profound, the idea that black people didn't suffer heatstroke, they could work long hours without becoming tired, take these beliefs

together and they constitute a profound apology for slavery. if you were a planter confronted with a vast field in a subtropical environment widely held to be a malaria's environment where people get malaria and a very hot environment where most white people or native americans might suffer heatstroke what better boon than to be given the creature who didn't feel pain, didn't get heatstroke, didn't die from yellow fever, that you were assured did not feel pain and was not going to have certain illnesses. it was like a boon, a wonderful thing. what doctors were doing with these theories was supporting enslavement and they continued to support it as enslavement changed suddenly with abolitionism exerting a lot of pressure to end the practice in other countries, ending enslavement so the medical theories became more and more,

frankly, hostile towards african-americans but their real purpose was support enslavement, lend moral and medical support for the practice. horrible situation and frankly you can still see aspects of it today. >> host: that is what i wanted to ask about next. have you found proof of that mindset having effects today? >> others have found the proof and actually sometimes it is really well-documented. for example pain. the belief that black people didn't feel pain which was used to justify forcing them into enslavement and harsh work and forcing them into medical research. it is okay to cut the genitalia of african-american women because unlike the white women they are not going to feel a thing. you would think that sort of

belief would be long gone but studies have shown consistently that we still believe that, medical practice is still incorporating that belief, most recent was 2016 at the university of virginia did a study and found 50% of medical students surveyed believe african americans did not feel pain the way whites did. they believe african-americans required more radiology, more radiation for treatment ended whites. these beliefs are right out of the nineteenth century and affect how people practice. they also found a good portion of practicing doctors believe this was we have doctors practicing in this country who believe african-americans don't feel pain. that is a very dangerous belief and again, it is straight out of a few centuries ago. i worry about things we are not tracking is not looking at. the only thing that abound now

is believe in racially disparate diseases. it sounds laughable but we have them still today. whereas back in the nineteenth century just as doctors believe black people did not die from yellow fever, malaria, today they also thought black people had diseases only they had. things like to put a mania, things that only affected and killed black people according to them. today we believe that too. it is a common belief even today that sickle-cell disease is of black people. it is not. the people at risk for sickle-cell disease are people whose ancestors who currently crop in an area where the mosquito is common. that mosquito carries malaria and being heterozygotes are

having traits of sickle-cell, not the disease the traits is protective against malaria. if you live in an area of malaria and have sickle-cell disease you are more likely to survive than people with sickle-cell disease or people who don't have it or don't have it, gives you a fitness advantage but it is a matter of where you have grown up, not a matter of your skin color and yet we treat in this country sickle-cell as a black disease. even when coronavirus 19, when research began on it in france french doctors quite promptly published an article in which they proposed their belief that africans and people of african descent reacted to infections of all kinds very differently than white people. this biological dimorphism is

still driving medical thought even though there is often no evidence at all or the evidence is very weak or poorly understood as a with malaria. we've not shaken this off four century later. >> host: harriet washington, your most recent book, carte blanche, the erosion of medical consent can you open with a modern-day story of a doctor named doctor robin armstrong. >> doctor practicing in texas treating nursing home cases, hydroxycaloric when first promulgated by donald trump who by the way had a profound conflict of interest, owning stock in a consortium that includes, in any event this was made, this was popularized by

trump. a lot of his political supporters embraced it and robin armstrong, a supporter of trump, was the first to propose his nomination for president. in texas. we that he began giving it to nursing home patients and employees but the nursing home patients, many of them were too and firm, too all or cognitively deteriorated to offer informed consent. you can't give informed consent if you have cognition problems or not thinking very well or are very well. this fell into that category and those cases it is typical to go to the next of kin. you talk to their children, to make decisions for them. when asked about it, reporter said i didn't do that because of i talked to the families about every treatment i wanted

to give i would spend my time talking to family so he is unrepentant about the fact he was not getting informed consent. he claims people had been cured but when local health officials examined the records they found something very different, a good number of people had gone on to become ill and die despite getting this medication. the larger question, the larger issue is this penchant for not obtaining consent in situations where consent has been mandated by law and by practice or in cases where doctors or institutions decided is more important, expediency the organization is more important than observing people's right to say yes or no.

the larger question is 1996 without people being aware of it with total lack of transparency, we had large changes in the law that took away people's right to consent to medical research. no transparency. people don't know this. we are seeing more and more experiments conducted on people who never had the chance to say yes or no whether they were involved in medical research. it is a fateful step, doctor jack katz said in 1996 and i'm frankly puzzled by the fact that so few people, has been so little information about it. people have to know this pattern in this country, unless it is arrested it will continue and we will wake up to find out we don't have the right to consent to many things we expect to have the right to consent to.

>> host: harriet washington, what is the legal and medical definition of informed consent? >> guest: they are nearly identical. it is more than just asking someone or conduct an experiment and have them say yes or no. everything a person needs to know to make a decision. tell them what it is you propose to do. how you do it in detail. risks that you don't know of that you can't address those obviously. tell them the risks you do know at the benefits you hope will accrue and research you cannot sure there will be benefits. just as easily be harmful, might be beneficial and tell them anything you know how it might affect them. will they be tired, hungry, unable to eat or drive, all

these things are revealed to the person. lifestyle changes, what the purpose of the research is is very important and violated in the past. hard to see how important that is until we see a violation of that. you tell them all that but that you are not finished. once they are in the research as things change as new information emerges, say hypothetically you find this particular drug causes the hair of redheads to turn brown you've got to tell everybody that as well. everything that arises has to be shared with people so they are always in a state of knowing everything a person would have to know. you must tell people no matter what they have signed or what they have paid they always have the right to lead the research, that is very important.

