As the ranks of the Black Panther organization rapidly swelled after its founding in 1966, community service became progressively central to its mission. In 1968 Party headquarters mandated that all chapters inaugurate “serve the people” programs. Within two years, attention to medical issues and the provision of healthcare played a considerable role in the Party’s service endeavors. By 1970 the establishment of People’s Free Medical Clinics was a chapterwide requirement. In 1972 Huey Newton and Elaine Brown revised the Party’s ten-point platform and program, adding to it an explicit demand for “completely free healthcare for all black and oppressed people.”1 How did it come to pass that the Black Panther organization within six years of its founding became involved with health concerns to such an extent that its leadership amended its core principles? The previous chapter began to shed some light on this process: as would be borne out by the strategic repertoire employed in the Party’s work around issues of medicine and wellbeing, it was heir to a legacy of African American health advocacy. From this perspective, the Panther health “turn” was an extension of the long civil rights movement rather than a strategic about-face.
Like the organization itself, Party health politics was at the same time a referendum on proximate civil rights legislation and attendant policy developments. The passage of the Civil Rights Act and the Economic Opportunity Act in 1964, and of the Voting Rights and the Social Security Act the following year, was intended to solidify civil citizenship and extend social citizenship for vulnerable groups, including the poor, the elderly, and racial minorities. Spurred on by an efficacious overlap of antiracist activism (e.g., SNCC, NAACP, and their many allies), judicial rulings and the support of liberal politicians (most notably presidents John F. Kennedy and Lyndon B. Johnson), these laws and policy initiatives were heralded by many as marking a thoroughgoing societal transformation.
The Party soundly disagreed. It was skeptical about the possibility of social equality for oppressed groups under the conditions of capitalism. Through its activism, the organization exposed the limits of civil and social rights for the black poor in particular. Pointing to declining industrial bases, entrenched poverty, residential segregation, racially motivated “law-and-order” policing, and deficient social services in Oakland and elsewhere, Bobby Seale and Newton founded the Party to address abiding barriers to equality despite recent legislative strides. Social welfare concerns were therefore intrinsic to the organization’s very formation. The Party’s demand for health rights in its 1972 platform was a new articulation of a long-standing matter of concern, as the organization’s ideological blueprint always included attention to social issues. As Party minister of education Ray “Masai” Hewitt asserted in 1969, the germ for the “People’s Health Plan” was “always in the . . . 10-point program.”2
Moreover, the actualization of Party health politics arose from a nexus of institutional, tactical, and ideological influences. First, Newton’s and Seale’s critical appraisal of both federal antipoverty programs and public higher education inspired the formation of the Party as a political and institutional alternative: the Party’s founders had firsthand knowledge of community action projects intended to alleviate urban poverty and, as a result of these experiences, became sharp critics of them. As depicted by the Party, these War on Poverty programs extended the federal government’s promise of the “maximum feasible participation” for local community cooperation in the administration and oversight of these initiatives while undermining this very possibility.3 Furthermore, Newton and Seale contended, these programs failed to generate appreciable improvement in the lives of poor, black populations. The emergence of the Party also reflected the founders’ frustration with campus activism. Newton and Seale rejected what they perceived as the fecklessness of the cultural nationalism that was gaining prominence among black students; this style of advocacy, the future Panthers believed, focused on cultural expression at the expense of realpolitik. The formation of the Party and indeed the successive establishment of its medical clinics, health initiatives, and other service programs was a direct rejoinder to what the activists deemed incomplete institutional and cultural approaches to the betterment of black life.
Second, while the Party had been primed from the beginning to be a vehicle of community service, its concentration on this focus owed also to political exigencies that prompted a shift in the group’s tactics. Specifically, the incarceration of Newton after his arrest for the attempted murder of a police officer in 1967, and other Panther members’ often fatal encounters with law enforcement, decimated the group and threatened to erode community support for the organization. In response, the Party reoriented the emphasis of the two issues that defined it—protecting local communities through armed resistance to police harassment and protecting local communities by providing social services. In bringing health-based activism and other social welfare programs to the fore of its mission, the Party leadership was making a strategic calculation to literally and figuratively stay alive. As former Party chairwoman Brown reiterated in her memoir, A Taste of Power, these “successful [serve the people] efforts spawned a true survival program for the Party, as confused police and FBI had to regroup, bury their old assault plans, and invent new tactics to attack us.”4
Lastly, the Party’s social welfare politics displayed the foundational influence of the political theorists Ernesto “Che” Guevara, Frantz Fanon, and Mao Zedong. The ideas of these thinkers are widely acknowledged as formative to the Party’s vanguardist organizational structure and its espousal of guerrilla tactics and revolutionary violence, among other matters. Here I suggest that concepts and theories drawn from these theorists—two of whom were physicians—likewise collectively supplied the Panthers with a storehouse of health political ideology. The Party’s articulation of the repressive potential of medical authority as well as the revolutionary possibilities embodied in dispensing health-care services reflected this influence.
