Seven Questions for Harriet Washington

Medical ethicist, author and UNLV Shearing Fellow on mental illness, Big Pharma and the power of one

UNLV Black Mountain Institute's Harriet Washington | Photo: Aaron Mayes / UNLV Photo Services

UNLV Black Mountain Institute’s Harriet Washington | Photo: Aaron Mayes / UNLV Photo Services

In Infectious Madness [Little, Brown and Company, $28, October] you discuss the infectious causes of mental illness. It’s terrifying to learn that pre-natal flu could cause schizophrenia or strep throat could cause Tourette’s syndrome. What can we do with this knowledge, other than become hypochondriacs?

It sounds scary, but it’s very good news because I’m talking about mental disorders for which [for the most part] we don’t understand their cause. One reason schizophrenia is so frightening is because we don’t know what causes it. … Once we know what causes it, we can craft better tools against it. We can do better than treat a disease—we can actually prevent it. … The other thing is a lot of mental disorders have very serious stigmas. Those beliefs can be [mitigated] by understanding that at least in some cases, it’s simply a biological disorder like any other.

What are you working on now?

I have been speaking and writing about the Ebola crisis as a Rorschach test for the way we approach crises in the developing world. Some really troubling misconceptions and issues keep arising whenever there is a conflict that is dramatic enough for the West to notice. Although we are inclined to approach poor people in the developing world as supplicants, that’s not accurate at all. Many health care providers [treated] people with Ebola before Western physicians addressed the epidemic. Our news media ignore them, and that leaves the impression that there are no health care providers there.

You’re based in New York, and you’ve done fellowships at Harvard, one in public health and the other in medical ethics. What attracted you to Las Vegas and the Shearing Fellowship at UNLV’s Black Mountain Institute (BMI)?

I’m tempted to say the weather, but I didn’t find out until after I got here how wonderful the weather is. I’d spoken here [in 2012] on a medical ethics panel. It was really great, and when I learned about BMI, with the variety of writers they have, I was really impressed. … I thought [this fellowship] would be perfect, so I applied. It’s wonderful. I’m expected to give at least one presentation on my work and to attend the functions of the institute. I’m basically doing the things that I would’ve done anyway, but in this really collegial atmosphere. Writing can be lonely; I love the idea of doing it here among other writers.

Do you ever wish that you’d simply become a medical doctor?

That was my original plan. But when I went to college [in 1969], my adviser strongly [discouraged] me from going into medicine. I was told that a lot of medical schools didn’t accept applications from black people. I was told that there were no black women doctors—a lie, of course, but I didn’t know any better. I’d never met one. Unfortunately, I was 17 years old, and I believed it. It’s one of the last times I took somebody’s word for something. … I used to say it was the one regret of my life. But now that I’m a bit older, I consider myself very fortunate because I love what I do. …

[Science and writing are not as] unrelated as people might think. If you’re communicating about medicine, then it’s important to be verbally adept. You have to be very good with language because you’ve got scientific jargon and conventional English. I enjoy writing about the history of medicine, medicine culture and ethics, so it allows me to indulge my two interests.

In 2012’s Deadly Monopolies, you explored the dangers of the medical-industrial complex including the patenting of human genes. Is there a solution to the medical status quo and the emergence of Big Pharma?

The solution is simple, but it’s not easy. One of the reasons why the pharmaceutical industry can do what it does with impunity is that there have been a lot of laws passed that promote its interest. Why? Because the pharmaceutical industry hires an immense number of lobbyists [who push] legislators to vote for a company’s interest rather than for the interest of U.S. citizens, to say nothing of the interest of people in developing countries. Lobbying in any health care arena should be banned.

What do you say to those who refuse or are skeptical of vaccines?

I’m old enough to understand that a lot of the problem comes from the fact that the people who are making decisions today did not live in the pre-vaccination era. … It’s absurd that people balk at vaccinations from a nebulous fear; there’s been great evidence showing that it’s not a rational fear. … It’s important not to discount their fears, or say, “Oh, you are paranoid,” or “How stupid are you that you don’t understand vaccination is necessary?” Vaccination is necessary and it’s a good thing, but people aren’t stupid because they’re afraid of it. It’s just human nature. Public health just has to do a much better job of showing people that they’re safe and not resort to shaming.

Throughout your years of research, what has really surprised or inspired you?

All too often I found in my research people who stood up and refused to do something they thought was wrong. And [they] actually stopped it. Until a few years ago, women all around the world who were about to go into surgery had their bodies [used] so that medical students could practice intimate examinations—until a few students in London said that’s not right. Never discount the fact that one person can change centuries of injustice by speaking out.

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