this has to be conveyed to people and that is in the code of federal regulations in section 50 that deals with human experimentation, in 1996 two exceptions were passed to the law and that is where the problem comes in. in certain types of research in this country, they don't have to tell you you are in a research study. >> host: from carte blanche harriet washington right since 1996 being forced to participate in medical research has been permitted under the federal code of regulations, provided certain conditions are met. what are those conditions? >> conditions are various. if you're testing a new treatment, it is a strange condition, testing new

treatment, you have to make a case that it is better than the existing treatment. the problem with that is the vague language that permeates these laws. what is better? what that results in in my opinion is you want to test something new there is a full on press to try to disparage the existing treatment, treatment nobody questioned but something new to test, the problem is giving saline to people losing xyz. that is easily done and that will satisfy the condition. you often, not always, have the condition that you don't have to tell people they are in the study, you don't have to get there admission but sometimes you are told you do have to tell people who live in the area that you are doing this study. they are aware of the fact they

are shot in the chest, they end up in a situation where they have artificial blood pumped into their body, tell people that in general so that they know. they called this community consent but no consent involved. they changed the name and call it community notification of the problem with that is some areas like north carolina and the area of duke university, you had 5 million people in that region who could be affected but when they did community consent, only a tiny percentage of these people, a few hundred people and that is what happens. the example was in seattle where at one point they told people the same thing, testing artificial blood, we may put this artificial blood in you, they were deluged by requests for exemptions and the exemptions instead of being a

bracelet that you had to wear 24 hours a day every day saying i decline the study. in this case i decline the study, got so many requests that they ran out, they ran out of bracelets for one year. during that year, nobody could get exemptions from the study. it wasn't a real, really wasn't observed even though they claimed it was. what are the other conditions? those are essentially it, those are important ones. conditions on vague language, other kinds of care, it has to be flawed in some ways. you are pressed to find any treatment that doesn't have some flaws but that is exploited to denigrate it and push for an experimental administration of something without getting people's permission.

>> our guest this month on booktv's "in depth" is medical ethicist and scientist harriet washington. she is the author of several books, beginning in 2000 with living healthy with hepatitis "medical apartheid: the dark history of medical experimentation on black americans from colonial times to the present" came out in 2007, shocking corporate takeover of life itself--and the consequences for your health and our medical future" which we haven't talked about yet, came out in 2011. "infectious madness: the surprising science of how we 'catch' mental illness," "a terrible thing to waste: environmental racism and its assault on the american mind" came out in 2019. the most recent book just out this year, carte blanche, the erosion of medical consent. we will continue talking, we want to hear your voices as

well. this is a participation program, you can call in with a question or comment for other harriet washington. 202-748-8200 for those in the east and central time zone, 748-8201 for those in the mountain and pacific time zones. if you want to send a text you can send it to this number 202-748-8903. if you do send a text message please include your first name and your city. you can also participate via social media. just remember@booktv, facebook, instagram, twitter, finally our email, booktv@c-span.org. we will scroll through those during the program but several ways to contact harriet

washington. what we have been talking about so far kind of leads me to think about the henrietta lacks. harriet washington? >> guest: couldn't hear you for a moment. >> host: everything we talk about leads me to think about the henrietta lacks story. >> guest: henrietta lacks first of all i am so happy that henrietta lacks is now a household name. it is a very important story and i am glad that so many americans know what happened to her. in 1994 i spoke with her husband who was still alive and her family about her. i was deeply concerned that this woman, 1951, had been

suffering ovarian cancer, had been cultured, kept alive without her permission. her husband was very vehement, told me in no uncertain terms he had refused permission for her cells to be taken and the hospital did it anyway. this has been something that has befallen people of color since they came to the american shores. it happens all the time. in her case her cells were very unusual and turned out to be biologically very valuable in terms of providing a good medium for culturing disease, testing medication, including the polio vaccine. yet her family was lied to. first of all her husband who

had no idea herself had been taken over his stringent objections and her children, i spoke with her son david many times and at length and visited him in baltimore and he told me they found out by accident from a family member who worked at the hospital their mother's cells being kept alive. one researcher at johns hopkins who had been frank with him, told him everything and even included their mother's story in his textbook but all the others were denied it. they tricked the family by telling them at one point we are concerned you might have the same cancer your mother had so we had to get samples from you. that's not why they want to the samples. they wanted the samples because poor laboratory technique was calling -- causing the samples to be misidentified and they needed to identify which samples and which were not.

that became an international problem, cells were distributed so widely, were so valuable they actually have a lot of samples and cultures that were misidentified, thought they were looking at prostate cells, but they were gila cells. what is interesting to me about that when i read the original medical journals, the way her cells were belatedly racialized, most cell cultures came from white people in part because a lot of researchers would tend to take their own family's bodies, cells and their bodies but in this case, i can only describe it as poor laboratory technique caused contamination instead of blaming the researchers the blame went to the cells. you saw language about the soul being rapacious and aggressive and taking over other cultures as if they were jumping around the laboratory.

it was ridiculous but it was one of the aspects that these cells were especially aggressive and not respecting boundaries so any way the problem, the thing is kind of a horrible example of how the family was lied to, the cells were seen without permission, very lucrative cells, a great deal of money was involved and researchers were consistently saying there is no monetary value to the cells, that's not true at all. no monetary value they wanted to admit because they didn't want to compensate the families. fast forward the positive aspect of this is the -- belatedly johns hopkins took responsibility and belatedly the nih worked with the family in order to moderate distribution of the cells and include the family and their

own rights and that is a good thing. only applies to herself unfortunately. it is the kind of thing i would like to see applied more widely but the other aspect is there was also a white man whose cells were treated in a similar manner. one of the things people have no way of understanding or knowing is even those dramatic examples of the appropriation of cells, lying and withholding credit from the family, today we are facing a very different type of appropriation. it is no longer unusual cells like henrietta lacks, no cells have ever been found that have the qualities that has had. but now companies actually find large amounts of normal cells, very valuable, that have contracts with hospitals to

take the surgically excised cells from patients after surgery to acquire the from the hospital for money and then use them for medically valuable procedures. that means all of us are henrietta lacks. we all have sold -- cells that are vulnerable to being taken without our knowledge or understanding and taking these cells is not only profit. i notice a lot of this focuses on the monetary, the monetary value was but when i talk to her family that is not the prime consideration. they were more concerned with the fact that their mother had been a local benefactor. she had given something important to medicine and it has been acknowledged.

that is what they ask me about, didn't talk about the money involved in the cost of the cell. a lot of journalists perhaps well-meaning first think about the monetary value and focus on that but that was not the family's concern. it was i think they didn't want to know this was a black lady helping the world were his exact words and told me a poignant story about how when i told him some of the things that transpired in 1994 he wanted to see for himself, went to johns hopkins medical library, they wouldn't let him in. he wasn't able to read information about his own mother. so yes, he is very significant, but time has moved on and the patent system, we are now henrietta lacks. it is sometimes our own tissues

on the option block and that means more than a financial value. more importantly lack of control of the way our tissues are used and lack of agency. no one is asking us. it is true there are consent forms sometimes but if you have been a patient in the hospital you know what it is like to begin a sheaf of consent forms. they may not notice some of those forms have to do with tissues taken out of surgery and the language on the forms tends to have things in it like we want to take your discarded worthless tissues. if they were worthless they wouldn't want them and because something is discarded doesn't mean you lose all interest in

