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White Coat, Clenched Fist: The Political Education of an American Physician
In the sixties, Fitzhugh Mullan was an activist in the civil rights struggle. While in medical school, Mullan was shocked by gaps in what the students learned, and the lack of humanity in the classroom. Later, Dr. Mullan was outraged at the conditions he discovered when he began to practice. He helped found the Student Health Organization, organized the Controversial Medical Collective at Lincoln Hospital in the Bronx, and struggled to offer improved medical care to those who needed it most and could afford it least. This landmark book charts the state of medical school and practices in the 1960s and 70s. This new edition is updated with a preface in which Dr. Mullan reflects on the changes in the medical field over the last thirty-plus years. Fitzhugh Mullan is Murdock Head Professor of Medicine and Health Policy at George Washington University. He worked at the U.S. Public Health Service where he attained the rank of Assistant Surgeon General (1991-1996). Dr. Mullan is the co-founder of the National Coalition for Cancer Survivorship and the author of numerous books, including Plagues and The Story of the United States Public Health Service , and his most recent book, Narrative The Power of the Personal Essay in Health Policy .
248 pages, Paperback
First published January 1, 1976
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Displaying 1 - 7 of 7 reviews
July 10, 2013
This is well-written account of a physician who was active in the radical medical student movement in the late 1960s and early 1970s. Mullan did his medical training in Chicago and volunteered with civil rights workers in Mississippi. This book is partly a very personal memoir of his own medical training and learning to become a doctor and partly a personal account of a movement to reform medicine, politically and culturally.
The early part of the book sort of alternates with chapters of personal history and chapters of historical analysis about the medical profession, the medical student movement, and the history of public health services in New York City. As the book goes on, the chapters become increasingly intertwined, and it becomes more and more difficult to separate the personal narrative from the political project.
My overwhelming reaction is that it’s so sad to read of such optimism and courage in a group of young medical students who wanted to change healthcare in the seventies, and to reflect on how little the system has changed overall since then. Mullan sums up the current state of affairs in the 2006 preface by saying, “Without stated purpose but with disturbingly steady step we have put in place policies that create new technology, stimulate expenditures, deprecate planning, ignore evaluation, and promote ‘markets’ to serve those with money or entitlements” (p. xiv).
In the introduction, Mullan reflects back wistfully on the sixties, saying that at that point, the enemy was clear. They were united against the AMA, and challenging the racist, sexist, elitist, bourgeois politics that the professional lobbying association embodied. Mullan points out that although the AMA’s power has declined over recent decades, other institutional actors have crept in to continue the exclusionary, individualistic, and profit-seeking motives they once protected. Activists who hope for radical reform in medicine these days have a wider variety of opponents they must engage, including for-profit hospitals, HMOs, for-profit insurance companies, and drug and device manufacturers.
The early part of the book sort of alternates with chapters of personal history and chapters of historical analysis about the medical profession, the medical student movement, and the history of public health services in New York City. As the book goes on, the chapters become increasingly intertwined, and it becomes more and more difficult to separate the personal narrative from the political project.
My overwhelming reaction is that it’s so sad to read of such optimism and courage in a group of young medical students who wanted to change healthcare in the seventies, and to reflect on how little the system has changed overall since then. Mullan sums up the current state of affairs in the 2006 preface by saying, “Without stated purpose but with disturbingly steady step we have put in place policies that create new technology, stimulate expenditures, deprecate planning, ignore evaluation, and promote ‘markets’ to serve those with money or entitlements” (p. xiv).
In the introduction, Mullan reflects back wistfully on the sixties, saying that at that point, the enemy was clear. They were united against the AMA, and challenging the racist, sexist, elitist, bourgeois politics that the professional lobbying association embodied. Mullan points out that although the AMA’s power has declined over recent decades, other institutional actors have crept in to continue the exclusionary, individualistic, and profit-seeking motives they once protected. Activists who hope for radical reform in medicine these days have a wider variety of opponents they must engage, including for-profit hospitals, HMOs, for-profit insurance companies, and drug and device manufacturers.
June 13, 2024
Reading this book while in the thick of working on med school apps has been kind of rough since it feels like I’m trading work with work (since this book is kinda dense) but also super energizing because it reminds me of why I want to be a doctor and has helped informed my med school list. Reading a book about healthcare activism set in the 70s but that still includes so many issues of today is so frustrating, but also makes me excited because of course there’s nothing I love more than a challenge and fixing the systematic health issues seems like a fun one to tackle. This book was great at showing the realities of activism and how the amount of effort you put into solving a problem doesn’t necessarily equate to how much closer the problem is to being fixed. This sounds disheartening but it’s nice at times to put into perspective that change may not be immediately visible and may still be taking affect over 50 years, but still things get done and i maybe optimistically maybe naively believe the world still slowly gets better and better so we just got to keep on throwing our bodies at the brick wall that is life. Thanks bestie Bob from the soup kitchen for loaning me this book ❤️
February 11, 2008
James Tracy handed this book to me after a fun night of drinking beer at a bar near his house after I expressed my desire to learn about the radical doctors that came before me. He couldn't have handed me a better book.
This book is the account of a radical doctor who received their medical education in the midst of the Freedom Rides and rise of the Black Panthers and Young Lords. Mullen provides a great analysis and critique of medical school education and the medical establishment in NYC during the late 1960s and 1970s. He also provides an account of the kinds of organizing efforts he was a part of during school and during his residency in the Bronx.
The best thing this book offers is an account and analysis of what radical doctors during this period of time tried to do to make change, from their best (like siding with the Young Lords during their takeover of Lincoln Hospital) to their worst (like continuing the medical hierarchy and disrespecting nurses and taking them for granted). This is an important book for radicals going into establishment medicine--we are carrying on a legacy that we have so much to learn from!
This book is the account of a radical doctor who received their medical education in the midst of the Freedom Rides and rise of the Black Panthers and Young Lords. Mullen provides a great analysis and critique of medical school education and the medical establishment in NYC during the late 1960s and 1970s. He also provides an account of the kinds of organizing efforts he was a part of during school and during his residency in the Bronx.
The best thing this book offers is an account and analysis of what radical doctors during this period of time tried to do to make change, from their best (like siding with the Young Lords during their takeover of Lincoln Hospital) to their worst (like continuing the medical hierarchy and disrespecting nurses and taking them for granted). This is an important book for radicals going into establishment medicine--we are carrying on a legacy that we have so much to learn from!
July 3, 2008
i just finished this on the j-church today, and am really glad that i picked it up. i really enjoy historical accounts of social justice application, especially when the writer is humble and honest about both their successes and failures--i think it creates a living text that can be super applicable to the further legacy of radical medicine. this book is all of those things.
April 27, 2007
Amazing. period.
May 17, 2010
More political than I had hoped. Not what I wanted to get out of this book.
March 29, 2017
Highly recommended to students and healthcare professionals interested in social justice in medicine. Mullan recounts his experiences honestly, including both successes and failures. It is sobering to think how relevant the book is now, 40 years later, how little has changed... but as Mullan says, those who seek to follow a similar path should be able to learn from his experiences.
Displaying 1 - 7 of 7 reviews