Serving the People as a Response to Cultural Nationalism
The confluence of geographic context, historical contingency, political currents, and dynamic, charismatic leadership that conditioned the formation of the Party has been established by recent scholarship. Here I retrace some of this familiar terrain to draw out how and why the “serve the people” or “survival” programs, in general, and health activism, in particular, came to play a key role in the Panthers’ endeavors. It is my contention that in revisiting the foundational narrative of the organization through the prism of its social programs, we come to see how the Party expressed citizenship claims and political demands—on behalf of blacks and the poor—through the discourse of fundamental human rights and needs. In doing so, we also gain new perspective on the intrinsic factors that primed the Panthers’ social welfare activism and the extrinsic forces that pulled it toward the community service pole.
The historian Komozi Woodard maintains that like other black social movements of the late 1960s and early 1970s, the creation of the Black Panther organization was conditioned by the structural processes of migration, urbanization, and deindustrialization that exerted considerable influence on the social, economic, and political climate of postwar Oakland.5 In the 1950s both Newton and Seale, as children, migrated from southern states with their parents, who were both in search of employment opportunities in San Francisco Bay Area defense industries and in flight from Jim Crow.6 Newton’s and Seale’s families had followed a route to Northern California that was typical among blacks from the westerly southern states of Louisiana and Texas, respectively.7 The future Panther leaders were therefore children of the Great Migration, that mass movement of blacks from the segregated South to the northern and western United States in two waves between 1910 and 1970.8
The generation of Newton’s and Seale’s parents established a foothold in Oakland’s employment sector. The Party founders, however, were members of a generational cohort of young black men and women in the Bay Area for whom jobs were less readily available. In fact, by 1960, 75 percent of persons in Oakland under the age of twenty were unemployed.9 Reacting to the presence of this large, unemployed, “rapidly growing[,] and disproportionately young migrant population,” the historian Donna Murch explains, local law enforcement officials “developed a program to combat ‘juvenile delinquency’ that resulted in high rates of police harassment, arrest and incarceration.”10 The interrelated issues of bleak job prospects and the criminalization of Oakland youth were compounded by the decline of the manufacturing industry in the city as jobs moved to other nearby cities and suburbs.11 The white middle class (and a significant portion of the city’s tax base) followed industry and business out of Oakland, creating a “spatial mismatch” between the locations of employers and employment opportunities.12 Thus, by the mid-1960s, impoverished, segregated, and predominantly black West Oakland was crisscrossed by highways and public transportation routes that led to more prosperous, postindustrial regions. Goods, services, and jobs literally bypassed Oakland.
Against this backdrop of recent migration and dire economic straits, the concept for the Party was incubated at two important Oakland institutions: Merritt Junior College and the federally funded North Oakland Neighborhood Anti-Poverty Center. Newton’s and Seale’s experiences at these sites directly shaped their future direction and their shared vision for a fledgling Panther organization. Essential as well for the development of the Party’s health initiatives and other social welfare programs, the leaders’ encounters at both this college and the community antipoverty center led the activists to advance, by contrast, the Party’s plans for a “revolutionary” alternative.
