Guest Post By:
Sandra Martin Parham
Library Executive Director
Meharry Medical College Library
During the 2020 COVID-19 outbreak, nearly all medical library physical structures across the United States closed, and resources and services were delivered digitally. Conversely, the Meharry Medical College Library (MMCL) remained open. Its administrators designated the library as “essential.” Although librarians were not “required” to maintain a physical presence on the Meharry campus, they were “expected” to provide digital services and to maintain communication with faculty and students. Library personnel faced this conundrum bravely and performed their duties valiantly, of course, following the protocols for social distancing and keeping the environment sterile.
The role the library plays in the success of a viable medical college is well recognized. Librarians are there to serve both faculty and students as they engage in research. A primary duty of librarians is to assist the persons they serve to navigate through the vast resources of medical data. It is common knowledge that the LCME and regional accrediting bodies require medical school libraries to participate in the curriculum process and provide instructional classes to enhance critical thinking. Meharry had just hired an embedded librarian who was specifically developing instructional programs designed for the colleges of medicine, dentistry, and graduate studies. The embedded librarian would offer all that the literature suggests: literature searches, databases instruction, research consultations, and the opportunity to include library resources on faculty BlackBoard pages. All plans were well underway when COVID-19 hit. The nation and countries around the world went on “Stay at Home” mode. Only services deemed “essential” would continue to function, albeit, with newly mandated safety practices.
When a natural disaster occurs or an unthinkable pandemic such as the COVID-19 outbreak consumes the globe, the medical library certainly must be named among services deemed “essential.” The term essential is defined as “absolutely necessary; extremely important; crucial, fundamentally vital, so important as to be indispensable” (Oxford English Dictionary 269).
History and Geography
There are two medical educational institutions in Nashville, Tennessee—Meharry Medical College and Vanderbilt University School of Medicine. Founded in 1876 as the Medical Department of Central Tennessee College, Meharry was the first medical school in the South for African Americans with the primary mission to train black physicians (About Meharry Medical College). From its founding, Meharry has trained and graduated approximately one-half of all the black doctors in the United States (Summerville, Preface xi).
During the post-Civil War Era, the health condition of freed slaves was so dismal that Nashville earned the unenviable distinction of having the highest mortality rate in the country. The abysmally disproportionate rate of death and disease among the ex-slave population was a result of scant available medical care. Consequently, “there was a critical need for an institution to educate Negro medical professionals to address this lack of health care.” Further, this institution would play a major role in garnering information and managing the public health of Nashville, the South, and ultimately, the nation. Meharry Medical College became the institution to take on this daunting, monumental task (Epps 1).
Nashville needed two medical colleges during its early history because of the terrain of the city. The bed of limestone on which Nashville was built inhibited the development of comprehensive water and sewer lines (Kreyling 2).
By the turn of the century, Nashville had become a hot bed for disease and vague viruses. One such disease was Pellagra. The 1910 Journal of the National Medical Association notes . . .
It is a new and grave problem with which the profession in this country is now grappling, and particularly in the South where it is assuming alarming proportions. This strange disease is Pellagra. The indefinite and pervasive character of its etiology, the vague manifestations of its pathology, with the lack . . . not only of any specific treatment but the apparent inefficacy of all treatment, made [Pellagra] indeed the medical mystery of the day (Townsend 65).
While Pellagra was contagious to blacks and whites, the outbreak largely was attributed to the “Southern Negro.” In 1910, the city and county health officers of Tennessee assembled and made the startling statement, “The Negro is the reservoir of disease in the South.” It was upon this declaration that Meharry Medical College began its journey on the road to prominent research (Townsend 70).
The Meharry Response
Following the accusation printed in Journal of the National Medical Association citing the Negro as “the reservoir of disease in the South,” Dr. Arthur Melvin Townsend wrote an immediate response to this scathing accusation:
Herein it seems to me that a strange and somewhat peculiar mission is now being evolved for the Negro physician. This new mission for the Negro physician is to defend his race from the impressions now being made and the efforts put forth to prove us a menace to society and the nation on the theory that “the Negro is the reservoir for disease in the South.” It is therefore imperative on the part of the Negro physician to find out for himself if such charges are true. If true, then work to alleviate them; if false, let the world know it (Townsend 70).
