Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer

by Barbara Ehrenreich

Predictably enough, the medical reforms of the early twentieth century narrowed the demographic base of the medical profession. The requirement that medical schools possess laboratories eliminated most schools that had admitted women and African-Americans. Furthermore, at a time when only 5 percent of the population had a college degree, the requirement of at least some college limited medical school admissions to the upper and upper middle classes. No longer could any “crude boy or…jaded clerk,” as one of the leading reformers described the run-of-the-mill doctors of his time,24 expect to gain medical training. Doctors would be recruited from the class of “gentlemen,” which was why even female patients could now entrust them with intimate access to their bodies. For most people, throughout most of the twentieth century, medical care necessarily involved an encounter with a social superior—a white male from a relatively privileged background.