Drawing our attention to the fact that, like SNCC, the Party was effectively a student movement (and as discussed in chapter 1, there were also important health activist intersections between the two groups), Donna Murch’s recent book, Living for the City, suggests that a network of students, campus groups, and political contests over school curriculum at public higher education institutions in the Bay Area undergirded youth activism in the black power era.13 More particularly, Murch complicates the widely accepted notion that civil rights struggles of the 1950s and 1960s gave birth to black studies.14 Although “we often think of Black Studies as the product rather than the catalyst of postwar social movements,” she writes, “in the Bay Area[,] fights over curriculum and hiring in the early 1960s were integral to the emergence” of black power activism.15
Black student organizations channeled and catalyzed Seale’s and Newton’s interest in social transformation yet also frustrated it. The Party founders met in the early 1960s at Merritt Junior College, where both took classes. At the college, they became involved in a political study group as well as other black student activities. They also participated in the Afro-American Association, a Bay Area student group established in 1961 that, for a time, was an eclectic, ecumenical organization with a membership that variously championed cultural nationalism, electoral politics, and the black radical tradition, among other political perspectives. Newton also took an interest in the Merritt Black Student Union’s campaign to instate black history classes and African American faculty at the college. Newton proposed an attention-grabbing rally and march to be held on the occasion of Malcolm X’s birthday and at which black students would brandish weapons before an audience of invited local press and community members.16 His peers in the union demurred. Nevertheless, the contours of the Party’s distinct method of social engagement were visible.
Newton found the union to be too beholden to political moderation. The future Panthers were similarly disturbed by student acolytes of black cultural nationalism. The sharp and bitter chasm that existed in the black power era between revolutionary nationalists and cultural nationalists was evident in the bad blood between the Panthers and the US (as in “us” vs. “them”) Organization. For the Party, groups like US were wrongly preoccupied with proper comportment, right mannerisms, and the adoption of a romantic notion of putatively “African” lifeways into black American culture.17 Newton took up this issue directly:
Cultural nationalism . . . is basically a problem of having the wrong political perspective. . . . The cultural nationalists are concerned with returning to the old African culture and thereby regaining their identity and freedom. . . . The Black Panther Party, which is a revolutionary group of black people, realizes that we have to have an identity. We have to realize our black heritage. . . . But as far as returning to the old African culture, it’s unnecessary and it’s not advantageous in many respects. We believe that culture itself will not liberate us. We’re going to need some stronger stuff.18
As Newton’s comments implied, the Party deemed cultural nationalism too abstracted from material reality and too apolitical to be of benefit to poor black communities.19 Newton and Seale were also wholly dissatisfied with their peers’ unwillingness to directly confront or respond to the serious issues troubling Oakland’s schools and neighborhoods.20
The Merritt College experience nevertheless served the purpose of helping the first Panthers distill their own ideology. Newton and Seale eventually advocated direct confrontation with the forces of racial and economic oppression with a gun and a helping hand. They believed that social transformation could be effectuated through both approaches.
Cultural nationalists were dismissive of the Party’s aspiration to serve the people and doubted the revolutionary potential of doing so. Echoing a common critical refrain about the Panthers’ social welfare programs, US’s leader Maulana Karenga declared that community service was “not a revolutionary act.” “To set up a free clinic is no novel idea. Medicare has preceded that with much more money and much more technical organization . . . to set up a kitchen and put out food for people, the welfare does that, the bureau of public assistance.”21 What Karenga failed to appreciate was that the Panthers carved out a political niche in contradistinction to both campus-originated black cultural nationalism and state-sponsored social welfare programs.
Serving the People as a Response to the War on Poverty
The service programs were instituted as parallel alternatives to the Johnson administration’s antipoverty scheme. Many African Americans shared the belief, summed up in a 1970 editorial in the L.A. Sentinel, that “the vast majority of Black people have yet to experience any significant change in their way of living despite the passage of civil rights legislature and the promises of anti-poverty programs.” With its programs to serve the people, the Party sought to remedy the practical and ideological deficits of civil rights “progress” as it was embodied in the War on Poverty. Established in 1964 through the Economic Opportunity Act, and administered by the then new Office of Economic Opportunity, the War on Poverty was partly composed of an array of federally funded Community Action Programs (or CAPs); by 1965 these included the community health centers program, Job Corps, Head Start (a comprehensive social service program for children), and Volunteers in Service to America (or VISTA, a national service program now part of AmeriCorps).22
In the summer of 1966 Newton and Seale worked at a Bay Area CAP, the North Oakland Neighborhood Anti-Poverty Center.23 At the Center, they developed a close-quarters critique of the War on Poverty. By October of that year, their ruminations had produced a name, the Black Panther Party for Self-Defense (later shortened to the Black Panther Party),24 and a mission statement, the ten-point platform and program.25 Newton and Seale availed themselves of the antipoverty center’s resources: from this perch they formulated plans for the Black Panther organization. Its library provided the law books Newton and Seale used to educate themselves about the finer points of the California legal system. The center’s office was the Party’s first headquarters.