In brief, Dr. Townsend sent a clarion call to Negro physicians to destroy an unfair, racist, rush-to-judgment accusation that targeted the black race. Moreover, Dr. Townsend eloquently defended the integrity of black physicians by urging them to disprove the “almost universal opinion” that black physicians were not researchers.
We must prove that the Negro physician . . . is not like a cistern, good to hold the thoughts of others alone and when the time comes that it is forced to rely on itself [the cistern] has no power to do so; but, that [the Negro physician] is like a river, which is being constantly fed by its own springs and when the learning of others comes to it, unites with its waters, and its stream widens and deepens as on it flows (70).
Dr. Townsend was uniquely positioned to trumpet these calls because he had been appointed chairman of the Commission on Pellagra among Negroes. He had moved to Nashville in 1891, and in 1898, he graduated from a Nashville area high school as valedictorian of his class. After high school, Townsend entered Meharry Medical College where he earned the M.D. degree with honors in 1902. Immediately following graduation, Townsend remained in Nashville where he began to distinguish himself as a practicing physician. For eleven years (1902-1913), Townsend was a member of the Meharry faculty and was appointed the chair of pathology and materia medica. During this time, he developed an early concern for diseases and their cures which prompted him to publish his research findings (Cobb 323).
Dr. Townsend subsequently answered his own call to find out if the Negro was “the reservoir of disease in the South.” He developed and conducted surveys appropriate to respond to the questions that needed to be answered. Townsend’s research resulted in a report followed by two articles: “Pellagra” and “Report of Commission for Study of Pellagra.” Both were published in the Journal of the National Medical Association, the same year the journal had cast a disparaging accusation only about Negro victims of Pellagra despite the fact there were white victims suffering the same malady.
The language of Townsend’s findings and the documented expositions that followed are clear indications of the physician’s modern orientation, scientific competence, and sense of responsibility. His writing strongly indicates that Townsend likely would have made further significant contributions to scientific medical advances if he had worked in a more cohesive and racially equal climate. Nonetheless, Dr. Townsend enjoyed a stellar career as a physician, researcher, administrator, and author. For the last 36 years of his life, he was a member of the Meharry Medical College Board of Trustees and holds the distinction of being the first alumnus appointed to this post (Cobb 323).
Today a Meharry Medical College scientist, Dr. Donald Alcendor, one of the scientists who worked on a successful anti-virus to the Zika virus a few years ago, says he is in the process of testing an anti-viral drug that may prevent COVID-19, according to NBC News.
“The process is understanding how the virus gets into your system, where it goes and how it infects,” Alcendor told NBC News about developing an anti-viral drug. “The struggle is that [the virus] is a single-strand that produces tremendous inflammation. The patient will feel like he’s drowning.”
Alcendor’s goal is to have the anti-viral treatment created within the next two weeks. Then it will progress to clinical trials, and, if successful, be approved by the Food and Drug Administration (FDA) within a “few months.”
The success of the Zika virus anti-viral drug makes Alcendor optimistic that his work can help and drastically lower the COVID-19 death rate. A vaccine will take up to 18 months to produce, but an anti-viral drug will be used to treat patients once they become infected.
“This is bigger than COVID-19,” said Dr. Linda Witt, senior associate vice president for development at Meharry. “We are called to serve on the front lines. For Meharrians, it’s natural to go into black communities. Meharry exists in a black community. But [our presence] is at a heightened level now. Having an HBCU presence, voice, and expertise are essential” (Bunn).
Currently, Dr. James Hildreth, president and CEO of Meharry Medical College, brings his expertise to wage war against COVID-19. Hildreth has been engaged in warfare against viruses for four decades—first as a Rhodes Scholar earning his Ph.D. in immunology, then as a researcher and physician bringing better medical care to fight against AIDS, particularly in the African American community.
As an infectious disease scientist, Hildreth knows and understands better than most that the contagious coronavirus would be most volatile in people with existing health conditions such as diabetes, high blood pressure, asthma, and other medical issues prevalent in black communities. “I have been pushing for pre-emptive screening with health officials to go into the underserved communities to start testing. Early testing is a way to get in front of [the virus before it attacks] the most vulnerable public,” said Hildreth. “If someone has a pre-existing auto-immune disease and other . . . health issues, the outcomes are much more severe. Vulnerable people are exactly who we have in [black] communities. The burden of the disease is so much higher” (Bunn).