what happens to it. you can choose to discard tissue but you may be invested in what is done with them. to give one example, if you have a therapeutic abortion, something mandated by your health status but you are anti-abortion, don't think abortion should take place and they take the abortus and do something with us, has to do with preserving, supporting abortion then you might not have wanted your tissue used that way. you can have interest in discarded tissue and that is something researchers would do well to incorporate in their decisions how to distribute these tissues. >> host: you talked to the lacks family in 1994 but it wasn't until 2010 but like you said henrietta lacks became a

common name in the american culture because of rebecca. >> guest: that is right. >> host: did you think about writing the story earlier? >> guest: i did want to. i wanted to write about the story. i had an interesting exchange. i wrote a brief article of a defunct magazine. the baltimore sun, and the magazine piece. focusing on the things that were most important to me and to readers, focused on the effects of appropriating these tissues, focused on failure to acknowledge the important role of this african-american woman and the ethics of distribution

and things like that, really weighty issues and the response from the baltimore sun was this is too heavy, can you humanize her a bit more? what do you mean? it seems so sad. it is sad, isn't it? can't you write about her dancing for example or wearing makeup or something to humanize her? i said i don't want to do that because it is an important ethical issue and i don't want to dilute that. they asked me some pointed questions, at least to me they were very pointed and showed a cultural divide. in baltimore, they had gone through several name changes. the african-americans referred to it as monuments involved. the official name is something like that. i referred to it as by the african-american name and they

were adamant i should change it. i said yes but they didn't even know that was the official name. then i began to realize most african-americans thought of it by that name. i realized there was a cultural disconnect and it wasn't going to be bridged. i wasn't going to write about her dancing and wearing makeup because i thought that would dilute the import of what happened and i wasn't going to impose -- would have been happy with both names but wasn't going to impose the wrong name, seems like there was a cultural problem here and so i said forget it. i don't want you to run the peace. they ran a piece afterwords and in that piece the -- it began by talking about henrietta lacks's nails being painted red

and focused on her dancing so that was a piece they wanted to write. i wanted to write the story, the focus, the editors i spoke with were looking for seemed to me to be the wrong focus, seemed to be a focus that would seem to undercut the severity of what had happened and the import that happened. intent on having family members saying things they were not saying. it wasn't going to happen in that climate, the interesting thing is the important thing about rebecca's book, now everyone knows who she is. i am grateful for that. one of the things i know as a medical ethicist in my training is the claims made in the book

and elsewhere about lack of ethical regulations and ethical strictures during this time, the claim that there were no medical ethics back then, scientists and doctors could do as they wanted, that is not true. i wrote a review of the organ days summer that made the same error and pointed out in detail there had been a number of court cases and a number of laws passed that established the right to informed consent, not just in law that hospital practice. people claim these laws just exist, what do they mean or not, tends to operate against acknowledging abuse of african-americans. they are absorbed when it comes

to whites but not when it came to black people. being -- saying they didn't exist is a way of exonerating researchers who chose not to observe when it came to african-americans. i would have written a very different book and who knows, may yet. >> host: author harriet washington is a lecturer on bioethics at columbia university, page 1 editor at usa today, research fellow, medical ethics at harvard. first call for her comes from marianne in new york. you are on with arthur harriet washington. >> caller: just got my c-span reinstated, didn't know anything about your book. can't wait to get my hands on it and my question recalls my own experience trying to take care of my elderly parents and

seeing how terrible, unbelievably bad elderly people get treated in hospitals. my question, does your book contain advice not to go on and on here, when i first -- somebody who came back from colorado, advanced directives didn't mean anything if you're not informed how bad this is a what they intend to be do and i was saying to her should i carry them with me, what happens if you're in a car accident or unconscious, don't know that they have them, how do you get that protection, in colorado getting tattoos, proof that there is protection. >> host: let's hear from harriet washington.

>> guest: excellent question. advanced directions and their limitations, i talk about how the elderly are particularly valuable in detail than in the book but the problem is it is hard in my opinion, what can one person do? you are confronted with laws and lack of transparency, during the pandemic heightened of necessity, you're even less likely to be able to see your loved one in the hospital or actually talk face-to-face to their doctors and caregivers and getting information is even more difficult. this is a problem that needs to be solved in the law. you can't ask individuals to negotiate and navigate in most

cases they don't have the leverage, don't have the information they need as you pointed out. we need to change the laws to prohibit making draconian decisions about giving or withholding care without the input of family members, other people who can touch their consent for the person who might not be able to give consent. an excellent question that affects a lot of people. it will affect even more i am convinced with the pandemic on. >> host: harriet washington's most recent book is carte blanche, the erosion of medical consent. our next call comes from gary in atlanta, georgia. >> caller: how are you doing? i am a native rochester area and. >> please call me harriet.

>> caller: i knew ron devote in college. >> guest: that is my late husband. you must tell. >> caller: what a great guy. the reason i am calling, as a black gay man, i just don't see a black gay men taking advantage, the cdc local organizations that try to get the word out. what is your medical opinion? do you think african-americans, particularly black gay men mistrust the medical system? you won't have to deal with aids and hiv and compared to our white counterparts, white gay men, 80% prep. there is a disparity and no one can answer the question as a

young black gay man living in atlanta and new york city where you have high prevalence of hiv in those communities why wouldn't you be on prep? >> host: have you gotten the covid vaccine? are you planning on getting the covid vaccine? >> caller: i'm already vaccinated, thanks for asking. dirksen senate office building >> host: you write in up -- dark history of medical experimentation on black americans from colonial times to the present," black eye for phobia is the fear of medicine. >> guest: that fear is often justified by history. it is interesting that we often talk about fear of medicine among african-americans without also talking about the untrustworthiness of the healthcare system. these go hand in hand, can't talk about african-american

behavior without talking about the healthcare system that routinely and consistently failed the more even abused them. if you do, the implication is african-american behavior is a problem. the problem is black people want to avoid types of care or don't trust care, the problem is we have a system that creates disparities, abuses people, particularly african-americans, punishes them for seeking medical care, for example, i talked earlier about the persistent contemporary belief that african-americans don't feel pain the way whites do, when they come to hospitals they are often, routinely turned away as drug-seeking. in that case whose fault is it? is a black person being afraid of care or the healthcare system? having said all that there is also the fact that sometimes african-americans as gary

points out to avoid certain types of healthcare or don't get types of healthcare often but we don't know in cases like that how often people are actively avoiding the care, black african-american gay men, are they avoiding prep? not trusting prep? is it less likely being held as an option? it is important to find out what is going on. unless we look and do studies designed to find out we can't know what is happening and i am really glad that you brought up the vaccine because a parallel case, we have been reading all last summer lots of daily headlines saying african-americans didn't want to sign up for clinical trials for covid 19, afraid to join clinical trials, every day those headlines but when the

data were published, a researcher at johns hopkins, what i saw was 10% of people in the moderna trial in 10% in the biotech trials were african-americans. african-americans are 12.3% of the population. that means african-americans were signing up. there was no whole scale abandonment. there was no refusal. we were right there. in fact my question is who is tracking white americans? how often were they signing up for clinical trials? are they signing up at the same rate of the population where only 50% of them? the question is why are we scrutinizing african-american behavior and so often calling it a and or adverse and behavior when in reality it could be just as easily lack of access or maybe as with vaccine files, right there and not being acknowledged.

