Medicine and culture
Medicine is the unbiased study of how the body’s physiology operates. Or is it?
Historical sociologist Shelley Reuter is interested in the social history of disease. Diseases are identified, studied, and treated by doctors, who carry the same social biases as everyone else.
“Doctors are both product and producers of culture,” Reuter argued during a recent student lecture sponsored by the Institute for Canadian Jewish Studies.
To explore this idea, Reuter studied the early history of Tay-Sachs disease from the first case in 1881 to the eve of World War II.
By examining the history of early medical attention to Tay-Sachs, particularly how it intersected with immigration policies and social beliefs, Reuter has traced the mutual influence of these seemingly disparate fields.
Tay-Sachs has been popularly understood as a genetic disease strictly affecting the Jewish population. Reuter illustrated the biases that led to this perception. Reuter pointed out that the notion of a Jewish disease is flawed since “there is no DNA sequence common and exclusive to all Jews.”
We now understand that Tay-Sachs is an autosomal recessive disorder. Children of two genetic carriers would have a one in four chance of developing the disease. Blood testing and monitoring have all but wiped out Tay-Sachs in the Jewish population.
Among the groups currently most affected by Tay-Sachs are French Canadians in eastern Quebec.
The link between Jewish families and Tay-Sachs was made fairly early by doctors. It became standard practice to identify cases as “Jewish”. Reuter quoted one doctor’s records that, in the absence of specific knowledge of a patient’s religion, pointed to the family name and physiognomy.
Some doctors simply did not believe families who claimed to belong to other communities. One doctor said, “Many apparently Gentile families have Jewish blood.”
From 1881 through to the dawn of World War I, two million Jews immigrated to the US from Eastern Europe.
Fears about their presence in the labour market and in society raised questions about immigration controls. In particular, Jews were considered less desirable because of their insistence on practicing their own religion and speaking their own language instead of assimilating
By 1910, the eugenics movement was gaining ground. This supposedly progressive belief system suggested that scientific principles could tame nature by determining which groups should be encouraged to parent, and which discouraged because they might produce mentally or physically weak offspring.
Reuter discussed the ways in which these social circumstances served to reinforce the notion that Jews were diseased, and a threat to “pure” American society.
At the same time, a number of Jewish doctors resisted the biological racialized link. For instance, one suggested that the perceived exclusivity of Tay-Sachs in Jews could be explained by environment, including “the terrible economic conditions, the nerve-racking fear and the starvation and misery of their lives in Russia.”
Other Jewish doctors used the racialized link as an opportunity to develop Zionist arguments for a Jewish state.
Ultimately, racial science has served a number of social agendas. By unpacking some of those agendas, Reuter has challenged the popular understanding of genetics as a bottom line that is entirely outside of the social.