These two eminent scientists, Dr. Alcendor and Dr. Hildreth, voice the same concerns today as did Dr. Townsend in 1910. The factual evidence that virus outbreaks are more prevalent in African Americans leads frontline scientists, physicians, and health care workers to voice the sentiment Dr. Townsends stated 110 years ago. Paraphrasing his words, herein is a mission evolving for the African American physician to solve.
Why We Remain Open
As such a time as this, herein is a mission evolving for the African American medical library. The narratives of doctors Townsend, Alcendor, and Hildreth are indicative that Meharry physicians have a history of being first-line responders to catastrophic viruses and diseases. Therefore, without a doubt there must be an entity to assist in the research. The decision to avoid disrupting the research of students was an agreed upon decision by President Hildreth and Dr. Dexter Samuels, Senior Vice President for Student Affairs & Executive Director, Center for Health Policy. The two designated MMCL as “essential” because the services provided by the library are authentic and do not duplicate services rendered elsewhere on campus.
Realizing the urgent need for library support, the MMCL remained open, and the library hours did not change. The library was staffed from 8 a.m. to 1 a.m. Let me reiterate that Meharry library and staff were not required to come to the library to work. We could work remotely from home as did staff members in libraries across the nation. Nevertheless, realizing the immense value of their work to the current circumstances, Meharry librarians and library staff have opted to rotate coming to work to accommodate faculty and student research. Yes. We practice social/safe distancing; we wear personal protective equipment (PPE), and we wash our hands frequently. But we also look one another in the face and reassure each other saying, “We are going to get through this.” Although students have had to transition to attending remote classes, they still have the option to visit the library to study, utilize technology, and most important, take a break from isolation and enjoy friendly, helpful, human contact.
While a part of me agrees with and applauds all commentary that recognizes the rationale that supports closing libraries, I must admit, I am proud that my work is deemed “essential.” It is a heady experience for librarians and staff to be invited to join scientific researchers and physicians who have convened for the sole purpose of brainstorming how Meharry Medical College will play a significant role to alleviate COVID-19.
Meharry Medical College continues to deliver its more than 144-year-old mission, that is, for African American doctors to take on the “imperative” to alleviate the diseases and viruses lurking and wreaking havoc in communities of color. Today, the charge is to attack and alleviate the suffering caused by COVID-19. The majority of Meharry graduates hold to the commitment of the founding fathers by practicing medicine on men, women, and children who live in underserved urban and rural communities.
History substantiates that African American research scientists and physicians have practiced their professions in controversial climates. In today’s climate, all scientists and physicians who suggest taking radical steps to stop the exponential spread of COVID-19 are facing insensitive political forums nationally and in some places around the world. “However, the pasts suggest these periods are cyclical, giving hope for a brighter future when times are hard” (Epps 119). Indeed, these are hard times. Meharry scientists, physicians, faculty, students, and staff understand far better than most that African Americans are susceptible to the COVID-19 virus more than most other segments of the U.S. population. Thus, research into the disease entities that overwhelmingly affect people of color must continue until those entities are controlled, if not eradicated. Without research and support, progress will be slowed or may never occur.
All personnel associated with the daily operations of MMCL are committed to the mission launched by Dr. Townsend and carried on by Drs. Alcendor and Hildreth. Three written histories speak poignantly about what drives Meharrians to fulfill the needs of black communities: The Spirit of a Place Called Meharry: The Strength of Its Past to Shape the Future by Charles W. Johnson, An Act of Grace: The Right Side of History by Anna Epps and Patricia Morris-Hammock, and Educating Black Doctors by James Summerville. Johnson has a chapter in his book titled “On Their Shoulders.” Today, Meharry scientists, physicians, and other health care professionals stand on the broad shoulders of the many forebearers of the torch that ignites the spirit that dwells in this place called Meharry. Johnson, Epps, and Hammock have eloquently defined the spirit of Meharry that has existed throughout the ages. Especially noteworthy is Johnson’s heartfelt commentary concerning the medical college:
The spirit of this place emerges from a set of vague attributes which contribute to both its uniqueness and that of all its peoples, i.e., the Meharry family. The spirit of this place encompasses a distinctive kind of atmosphere which represents a special and pervasive sort of ambiance. This environment is energizing and conducive to the rearrangement of the undisciplined potential of individuals into something equal to or exceeding their dreams or at least to something in excess of what society has expected of black people. The atmosphere which is characteristic of the spirit contributes to the development of a special kind of togetherness which is bonded by the hope and dreams as well as a strong belief in the potential for transcending both self and harsh realities.