It was also at this antipoverty center that the Party’s guiding principles were developed. Seale and Newton had in mind a two-pronged approach to social transformation—a practical program undergirded with an ideological one. Accordingly, Seale recalls,
Huey divided [the ten-point platform and program] into [two sections] “What We Want” and “What We Believe.” “What We Want” are the practical, specific things that we need and that should exist. At the same time we expressed philosophically, but concretely, what we believe. . . . [The platform] puts together concisely all the physical needs and all the philosophical principles.26
Newton and Seale sought to construct an organization whose commitments were more evenly divided between theory and practice, in contradistinction to cultural nationalism and, that distinct from federal antipoverty programs, would truly reflect the priorities of local communities.27 The Party’s platform and program was in point of fact a demand for full economic citizenship (“We Want Full Employment for Our People”) and related social rights—those benefits guaranteed in principle by citizenship status (e.g., “We Want Land, Bread, Housing, Education, Clothing, Justice And Peace”).28
Well after the Party officially came into being, Newton and Seale continued to instrumentally “use the poverty programs” for their own ends.29 They recruited members at the center: Robert (Li’l Bobby) Hutton, the Party’s first member, was recruited by Seale, with whom he had worked in a summer program at the center in 1966. (Hutton, who was the group’s first minister of finance, was killed during a fatal shoot-out with Oakland police in 1968. He was eighteen years old.) Newton and Seale worked with the center through 1967. In this year, the Panther cofounders joined its advisory board and from this position successfully lobbied municipal authorities to place a streetlight at a dangerous intersection in the community.30
In addition to the group’s leaders, several members of the rank and file had experience as either a staff member or a client of a War on Poverty project. Cleo Silvers, a Philadelphia native, was a VISTA volunteer and eventually joined a Party chapter in Manhattan’s Harlem neighborhood; as a Panther, she conducted neighborhood health surveys and worked as a patient advocate. In 1968 Brown worked in an “outpost field operation” of the Office of Economic Opportunity in Los Angeles, the Watts Happening Coffee House, that she described as “a rivulet of the Johnson Administration’s new-deal . . . dubbed the War on Poverty.”31 Working to change these programs from the inside out and with the conviction “that blacks now have concentrated in the cities . . . in such numbers that they can take over governments,” as the New York Times put it, Party members Erika Huggins, William Roberts, Andrea Jones, and Herman Smith were elected as board members of a Berkeley anti-poverty program in 1972. Party members also were elected to six of eighteen seats on the West Oakland Model Cities governing board.32
Party chapters’ interaction with federal antipoverty programs persisted for much of the organization’s life. Although the activists drew on a range of resources from the CAPs and other initiatives, this was a deeply equivocal association: the serve the people or survival programs were partly modeled on the War on Poverty, and some of the antipoverty projects in many ways made the parallel Panther projects possible. However, the radicals did not merely copy the state’s program, for its social welfare concern derived as well—and perhaps more centrally—from its Marxist-Leninist politics. For this reason, the activists were harsh critics of the CAPs and easily drew ideological distinctions between the Party’s social welfare work and that of the federal government.
For the Panthers the two important considerations that distinguished its work from that of the state were the organization of the programs and the anticipated outcomes of them. Its ten-point platform and program demanded “the Power to Determine the Destiny of Our Black Community.” Federal antipoverty programs, the Panthers complained, gave lip service to the full participation of the poor in administering these programs, but in practice, owing to ideological differences and local political struggles, constrained communities’ self-empowerment.33 As Newton explained, “I don’t think black people should be fooled . . . because everyone who gets into office promises the same thing. . . . The Great Society; the New Frontier. All of these names but no real benefits.”34
The diverse CAP initiatives shared the underlying principle that local community involvement in planning and implementing social programs was crucial to their success.35 Indeed, Title II of the Economic Opportunity Act mandated that these programs be “developed and conducted with the maximum feasible participation of the residents of the areas.”36 Yet as Senator Daniel Patrick Moynihan wrote in 1969, debates over actualizing community control would lead to “maximum feasible misunderstanding.”37 Brown gave voice to this misunderstanding when she bitterly recalled that the CAP center she worked at in Los Angeles “was supposed to be a cultural center operated by and for the black residents of Watts.”38
Soon after the War on Poverty programs were rolled out, it became apparent that some poor blacks interpreted the concept of community control differently from the federal government, local authorities, and, frequently, even middle-class blacks.39 While the Johnson administration envisioned the management of the CAPs as a partnership between community leaders, the poor, and government administrators, many African Americans interpreted local control as social, political, and economic autonomy, or in the parlance of the black power era and the Party, as self-determination. The Party regarded the War on Poverty as a plan that would not end poverty but merely amount to control and surveillance of the poor. With its community service programs, the Party had a more ambitious, revolutionary end in mind, a process that Fred Hampton, head of the Chicago Party chapter, encapsulated in this way: “First you have free breakfasts, then you have free medical care, then you have free bus rides, and soon you have FREEDOM!”40 The Panthers believed that serving the poor and enabling local communities to help themselves had transformative potential.