but because you seem to be following this really well and knowledgeable about it, let's assume it is exactly as you feared and african-americans are avoiding it. and after you rule out access problems, that becomes a matter of trying to make sure african-americans understand the advantage to them and find out if there are any fears find out what they are. can't ally them without knowing what the fears are and addressing them. it is a matter of doing a little research to find out what is really going on. maybe it is not being offered to them as often and we have to find out if they are avoiding it why are they avoiding it and 0 in on it and try to raise those numbers to where they should be. that is the one question, thank you for asking it. >> host: if you're intrigued by our conversation with harriet

washington today you can go to c-spanshop.org and you can purchase one of her books and part of that purchase price supports the c-span mission. c-spanshop.org. ron in san diego go ahead with your question or comment for harriet washington. >> caller: my name is ron brown. i was starting to talk about the racial bias in the medical profession. i recently found out when i get a blood test, they got a blood test for blacks and a blood test for others. why is that? and concerning henrietta lacks, the helix, how come they don't have any let us know how many

diseases this lady cured or anything? because to me she did more for medicine than anyone else. >> host: harriet washington. >> caller: you might be right about the latter point and that is exactly what her family was concerned about in 1994. as i began telling the things i knew about there was much more of course. .. they said. it's a question that i've been asking repeatedly about many people including medical researchers that attend not to get their due if they are african-americans and that is an excellent question. but in terms of this test, i am concerned what test is this. i have to say this is news to me. i had no idea that there were tests that were being administered on a racial basis is still. can you tell me a bit more about

it? >> host: ron is gone. i apologize. t >> guest: i wish i knew what he was talking about. maybe he will want to come back or text us to let us know because it is something i don't know about. and a lot of people know early >> early in the design of blood storage, blood in this country and a few other countries was, indeed, being kat: goized by race and charles was working on stories in uk but didn't want to work for that reason and it was based only racial superstition. absolutely no medical basis for it at all.

for those of whoa who can't get through, you can try social media, facebook, instagram, twitter, e-mail at c-span.org and finally phone numbers for our remaining hour with author harriet washington, 202-74-8700, 202-74-8801 for pacific and mountain time zones. barbara in new york city, good afternoon. >> good afternoon, peter, good afternoon, ms. washington. two questions. a little local newspaper here a woman wrote an article vaccine and asking why new yorkers are refusing to get the vaccine shot and at the end of her article she makes a statement implying that it's the duty of people to

get the shot and in your book you talk about how individuals are told that they have a moral responsibility to participate in research. can you speak if we have a moral responsibility to take vaccine, you talk about murder in order to sell the body to anatomist, can you explain why and when did that happen? i have her other book medical apartheid. >> i think she's wonderful. >> are you a medical professional in any way? are no, i'm not. >> -extra, before you go. repeat your question about

refusing the coronavirus vaccine. >> the lady wrote a title vacillating on vaccines. why are new yorkers still refuse to go get the covid vaccine. at end of it she implies, you have a duty to get the covid vaccine. >> thank you, thank you. i don't remember the particulars except it was a white woman

living in black neighborhood involved with a black man. block people in the area claim that and still claim that many black bodies had also been used. so white woman documented the black bodies are still, you know, was never documented. very concerning but happened a long time ago and hopefully that's nothing like that is being done today. in terms of moral responsibility for accepting the coronavirus vaccine, that's a tricky one. there are people who argue that it was a moral responsibility. the point is the more people vaccinated, the better protected are people who cannot accept vaccinations. so by -- excuse me. by accepting vaccination of

coronavirus you're protecting yourself including people that could not receive vaccination for some reason, maybe they are too young or allergy to one of the ingredients. there are people who cannot do it. also vaccines are not infallible. even though they are well designed and work really well in most people, they may not work for certain people, certain individuals. so the more people who are vaccinated, the better the chanceva we have as a community, as a country of avoiding illness altogether. so the argument is that that if you can be vaccinated, you really should be vaccinated to protect other people. and that argument has moral authority to it. it's hard to argue with that. going from that to saying that it's an imperative that we should force people to get vaccines, force to become vaccinated is quite a step.

sometimes it should be undertaken. i'm not really equipped to say whether it's something that wend should mandate by law. i think that mandating it by law is something that we should consider. i'm not sure that you should do it. americans, we love our freedoms. how many things have we seen invoked in the same of freedom of speech that people in other countries would not necessarily see as freedom of speech. so we love our freedom and we don't take kindly being told that we have to do something and yet that's a tool in public health that i sometimes think we don't use often enough. so i'm not prepared to say that vaccines should be mandated by law. i am prepared to say that wearing masks should be mandated by law for the simple reason that it's protective, we know it to be protective and right now

we so often rely upon organizations or institutions to like enforce it. we are not able to. how often, how many videos can you see of people in a whole foods refusing to wear a mask and exposing other people before you realize that the whole foods people are not necessarily equipped to enforce this. if it has to be enforced, it should be enforced by the government. this is something that's a tool that wee need to consider using more often in the case of vaccination, though, i'm not quite sure especially because a lot of the claims about people refusing vaccines i find to be -- african-americans accused of refusing of vaccines just like african-american refusing for signing up for clinical trials. african-americans are not getting vaccines now.

