Foreign Bodies: The Perennial Negotiation Over Health and Culture in A Nation of Immigrants

Foreign Bodies: The Perennial Negotiation over Health and Culture in a Nation of Immigrants
Author(s): Alan M. Kraut

Source: Journal of American Ethnic History, Vol. 23, No. 2 (Winter, 2004), pp. 3-22
Published by: University of Illinois Press on behalf of the Immigration & Ethnic History Society
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Foreign
Bodies: The Perennial
Negotiation
over
Health and Culture
in
a
Nation of
Immigrants
ALAN M. KRAUT
This
essay
is the
presidential
address delivered at the annual
meeting of
the
Immigration
and Ethnic
History Society,
held in
Memphis
on 5
April
2003.
ON THE MORNING OF 19
May
1900,
the Chinese
community
of
San Francisco found itself under
siege
in the name of state and munici
pal security.
It was not fear of bombs
or terrorist attack that
inspired
officials to commit
a wholesale violation of civil liberties that
morning;
it was fear of
disease,
specifically
bubonic
plague.
An
army
of
city
health care workers armed with
syringes
filled with
an
experimental
serum invaded Chinatown. Doctors cloaked in white coats and masks
grabbed
anyone
of Asian
appearance they
could and tried to inoculate
them
against
the
plague.
Few Chinese
cooperated willingly.
Instead,
the
community
rose in
opposition
to this intrusive
assumption
that
they
posed
a dire health threat to their non-Asian
neighbors.
Chinese
mer
chants closed their stores in
protest. Angry
Chinese clustered
on street
corners,
their voices and
gestures leaving
little doubt as to the
subject
of
conversation. All of Chinatown
was
under
quarantine;
those Chinese
who tried to leave California
were
turned back at the border unless
they
could
produce
a certificate of inoculation. Demands for
legal
redress
from the
poor
were echoed
by
the threats of lawsuits from business
people.1
Obviously,
the events of 19
May
can be understood in the context of
a
long history
of anti-Chinese nativism in California. But what
really
ruptured
the
relationship
between the
foreign-born
and their reluctant
hosts
was
the
panic
occasioned when
a
single
Chinese
immigrant
died
on 6 March from what
appeared
to be bubonic
plague.
Faced with
a
tangible
threat to their own
security,
local and federal officials had
absolutely
no
compunction
about
violating
the civil liberties
they
were
pledged
to
protect.
Eventually
the Chinese did
get
to court. The Six
Companies
hired
a
4
Journal
of American Ethnic
History
/ Winter 2004
prominent
law firm
?
Reddy, Campbell
& Metson
?
to
represent
Chinese merchant
Wong
Wai in a
suit
against
federal health officer Dr.
Joseph Kinyoun
and the members of the San Francisco Board of Health.
The suit
charged
that
compulsory
inoculation with an
experimental drug
?
Haffkine's serum
?
under threat of
being
forbidden to leave the
city,
constituted "a
purely arbitrary,
unreasonable, unwarranted,
wrongful,
and
oppressive
interference" with
Wong
Wai's
personal liberty. Though
not
filing
a class-action suit
per
se,
Wong
Wai's counsel asked the court
to view him as
representing
a class of
complainants
whose
right
to
pursue
a "lawful business" was
being
curtailed. Because the Chinese
were
being singled
out,
the brief
argued,
the Chinese of San Francisco
were
being
denied
"equal protection
of the laws." The state
argued
that
it had the
right
to
compel
behavior in the interest of the
public's health,
even if it meant
regulating just
the Chinese. The state's
justification
was
that thus far all of the
plague
victims had been Chinese and that the
state's actions were warranted because the Chinese
were more
suscep
tible to
plague
than other
groups.2
Although
the
judge,
William
Morrow,
was a
Republican
with a
repu
tation for
being unsympathetic
to the
Chinese,
Morrow ruled in favor of
Wong
Wai. He said that measures
taken,
including
the
compulsory
in
oculation,
were
"boldly
directed
against
the Asiatic or
Mongolian
race
as a
class,
without
regard
to the
previous condition, habits, exposure
or
disease,
or residence of the individual"
on the
unproven assumption
that
this "race" was more
liable to the
plague
than
any
other.3 The
judge
found that the racial
provision
of the order to inoculate
clearly
violated
the
equal protection
clause of the Fourteenth Amendment. Morrow's
decision not
only
saved the Chinese from future
compulsory
inocula
tions,
it also set a
legal precedent
that limited
government's ability
to
override the
rights
of individuals in the name of
public
health.
The case of the Chinese and bubonic
plague
in 1900 seems to echo
across time and is
especially
relevant
as we deal with current issues of
migration,
acculturation,
national
security,
health,
and civil liberties vio
lations. Scholars have treated the matter of civil
liberties,
national secu
rity,
and
immigration
before.
Certainly, depriving
ethnic minorities of
their
rights
in the name of national
security
is
nothing
new.
Roger
Daniels
has written
extensively
on the
plight
of the
Japanese
in internment
camps
during
World War II.4
Stephen
Fox and Lawrence Distasi each have
written about the Italian internment.5 Arnold Krammer has told the
story
of the internment of German aliens.6 A
colleague
and I wrote
about the
hesitancy
to admit
refugees
from
Nazi-occupied territory prior
Kraut 5
to United States
entry
into World War II for fear that
they might
actu
ally
constitute a Fifth Column.7
Renaming
French fries in the
dining
room of the House of
Representatives
in the
Spring
2003 because the
French would not send
troops
in
support
of the United States invasion of
Iraq brings
to mind the
Liberty cabbage
that
replaced
Sauerkraut on
menus
throughout
the
country during
World War I
?
certainly
a
silly
expression
of national
solidarity.8
But there was
nothing
even
remotely
amusing
about the
discriminatory
treatment of German-Americans dur
ing
that conflict.
Scholars have been less
quick
to focus
on the
allegations
that immi
grants
and ethnic minorities
pose
a
threat to a different kind of national
security:
the
security
of the nation's health and
vitality.
The
very
dormi
tories that now confine
young
Muslim men at Guantanamo
Bay
without
due
process
once
housed Haitians
refugees suspected
of
being
HIV
positive
and a
health risk to Americans.9 In one of
my books,
Silent
Travelers:
Germs, Genes,
and the
"Immigrant
Menace" I demonstrated
how some
nativists
hoped
to
legitimize
their
prejudices by spotlighting
the
possible
threat to the
public's
health and
well-being posed by
par
ticular
groups
?
both before and after the
acceptance
of
germ
theory
as
an
explanation
for infectious disease.
Examples
abounded. The Irish
were
charged
with
bringing
cholera to the United States in 1832. Later
the Italians were
stigmatized
for
polio.
Tuberculosis was called the "Jew
ish disease."10 A handful of other scholars have since made similar
observations
concerning
the
stigmatization
of newcomers as the bearers
of harmful
pathogens.11
Even less well-documented are the
ways
in which issues of health
and
well-being shape
the manner in which
immigrants integrate
into
American
society.
