PUBLIC DISABILITY HISTORY AWARD -Applications Due Dec. 20, 2019

Did you complete a public disability history project in the last two years? Was it a community-anchored or community-led project designed with physical and programmatic accessibility in mind?

Apply now to win a new cash award sponsored by the Disability History Association. 

Visit our web site(http://dishist.org) to learn more about project criteria. Applicants must currently be members of the Disability History Association. You can join or renew your membership here

Submit a cover letter, project description, and other supporting materials such as media coverage to Nicole Belolan, Award Chair and Disability History Association Secretary, by December 20, 2019, at nbelolan@gmail.com. Questions about the application process are welcome and encouraged. Award will be announced in February 2020.

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REVIEW: Robson on Reber, ‘Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires’

by H-Net Reviews

Vera Blinn Reber. Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires. New York: Routledge, 2018. 348 pp. $149.95 (cloth), ISBN 978-1-138-35950-5.

Reviewed by Charmaine Robson (University of New South Wales) Published on H-Disability (October, 2019) Commissioned by Iain C. Hutchison (University of Glasgow)

Printable Version: http://www.h-net.org/reviews/showpdf.php?id=53717

This is a study of two cities—Buenos Aires in South America and Philadelphia in North America—and their experiences of tuberculosis in the period 1870-1945. In the nineteenth century, this disease emerged as a major cause of infirmity and mortality internationally, linked to the rise of urbanization and industrialization, but for most of this period it was poorly understood. Tuberculosis in the Americas 1870 to 1945 by historian of medicine, Vera Blinn Reber, opens at a time when advances in European biomedicine occurred, leading to international consensus on the etiology and treatment of tuberculosis. Crucial to this development was the emergence of germ theory and, in particular, identification of the causative bacillus by Robert Koch (1843-1910), Mycobacterium tuberculosis, in Berlin in 1882. But a cure did not follow until 1945, when streptomycin, a newly discovered antibiotic, was found to be effective. In the intervening years, with 8-15 percent of all deaths worldwide attributed to tuberculosis, the disease became both a global public health issue, with measures to prevent the spread of the disease, and the subject of medical research in the battle to find a cure. This forms the medical context for the social and public health histories presented in this book.

Tuberculosis in the Americas has seven chapters plus an epilogue. The first chapter focuses on medical and scientific discourse in relation to tuberculosis from the 1890s to 1920s. In this period, the theory of heredity was gradually replaced by that of contagion, as reflected in public health policies of isolating the tuberculosis sufferer from society. Chapter 2 describes Philadelphia and Buenos Aires during the period under discussion. It shows that in many ways these cities were like others of their time and, interestingly, resembled one other. As of the 1920s, they had become leading cities of their respective nations and modern centers of commerce, education, and manufacturing, with a rising middle class and growing migrant populations. By 1907, deaths from tuberculosis in both Buenos Aires and Philadelphia exceeded deaths from all other infectious disease epidemics. Both cities established internationally recognized research and treatment facilities for tuberculosis, but local variables, such as climate and culture, to some extent differently shaped the sites and nature of medical institutions that found acceptance for tuberculosis treatment in the two cities. 

In chapter 3, Reber analyzes the incidence of tuberculosis and its consequences for the cities’ migrants, both from within and outside the Americas. To the extent that these groups occupied the lowest socioeconomic positions, this chapter offers both a class and race critique of public health policies. Its conclusions echo what historians have found elsewhere: the correlation of tuberculosis deaths with substandard living and working conditions led to anxiety about the spread of the disease from the migrant poor and was accompanied by targeted, morally judgmental interventions from charities and government.[1] However, Reber also points to positive responses by authorities in their initiatives to improve housing and green spaces, which ultimately resulted in ameliorating the poor health of their citizens and lessening the risk of contracting tuberculosis.