These programs were, furthermore, vehicles to enlist the community in the Party’s political causes. Chief of Staff David Hilliard illustrated how the Party understood this process when he described the political effects stimulated by the “Community Pantry,” also called the Angela Davis People’s Free Food Program. The “food serves a double purpose, providing sustenance but also functioning as an organizing tool: people enter the office when they come by, take some leaflets, sit in on an elementary PE [political education] class, talk to cadre, and exchange ideas.”41 As such, the community service programs were, as one Oakland Panther, Carol Rucker, explained, “another tactic for revolution” alongside armed self-defense.42
CAP initiatives like the North Oakland Neighborhood Anti-Poverty Center, according to the historian Daniel Crowe, “unwittingly supported and trained a new generation of black radicals that included the co-founders of the Black Panther Party.”43 The Johnson administration was alarmed to discover that the resources it provided to wage the War on Poverty were being used to radicalize and organize black community activists.44 As Moynihan explained in his analysis of the failings of the federal antipoverty campaign of the late 1960s and early 1970s, government officials did not share this view. “Washington has an entirely different, almost antithetical view of the style and function of ‘community action’ from that of its proponents in the field,” he wrote.45
This battle over the boundaries of community participation at the Office of Economic Opportunity’s community health centers—launched in 1965 as part of the War on Poverty—typified the “misunderstanding” between poor blacks, activists, African American elites, the state, and other stakeholders over the definition of “maximum feasible participation.” The community health centers operated through federal grant monies given to medical schools and teaching hospitals that in turn organized and directed primary care and basic healthcare services.46 Although the centers had community advisory boards and also drew staff from local areas, the historically vexed relationship between black communities, academic hospitals, medical schools, and the public health system and the scientific authority embodied in even these small-scale neighborhood institutions meant that these clinics were destined to court controversy in some quarters.
Teaching hospitals emerged in the early twentieth century, when doctoring was becoming a “profession” and medicine a “science.”47 This transition of medical education in the United States to a teaching hospital system included “university-based” medical schools, “faculty . . . engaged in original research,” and students, who “participate[d] in ‘active’ learning through the laboratory study and real clinical work” with disproportionately poor or otherwise vulnerable patients.48 The expansion of biomedical science through this new vision of medical education at times came at a particularly high cost for marginalized groups. In the shift from medicine to biomedicine that began around 1910, “African American, indigent, and low-income working class patients were still required to virtually sacrifice their bodies in exchange for treatment,” the scholars of race and medicine Linda Clayton and W. Michael Byrd pointedly note.49
In the mid-twentieth century, patients at teaching hospitals such as the Johns Hopkins Hospital in Baltimore—where Henrietta Lacks’s cervical cells were taken without her permission by a biomedical researcher in 195150 —were made to contend with “certain indignities and discomforts,” including long waits for care; impolite hospital staff; and “underfunded, understaffed, overcrowded and poorly maintained” facilities.51 Racial discrimination further compounded the problems of teaching hospitals. During Jim Crow, “frank racism,” in the form of segregated facilities and wards, “was not uncommon at teaching hospitals,” the medical historian Kenneth Ludermer argues.52 At some institutions black patients were only ever seen by medical students. In the late twentieth century, uninsured and underinsured poor and minority communities and welfare recipients not infrequently received substandard care at teaching and public hospitals. In the 1970s, for example, there were numerous controversies involving poor women of color who received shoddy care or authoritarian treatment or both at teaching hospitals. As well, unnecessary and often coercive hysterectomies were performed on women of color at teaching hospitals.53 During this time, the Black Panther was replete with accounts of the pitiable and at times fatal healthcare doled out to the Party rank and file and members of the local community at both teaching and public hospitals.54 As Panther volunteer Marie Branch expressed, “We were battling a lot of things. . . . [doctors] told women that if they removed part of the uterus, they could still have a baby. . . . We were fighting the partial hysterectomy myth and sterilization attempts.”55 Thus black activists’ demands for “community control” of healthcare facilities was also a call to change an often harrowing, disrespectful, and unaccountable culture of medical practice.