It has been
my experience
as a historian of
immigra
tion and
ethnicity
that the
negotiations
of aliens and Americans in the
areas of health and medicine
are
every
bit as
important
as in the realms
of
politics,
economics,
and culture. I have also found that historians of
American medicine and
contemporary
health
policymakers
are
eager
to
learn the lessons that we scholars of
immigration
and
ethnicity
have to
teach.
Unfortunately, immigration
historians have
largely neglected
health
care as a
crucial terrain in the
struggle
over
integration. Specifically,
we
have
neglected
the individuals and institutions crucial to the cultural
negotiation
between
newcomers and the host
society. Immigration
schol
ars have said too little about the
physician
as a
cultural mediator. While
we
have done
justice
to the urban
political
boss as cultural mediator and
6
Journal
of American Ethnic
History
/ Winter 2004
power broker,
we have not
exhaustively
examined the role of the
physi
cians,
who often have far more direct contact with newcomers in their
homes than
politicians.
While
we
have done much to
explore
consumer
culture,
we have done less to
explore
the culture of
medicine,
especially
those institutions to which newcomers turn for health
care,
specifically
hospitals
and clinics.12
In the United
States,
physicians
often find themselves
practicing
medi
cine at an
invisible border which
separates
them from
foreign-born pa
tients. Far more
significant
than
a mere division of
language,
this border
depends
on
complex
cultural differences that lead to
misunderstanding
on one
side,
intimidation
on
the
other,
and
deep
frustration
on
both.
Different
immigrant groups
react to American
physicians differently
?
but
always
within the rubric of their own
history
and customs. In the
towns and
villages
of southern
Italy
at the turn of the last
century,
physicians (usually paid by
the
state)
were distrusted
as
hostile intrud
ers,
incapable
of
curing
illness but
quite capable
of
self-aggrandizing
exploitation. Instead,
religion
and
custom,
including superstition grounded
in the
pre-Christian
pagan
beliefs
ubiquitous
in
Italy's
southern
prov
inces,
became the
guardians
of
well-being.
In such
towns,
and later in
the Italian
neighborhoods
of American
cities,
contadini defined illness
as an
enemy's
curse,
a work of human
jealousy
or
spite,
administered
through
the
gesture
of the MaVocchio
('Evil Eye").
Restored health was
a divine
blessing,
often a
sign
of the Madonna's indirect intervention.
Such a
blessing
was meant to be shared with others.
According
to cul
tural
anthropologist
Robert
Orsi,
a ritual
practice
in southern
Italy
that
carried over into New York's East Harlem
required parents
to donate
the
clothing
of
recently
healed children to the church for distribution to
the
community's poor.
The transaction
expressed appreciation
of the
"intimate connection between
private grief
and
joy
and the claims and
contributions of the
community."13
One
way
in which Italian
immigrants
in America
sought
to reconcile
themselves to the shift from custom to
physician's prescription
was
by
only consulting
doctors of their
own ethnic
background.
An Italian
phy
sician from New York described his
group's preferences:
Italians almost
always
call an Italian doctor because of the mutual
sympa
thy
and common
language.
The Italians are
very
fond of their
families,
and will
spend every
cent to care for a member if ill.
They
are not
satisfied with the American doctors because
they
make a short
visit, pre
scribe,
and leave. This leaves the
family
in much doubt and accounts
Kraut 7
somewhat for their
calling
in another doctor if there isn't marked im
provement
in a few hours. The Italian doctors tell the
family
what the
malady
is,
and
explain
to them all about
it,
and this is what
they
expect... They always pay
cash and as a
consequence they
are inclined
to call various doctors at different
illnesses,
just
as
they patronize
differ
ent stores.14
Italian
physicians
in the United
States,
especially
those who were
first-generation immigrants
themselves,
often understood their role as
cultural mediators. One such
physician
was Dr. Antonio Stella.
Although
Stella's roots were not humble
?
he was the well-educated son of
a
lawyer
in Lucania and received his M.D. from the
Royal University
in
1893
?
he did
emigrate, becoming
a naturalized American in 1909. In
New
York,
Stella had
wealthy patients, including
the
great opera
star
Enrico Caruso.
However,
it was the
plight
of the
poor
that drew Stella to
investigate
and
publish
on
tuberculosis. In
1904,
he
sought
to refute the
notion that Italians were
bringing
tuberculosis to the United States. He
hoped
to
explain
to Americans that it was life in the United States that
was
contributing
to tuberculosis
among
the Italians. Stella
wrote,
"One
must follow the Italian
population
as it moves in the tenement
districts;
study
them
closely
in their
daily struggle
for air and
space;
see them in
the
daytime
crowded in
sweat-shops
and
factories;
at
night heaped
to
gether
in dark windowless
rooms;
then visit the
hospitals' dispensaries;
and
finally
watch the
out-going steamships,
and count the wan
emaci
ated
forms,
with
glistening
eyes
and
racking cough
that return to their
native land with
a
hope
of
recuperating
health,
but often times
only
to
find a
quicker
death."15
While Stella called for
understanding
of the conditions that made
Italians
immigrants
ill,
and
compassion
for their
condition,
he and other
Italian
physicians
issued the loudest calls for
change
in Italian habits of
health and
hygiene.
One such
physician,
Dr. Rocco
Brindisi, wrote,
"The
Italians,
like all
peoples
with ancient habits and
traditions,
cling
to
many prejudices
and
superstitions,
which often
hamper
those who work
with them." Brindisi
was
confident that his
compatriots
were on
the
road to
"regeneration"
and that he himself was an
instrument of
change.
"It is education
through
the
public
institutions and the
missionary
work
of the
physicians
that will
bring
the
principles
of
hygiene
and their
practical
benefits into the Italian
homes,
while
waiting
for the
more
substantial fruits of the schools." He told all who would listen that there
was not the
slightest
doubt in his mind "that the
rising generation
of our
8
Journal
of American Ethnic
History
/ Winter 2004
Italians will
be,
in
regard
to
sanitary
conditions,
on the same level with
the American
people."16
Among
Eastern
European
Jewish
immigrants,
as
among
the
Italians,
physicians
were
significant
as
cultural mediators in the
process
of inte
gration
after the mass
migration
of the late nineteenth and
early
twenti
eth centuries. In the
impoverished
streets of the Jewish
quarters
of East
ern
European
cities,
as well as in their rural
villages
or
shtetlach,
the
first consultation in matters of health was with a
folk healer.
Physicians
were often too
expensive.
Well-educated
physicians
also seemed to
many
to be
culturally
distant. Eastern
European
Jews
initially
continued these
patterns
after
arriving
in the United States.
However,
on
New York's
Lower East Side and in other
immigrant
enclaves
throughout
the
nation,
Jews found both non-Jewish and Jewish doctors
living nearby
and will
ing
to
negotiate
fees. Jewish mutual benefit
societies,
or lands
mannschaftn,
also
employed physicians
to care for their members. These
physicians
contracted with one or more
of the
many
mutual benefit
societies active in the
immigrant community
and received
monthly
fees.
Patients
paid nothing
or a small nominal fee at the time
they
were seen
by
a
physician,
whether in their home or at the doctor's office.