The spirit of this place includes all those special forces and elements which are hidden beneath the surface of reality, giving rise in part to what might be called the “expertise of deprivation.” Development and utilization of extraordinary skills and ideas are required for survival and coping in a society which is frequently considered to be unfavorable. Components giving rise to a spirit of place are richly diverse and complex. These elements emanate from the energies and offerings of both identifiable and anonymous participants. Contributions from this expansive family enables the institution to develop an inner life which has a special kind of vitality and identity. This spiritual state persists in the midst of job turmoil and in time of change. It might even appear stronger and bolder in instances of increased stress. These components are derived from both the struggles and joys of our prior existence. They are derived from knowledge of the committed service and loyal and proud predecessors who worked with limited tools.
An invisible force, like a spark of electricity, emanates from this place, Meharry Medical College. It transforms the lives of individuals and the communities to which these individuals belong in both tangible and intangible ways. The spirit of place is the product not only of all who are a part of it now but all who were a part of Meharry years ago and whose names may no longer be remembered. The spirit of place, here and now, and in years to come will empower those of the Meharry family to achieve and accomplish that which might not be possible in the absence of membership in this or a similar medical and scientific community. The nurturing quality of the spirit of this place enhances germination and growth of the seedlings of fuller individual humanity.
These are the reasons MMCL doors remain open. Present-day Meharry family have internalized the spirit of this place. And the Spirit moves us to selflessly contribute to the medical health, welfare, and safety of communities of color and beyond. The spirit of community and family gives Meharrians the farsighted vision to look beyond ourselves and look into each other’s eyes with conviction and say, “We are in this together.”
“About Meharry Medical College.” Meharry Medical College, 4 May 2020, https://home.mmc.edu/about/. Accessed 4 May 2020.
Bunn, Curtis. “Black Scientists Hope to Begin Testing Antiviral Drug for Coronavirus in Two Weeks.” NBC News, 16 April 2020, www.nbcnews.com/news/nbcblk/black-scientists-hope-begin-testing antiviral-drug-coronavirus-two-weeks-n1181101. Accessed 4 May 2020.
Cobb, W. Montague. “Arthur Melvin Townsend, M.D., 1875-1959.” The Journal of the National Medical Association, vol. 41, no. 4, 1959, pp. 323-24.
Epps, Anna L. Cherrie and Patricia Morris Hammock. Introduction and Epilogue. An Act of Grace: The Right Side of History, by Epps and Hammock, 2009.
“Essential.” The Oxford English Dictionary, 3rd ed., Oxford UP, 1997, p. 269.
Johnson, Charles W., Sr. Introduction. The Spirit of a Place Called Meharry: The Strength of Its Past to Shape the Future, by Johnson, Hillsboro Press, 2000, p. 5.
Kreyling, Christine, et al. Prologue. “Nashville Past and Present.” The Plan of Nashville: Avenues to a Great City, Vanderbilt University Press, 2005, p. 2. Nashville Civic Design Center, www.sitemason/com/files/hYGg61/ PON_History_PastPresent.pdf. Accessed 4 May 2020.
Summerville, James. Preface. Educating Black Doctors: A History of Meharry Medical College, by Summerville, University of Alabama Press, 1984, xi.
Townsend, Arthur M. “Pellagra.” The Journal of the National Medical Association, vol. 11, no. 2, 1910, pp. 65-70.
Townsend, Arthur M. “Report of Commission for Study of Pellagra.” The Journal of the National Medical Association, vol. 11, no. 2, 1910, pp. 252-64.
Weber, Lauren. “A Top Immunologist on Why Coronavirus is Killing More African Americans.” Washington Post, 22 April 2020, www.wsj.com/amp/articles/a-top-immunologist-on-why-coronavirus-is killing-more-african-americans-11587556800. Accessed 4 May 2020.