Keith Wailoo, the Martin Luther King Jr. Professor of History in New Brunswick, has helped shape new understandings of disease, politics, and culture in America. This exceptionally productive scholar came to Rutgers in 2001 with joint appointments in the Department of History and the Institute for Health, Health Care Policy, and Aging Research. An historian who writes about contemporary issues, his award-winning books have earned accolades for elucidating questions of racial justice and inequality in medicine and health care. His latest work, a co-edited volume, A Death Retold: Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship (University of North Carolina, 2006) – explores a common theme: how scientific and technological understandings have interacted with health care politics, racial and ethnic relations, and cultural politics to inform responses to disease over time. Wailoo is the recipient of the James S. McDonnell Fellowship in the History of Science, a $1 million award for an historical investigation of cancer, immunology, genetic disease, and pain, and the Robert Wood Johnson Foundation’s Investigator Award in Health Policy Research to carry out a study of the history and politics of pain medicine. He recently added another distinction to his list of accomplishments – election to the Institute of Medicine, one of four learned academies that advise the government on matters of health and medicine.
Focus: Your undergraduate degree from Yale University is in chemical engineering. How did you arrive at the scholarly crossroads of medicine, politics, and society?
Wailoo: From early on, I was fascinated by the applied nature of science, and I think that’s what drew me to engineering. (I had a terrific high school teacher who piqued my interest particularly in chemical engineering – home made experiments, and so on.) But in college – especially at a liberal arts university like Yale – I found myself less interested in how to build, say, a methanol synthesis plant than in the broader questions, such as what impact the plant would have on the environment, on fuel dependence, on nearby neighborhoods. … After graduation, I decided not to pursue engineering but to write about the way in which science and technology affected people and society. Over three years or so, I wrote for publications like the American Scientist on issues such as physics, pharmaceutical developments, Lyme disease (a new phenomenon at the time) – and their implications for society.
This interest in writing about -- and understanding -- science, health, and society, led me to the University of Pennsylvania’s program in the history and sociology of science, from which I earned my master’s and doctoral degrees. I’ve been combining teaching – I taught for nine years in the medical school and the history department at the University of North Carolina at Chapel Hill before coming to Rutgers – and writing ever since.
Focus: What are the types of issues that a study of the history of medicine can reveal?
Wailoo: Well, the possibilities are limitless – a wide array really. I teach a course on drugs, medicine, and society – and the ways in which historical drug controversies over issues like opium or the cigarette or penicillin relate to contemporary ones. I recently had an article published in The New York Times on the history of performance-enhancing drugs. In the spring, working with two colleagues at Rutgers – Mia Bay in history and Catherine Lee in sociology – and a colleague at Yale, we’re organizing a symposium on “Race, DNA, and History.” I’m also organizing another conference, “A Cancer Vaccine for Girls? The Science, Ethics, and Cultural Politics of HPV Prevention” with Julie Livingston, a colleague in history and at the Institute for Health, Health Care Policy, and Aging Research, and two other colleagues at the University of Pennsylvania and UC–San Diego.
Focus: Some of your work has focused on how ideas about diseases, such as sickle cell anemia, change over time. Can you explain how the seemingly straightforward process of identifying disease is invariably influenced by personal, professional, and social factors?
Wailoo: Breast cancer and AIDS, to name only two, are two particularly obvious cases where diseases become formidable and potent symbols of gender, identity, and cultural politics. As it happens, disease has always had a political factor, and questions about diagnosis, appropriate treatment (radical mastectomy versus lumpectomy, for example), and prevention, have shifted with the era’s changing politics. This dynamic interaction between politics, science, and identity is true in many of the diseases I’ve studied – from Tay Sachs, a common genetic disease among Ashkenazi Jews, to sickle cell disease and African-Americans, to cystic fibrosis and Caucasians, to cancer in multiple groups of people. For me, the study of disease traced over time is a vehicle for understanding not just changes in medicine or science, but changing social arrangements.
Focus: Given the influences swirling around patient care, how can an historical analysis of medicine inform health policy and improve patient care?
Wailoo: This is a tricky question because there is no one simple, one-dimensional answer to what makes history relevant. The past plays a role in health policy sometimes in subtle ways. For example, it is clear that the history of President Clinton’s failed health care reform in the early 1990s is casting a very long shadow over the current presidential politics. Hillary Clinton’s role in that failure is debated every day on the campaign trail and in the media, and it is very much at the center of our current political debates. History – sometimes recent, but often more distant – always is a crucial factor informing health policy and shaping the possibilities of the present. We just don’t always see it clearly because we’re so caught up in the moment. And if you go back to the early 1990s, you’d see that those players were very much aware of their recent past – successes like Medicare, and other more distant failures like Truman’s national health care plan. One role of a historian, among many, is to bring these hidden histories into the open, so that we can navigate the present with a richer, more informed understanding of the stakes and underlying questions.
Focus: You were born in Guyana, a former British colony, and emigrated with your family to America as a young boy. How has this experience factored in your life’s work?
Wailoo: As an immigrant I think you take nothing for granted, but for me, coming here at age 8, I also became aware over the years that there were many things I did not understand about the U.S., and that many of the crucial gaps in my own awareness were historical in nature – things that happened either in the recent or the distant past.
Focus: You are the founding director of Rutgers’ Center for Race and Ethnicity. How does the center intersect with your research?
Wailoo: The Center for Race and Ethnicity is fundamentally interdisciplinary in orientation, and I think this is the most direct way it connects with my work. As you’ll see from visiting our website, however, the kinds of discussions the center promotes – from the question of race and vulnerability in the story of Katrina, to the role of race and ethnicity in criminal justice, to understanding Hispanic identity in the new millennium – are not necessarily focused on health, but on the wide range of topics in race and ethnicity where Rutgers has considerable strength, as well as depth and breadth of expertise across schools, departments, and disciplines.
Focus: What do you do outside the world of research – strictly for fun?
Wailoo: I run for fun, shorter distances than in my marathoning days – and I spend lots of time with my kids, a third grader and a kindergartener, taking an interest in whatever they are up to. We’re all learning (relearning in my case) piano right now, so the house is often filled with music these days – not necessarily great music, but music. It’s a start.