Though
many
such
physicians
were
attentive and
sympathetic
to their
patients,
others
grew
so
tired of
climbing
tenement stairs that
they
would call
up
to a sick
patient,
make the
diagnosis,
and
suggest
a
prescription
from the
bottom of the stairs.
Still,
physicians
were in
general
much admired in
the Jewish
community,
and their words carried considerable
weight
with
their
patients.
Some Jewish
physicians
defended their
community
to those who
pro
nounced Jews a threat to the
public
health. And the critics were
vocal. In
1908,
Dr.
Manly
H.
Simons,
medical director in the U.S.
Navy,
com
plained,
"The
poorer
classes of Jews are
very
unsanitary; they
work and
live in
dirty
and
badly
ventilated
quarters. Though special
virtue is
claimed for the Jewish method of
killing
the animals
they
use for
food,
this is offset
by
the dirtiness of the
shops
in which the meat is sold."17
Six
years later,
E.A. Ross at the
University
of Wisconsin observed that
Jews
appeared
wasted and
lacking
in the
physical vitality
that he attrib
uted to America's
more robust
Anglo-Saxon
stock,
deficiencies that
were inborn and then exacerbated
by
the vicissitudes of life in America.
He
lamented,
"On the
physical
side,
the Hebrews
are
the
polar opposite
of our
pioneer
breed. Not
only
are
they
undersized and
weak-muscled,
but
they
shun
bodily activity
and are
exceedingly
sensitive to
pain."18
Renowned nativist Madison Grant
predicted
that it would be
impossible
Kraut 9
to transform into an American "the Polish
Jew,
whose dwarf
stature,
peculiar mentality,
and ruthless concentration on
self-interest
are
being
engrafted
upon
the stock of the nation."19
One who dueled with such nativists was Dr. Maurice
Fishberg.
Be
cause of his own
immigrant background, Fishberg
was
quick
to defend
his Jewish
patients
from nativist attacks in his
many articles,
often
citing
statistical data
indicating
that Jews were less
prone
to
many
diseases
than non-Jews in the
immigrant population.
In
arguing
that
cleanliness,
so
important
to
good
health,
was central to Jewish
culture,
sacred and
secular,
he not
only
cited the ritual
bath,
or
mikva,
essential to Orthodox
Jews,
but the Russian steam baths so
popular
with recent
immigrants.
He described
how,
during
the
summer,
the
public
baths on
the East
River were "crowded with Jewish
humanity
from
daybreak
till late in
the
evening."20
He noted that
religious
law
required
the observant Jew
to
clip fingernails
and toenails
weekly,
wash hands before and after
eating,
and wash face and hands each
morning.21
He credited the di
etary
laws of Kashrut with
requiring
Jews to eat food that was untainted
and
healthy. Hoping
to shatter the
impression
that Jews were a
primitive
people living
in their own
squalor, Fishberg
cited the words of one
European
commentator on Jewish
habits,
who characterized Judaism as
having
"made
religion
the handmaid of
science;
it has utilized
piety
for
the
preservation
of health."22
As a cultural
mediator,
Fishberg
was
especially
attentive to those
newcomers so
unhappy
in the United States that life in America
was
quite literally making
them sick. In his
capacity
as medical examiner for
United Hebrew
Charities,
Fishberg
was in a
position
to
help
those who
needed to
escape
the stresses of
incorporation
and return to their homes
in
Europe.
His notes described the case of an
eighteen-year-old
male
who came from Russia
intending
to make
money
for his
family's
trans
Atlantic
passage.
The doctor wrote of the
young
man that after three
months,
"His
general
appearance
is
worried,
his look is rather anxious.
He tells
me that he suffers from
'pain
in the
heart,' insomnia,
loss of
memory,
and
inability
to concentrate his mind on
anything.
He
is,
he
claims,
too weak to work. The cause of all this he knows. The climate
has an
injurious
effect on his
organism;
the air is rather 'too
strong'
for
him. He knows he will die soon. All he asks is that the United Hebrew
Charities
pay
his
transportation
to Russia where he
may
die near his
parents.
A
physical
examination reveals
that,
excepting
minor
bow-legs
and
slight
anemia
...
he is a
healthy
man. His heart and
lungs
are nor
mal."23
Fishberg
found such cases where the individual could not
fully
10
Journal
of American Ethnic
History
/ Winter 2004
engage
in the
process
of
integrating
themselves into their new
society
especially distressing
and difficult to treat.
Occasionally, physicians
offered nonmedical advice because
they
well
understood the
relationship
between
lifestyle
and health. To the
plain
tive moan of a Jewish
immigrant
who had succumbed to
tuberculosis,
"Luft, gibt
mir
luft" ("Air, give
me
air"),
one
physician
offered more
than
platitudes. Knowing
that his
patient
could not afford sanatorium
care,
the doctor
prescribed
rest,
some
cough
medicine,
and one
thing
more. He scribbled on the
prescription slip,
"Join the Cloakmakers'
Union."24 For that
physician,
the
origins
of disease were as much the
social conditions of his
patient's
life as in the microbes that had invaded
the
poor
worker's
lungs.
Beginning
in the mid-nineteenth
century, preference
for treatment
by
one's
own
led
many
newcomers to start their own
health care institu
tions. These became arenas of
negotiation
and
compromise,
and remain
so
today
for newer
ethnic
groups.
The Roman Catholic Church led the
way.25
In the
1840s,
Catholics founded St. Vincent's
Hospital
in New
York to offer health care to the Irish
poor
in an
atmosphere
that was
spiritually
familiar. The
presence
of a
priest
at the bedside and a kitchen
that observed meatless
Fridays
offered the
support
that the sick and
dying sought
in their faith.
Moreover,
dreaded Protestant
evangelicals
in
search of souls
acquired through
deathbed conversions were barred from
St. Vincent's wards.26
German Jewish
philanthropists
in Cincinnati established
a
hospital
there in 1850 to serve that
city's
4,000
Jews and the
impoverished
itinerant
peddlers
who returned to Cincinnati
periodically
to
replenish
their stock. New York's Jewish
community
soon followed this
example.
The Jews'
Hospital
of New
York,
later renamed Mount
Sinai,
opened
in
1855. Over
sixty
Jewish
hospitals
were
subsequently
established across
the nation. More than
fifty percent
of these institutions were founded
between 1880 and
1930,
during
the
period
when
immigration
increased
the Jewish
population
of the United States from
230,000
to 2.5 million.
Jews built
hospitals
in
Philadelphia,
Baltimore, Newark,
St.
Louis,
San
Francisco, Cleveland, Louisville, Denver, Hartford,
and Boston. Studies
are
needed to
explore
the reasons
why
such institutions were
founded,
how
they
served their
communities,
and what
happened
to them in the
late twentieth
century
when their communities relocated or
simply
no
longer
needed faith-based
hospitals.27
Historians of American
hospitals
too
frequently neglect
the ethnic
conflict that
gave
birth to
many voluntary hospitals,
conflicts that are
Kraut 11
well understood
by immigration
scholars.28 Take for instance those Jew
ish
hospitals.