a lot of it is due to lack of access. we have policies that separate african-americans from vaccination. we have practices that separate them from vaccination and so mandating by law would be problematic because you will end up punishing people for things that are not their fault. you know, we have a policy that dictates that people who are 85 and older get priority, then you have to face the fact that in this country african-americans, hispanic americans, native americans are all young populations. much less likely to reach that age of 85. 90-year-olds in this country. you have twice the rate of 90-year-olds that are white as 90-year-olds that are white in this country. when you have a policy that prioritizes and privileges that are 85 and older you're actually operating against people of color. we should certainly be prioritizing older people. i'm not saying that. we should be doing but we have

to prioritize people of color that are at higher rates, higher risk of infection. we need better policies, not punishing people for things that are not their doing. >> harriet washington, have you gotten your vaccine and what kind of research did you do if you didnd get it or didn't? >> i got my vaccine but i'm first one to admit that although i was happy that the vaccine, very happy mra vaccines worked out well, they could reproduce very quickly and effective. they seem to be extremely safe. how much research can one really do. they have of necessity the vaccines were, indeed, generated more quickly and without the same meticulous data that we require from other vaccines. that's just a fact of life. we did not have the luxury of an extra 5 or 6 years, you know, to dot all the i's and cross all

the t's. i think we did the right thing knot to do that. it also means that we were relying upon companies' certifications that their vaccines had 90% efficacy, not quite the same. the thing was, in my opinion it was the only logical step. i was very happy we had a vaccine. i embrace the vaccine because look at the alternative, the longer people take to embrace the vaccine, i keep -- i try to make it very clear to people that it's not 100% guaranty that they'll be no problems, that's an unrealistic goal but 100% guaranty that if you don't take vaccine you're much higher rate of becoming infected and infecting victim yourself and falling victim to a variant that

can be much worse than we are seeing now. i worry about the people who say they are going to wait and see. in fact, i talked to a doctor who has written well about this at mgh. i'm going to wait and see what happens, the longer you wait, the more chance that you're going to be exposed to some variant that would be worse than what people are experiencing now and that are more ill and spread that variant. so it's a dangerous thing to wait and see. it's very clear that the best policy course is to take the vaccine. >> mgh is massachusetts general? >> you're right, massachusetts general hospital in boston. taking the vaccine in my opinion is the only logical route. it's the thing to do. i'm glad that we have that option and if it hasn't been

abundantly clear it's important that african-americans understood that. that's why we were in the clinical trials in the contrary. there's a lot of noise and anecdotal that african-americans whoo don't want to take the vaccine and i convince the numbers are dwarfed by those who want the vaccine and have a hard time getting it. >> regarding the question that ron just asked. i had heard that there are different test standards for things like diabetes for black people than other races in determining whether someone has diabetes. >> i don't know about diabetes. i do know that there are

algorithms. you know, basically formula used to determine whether someone is in a disease state. yes, you're right about. they are also used to determine what treatment should be given to people and unfortunately you're right in that race is factored in and should not be factored in. i think that is changing too slowly but we are beginning to see changes. for example, excuse me, if you read medical journal articles, you'll see when describing a patient race is almost immediately one of the first things they say about the patient and my question is why. shouldn't you be ascribing the patient, what their symptoms are, their own history. why do we need to know that that's african-american than a white person? that's a deep flaw in your thinking and the algorithms contain the flaw deciding that a

diagnosis will be different if a person is black or white. i spoke with patricia williams. actually i was on a panel with her and she described eloquently exactly what you're saying. she had osteoporosis test and the doctor was trying to run the results and it wasn't working. i couldn't get the response from the testing mechanism. they kept saying no response possible until her doctor decided he was going take the fact that he wasas african-american out of that equation and immediately they had a value for her. so,, yes, something that's been done in american medicine and beginning with incorporating that the person is african-american from the beginning and in the assess rent and that's wrong. it should not be there. all it does is skew results and that's very problematic. so i wish i could say that i see evidence that this is changing

quickly. i see evidence that it's changing glacially slowly. >> i'm a psychiatric nurse. one of the things i've noticed during the years of working in psychiatric units is that patients of color especially black patients were given higher doses of psycho active meds compared to white patients that had similar symptoms from the same diagnosis. that always bothered. >> yes. you're absolutely right. it's been a long time but a long time ago i worked in a psychiatric unit in the emergency department actually and i saw the same thing. african-american patients are more likely to be diagnosed with a sycosis, a serious mental illness. the same symptoms will give a white person a nerosis, a less serious illness and symptoms

tend to be interpreted much more dramatically with much more severe illness than the same behaviors and same symptoms of white people. they tend to be given more higher dose of medication than whites. when i asked a psychiatric nurse why it was that black people were receiving higher doses, he looked at me and she was perfectly serious. she said, you have to understand, african-americans have more muscle mass and harder for them to metabolize and i knew that was sheer bs and i was keshock today hear her say that and that's the same kind of thinking that i talked about we saw in 19th century with doctors deciding that african-americans had different diseases, that they had diseases they were immune to and that they were

reducing the pain and they believed that medications given to black people and white people and some some medication didn't work for black people at all and they needed higher dose, more rradiation for cancers. it's complete fiction and no basis in fact and yet it's being done. something that needs to be challenged and who knows maybe you or somebody working within the profession can get some spirits to whether they need to continue to do this. >> onhave you thought of going back to medical school? >> me? i'm a bit old now. i probably would if i were younger. >> norma in eugene, oregon. >> good morning. >> hi, norma. >> good morning. >> hey, ms. harriet. i've got a question for you. i'm a 74-year-old mostly apache

heritages. i was diagnosed with polio at the age of 22 months old. mind you polio doesn't affect the face but that's the most of my body that was paralyzed and i feel like i was experimented quite a bit -- >> norma, why do you say that? >> well, okay. since september of 2019, i've had 7 face procedures. prior to that, when i was younger i was in the hospital from 22 months of age, pretty much continuously till i was 9 year's old. >> oh my goodness. >> most of this care was paid for by the march of dimes. so there was money to cover what they wanted to do with me.

and i was in isolation, the theory that polio was contagious. >> norma, is this just looking back you think that maybe experiments were done at you or is this something that you have proof of? >> no, that is most of my questions. how do i research this because i was in isolation so i don't know what other patients were going through. >> thank you, ma'am. we got that good question there. how can she find out of her cmedical history harriet washington. >> right, it's difficult to prove when one has been used to research without one's knowledge. it's very difficult to prove. you can looking at olds records is a really good start. the problem is that old records sometimes are unavailable. they might not ever have been digitized. all too often what i found over in researching

events is that records are quote, unquote, lost. when i hear that records are lost, i almost immediately have a negative reaction, the thinking of okay, maybe they were lost and maybe they were lost on purpose but the reality is, you have to go into it with your eyes open and realize that they may not be able to have taccess to these things, howev, one good thing approach might be finding a sympathetic ear in a journalist, perhaps a journalist in a local publication of yours because they've very practiced and skilled at getting information. the freedom of information act is something that anybody can file but as most journalists know, there can be small changes in the way that you file it, increase your chance of success. so ratheras than going into this on your own, you might want to try to find an ally, if you can get a journalist interested in this, that could help you.