By placing large teaching hospitals in charge of the community health centers program, the federal government did not inspire the confidence of marginalized groups. In addition, debates about “community control,” while certainly concerned with both patient and local autonomy, voiced objection to the lived experience of racism and poverty. As Crowe explains, “low-income residents throughout the Bay Area interpreted . . . the War on Poverty [as] part of the black struggle for civil rights.” In contrast with federal reformers, these communities believed that the “CAPs should serve as vehicles for protest” and “should be on the front lines in the battle against racism.”56
The Party founders had a social and ideological vision—Seale characterized this perspective as “revolutionary, community, socialistic”57 —that was different from that of the Great Society imagined by LBJ.58 Newton’s and Seale’s experiences at the antipoverty center thus impressed on them the limits of state-sponsored reform and black citizenship after the (re)codification of African American civil rights and compelled them to forge an alternative path. At its originary moment, the Party drew on its members’ experiences with the War on Poverty programs in conceiving its own community service platform. These programs responded to the perceived failure of U.S. welfare state programs to meet poor African American communities’ needs and reflected the activists’ sense that black well-being could not be achieved without self-determination.59
Despite its initially broad vision and forays into other community issues, the Party’s early activism focused on armed surveillance of Oakland law enforcement—through “defense patrols”—to quell harassment from law enforcement.60 The intimate knowledge the Panther leaders gained about firearms regulations and arrest procedures in the state influenced their use and endorsement of armed militancy.61 These patrols used tape recorders and cameras to record police brutality. More famously, the Party deployed armed members to “police the police.” In doing so, the Party followed to the letter an obscure California law that permitted citizens to carry loaded arms in public. A Republican state legislator, Don Mulford, responded to the Party’s audacious tactics by proposing a bill to prohibit the public bearing of loaded weapons. On May 2, 1967, the day that the bill was to be discussed on the floor of the state legislature, Newton dispatched Seale and several other openly armed Party members to the state capitol in Sacramento to protest the proposed legislation.62 Though the Party’s protestations garnered national press attention, the California state assembly ratified the Mulford Act prohibiting the possession of loaded weapons in public in July 1967.63 Seale was arrested for his participation in the protest at the California state capitol and was sentenced to a six-month jail term in August 1967.64
All the same, Party members continued to carry loaded weapons, and run-ins with Bay Area police persisted. On October 27, 1967, Newton was arrested for a shooting incident with Oakland police during which he and an officer were injured and another officer was killed. After this incident, the Panther leader was jailed while awaiting a court date and during his subsequent murder trial. Newton’s incarceration and Seale’s brief stint in jail for his involvement in the dramatic Party protest at the California statehouse created a leadership vacuum in the organization.65 Though Seale was the “titular head” of the Party and could have resumed his role as leader after his release from prison in December 1967, Minister of Information Eldridge Cleaver’s power had grown in Seale’s (and Newton’s) absence.66 Concurrently, media coverage of the California capitol demonstration and the “Free Huey” campaign galvanized black communities’ support for the Panthers across the United States and caused the Party’s membership ranks to swell unexpectedly (despite its cofounders’ incarceration). Under Cleaver’s direction, violent encounters between the Party and local authorities escalated. In April 1968 Cleaver allegedly instigated a shoot-out with Oakland police, during which Hutton was killed.67 Cleaver and Hilliard were arrested and jailed after this incident.68
The Party was forced to confront the implications of its armed militancy. In 1967 the organization dropped the phrase “for Self-Defense” from its name because as Seale put it, the Panthers “didn’t want to be classified as a paramilitary organization.”69 Newton was convicted of voluntary manslaughter in September 1968. With his fate determined for the next two to fifteen years, from prison he instructed the Party to devote more of its attention to programmatic issues and creating local institutions. The Party cofounder had grown concerned by the violent direction the Party had taken. (The price of freedom that Newton paid as a result of his own violent encounter with the Oakland police was perhaps not lost on him.) In his words, Newton “wanted to emphasize the community development aspect of the party. . . . I felt that we should turn away from the arms because too much had been made of them.”70 With somewhat similar sentiment, Seale argued also that negative views of the Party had been exaggerated by inaccurate “preconceived opinions” about the organization and its aims. Newton and Seale accordingly shifted the balance of the organization’s commitments, bringing the Party’s attention and energies to bear on aspects of its platform that had been eclipsed by their other activities. “The gun itself does not symbolize a revolutionary,” Newton declared in an interview with the Los Angeles Times. “Fascists also carry guns.”71