Some
proponents argued
that
founding
a
Jewish
hospital
with a
nonsectarian admissions
policy
would diminish
anti-Semitism,
because it would be an act of
generosity
toward the
gentiles
and assure
non-Jews that Jewish
immigrants
would not become a burden to the
general community.
Others
argued
that there was
already
such a suffi
cient reservoir of anti-Semitism that Jews needed
separate
facilities to
shield themselves from the
contempt
of the
very
individuals who would
be their healers. Otherwise decent
physicians
who were neither conver
sant in Yiddish nor informed as to the customs and
problems
of Jewish
immigrants diagnosed
neurasthenic
symptoms
as a
uniquely
Jewish ail
ment,
dubbed "Hebraic
debility."
Those so
diagnosed
were said to be
highly
nervous,
with
difficulty adjusting
to life in the United States.
Exacerbating
the burden of such
peculiar,
culture-bound
diagnoses,
some
physicians
felt an
almost uncontrollable
repugnance
at the
sight
of Jew
ish
immigrant patients.
Richard C.
Cabot,
a
distinguished physician,
admitted in his 1931 memoir to
having
treated Jewish
patients
as invis
ible men and
women,
much as
Caucasians do African Americans in
Ralph
Ellison's classic
novel,
Invisible Man.
As I sit in
my
chair behind the
desk,
Abraham
Cohen,
of Salem
Street,
approaches,
and sits down to tell me the tale of his
sufferings;
the chances
are ten to one that I shall look out of
my eyes
and
see,
not Abraham
Cohen,
but a
Jew;
not the
sharp
clear outlines of this
unique
sufferer,
but
the
vague misty composite photograph
of all the hundreds of Jews who in
the
past
ten
years
have shuffled
up
to me with bent backs and
deprecating
eyes,
and taken their seats
upon
this stool to tell their
story.
I see a
Jew,
?
a
nervous,
complaining, whimpering
Jew
?
with his beard
upon
his
chest and the inevitable
dirty
black frock coat
flapping
about his knees. I
do not see this man at all. I
merge
him in the
hazy background
of the
average
Jew.29
If Jewish
patients
needed
hospitals
where
they
could recover their health
in an
atmosphere
of
respect
and
acceptance,
Jewish
physicians
needed
the Jewish
hospital
even more. Jewish medical students
were
often met
with
hostility, subjected
to admissions
quotas
in medical
schools,
denied
residencies in non-Jewish
hospitals,
and sometimes
even
refused
hospi
tal
privileges
so
they
could continue the care of
patients requiring hospi
talization.30 One of the main reasons for the rise of the Jewish
hospital
in America
was
the need for
a
place
where Jewish
physicians
could train
and
practice
medicine. In
1923,
the
progressive journal Survey
said that
12
Journal
of American Ethnic
History
/ Winter 2004
Jewish
hospitals
were needed "to obviate the discrimination
against
Jewish
physicians
in non-Jewish
hospitals."
In
Hartford, Connecticut,
Dr. J.J.
Goldenberg, glancing
at the
photographs
of men
and women on the
walls of Hartford's Mount Sinai
Hospital,
recalled,
"They
founded this
hospital
for the Jewish doctors who were
unable to
get
staff
privileges
at
the other
hospitals
in town." He
bitterly
remembered the
indignities
suffered
by
Jewish
physicians
at the hands of non-Jewish
hospital
ad
ministrators. "Jewish doctors had to
put
their
patients
on a list for elec
tive admission to the
hospital. Usually
a week or two would
pass
before
a
gentile colleague
would admit
your patient
and turn over the care to
you,
if
you
were
lucky!"31
The Catholic St. Francis
Hospital
took a few
Jews on
staff,
but not until Mount Sinai
opened
its doors in 1923 could
Jewish
physicians
be certain that
they
would not fall victim to discrimi
nation. Dr. Arthur
Wolff,
the future chief of staff at the
hospital,
ob
served that the
founding
of Mount Sinai was critical "for the
younger
medical men of our
city
who for
years
have been
hampered
in the
accomplishment
of their
surgical
work."32
In
Detroit,
physician Harry August
cited the
difficulty
of
obtaining
internships
and residencies at
hospitals.33
While some of Detroit's Jew
ish
physicians
worked in clinics that had been built and sustained with
philanthropic
contributions,
the
Survey
article was
critical of such clin
ics. The author of the
report,
S.S.
Goldwater,
thought
such clinics "iso
lated" and
capable
of
providing only
"discontinuous medical services"
because
they
could not follow clinic treatment with
hospital
care,
while
the
physicians
who
practiced
there did not benefit from an
environment
enriched
by
research and
teaching.
From a
physician's perspective,
clinic
work
usually
entailed
providing
free medial care to
impoverished
immi
grants.
Such
service,
while
noble,
offered no
path
to
professional
devel
opment
for
physicians,
no
possibility
of research
opportunities
to those
drawn to the
laboratory,
and no advancement derived from offers of
positions
from more
prestigious
and
wealthy
medical institutions.
Not all Jewish
physicians supported
the creation of Jewish
hospitals.
This was
especially
true of those who had
managed
to achieve
positions
on
the staffs of non-Jewish
hospitals.
Some of Detroit's most
prestigious
German Jewish
physicians opposed building
a
Jewish
hospital,
includ
ing
Doctors
Hugo Freund,
David
Levy,
Norman
Allen,
and Max Ballin.
Dr. Freund served as chief of medicine at
Harper Hospital
from 1928 to
1945. He also sat on
the Board of Health and on the Board of Public
Welfare. Ballin labored
tirelessly
in clinics to
help
the
poor,
and he
managed
to become chief of
surgery
at
Harper Hospital. Despite
a sur
Kraut 13
vey
commissioned
by
the North End medical staff in 1929 that con
cluded Jewish doctors were
indeed
under-represented
on
hospital
staff,
these
prominent
Jewish medical leaders continued to
oppose
the
cre
ation of
a
separate
Jewish
facility.
Some,
such
as Emil
Amberg
and
David
Levy,
claimed that the real barrier to most new
Jewish
physi
cians,
especially
those of Eastern
European background,
was their
poor
qualifications.
Those Detroit
physicians
who
opposed building
a Jewish
hospital
were not without self-interest. Jewish
practitioners
who needed
hospital
care for their
patients
were forced to send referrals to one of the
physi
cians who had such
privileges.
Also,
established staff doctors such as
Freund, Ballin,
Levy,
and
Amberg
had the attention and
loyalty
of
Detroit's wealthiest Jewish
families,
most of them
German-Jewish,
in
cluding
the Winemans and the Butzels.
By
and
large,
members of such
families found
physicians
of Eastern
European background
and
hospi
tals with kosher kitchens to be uncomfortable reminders of their ethnic
ties to those
they regarded
as their social inferiors.34
Despite
such
oppo
sition,
Jewish
hospitals
continued to be established and to thrive in those
cities with substantial Jewish
populations.
Ultimately,
these
hospitals developed
into
powerful
cultural media
tors for the Jewish
community.