Chapter 4 examines the medical treatment of tuberculosis patients. It does an excellent job of explaining the available tests, treatment regimens, and education campaigns during this period, as well as the different sites of treatment—home, outpatient clinics, and hospitals. With a subtitle of “Patient and Physician Experiences,” we might expect this chapter to consist mainly of diverse first-person perspectives, but this is not the case. The only substantial accounts were between Dr. Lawrence Flick (1856-1938) and his wealthy patient, George Macklin, as conveyed in Bargaining for Life: A Social History of Tuberculosis, 1887-1938 (1992) by physician Barbara Bates (1928-2002). There is little to substantiate the chapter’s early claim that “gender, class and age” affected diagnosis and treatment, despite some allusions to these different categories (p. 123). Read on to the next two chapters, and class and age are subject to some analysis. Chapter 5 expands on tuberculosis treatment by looking at life in the sanatoria, with an interesting section on patient protest and how it differed between the two cities. Chapter 6 is an excellent study of tuberculosis measures for children, especially the poor of Buenos Aires and Philadelphia. As Reber reminds us, governments were willing to foster expensive public health measures for the young in the interests of producing “vigorous, patriotic adults who could serve in the military and contribute to the national economy” (p. 216).

Chapter 7 considers the two cities against the background of international tuberculosis policies and practices, providing glimpses of, for example, Spain, whose changing relationship with Argentina was reflected in the latter’s shifting medical discourses. The epilogue does three things: it provides the aftermath to successful antibiotic therapy in the 1940s, it sums up the book’s content, and it provides an analysis of the late twentieth-century tuberculosis global outbreak.

Tuberculosis in the Americas relies on a rich selection of sources for its evidence, including the secondary literature and government archival records. The book is replete with tables setting out a myriad of statistics, connecting tuberculosis deaths to occupation, age, place, et cetera. Reber’s main point is that, while modern medical advances were crucial to combating tuberculosis in Philadelphia and Buenos Aires, improved living and working standards and access to health services were also essential to the decline of tuberculosis in the two cities. 

The importance of this book does not lie in any significant break with current historiographical themes and insights of tuberculosis history. Indeed, Reber makes the point that Philadelphia and Buenos Aires were not exceptional in the approaches taken to manage tuberculosis in this period. Her work, to quote the editors of one volume on tuberculosis history, is an example of the several “studies that show the contingent character of anti-TB policies across time and space.”[2] Nonetheless, Tuberculosis in the Americas contributes to tuberculosis and public health history through its painstaking documentation and broad-ranging study of institutions, treatments, medical discourse, and social conditions in these two cities of North and South America.

Notes 

[1]. See, for example, Emily K. Abel, Tuberculosis and the Politics of Exclusion: A History of Public Health and Migration to Los Angeles (New Brunswick, NJ: Rutgers University Press, 2007); and Matthew Gandy and Alimuddin Zumla, eds., The Return of the White Plague (London and New York: Verso, 2003).

[2]. Linda Bryder, Flurin Condrau and Michael Worboys, “Tuberculosis and its Histories: Then and Now,” in Tuberculosis Then and Now: Perspectives on the History of an Infectious Disease, edFlurinCondrau and Michael Worboys (Montreal: McGill-Queen’s University Press, 2010), 8.

Citation: Charmaine Robson. Review of Reber, Vera Blinn, Tuberculosis in the Americas, 1870-1945: Beneath the Anguish in Philadelphia and Buenos Aires. H-Disability, H-Net Reviews. October, 2019. URL: http://www.h-net.org/reviews/showrev.php?id=53717

Call for applicants: DHA Mentorship program

The Disability History Association’s Mentorship Program was founded as part of the American Historical Association’s Advisory Committee on Disability, to assist in facilitating network connections between graduate students and established faculty working on disability history. 

Mentoring is a crucial process of academic learning. For graduate students, it offers an opportunity to ask questions about challenges they may face in the duration of their career: doing research, preparing for their exams and defense, learning about effective teaching strategies, dealing with administrative roadblocks, and more. For faculty volunteers, mentoring serves as an extension of teaching skills and presents an opportunity to guide rising scholars in the field. 