Dr. Terry Kupers, an MCHR member and close collaborator with the Southern California chapter of the Party chapter, recalled that after the murders of Alprentice “Bunchy” Carter and Huggins at UCLA resulting from the bitter feud with the US Organization, “there was a question . . . what could people do to . . . keep the Panthers going and being active and getting their message across . . . that fit the Panther platform?”72 Kupers, then a psychiatry resident at UCLA, led the formation of this clinic with Marie Branch, an African American nursing professor at the university, Party chapter leader Brown, and other Panther cadre. It was not a coincidence that this chapter soon launched its Bunchy Carter PFMC. From the perspective of the MCHR, Kupers argues that the clinic “was an attempt to keep the Panthers and their positions alive after the COINTELPRO attack on them in Chicago, LA and elsewhere.”73 One tragic reflection of how violence spurred the creation of the Party’s social welfare politics is suggested by the fact that, as in Los Angeles, PFMCs were often named for “martyred” cadre, for example, the George Jackson People’s Free Medical Clinic in Berkeley and the Fred Hampton People’s Health Clinic in Portland, Oregon.74
Although Newton, Seale, and other members of the Party leadership began to reorganize the Party’s structure and rethink its strategies, the heightened emphasis of the service program did not amount to the Party’s complete abolition of armed self-defense.75 Rucker, who worked at the Oakland PFMC (when she was not waitressing at the Party’s Lamp Post bar), recalled that “nobody in the Party was about to give up guns.”76 Rucker underscored the “contradiction” inherent to the Party’s community service strategy: police were in neighborhoods “looking for us” and “kicking in doors.” “Can we claim to serve the people, body and soul, and scare them to death at the same time?” she asked.77
The centerpiece of the Party’s renewed community service strategy was a diverse, evolving set of programs and initiatives. Newton’s prior attempts to develop the Party’s community programs had created tension in his relationship with Cleaver, who preferred to conceive of the Party as an armed underground resistance movement of urban guerrillas rather than social workers.78 Ironically, not entirely dissimilar from Karenga’s critique of the “serve the people” campaign, Cleaver viewed the programs as attempts to reform the existing system rather than to completely transform or revolutionize it, and vocally protested their implementation. Newton, on the other hand, contended that “you can’t very well drop out of the system without dropping out of the universe . . . you contradict the system while you are in it until it’s transformed into a new system.” Cleaver eventually resigned from the Party over precisely this clash of vision about the direction of the Party. However, as late as 1967, even he backed the survival programs as part of a larger revolutionary strategy and notably penned a piece affirming them in the Black Panther: “If we can understand Breakfast for Children, can we not also understand Lunch for Children, and Dinner for Children, and Clothing for Children, and Education for Children, and Medical Care for Children?” Cleaver wrote.79
In late November 1968 Cleaver went into exile to avoid an attempted murder charge, and Seale instituted the community programs as he and Newton had envisioned them. In this same month, Seale announced the launch of the Party’s expanded slate of community service programs in the pages of the Black Panther.80 With this announcement, preexisting neighborhood service programs and new initiatives were bundled together into an impressive array of locally controlled alternative institutions that harked back to a tradition of community institution building in the long medical civil rights movement, evinced the Panthers’ frustrations with the War on Poverty and facets of the black power movement, and, as I describe below, operationalized political theories that were their groundwork. Grouping these programs under the umbrella of the service campaign, the two-year-old Party served notice that it was shifting the emphasis of its endeavors. While in keeping with the initial seed ideas contained in the ten-point platform, which sought to balance political ideology with the needs of the people, the expansion of the community service programs marked a shift from armed self-defense to social self-defense.81