There
was,
for
instance,
the
example
of
tuberculosis. Jews were often
stigmatized
as
disproportionately consump
tive.
Fearing
that those of their brethren who did contract the disease
would become
a
burden to Americans and
trigger
an
anti-Semitic back
lash,
Jewish
philanthropists
and
voluntary organizations
bent their ef
forts toward
creating
a Jewish institutional
response.
The standard of
care for
consumptives
was a
sanatorium
stay. Separated
from
family
and
coworkers,
consumptives
in sanatoria
were
exposed
to such standard
therapies
as a
beneficial
climate,
fresh
air,
and
a
supervised
nutritious
diet.35 The sanatorium could not offer a
specific
cure for
TB,
but it
reflected
a
revision of how the disease was viewed. If not
curable,
TB
was treatable. Survival was
possible
with sanatorium care.
Denver, Colorado,
became a
magnet
for
"respiratory refugees"
who
came to breathe the clear mountain air.36 In October
1903, twenty
or
thodox Jewish
tradespeople
?
including
a
tinner,
a
furrier,
a silk
weaver,
a
tailor,
a
house
painter,
a
cigar
maker,
an
actor,
and a
photographer,
all
victims of tuberculosis
?
met to found
an
institution that would meet
their
physical
and
spiritual
needs.37 It was a
humble
beginning. Among
themselves,
the
twenty
could raise
only
a
$1.10
for their Denver
Charity
for
Consumptives (later
renamed the Denver
Appeal Society
for Con
14
Journal
of American Ethnic
History
/ Winter 2004
sumptives
to eliminate the word
charity,
because
they
felt it had conde
scending connotations).38
The Jewish
Consumptive
Relief
Society
(JCRS),
as the institution
eventually
was
named,
received most of its
contributions from workers and their labor unions. A letter of 28 Febru
ary
1908 thanked the
Workingmen's
Circle of New York for its contri
bution of
S3.00.39
A similar letter written several months later
expressed
appreciation
to the
president
of the
Rochester,
New York Workman's
Circle for a
personal
donation of
$1.35.40
Agents
of the JCRS combed
Jewish communities around the
country
for
donations,
entreating philan
thropists
and
placing pushkes (collection boxes)
in
stores, homes,
and
meeting
halls for whatever
a
community
could
spare.41
All these coins
and wrinkled bills did the
job;
in 1904 the Jewish
Consumptive
Relief
Society
admitted its first
patient.
Physicians
at the sanatorium found themselves cast as mediators be
tween different factions of the same
religious group
on issues such as
kosher food. Reform Jews took the word of
physicians
who said that
big
helpings
of meat and milk
products
at
every
meal were essential to
recovery,
while orthodox Jews
argued
that
separating
milk and meat
would not
impede
recovery.
One
physician
at the JCRS
argued
that
by
forcing
tuberculars to forsake
dietary
laws,
more
damage might
be done
to
patients'
health and welfare than
any positive
nutritional value that
might
result
by violating
the laws."42
Most Jewish
hospitals
did not
specialize
in a
single
disease as the
tuberculosis sanatoria did.
Instead,
most were established in the midst of
urban
neighborhoods
where
poor,
immigrants
Jews resided.
There, among
the
synagogues, shops,
and
schools,
these medical institutions treated
the illnesses and
injuries
of Jews and non-Jews alike.
After World War
II,
the sons and
daughters
of Jewish
immigrants
joined
the middle-class exodus to suburbia.
Large
numbers the children
and
grandchildren
of
immigrant
Jews moved to
suburbia,
leaving
the old
neighborhood
and the local
hospital
behind.
By
the
1990s,
the Jewish
hospital began
to lose its
importance
as an extension of the Jewish
cultural
presence
in the United States.
Though
still
top-drawer
medical
institutions,
Jewish
hospitals
treated fewer and fewer
Jews;
especially
reduced
were the number of observant
patients requiring
kosher meals
and services. In Cleveland
by
the
mid-1990s,
only
fifteen
percent
of Mt.
Sinai's
patient population
was
Jewish.43
Today,
Jewish
hospitals
in in
ner-city neighborhoods
treat more
African-Americans
or Latinos than
Jews. Jewish
hospitals
also seek to minister to
special
needs of inner
city populations.
New York's Beth Israel Medical Center
runs one
of
Kraut 15
New York's
largest
substance-abuse
programs, serving
8,000
addicts
annually,
most of whom are
publicly
assisted
patients
in methadone
programs.
Beth Israel also has a full-time Cambodian translator to serve
the latest wave of
immigrants.44
As millions of Latinos and Asians enter the United
States,
the bedside
remains a
place
of cultural
negotiation.
In cities with
large populations
of Southeast Asian
immigrants,
shamans and their amulets are often
preferred
to
physicians
with their
syringes
and
sophisticated technology.
In communities such as St.
Paul, Minnesota,
with its
large Hmong
settle
ment,
physicians
have learned that the secret to
getting patients' permis
sion for invasive
procedures
such as
blood tests is to establish collabora
tive
relationships
with shamans. Both stand at the
patient's
bedside and
support
each others' efforts.45
Cultural
misunderstandings
can
have disastrous results. As
recently
as
May
2002 in
Omaha, Nebraska,
police suspecting
child abuse
re
moved ten children from two
Hmong
families who
performed coining
or cao
gio
on
them.46 The
therapy
involves
rubbing
warm oils or
gels
across a
person's
skin with a
coin, spoon,
or
other flat
object.
It leaves
bright
red marks or
bruises,
but
many
Asian families believe the marks
signify
that bad blood is
rising
out of the
body, allowing improved
circulation and
healing.
Such arrests no
longer happen
in St.
Paul,
thanks
to the efforts of the
Hmong
Cultural Center there.47 And in
Nashville,
the Vanderbilt
University
Medical Center includes an
image
on its web
site of the
long
red bruises created
by coining
so
that
physicians
can
correctly distinguish
the
practice
from child abuse.48
More
complicated
is
comprehending
and
treating
mental disorders.
Just
as
Fishberg
encountered an
immigrant
who wished to return to
Eastern
Europe
because the "air" in the United States was "too
strong"
for
him,
today's physicians
see
immigrants
who also suffer from ail
ments which reflect the difficulties of
adjustment.
Effective
therapy
re
lies
on nuanced cultural
negotiation.
Some mental illnesses
are culture
bound. In our own
culture,
anorexia
nervosa is one such condition. At
some New York
City hospitals, psychologists
are
seeing
pa
feng,
a
phobic
fear of wind and cold
among Chinese;
hwa
byung,
a
suppressed
anger syndrome
suffered
by
Koreans;
or
Latah,
a
Malaysian
and Indo
nesian
psychosis
that leads to uncontrollable
mimicking
of other
people.49
Because the
stigma
and shame attached to mental illness is
greater
in
Eastern cultures than in the
West,
getting
treatment to those who need it
is often difficult. This
past January,
Dr.
Yuong
Cho told the New York
Times,
"They [the immigrants] may go
to a
pastor,
a
fortuneteller,
or a
16
Journal
of American Ethnic
History
/ Winter 2004
friend's
mother,
but never talk to a shrink."