The DHA Mentorship Program aims to match volunteer mentors with students who are either pursuing a graduate degree in the same subfield of history or who have the same disability, if that information is disclosed. The mentor is not meant to replace or interfere with the supervisor-student relationship, but rather to serve as a helpful resource in the field for general advice and professional development. 

This informal Program is based on communication through email, phone, or Skype. The frequency and mode of contact will depend on the mentee and mentor, but DHA recommends it must be no less than 1-2 hours every 4-6 weeks for at least a year.

QUALIFICATIONS FOR THE PROGRAM

Mentees

  • Graduate students doing a MA or PhD in history, disability history, history of science or history of medicine with a specialization in disability history. Students working in related disciplines, such as American studies, historical sociology, historical anthropology, or material culture studies are also welcome. Students working outside the U.S. are welcome to apply.
  • Demonstrated an interest in developing a career as a researcher and teacher/faculty in the history of disability
  • Students with disabilities are especially encouraged to apply

Mentors

  • Scholars worldwide working in the area of disability history or related fields 
  • Faculty with disabilities are especially encouraged to apply

To apply, please send an email to Dr. Jaipreet Virdi, director of the Mentorship Program at jvirdi@udel.edu with a short paragraph outlining:

  • Your name, affiliation, and email
  • Your field of study/program, year of graduation (mentees), and area(s) of specialty.
  • What do you aim to achieve from this program?
  • If so desired, you are welcome to disclose your disability/disabilities 
  • For mentors: how many mentees are you willing to take on if they are a good match? (DHA recommendation is 1-3) 

Applications for the fall semester are due AUGUST 19. Mentee-mentor matches will be set by September 1. The next round of applications will be in December for a January match. 

If you have any questions, please contact the director of the Mentorship Program, Dr. Jaipreet Virdi at jvirdi@udel.edu.

A Word Document of this call is available here.

Review of Melanie Yergeau. Authoring Autism: On Rhetoric and Neurological Queerness. Raleigh: Duke University Press Books, 2018.

Reviewed by Marion Schmidt (Georg August Universität, Göttingen) Published on H-Disability (November, 2018)
Commissioned by Iain C. Hutchison (University of Glasgow)

Some years ago, I read Melanie Yergeau’s “autie- ethnographic” account of her experience of being invol- untarily committed to a psychiatric ward during her sec- ond week as a professor of English at the University of Michigan.[1] This was, she recounts, a surreal expe- rience, in which she faced various health care profes- sionals claiming that this was no longer Yergeau her- self acting and talking, but her condition—autism. As an autistic person, conventional theory and popular belief hold, she lacks insight into her own behavior and that of others. For Yergeau, this denial of agency and rhetoric has been a familiar situation ever since she was diag- nosed as a young adult. “Suddenly,” she writes, “with the neuropsychologist’s signature on my diagnostic papers, I was no longer my body’s author” (p. 1). Autism ac- tivists and scholars have long criticized that past and cur- rent theories of autism—from Bruno Bettelheim’s Empty Fortress (1967) to Simon Baron-Cohen’s theory of mind and mindblindess—deny autistic people subjectivity and personhood, in effect dehumanizing their very being. This leads to the ironic situation that autistic authors of- ten find their authorship questioned.

In the 2018 Authoring Autism: On Rhetoric and Neuro- logical Queerness, Yergeau challenges this denial of autis- tic authorship and, simultaneously, questions traditional definitions of rhetoricity and personhood. Chapter 1, “In- tention,” questions the “centrality of intentionality and purpose within rhetorical tradition” that is deeply in- grained in ableist traditions of humanity and subjectiv- ity (p. 32). Yergeau points out how “demi-rhetoricity”— the assumption that autistic people possess a not-quite rhetoricity—has been used to deny their agency and per-

