Mixed Race Studies

A Medical Humanities Perspective On Racial Borderlands

Literature, Arts and Medicine Blog
2008-06-30

Felice Aull, Ph.D., M.A., Associate Professor of Physiology and Neuroscience; Editor in Chief, Literature, Arts, and Medicine Database
New York University School of Medicine

I have long been interested in the metaphor of borderlands as a tool for exploring areas of ambiguity in medicine and in society. Courses that I teach (to medical students) consider ambiguous boundaries between student and professional, patient and physician, personal life and professional life, disease and health, and the cultural confusion that derives from migration and dislocation. I address those issues using theory from the social sciences and humanities in addition to fiction, memoir, poetry, and art. One of the topics that we consider is the ambiguity inherent in concepts of race. This has become a topic of recent interest (and controversy) because race, medical research and practice, and health policy are being linked with the genomics revolution. And since all of these endeavors take place in a sociopolitical context, recent events and discussions in the national political scene cannot help but play a role in our thinking about these topics. With this as background, I offer some thoughts triggered by a recent confluence of events.

The events

1. The presumptive nomination of Barack Obama as the Democratic Party’s choice for president.
2. The March, 2008, announcement that the National Institutes of Health established the Intramural Center for Genomics and Health Disparities, whose priority is to “understand how we can use the tools of genomics to address some of the issues we see with health disparities.”
3. Publication in the journal, Literature and Medicine, of “How Culture and Science Make Race ‘Genetic’: Motives and Strategies for Discrete Categorization of the Continuous and Heterogeneous,” by Celeste Condit. (26/1, Spring 2007 pp.240-268).

What is race?

Because Barack Obama was chosen to be the presidential candidate of a major political party, much has been made of the advances this country has made in racial tolerance and acceptance. Yet the fact that so much attention is being given to the racial component of the upcoming election emphasizes that race and color are still important in the national narrative. Obama personifies the contradictions and fallacies of the way we traditionally think about race. Born in Hawaii to a “white” American woman and a “black” man from the African country of Kenya, Obama is identified by virtually everyone as “African American” and black, although he is culturally atypical in that he is not descended from US slaves. He himself for the most part accepts that designation but he has consistently sought to move beyond race and has even been described as “post-racial.” In this country Obama is virtually forced to identify as African American because he is so identified by almost anyone who notices the color of his skin. Mr. Obama could not identify himself publicly as a white American or as “Caucasian,” even though his ancestry is as much white as it is black. He could not “pass” as white, simply because we tend to equate skin color and other physical characteristics with something that many call “race.”…

…Race-based medicine…

In my teaching I used the recent penetrating article by Celeste Condit in Literature and Medicine (event #3 above) to consider concepts of race and race-based medicine. Condit lays out the background for the current interest in race-based medicine and then proceeds systematically to demonstrate that the complexity of human genetic variation can not be fit into discrete categories like race or what is more often now discussed as continent of origin and gene clusters. She marshals the evidence that “there are no discrete boundaries among groups; instead there are slowly changing [gene] flows” (p. 253). And here is why this essay appeared in a journal of literature and medicine: Condit asserts that language “is always predisposed toward discreteness and binarity” and that we cannot wrap our minds around “any single word or visual map that could capture the 3 million different patterns of difference [in the 3 million base pairs in the human genome that vary]” (250). In addition, Condit argues that the notion that “human genetic variation partitions people into ‘races’ ” is a two-step [probably unconscious] rhetorical strategy that claims (1) gene clustering coincides with continental boundaries and (2) continents coincide with five historically designated racial categories(254). She shows how verbal manipulation is involved in mapping genetic clusters with five continental groupings and then enumerates the many ways that racial designations fluctuate and do not consistently correspond with the five groupings or with genetic clusters…

Read the entire essay here.