Among
his
patients,
Dr.
Cho has a number who he describes as
suffering
from culture shock.50
Historians have
long
known about downward
mobility
associated with
migration
and the stress of not
being
able to communicate well in En
glish, especially among
immigrants
who were
well educated and suc
cessful in their
country
of
origin.
However,
physicians examining pa
tients who seem to
present symptoms
of mental disorder often fail to
appreciate
the Stressors of
immigration.
American
hospitals today
can be
unfriendly places
for
newcomers,
for reasons that have less to do with culture and more to do with the
economics of
immigration.
The institutions and their staffs feel inun
dated
by immigrants, especially
undocumented newcomers
who have no
health insurance and seek most of their medical attention in
already
overtaxed
emergency
rooms. As one
hospital
administrator said
recently
at Martin Memorial Medical Center in
Florida,
"We have
people
com
ing
to our
country
in
good
faith to
work,
but we have no
system
in
place
as a nation
as to what to do when these
people get
sick. Each
hospital
is
left to kind of
figure
out what to do for itself."51
Hospitals
are
coping by
writing
off the
expenses. However,
the
healing
environment that emer
gency
rooms
provide
can be cold and
alienating.
Some
communities,
including
my
own in
Montgomery County, Maryland,
are
responding
with the Mobile Med
program,
ethnic-friendly
mobile clinics. What
does that mean? It means that the clinic is staffed with those who
speak
the
group's language
or
perhaps practice
the same
religion. Recently,
Muslim doctors from
a
mosque
in Silver
Spring, Maryland, began
offer
ing primary
care to a limited number of
uninsured,
primarily
Muslim
patients
a
few hours a month.
Meanwhile,
St. Camillus Catholic Church
in Silver
Spring,
which has more than 113 different nationalities in its
parish,
is
working
with Mobile Med on
plans
for a clinic for French?
and
English-speaking
African
immigrants.52
Can
immigration
historians
play
a role in the
making
of
public
health
policy?
Sometimes. In 1998 the National Research Council issued a
report,
From Generation to
Generation,
The Health and
Weil-Being of
Children in
Immigrant
Families. It was the culmination of two
years
of
study.
Of the nineteen
panel members,
there were
physicians, psycholo
gists, sociologists,
and
anthropologists
and one
immigration
historian
?
me.
Our task was to
study
the health and
well-being
of children
among
today's immigrants
to the United States and make recommendations for
improvement.
I think I contributed to the
panel
in
a
variety
of
ways.
First,
when the
panel
was
seeking
a venue in which health
care
provid
Kraut 17
ers
could reach
immigrant
children and offer
some
preventive
care as
well as
treatment,
I
suggested
the
public
school classroom. I had learned
from
my
historical studies that nurses and
physicians
were fixtures in
many
schools in the
early
twentieth
century,
even
performing
minor
surgeries. Increasingly,
school
systems
have taken less and less
respon
sibility
for
seeing
that children
get
the care
they require. Insisting
that
students
get
vaccinated before
coming
to school is not the same as
being
a
site where such vaccinations are administered. Few
on the
panel
knew
how central
a role the schools had once
played
in
bringing
medical
attention to
poor
children and
especially
to the children of the
foreign
born.
One of the
panel's
conclusions
was that sometimes America can be
bad for the health of its
immigrant
children. Some
on the
panel
were
puzzled
to learn
that,
on
average,
the health of infants born to mothers
newly
arrived from Latin American countries is better than that of those
born to Latinas who have lived in the United States for some time.
Why?
The
panel
needed to be reminded
that,
historically,
habits of life
change
as newcomers
begin
to assimilate. In this
case,
mothers
new to
the United States breastfeed
longer,
as was the custom in their
villages.
Mothers who had come to the United States
many years
before
are far
from their female
support systems
and distanced from custom and tradi
tion.
They
often
wean their babies too
early
so
they
can take or resume
employment
outside of the home. As
a
result,
the babies are less well
able to fend off infant diarrhea and a host of other ailments. Understand
ing
this
phenomenon
is
helping public
health care workers devise
more
effective
programs
of maternal
care. The cultural
sensitivity
that
comes
with an
appreciation
of
immigration
and ethnic
history
can indeed make
a difference.
It is not
my
intention to turn
every
course on
immigration
and ethnic
history
into one on the
history
of
medicine,
or vice versa.
However,
we
have been remiss in our courses and in our
scholarship by
not acknowl
edging
the role that health and disease
play
in
shaping patterns
of inter
national
migration
and cultural
integration. Reflecting
in 1986
on his
renowned
essay, "Migration
from
Europe
Overseas in the Nineteenth
and Twentieth
Centuries,"
Frank Thistlethwaite
mused, "by
1960,
it had
gradually
dawned
on me that the
history
of
migration
was an Androm
eda,
chained to the rock of national
history
and
crying
to be freed to
become
an
independent
force." Issues such
as health and disease
help
us
to shatter those chains.
Pathogens
transcend national boundaries. The
culture of medicine in host countries
never remains
static,
but is reactive
18
Journal
of American Ethnic
History
/ Winter 2004
to both
immigrant
bodies and the traditions of medicine that
they bring
with them.
This cross-fertilization of
migration history
and the
history
of medi
cine is not
just
valuable to those of
us
engaged
in
speculative
scholar
ship.
Scholars who venture outside academia into the world of
public
history
can and should
put
the
past
in the service of the
present.
The
cultural
sensitivity
that emanates from the classroom
can offer valuable
perspectives
to those who are
dealing
with
today's
newcomers and their
problems.
Those
helping
a new
generation
of
immigrants
will listen to
us if we
speak
to them and
prepare
our
students to assist them.
Finally,
when
we learned that an infectious
respiratory
disease identi
fied in China in
Spring
2003,
S ARS
(Sudden
Acute
Respiratory Syn
drome)
can within
days
of its identification
menace those
living
in Vir
ginia
or New
Jersey
or
Toronto,
we
learn that illness is
more than ever
before
a transnational
experience.
Some Americans reacted to SARS
by
stigmatizing
all those of Asian
background.
Social humiliation and loss
of business
were the
consequences.
Lest we
repeat past
errors,
it be
hooves all of
us with
an
expertise
in
immigration
and ethnic
history
to
see that the
experience
of
Wong
Wai is not
repeated,
and that the
patient
is not confused with the disease. Violations of civil liberties in the name
of
public
health and national
security
must not be an historical
pattern
we are condemned to
repeat.
NOTES
In this address I have drawn
heavily
from material
developed
in two
previous
studies,
Silent Travelers:
Germs,
Genes and the
"Immigrant
Menace
"
(New
York:
Basic
Books, 1994)
and "'No Matter How Poor and Small the
Building":
Health
Care Institutions and the Jewish
Immigrant Community,"
in
Religion
and
Immigra
tion:
Christian, Jewish,
and Muslim
Experiences
in the United
States,
ed. Yvonne
Yazbeck
Haddad,
Jane I.
Smith,
and John L.