sonhood. Yet she also suggests that such partial or residual rhetoricity can be a tool for reclaiming autistic agency, an approach she further explores in chapter 4. Chapter 2, “Intervention,” looks at the history of applied behavioral analysis (ABA) as the most common and per- vasive therapeutic intervention used with (on?) people with autism. ABA originated in behavioral psychology and breaks down behavior into small units, in which sub- jects are then repeatedly trained or taught and in the pro- cess are rewarded for success and punished for noncom- pliance. It is not concerned with the cause or nature of the condition in question, but “with reinforcing and ex- tinguishing antisocial (or inappropriate) patterns” such as autistic stimming, echolalia, or repetitive behaviors (p. 96). Consequently, as ABA does not aim at the causes of deviance, but only at its expression, the goal is not recov- ery, but merely “faking the becoming of normativity” (p. 105). It is a highly time-intensive form of therapy, ide- ally shaping all interaction. As Yergeau remarks, for “the neuroqueer child, ABA is life!” (p. 97).

This evokes, of course, the histories of other disabili- ties, where therapy claims a civilizing effect, and it would have been useful had Yergeau drawn from these histories of psychology, psychiatry, education, and disability, and, perhaps more generally, of society and civilization. Tapping into this larger scholarship also would have been relevant to her exploration of the overlapping history of ABA as a treatment for autistic and for non-gender- conforming children or, as she puts it, queer, and neuroqueer people. In the 1960s, clinical psychologist Ole Ivar Lovaas, a pioneer of ABA, ran both a Young Autism Project and Feminine Boy Project, both with the goal to normalize deviant behavior. Yergeau makes some valid and thought-provoking points about the overlap in ther- apy directed at those two groups. Yet her admitted col- lapsing of the “finer categories of autism or gender or sexuality under the broader banner of neuroqueer” evokes as many questions as it answers (p. 100). Not least—and this goes to my main point of criticism (and confusion) with Yergeau’s approach—the reduction of all kinds of difference and deviance to “neuro,” which is particularly problematic if applied to the past as in Yergeau’s explo- ration of the history of eugenics and stimming. Neu- rological identities certainly have become increasingly fashionable, yet to me their use brings up the question of the value of simultaneously deconstructing and con- structing neurological difference.

Chapter 3, “Invitation,” deals with the effects and con- sequences of disclosing autism diagnoses. Disclosure, Yergeau observes, is “both imperiled and politically gen- erative” (p. 140). Often, it is necessary for receiving services, yet it also renders an individual vulnerable to question and doubt, and to losing friendships or even jobs. It brings the potential to engender exchange and discussion, which are, as Yergeau argues from her own experience, “often agonistic, expectant of allistic refu- tation” (p. 33). Thus, the statement “I am autistic” or “disabled” is usually treated as “elliptic rhetoric,” a state- ment to be filled with meaning by the non-autistic per- son because the autistic speaker lacks the ability to do so. Chapter 4, “Invention,” finally, looks at the ways autistic communication can contribute to new understandings and definitions of (demi-)rhetoricity. Yergeau turns around the very traits that supposedly limit the agency and rhetoricity of autistic people—namely their partiality, residuality, and not-quite-rhetoricity, their use of em- bodied communication—as starting points for engagement. Such inventions, she emphasizes, need not al- ways be discursive, voluntary, or positive, to serve as “stimpoints” that trigger reactions from others. Autis- tic people, she writes, may, at times, live in “nondiscursive world[s]” that are “idiosyncratic or mutually unintelligible,” yet nevertheless, “these worlds hold value and meaning” (p. 34).

Overall, Authoring Autism provides many thought- provoking insights for disability scholars. This goes in particular for her engagement with disability theories, selfhood, and identity, and for pointing to the ways in which privilege is part of disability politics. It is a very dense book, packed with thoughts and observations that are perhaps best described as a meandering ambivalence, which is often a strength, and sometimes detracts. Here, it is Yergeau’s double perspective as a rhetorician and autistic activist that makes Authoring Autism valuable to a larger audience, on whom, as in my case, her finer points about rhetoric theory may be lost.

Note

[1]. Melanie Yergeau, “Clinically Significant Distur- bance: On Theorists Who Theorize Theory of Mind,” Dis- ability Studies Quarterly 33, no. 4 (2013), http:// dsq-sds.org/article/view/3876/3405.