if you can want, it's a matter of educating yourself. you know the institution where you were treated or surgery, et cetera, was done, then you do a freedom act and ask information about your own case. depending on where your live, regulations might prevent you from getting information on any other cases but you should be able to find about your own and also matter of finding out when you can, what kind of procedures were done, experiments were conducted and that can also be very difficult. if youth live in california, its a bit easier because california has the, quote, sunshine laws that make it easier for you to find out about governmental activities. other states are basically a fishing ebbingg pedition that cn take a long time. you mentioned the procedures done fairly recently in 2019,

and those your chances might be a bit better in finding out precisely what happened. hey, i'm interested in knowing more, what procedures you did on me and if that gets you nowhere, finding freedom information act and i wish you all the luck in the world and it can be done, but, again, i would urge you to try to get the assistance of a journalist or somebody who maybe do the things in a little more skilled manner than most of the rest of us can. >> looks like we have ron from san diego back on the line, ron, what kind of medical tests were you talking about? >> i was talking about blood test. you go and get a blood test and

they have an algorithm where you take the test, they use the algorithm to determine. if you are black, they have algorithm and they have algorithm for others. that's racial bias. >> it is. >> the way i looked at new england journal of medicine and also the va. va is now -- the question has been put up from me and i guess others about this situation. racial bias and medicine and new england journal of medicine and there are a lot of scholars, papers, you can go to see. >> all right, ron, we are going the leave it there and hear from harriet washington on this. >> yes, the algorithms are absolutely in play here.

i wanted to know what kind of test, there are many types of blood tests and there's one in particular that you were pursuing. >> i apologize, harriet washington, i let ron go. ii wanted to get in more calls o i apologize to both of you for that. susan in cambridge massachusetts. hi, susan. >> hi, thank you for taking my call. i'm at the beginning doctors who don't belong but still revered and one to look into harold, father of head medicine and pioneer in psycho subpoena sematic illness. he worked for the cia. there's a number of books, 3 books that i know that explain his involvement in developing torture techniques to the cia

which you then used on the migraine patients, i doubt with any concept. and my brother was a patient of his who had brain tumor for 6 years until it ruined his life. so his research on psychosematic illness. what he did he took torture techniques, et cetera, and used them on migraine patients who the cia records say came outer fied and said headaches were gone and they didn't know because -- >> susan, can you put a period on this? >> published a profiled of him in 2016, i think, it was.

>> we are going to leave it there. there's a lot of information harriet washington. anything that you want to respond to susan about? >> i'm very, very susan about your brother. that sounds horrific. dr. wolf, you said has been the subject of 3 books you said and other publications and i'm glad that this has beenn exposed but i'm very sorry about what happened with your brother. >> gladis, baltimore, good afternoon, you're on c-span2 with harriet washington. >> good afternoon to your guest there and you too. this is my first time to ever call, i believe. i'm curious about the president of nigeria. i don't know him but i'm curious. he's been to the doctors over in england a couple or more times and i'm wondering why he hasn't

selected united states for his medical problems. i don't want to know what his problems are too, so harriet, could you tell me why he's going over to england all of the time? >> gladis, what's the crux of your question, it's a distrust of u.s. medicine, is that what you're asking? >> yeah, i would say that, that would be the answer, yes. >> thank you, ma'am. >> i'm afraid i t can't help yo, gladis, i have no idea what he's serving from and why he's preferring doctors from the uk to the u.s. sorry. help you, >> we have not talked yet about a terrible thing to waste, environmental racism and assault on the american mind. what's the definition of environmental racism? >> if you ask 10 people you get

10 definitions. the exposure to toxic substances whether they are industrial chemicals or heavy metals or pathogens, this exposure is racially immediated in the country. people of color are exposed to it at much, much higher rates than people who are white, even profoundly poor white people are less exposed to environmental hazards than our middle-class black people. it's racially immediated and recognized as such. a lot of results are racially immediated. excuse me. environmental racism, we find that lead poisoning is success among white children in the country but black and hispanic children it's still a scourge that robs them off of their health but cognition over time. we have the racially brain

problems and brain damage in the country due to our failure to regulate hazardous materials effectively. >> now, would lead paint be part of this problem? >> yeah, lead is a heavy metal that we know causes a variety of physical illnesses. it's locate anything but also the brain. we know it damages the brain. lead in terms of paint, lead and gas, even lead-lined water types as we -- that causes all the destruction in places like flint, pittsburgh, u.s. in fact, most major american cities. yeah. lead paint is probably the iconic source of environmental

toxicity. >> harriet washington, your book deadly monopolies came out in 2011 and we -- we reference this a little bit when we were talking about henrieta lax, in this book, in 1980, colleges and universities secured 260 patents per year. in 2000, that number was 3,000 per year and they make hundreds of millions of dollars, the colleges and universities do on those sales, what happened? >> but the college university makes a few hundreds of millions of dollars but pharmaceutical industry makes $6 billion a year. basically what happened in 1980 was that businesses convinced congress people and especially -- they needed to be able to

exploit the patents developed in universities. the federal government was supporting university research and it was coming up with a patent and molecules and discoveries that were potentially important but universities were not in the business of producing products. so industries said, let us buy these patents or, you know, rent these patents and duplicate products, we will create more medicines that are needed and generate a lot of industry and we will make them into medications. the government said good idea, pass the law to allow them to do this and as a result of that law pass 1980 and similar laws. passed 1980. we now have corporations who have basically controlling medical research. they determine what drug are developed, how much the drugs are going to cost, they determine which drugs are going to be discouraged and ignored and the things that universities

once did, corporations now do, but corporations are focused on the bottom line, they will make a decision that's going to garner them the most money. they're not making decisions that are going to gardner -- garner us the best drugs and that's why we have 20 drugs for reck tile dysfunction and almost no new drugs for malaria. the latter is a killer but erectile dysfunction is something that are willing to pay a lot of money for. we turned control of medical research from universities over meto corporations and it was noa good deal. >> why do drugs seem to cost more in the u.s. than in other countries, is it because they are not subsidized? >> the drug companies will charge what people are willingtr and able to pay to stay alive. it's no accident that the most

expensive drugs are for the most dangerous diseases. so if you have a drug that might save you from dying of cancer, the companies know you're willing to pay almost a million dollars a year for that drug or your insurer and that's how they charge. however, in the developing world you don't have people that can pay that kind of money either the drug company won't sell or the people in the developing world can't afford it. in this country people go bankrupt more medication and in the developing world people just die. >> what about generics? >> they are made by the same companies that make the, you know, patented for profit brand and the thing is so generic drugs are approximately 20% lower, at least in 2001. 20% lower than the first-brand drugs. the problem with generic drugs