Esposito (Walnut Creek, CA., 2003),
129-58.
1. Sacramento
Record-Union, May
20,
1900. The entire
episode
and
underlying
racism is most
recently
described in
Nayan Shah, Contagious
Divides,
Epidemics
and Race in San Francisco's Chinatown
(Berkeley, 2001),
120^47. Also see Alan
M.
Kraut,
Silent Travelers:
Germs,
Genes and the
"Immigrant
Menace,
"
(New
York, 1994),
78-96.
2.
Wong
Wai
v.
Williamson,
Civil Case No.
12, 937,
RG 21 U.S. National Ar
chives,
Pacific-Sierra
Regional
Branch,
San Bruno California. For a
through
discus
sion of the
Wong
Wai
case,
see Charles
McClain,
"Of
Medicine, Race,
and Ameri
can Law: The Bubonic
Plague
Outbreak of
1900,"
Law and Social
Inquiry
13
(Summer 1988):
447-513. A broader
study by
McClain is his fine
volume,
In
Search
of Equality:
The Chinese
Struggle Against
Discrimination in Nineteenth
-
Century
America
(Berkeley, 1994).
See also
Kraut,
Silent
Travelers,
91-96.
Kraut 19
3.
Wong
Wai v.
Williamson,
103 Fed.
Rep.,
1900,
7. See
Kraut,
Silent
Travelers,
92.
4.
Roger Daniels,
Prisoners Without Trial:
Japanese
Americans in World War
II
(New York, 1993).
See Daniels' other volumes
on
the
Japanese
in internment
camps, especially,
Concentration
Camps,
North America:
Japanese
in the United
States and Canada
During
World War II
(Malabar,
Florida: R.E.
Krieger
Publish
ing,
1981;
reissued
1990)
and Daniels and
Kay Saunders, eds.,
Alien Justice: War
time Internment in Australia and North America
(St. Lucia, Queensland, 2000).
5.
Stephen
Fox,
The Unknown Internment: An Oral
History of
the Relocation
of
Italian Americans
During
World War II
(New York, 1990)
and
Biography of
Ger
man American Internment & Exclusion in World War II
(New
York:
Lang, 2000).
Lawrence Destasi and Sandra
Gilbert,
eds. Una Storia
Segreta:
The Secret
History
of
Italian American Evacuation and the Internment
During
World War II
(Berke
ley, 2001).
6. Arnold
Krammer,
Undue Process: The Untold
Story of
America's German
Alien Internees
(Lanham, MD., 1997).
7. Richard Breitman and Alan M.
Kraut,
American
Refugee Policy
and Euro
pean Jewry,
1933-1945
(Bloomington, Ind., 1987),
112-25.
8. Sean
Loughlin,
"House Cafeterias
Change
Names for 'French' Fries and
'French'
Toast,"
http://www.cnn.com/2003/ALLPOLITICS/03/ll/sprj.irq.fries.
9.
Lynne Duke,
"U.S.
Camp
for Haitians Described As
Prison-Like,"
Washing
ton
Post,
19
September
1992.
10.
Kraut,
Silent
Travelers, 32-34, 108-12,
155-58.
11. Howard
Markel, Quarantine!
East
European
Jewish
Immigrants
and the
New York
City Epidemics of
1892
(Baltimore, 1997)
and
Amy
L.
Fairchild,
Science
at the
Borders,
Immigrant
Medical
Inspection
and the
Shaping of
the Modern
Industrial Labor Force
(Baltimore, 2003).
12. Two fine articles have treated the Catholic
hospitals
that
were
founded to
aid the
immigrant
communities in
Philadelphia.
Gail Fair
Casterline,
"St.
Joseph's
and St.
Mary's:
The
Origins
of Catholic
Hospitals
in
Philadelphia," Pennsylvania
Magazine of History
and
Biography
108
(July 1984): 289-314.,
and Judith G.
Cetina,
"In Times of
Immigration,"
in Pioneer Healers: The
History of
Women
Religious
in American Health
Care,
ed. Ursula
Stepsis,
C.S.A.,
and Delores
Liptak,
R.S.M.
(New York, 1989),
86-117.
13. Robert
Anthony
Orsi,
The Madonna
of
115th
Street,
Faith and
Community
in Italian
Harlem,
1880-1950
(New
Haven, 1985),
181-82.
Also, Kraut,
Silent
Travelers,
105-135.
14. Michael M.
Davis, Jr.,
Immigrant
Health and
Community (Montclair,
N.J.,
1971;orig.l921),
138-39.
15. Antonio
Stella,
"Tuberculosis and the Italians in the United
States,"
Chari
ties 12
(1904):
486-89.
16. Rocco
Brindisi,
"The Italian and Public
Health,"
Charities 12
(1904):
486.
17.
Manly
H.
Simons,
"The
Origin
and Condition of the
Peoples
Who Make
Up
the Bulk of Our
Immigrants
at the Present Time and the Probable Effect of the
Absorption Upon
Our
Population,"
The
Military Surgeon
23
(December 1908):
433.
18. Edward Alsworth
Ross,
The Old World in the New: The
Significance of
Past
and Present
Immigration
to the American
People (New
York, 1914),
289-90.
19. Madison
Grant,
The
Passing of
the Great Race
(New York, 1916),
14-16.
20. Maurice
Fishberg,
"Health and Sanitation of the
Immigrant
Jewish
Popula
tion of New
York,"
Menor ah 33
(August 1902):
73.
20
Journal
of American Ethnic
History
/ Winter 2004
21. Ibid.
22. Anatole
Leroy-Beaulieu
as
quoted by Fishberg, Ibid.,
(August, 1902):
75.
Leroy-Beaulieu's
words of
praise
were in
sharp
contrast to most of what he be
lieved about the
physical degeneration
of Eastern
European Jewry.
His 1893 vol
ume was translated into
English
as
Israel
Among
the Nations.
23. Maurice
Fishberg,
"Health Problems of the Jewish
Poor,'
a
paper
read be
fore the Jewish
Chatauqua Assembly
on
Monday,
27
July
1903 at Atlantic
City,
New
Jersey,
later a
pamphlet reprinted
from The American Hebrew
(New
York:
Press of
Philip
Cowan, 1903), p.5.
24. Isaac Metzker tells the anecdote in his
commentary
on a letter to the editor
of the Jewish
Daily
Forward's "Bintel
Brief" ("Bundle
of
Letters")
column in
Metzker, ed.,
A Bintel
Brief {Garden City, 1971),
83. Also
quoted by
Stefan
Kanfer,
A Summer
World,
The
Attempt
to Build a Jewish Eden in the
Catskills,
From the
Days of
the Ghetto to the Rise and Decline
of
the Borscht Belt
(New York, 1989),
52.
25.
Casterline,
"St.
Joseph's
and St.
Mary's," 289-314,
and
Cetina,
"In Times
of
Immigration,"
86-117.
26. First Annual
Report of
Saint Vincent's
Hospital
under the
Charge of
the
Sisters
of Charity for
the Year
Ending January
First, 1859,
p.4.