Review of Madhouse: Psychiatry and Politics in Cuban History

Jennifer L. Lambe. Madhouse: Psychiatry and Politics in Cuban History. Envisioning Cuba Series. Chapel Hill: University of North Carolina Press, 2017. 344 pp. $32.95 (paper), ISBN 978-1-4696-3102-8; $90.00 (cloth), ISBN 978-1-4696-3101-1.

Reviewed by Michael Murphy (Mississippi State University)

Published on H-Disability (October, 2018)

Commissioned by Iain C. Hutchison (University of Glasgow)

In recent years, probably linked to the realities and stories concerning psychiatric and psychological disorders in today’s society, examinations of the history of mental health and illness have come from the historical profession at a rate not seen since the mid-1990s. Jennifer L. Lambe’s Madhouse: Psychiatry and Politics in Cuban History joins this renewed examination of this history, which reevaluates the place of mental health and illness in relation to society and the state while also weaving the agency of patients into the narrative. Mental health and illness and their institutions are no longer merely historicized. Works such as Lambe’s skillfully examine this topic in relation to society and the state over time. She details the history of Hospital Psiquiátrico de La Habana, Cuba’s most well-known state hospital, throughout the twentieth century. More specifically, Lambe shows how the hospital, commonly known as Mazorra, developed over time from the late nineteenth century, when Cuba was a colony, through to the end of the Cold War. Over seven crisply defined chapters, Lambe ultimately argues that “the history of Mazorra and madness in Cuba offers a unique stage to witness the evolution of the Cuban state” and “provides a window onto those populations, both Cuban or not, who remained maddeningly but also stubbornly outside it” (p. 15). After a succinct introduction, which includes an overview covering methodology and terminology, and chapter breakdowns, Lambe delves into Mazorra’s place in the unstable and unsure years of the Cuban War of Independence and the immediately preceding decades. During Spanish colonialism, the poor conditions at Mazorra became synonymous with the overall health of colonial Cuba; these conditions became worse with the start of war. Lambe details the inhumane conditions of Mazorra, concurrent with reports of suffering across Cuba during the late 1890s. At the end of 1896, the hospital housed 1,052 patients. By the beginning of 1899, nearly four years into the war, its population had plummeted to 393 patients due to “hunger, malnutrition, and gastrointestinal illness” (p. 19). With the United States’ occupation of Cuba by the early days of 1899, the promise of change and improvement came to Mazorra. At the time of the American occupation during the early twentieth century, a correlation existed between the newly liberated hospital and the establishment of the Cuban state. Lambe explains, “The hospital’s political import, forged at the nexus of colonial abjection, patriotic euphoria, and imperialist conceit, would become an enduring legacy of independence” (p. 21). She goes on to detail how the progressive movement in the United States influenced Cuba’s admission practices to the hospital. In the wake of Civil Order No. 57, initiated by the occupation government at the insistence of local native leaders, Mazorra opened its doors to a vast number of individuals with mental illness from across the island. Also during this time, standardization, dating back to the US reformist period of the mid-nineteenth century, known for uniformity and regularity under the Kirkbride Plan, came to the state hospital in the form of more civil orders. In both socially scientific and political senses, US progressivism played a major role in Mazorra’s transformation. This led to an embracement of the moral treatment theory in the treatment of the mentally ill, a practice that fell out of favor in the United States in the late nineteenth century.However, the condition of state-sponsored care for the mentally ill in Cuba held parallels to those in the United States in the early republic and early Age of Jackson. During and after the second US occupation, sanctioned under the Platt Amendment, Mazorra went through a period of uncertainty, and sharp shifts in policy, funding, and support. The second occupation brought paternalistic patronage to the people of Cuba and to the patients of the hospital, but faltered in the decades after the occupying forces left. Lambe explains that after the second occupation, the strategy of moral treatment was labeled a failure and it lost support. She notes that Cuban leaders who still supported moral treatment argued that Álvarez Cerice’s moral revolution for the hospital, linked to the revolutionary spirit of 1898, fell out of favor and became labeled a failure due to unsettling chaos and sharp changes in policy brought