is that they're not the answer because the same companies that are making them and what will happen is that in this country they're not that much cheaper and the companies will come up with another drug that's unpatented that might do the same thing but is advertised as better than the old drug. the old i drugs might work perfectly well or might work even better for some people than the new ones but the new ones are the ones that are being pushed and doctors are under pressure to prescribe to patients and so thick about -- thing about generic drugs, in some countries for a very long time you had drugs -- you had countries that had different patent systems. so, for example, in this country what's patented is the actual composition of the drug. in another country -- in india,

what you patent might be the manufacturing process. that meant indian companies were reverse engine and sell the same drugs being sold in our country but much more cheaply to places like nigeria, thailand where people could not afford our drugs. unfortunately the world trade organization passed some laws forcing poor countries to respect the western patents. they couldn't do that. they have to buy the expensive drugs. even though the patent system has written into it basically an escape clause, it's perfect legal for the u.s. and any other country to say, we are going to take the patent away from the company that is selling the drugs for a lot of money and we will give it to the company that promises to make the drug for something less that people can actually afford, but when companies have done that, the u.s. is quick to accuse them of

intellectual property theft and castigate them as doing something criminal. it's really frowned upon. our government and ourna compans don't want to do this and won't do this and castigate people who do this and the clause is not being made available to us. drug prices are being maintained arthel: officially high level and the prices, let's be very clear, have nothing to do with the cost of the drug. the companies claim their rational that drugs are expensive to produce and market and they are but they are not nearly as expensive to merit the prices that are being asked for them. so reality is that the cost is one thing, but the prices are something that are based on what people are willing to pay.

>> we will show you the books that harriet washington, some of her favorite books and some of the books that she is reading. here areks some of her favorite. aero smith, jumpa, the war by anthony, the beggar's opera, other stories by samuel delaney and currently reading button brooks by thomas man. went through a lot of books

harriet washington. you added this mote to our producer and you said that i just finished reading 30 plus books in my role as national book critic circle board member, so i'm taking a break. >> that's a lot of books. >> that is a lot of books. >> i'm lucky enough to be in this group of people that are also fervent about books and reinforce each other's sickness. there you have it. >> when we were reading the list of books and you heard what some of your favorites were, which ones trying you that you want to talk about. >> aerosmith. >> okay. >> i can't completely explain the fascination for me. it's a fascinating book. i read it at least once a year. ii have to admit reading more often and i find -- it's weird because the book was published in 1920's.

sinclair was given nobel prize for this book. but it'soo embraced more by scientist than literature people which i kind interesting and on the face ofpl it it's kind of straightforward. it talks about a young man who becomes a medical researcher, but before he engaged in pure research, he start, he has a lot of like faints public health, private practice and aspects of medicine which reveal something about his personality but described by sinclair lewis perception of him that seems to be mocking but also very true, you know. it's hard to describe except that sinclair lewis had invented

part of the american continent and didn't actually exist but when you read it it's recognizable and real and did it in 1920's in way today. aero smith talks about one of the signal events is when there's pandemic, epidemic breakout in a tropical island and martin has to decide whether he's going to give half the people on the island what he hopes is a cure, a vaccine and the other half go unvaccinated in ordernd to preserve as contrl and he does this and he justifies it but the dilemma that we face today. today we are faced with dilemma what are we going to use some people in the world as basically

test subjects to improve the health of other people, dilemma and lewis captured it perfect in 1920's in the way that you can recognize today. w anyway, it's a wonderful book. i can't recommend it more. you will recognize a lot of things and probably fresh revelations and it's probably the best of american medical landscapes i've read ever. >> well, what i noted in your writing is that george bernard shaw seems to make an appearance every now and then. >> yes, a doctor friend of mine said, shaw, was a great doctor hater but i don't think he was. i think he was a very clear-eyed realist and a few things that he summed really well. one of the things that he said that i actually supplied to african-americans when i wrote apartheid that he talked about the fact that for a lot of

people in medicine is a tragedy because you have to trust hmedical people, trust doctors and researchers with your life and yet you don't trust them. it's a horrible dilemma. it's a real american dilemma that a lot of people in the country face every day. so i think shaw was right on the money there. i don't think he hated doctors, i think he had a clear-eyed view that doctors were highly skilled and idealistic but, you know, again, human beings, flawed like the rest of us. >> we have about 15 minutes with author harriet washington and steve in cincinnati, good afternoon, you're on book tv. >> hi, thank you very much for letting me come on and speak and my congratulations to ms. washington for fabulous books, just amazing. there's a doctor in 1985 harold

freeman was at harlem hospital, a cancer surgeon and came up with a procedure called navigation where he helped people- >> yes. >> get from the community to cancer care and turned upside down the whole issue of mortality. he became the first african-american president of the american cancer society. but he was also a member of the colombia university medical school of faculty as well but his procedures never really spread across w the country and here in cincinnati we are still reluctant to use his procedures even though they are so effective. i wonder if ms. washington knows about his work and knows also why people are reluctant to use this navigation approach? >> steve, why are you familiarig with harold freeman? >> i just came across his work and incredibly impressed with research showing that in 5 years he had transformed 70% mortality

rate into a 70% success rate. >> are you in the medical field? >> yes. >> in what capacity? >> trying to help people get exams for cancer and other treatments and also to get vaccinated as well. >> thank you, sir. harriet washington. >> steve, thank you. thank you for bringing up dr. freedman. i know dr. freedman and i'm aware of his work, you're right, it's extremely important. ground-breaking work. freeman had, again, he saw things during -- i don't know, during the 80's and 90's that a lot of people only realizing just now. he's also the one who famous i will said that if you look at the life expectancy of a black man in harlem, it's the same as a bangladeshy man. so you can't compare the health

of black people, black people in new york as if they are all being treated well because they are different. what we saw about that. is reversal, he was taking the point of view of the patient. up until then, the focus had always been from the system centered. is this patient showing up for their appointments and complicit with taking medications and are they doing x and are they doing y. he took the point of view of the patient. how can the patient get their medications? are there barriers for the patient getting to the hospital and once they get there, how do they find out or navigate and find out how to get to the right clinic or the right caregiver. you know, he recognized that hospitals were largely opaque to

outsiders and patients and that a lot of the focus on patients not following through or patients not doingn what they're expected to do had more to do with system failures than it had to do with patient failures and that is a very hard view to take historically from the point of view of american medicine when there are certain -- the perspective often from the point of view of the surgeon or not doctor of high-social status, you know. what was being done from their point of view? was the patient doing x, y and z and how the system needed to be either navigated or -- or improved, it's a huge change and hard for people to make it. i have noticed anecdotally and i