The best
history
of
St. Vincent's
Hospital
is Marie De Lourdes
Walsh,
With a Great Heart: The
Story
of
St. Vincent's
Hospital
and Medical Center
of
New
York,
1849-1864
(New
York:
St. Vincent's
Hospital, 1965).
See also
Kraut,
Silent
Travelers,
45-49.
27. The most
thorough study
remains Ethan
Bridge,
"The Rise and
Develop
ment of the Jewish
Hospital
in America"
(rabbinical thesis,
Hebrew Union
College,
1985).
There have been
a number of individual
hospital
studies. Two of the best
published
volumes are
Dorothy
Levenson,
Montefiore:
The
Hospital
as Social In
strument,
1884-1984
(New York, 1984),
and Arthur J.
Linenthal,
First a Dream:
The
History of
Boston's Jewish
Hospitals,
1896 to 1928
(Boston, 1990).
28. The
single
most
comprehensive
volume on the evolution of the
hospital
in the
United States is Charles E.
Rosenberg,
The Care
of Strangers:
The Rise
of
America's
Hospital System (New York, 1987).
Two other volumes that describe the
hospital
as
a charitable institution that cared for the
impoverished
but often served as a venue
where those without families went to die is Morris J
Vogel,
The Invention
of
the
Modern
Hospital,
Boston,
1870-1930
(Chicago, 1980),
and David
Rosner,
A Once
Charitable
Enterprise: Hospitals
and Healthcare in
Brooklyn
and New
York,
1885
1915
(Princeton, N.J., 1982).
29. Richard C.
Cabot,
Social Service and the Art
of Healing,
2nd ed.
(New
York, 1931),
4-5.
30. Leon
Sokoloff,
"The Rise and Decline of the Jewish
Quota
in Medical
School
Admissions,"
Bulletin
of
the New York
Academy of
Medicine 68
(November
1992):
497-518. Also
by Sokoloff,
"The
Question
of Antisemitism in American
Medical
Faculties,"
Patterns
of Prejudice 31(1997):
43-54.
Also,
Kenneth
Ludmerer,
Time to Heal: American Medical Education
from
the Turn
of
the
Century
to the Era
of Managed
Care
(New York, 1999),
64.
31. J.J.
Goldenberg
as
quoted
in
Barry
A.
Lazarus,
"The Practice of Medicine
and
Prejudice
in a New
England
Town: The
Founding
of Mount Sinai
Hospital,
Hartford
Connecticut,"
Journal
of
American Ethnic
History
10
(Spring 1991):
21.
32. Arthur Wolff as
quoted
in
Ibid.,
35.
33.
Sidney Bolkosky, Harmony
and Dissonance: Voices
of
Jewish
Identity
in
Detroit,
1914-1917
(Detroit, 1991),
413.
Kraut 21
34.
Ibid.,
434-35.
35. Sanatorium care was introduced to the United States
by
Edward
Livingston
Trudeau. See
Trudeau,
An
Autobiography (Garden City,
N.Y., 1916).
For
a recent
and
popular
treatment of
Trudeau,
see Mark
Caldwell,
The Last
Crusade,
The War
on
Consumption,
1862-1954
(New York, 1988).
36. The term is borrowed from historian Patricia Nelson
Limerick,
who ob
serves that
many places
in the West were
refuges
for those who had trouble breath
ing, including
victims of asthma and bronchistis as well as
TB,
see The
Legacy of
Conquest,
The Unbroken Past
of
the American West
(New York, 1987),
89.
37. Charles
Spivak,
"The Genesis and Growth of the Jewish
Consumptives'
Relief
Society,"
Part
I,
The Sanatorium I
(January, 1907):
6-7.
38.
Ibid.,
Part 2
(March, 1907):
26.
39. Letter to Charles
Spivak
from Workman's Circle of New
York,
28
February
1908,
Workman's Circle
Folder,
Jewish
Consumptives'
Relief
Society Archives,
held
by
the
Rocky
Mountain Jewish Historical
Society, University
of Denver.
40. Letter to Charles
Spivak
from Rochester Workman's
Circle,
6 June
1908,
ibid.
41.
Irving
Howe,
World
of
Our Fathers
(New York, 1976),
149.
42. Dr.
Adolph
Zederbaum,
"Kosher Meat in Jewish
Hospitals
and
Sanatoria,"
The Sanatorium 2
(November 1908):
275.
43.
Marilyn
N.
Klarfeld,
"End of An
Era,"
Cleveland Jewish
News,
3 March
2000.
44.
Mary Wagner,
"Jewish
Hospitals Yesterday
and
Today,"
Modern Healthcare
21
(14 February 1991):
33.
45. Amos S. Deinard and
Timothy Dunigan, "Hmong
Health Care
?
Reflections
on a Six-Year
Experience,"
International
Migration
Review 21
(Fall 1987):
862.
46.
Jeremy
Olson,
"Asian
Remedy
Raises Few Alarms Elsewhere.
People
in
Cities With Closer Ties to
Hmong
Culture
Say
the Issue No
Longer
is a
Concern,"
Omaha
World-Herald,
3
May
2002. See
http://hmongunivers.angelcities.com/
news20020503b.html.
47. Erica
Goode,
"The Cultures of
Illness,"
U.S. News and World
Report,
15
February
1993, pp.
74-76. See medical
anthropologist
Geri-Ann
Galanti,
Caring
for
Patients
from Different
Cultures,
Case Studies
from
American
Hospitals (Phila
delphia, 1991),
95-96.
48.
Olson,
"Asian
Remedy
Raises Few
Alarms," op.cit.
49. Sarah
Kershaw,
"Freud Meets Buddha:
Therapy
for
Immigrants,"
New York
Times,
18
January
2003.
50. Ibid.
51. Dana
Canedy, "Hospitals Feeling
Strain From
Illegal Immigrants,"
New
York
Times,
25
August
2002.
52. Sarah
Park,
"Cultures of
Care, Montgomery Groups
Launch
Separate
Ethnic
Care
Clinics," Washington Post,
6
August
2002.
53. Donald J. Hernandez and Evan
Chamey,
eds. From Generation to Genera
tion,
The Health and
Well-Being of
Children in
Lmmigrant
Families,
a
published
report by
the Committee
on the Health and
Adjustment
of
Immigrant
Children and
Families,
a committee convened
by
the Board on Children Youth and Families and
the Institute of Medicine of the National Research Council
(Washington,
D.C.,
1998).
54.
Kraut,
Silent
Travelers,
227-54.
55. Hernandez and
Charney, eds.,
From Generation to
Generation,
61-63.
22
Journal
of American Ethnic
History
/ Winter 2004
56. R. G. Rumbaut and J.R.
Weeks,
"Unraveling
a
Public Health
Enigma: Why
Do
Immigrants Experience Superior
Perinatal Health
Outcomes,"
Research in the
Sociology of
Health Care 13B
(1996):
337-91.
57. Frank
Thistlethwaite, "Postscript,"
in A
Century of European Migration,
ed.
Rudolph
J. Vecoli and Suzanne M.
Sinke, (Urbana, Illinois, 1991):
57.

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