on by the occupations. Through the hard times in the decades after the second occupation, some began to push to criminalize blackness and Afro-Caribbean culture. Madness came to be linked to such classification and culture into the 1930s. Mazorra, known as the Inferno during this period, became what Lambe refers to as a cultural contact zone, “where new wealth met abject poverty, psychiatrists encountered mental healers of a religious bent, and nearly all national life met its shadow: the most marginalized constituents of the new Cuba” (p. 78). In the decades leading up to the Cuban Revolution of 1959, the hospital transformed into a catchall for political dissenters and became a model of the cronyism and nepotism associated with Cuba’s government under the rule of Fulgencio Batista. Much like the Cuban state during the last years of Spanish colonialism, Mazorra became synonymous with bedlam. Much like the ending and immediate outcome of the Cuban War of Independence, the Revolution of 1959 “would inherit” a failing Mazorra (p. 139). After the Cuban Revolution of 1959, the theme of revolution returned to Mazorra. The new government named Mazorra “the Hospital Psiquiátrico de La Habana,” and attempted to create an institution that represented the success of the revolution that it could show to the world. She goes on to note that “leftist and antiimperialist visitors to the island were invariably ushered to the institution” to laude its equivalence to facilities in non-Communist nations (p. 141). However, the cronyism that occurred during the Batista years continued into the Fidel Castro years. The first administrator of the Hospital Psiquiátrico under the new government, Celia Sánchez, came to this position not because of his qualifications in psychiatry but because Castro deemed him “the chosen one” (p. 143). Much as with the occupations of Cuba in the early twentieth century, the influences of the Soviet Union and United States on the treatment and classification of mental illness had lingering negative effects. Beginning in the 1960s, the treatment of mental illness became politicized. This became apparent with the criminalization and assumed treatment of homosexuality. At the Hospital Psiquiátrico, medical experts’ views fell into two camps that resembled party lines. Child psychologists drew on “socioeconomic factors and family dynamics” and antipsychoanalysts favored Pavlovian conditioning (p. 156). Lambe explains that while a campaign known as the Lavender Scare successfully led to the firing of numerous reported gay government employees in the United States and Nikita Khrushchev’s continuation of Joseph Stalin’s criminalization of homosexuality, Cuba sent purported homosexuals to labor camps. This politicization of the Hospital Psiquiátrico continued into the last decades of the Cold War. Lambe notes that under the banner of revolution, “it was the state rather than the mental health professionals” who would guide Cuba’s politicized treatment of mental illness (p. 157). By the last decade of the Cold War, Cuba began to experience worsening economic conditions that were linked to the economic downfall of the Soviet Union. Because of this, Cubans, with the blessing of Castro, began leaving the country for the United States on a dangerous trek across the Straits of Florida on what became colloquially known as the Mariel Boatlift. Upon their arrival in Florida, the refugees became the target of white nationalism and racism by citizens and sections of the press in the United States. Matters were made worse when it was revealed that a number of those sent on the boatlift were former prison inmates and state hospital patients in Cuba. This realization, as Lambe explains, “highlighted the shortcomings of deinstitutionalization” in the United States (p. 203). Beginning in the late 1960s, state hospitals in the United States began to release patients and cut rolls in the name of economic conservatism. By 1980, when the boatlift began, institutional psychiatric care in the United States could not wholly assist refugees who came from the Hospital Psiquiátrico. In the last pages of Madhouse, Lambe explains that “the madhouse has long served as a metaphor for the Cuban state,” especially after the Revolution of 1959, which she further explains in detail in the book’s epilogue (p. 230). In 2010, twenty-six patients at the Hospital Psiquiátrico passed away on a cold night. In response, the Cuban government swiftly placed the hospital’s director on trial and ultimately sentenced him to fifteen years in prison for “misappropriation” and “dereliction of duty” (p. 231). It is in this story that Lambe reminds the reader of the lasting power of revolution and its role in psychiatry in Cuba.

 

If there is additional discussion of this review, you may access it through the network, at: https://networks.h-net.org/h-disability