know anecdotally it seems to be more the norm in parts of the uk especially places like london and more appreciation and the navigation takes place. but you know, just like his success and getting people into successfully and getting seen appropriately has been mirrored by other people as well. i'm thinking of calendar when everyone was ringing hands and saying that african-americans won't sign up for organ transplant or won't follow through or they won't be complicit with it but quietly got many people, he got african-americans invested in the transplant system. signing up to be donors, getting their friends to sign up and even ottisbrawley had the same

inverted perspective from the point of view of the patient, of the subject, how are we failing them? how can we better serve them? that seems to be the big difference between them, taking that approach than how do we make them fit within the healthcare system which is admittedly flawed. so that inversion is a hard thing people to make culturally and also just so you know how can i put this, the habit of practice, you know, habitually and getting people to completely invert that, that's a big ask, but can be done and very successful and i hope that success that these people have had is going to militate for

others paying attention and doing things differently. we can only hope that was a great thing to bring up, steve, thank you. >> harriet washington, are we looking at your office at home? is this where you do your writing? >> this is my -- what passes for an office. i try to do all of my writing and you can't see it but i have a huge bookcase to the left and smaller one over here and my equipment and stuff and it's my little, you know, space capsule here. >> all right, part blanch started this year, how much of it was researching and how much was it writing? >> i don't know about research and writing. in fact, it's a hard thing to tease out for me because research is continual so i really don't know. i worked on it for about 2 years. i only planned to work on it for

one year but the pandemic intervened and made a lot of changes in publishing so the bookended up being published a later than it should havepu been fine.hed which is i'm really happy with that and i'm happy with colombia global reports and it was actually a bit of a relief to write a smaller book. i'm used the writing the huge doorstopper and this one was more focused than smaller and i really enjoyed that. >> are you ever surprised at what the research takes you? >> constantly. i worry if that weren't the case. one to have larger more broad surprises i've had is that in 2002 or so, 2002, i used to look on conspiracy theories very differently. i would sometimes, you know, hear fromen people who would tel me something that sounded

utterly fantastic and although i proud myself in keeping open mind and i have reaction that this can'tct possibly be so, you know. the more i have learned the more i've revised my thinking. now even when i hear the most fantastic things, my reactions tends not to be this can't possibly be so, i will see what's going on and look at it and find it and there were things that i found were true that i honestly did not believe could haveev happened and yet ty have happened and so it's really expanded my idea of what people are capable of and it's really expanded my idea of -- my appreciation of how often when we hear, we hear story, we hear claims, how often we -- and

include myself, judge veracity. i think to myself, i'm hearing from some person and they may not have that much education, they may not be that sophisticated and more likely to think conspiracy theory or something that's not really true. but then you often hear from people who are, you know, vastly credentialed and they will now -- know not to be true but the bottom line is i have better appreciation how often being dismissive a conspiracy theorist is a factor of the person's education, income, social status rather than, you know, how to what they're saying is. i think that's a really important thing to understand because we would -- we know more about history. we would know more about events if we judged them based on

actual excavating the history than judging them based on assessment of who the people are. >> just a couple minutes left with our guest. michael deerfield beach florida. >> yes, what a great segue. what you're talking about there is bias and blindness to huge moral inconsistencies. i have a question for you and hopefully a discussion to follow to propose covid natural herd immunity and public policy is textbook, dictionary definition. you don't know politics, just pure meaning of words, textbook dictionary definition of trump covid genocide and in this case specifically by intent eugenic genocide. >> we've got that, let's get an answer. herd immunity, genocide,

president trump. a >> one of the problems about series that are frankly elogical and infuse fiction into them and so much illogical assumptions but it has the lingering credibility. that's what happened with term herd immunity. there is such a thing of herd immunity. it does exist. it's not what these people are talking about and more to the point, what these people are talking about is very dangerous, you know. allowing a disease to rip through a community is suicidal. it's complicated and if you want to know more about it, there's an excellent book by paul iwald.

when you do that, you allow disease to proceed unchecked, you're risking, elevating the risk of all kinds of things, for example, that disease when it's going through the population unchecked, will kill many more people. we have last more than half an three quarters of million people in the country. how many more will die if it goes unchecked? probably will. for example, a variant that are more dangerous and things will escalate. it's a suicidal supposition and frankly illogical. it doesn't make sense to a person who has absolutely no

training or education, lay people will find this kind of -- should find this completely illogical and yet something that's being proposed. a lot of things are being proposed but it's really, really important to not rely upon things that sounds logical but s rely upon the experience of eepidemiologist who can understand the things that can occur. so what's really most important is if you ask someone like dr. anthony fauci or any other epidemiologist about this, peter, they will quite clearly explain to you why it's a concept and yet you have people thanks to the internet being catalyzed to spread the kind of very dangerous, dangerous rumors, i'm glad that you brought it up because it just can't be castigated enough. we have to be very careful not to listen to these kinds of things and ignore experts. >> harriet washington of

colombia university has been our guest for the past 2 hours on book tv. she is the author of 6 books, the most recent being this, carte blanch, the erosion of medical consent. thank you for your time this afternoon, ms. washington. >> oh, thank you. i'm very grateful to have been here. >> be sure to visit c-spanshop.org to get your copies of harriet washington's books. ♪ ♪ >> book tv on c-span2 every weekend with the latest nonfiction books and authors, funding for book tv comes from these television companies who support c-span2 as a public service. >> tonight on book tv on c-span2, colombia university law professor jamal green looks at

america's approach to individual rights and offers his thoughts on how to build a better system of justice, philosophy professor talks about free speech and the free exchange of requested and on our weekly author interview program after words, democratic senator tammy duckworth of illinois reflects on her life and career in the military and in the u.s. senate. find full schedule information online at booktv.org or consult your program guide. >> here is a look at some of the books currently on "the new york times" nonfiction best-seller's list. first the code breaker by ceo and best-selling biographer walter issacson and green light by author matthew mcconaughey.

the beauty of living twice, after sharon stone reflects on her life and some of the best-selling books according to new york city is activist memoir untamed. some of the authors have appeared on book tv and you can watch their programs any time at booktv.org. >> well, good afternoon, everybody. thank you for joining us for this event. heritage events live, i'm the director of the center for american studies at the heritage foundation. it is my pleasure to welcome everybody here for this event, conservatism in america's future, the topic as you know. i'm also delighted to welcome everybody here as part of this lecture series, russell kirk series, the permanent things. those moral and spiritual truths that makes government,