Keeping in mind Rucker’s mention of the “contradictions” of the Party’s community service strategy, the expansion of the survival programs should be interpreted also as a signal from the Party to the poor, predominantly black neighborhoods with which it worked that it appreciated that some shift in emphasis was warranted. Kent Ford, head of the Portland chapter, has commented that the programs succeeded in gaining both admiration and legitimacy for the Panthers in the eyes of local communities.82 Rucker concurs, saying that “we realized that we were alienating a lot of the community that we needed to reach—that we wanted to help. . . . We . . . start[ed] going into churches and just reaching out . . . the Survival Programs were going well but we wanted to branch them out—[to] start a clinic.”83
Crafting a Critique of Medicine
In addition to responding to the contemporary policy terrain, intraracial politics, and the many tolls of violence and state repression, the groundwork for the Party’s health activism was supplied by the writings of several theorists who unequivocally linked medicine and politics.84 Although the Black Panthers’ heightened attention to community programs had been compelled by tactical exigencies and influenced, partly, by its leaders’ experiences with federal antipoverty programs and their rejection of cultural nationalism, the Party had arguably been primed for this shift in register since its inception. The ideas of several “Third World” intellectual-activists, who linked revolutionary theory to the material needs of a society, were formative.
Chroniclers of the Party acknowledge its indebtedness to a few important political thinkers, especially Mao Zedong, the former leader of the People’s Republic of China; Ernesto “Che” Guevara, an Argentinean medical doctor and leading figure in the Cuban revolution; and Frantz Fanon, a Martinican psychiatric doctor turned Algerian revolutionary.85 Party memoirs, moreover, commonly testify to the importance of these thinkers in both formulating the organization’s theory and shaping its actualization into practice. In Newton’s autobiography, Revolutionary Suicide, for example, he writes that “we pored over these books to see how their experiences might help us to understand our plight. We read the work of Fanon, particularly The Wretched of the Earth, Mao Zedong’s four volumes, and Guevara’s Guerrilla Warfare.”86 Numerous other Panthers, including Seale, Hilliard, and Brown, likewise acknowledge the profound influence of these writers on the Party’s endeavors.87 Collectively, and as is widely recognized, the political ruminations of Mao, Guevara, and Fanon provided a blueprint for the Party’s revolutionary praxis, as well as an equally important if less acknowledged context for its community service programs.
Less appreciated is the fact that the ideas of these theorists provided the ideological foundation for the Party’s health activism. Two of these thinkers were physicians, and each of the three advanced a unique health political outlook that would in some way shape that of the Party. Guevara’s stress on the need for social movements to build total institutions to meet all of a society’s needs was rendered in the Party’s vision for its health programs. Similarly, Fanon’s analysis of medical oppression in colonial Algeria became a template for the Party’s criticism of the United States. Mao’s emphasis on “the masses” as the source of political and epistemological authority—exemplified by the People’s Republic of China’s “barefoot doctors” initiative—found voice in the Panthers’ commitment to having lay locals play a role in administering the PFMCs and providing healthcare services at them. The expansion of the Party’s communitarian orientation into health activism, moreover, was inspired by its adherence to the ideas of these political thinkers who offered a readily available ideological bridge between social revolution and “revolutionary medicine.”88
As the Party leadership and membership were close students of Guevara, his writings helped give ideological contour to its health programs and other community service initiatives. The Party’s focus on poor black communities’ basic needs drew on the model of War on Poverty programs and the activists’ critical reaction to these. However, it was also influenced by the activists’ simultaneous engagement with the ideas of Guevara, who, two years after completing medical school, was a leader in the Cuban revolution. Among Guevara’s political writings is a meditation on his personal evolution from a young man who sought ”to become a famous scientist or mak[e] a significant contribution to medical science”89 to a “fighter–doctor,”90 who recognized the broad intersections of corporeal and social well-being. Guevara’s account of the events leading up to the Cuban revolution depict a moment at which this fighter–doctor had to literally choose between retrieving a box of medical supplies or one of ammunition. He selected the latter.
Guevara nevertheless insisted that health workers had a vital role to play in revolutionary struggles. In the early stages, “revolutionary medical workers” provided comfort and care to guerrilla fighters. Once revolution was accomplished, these same health cadres were needed to establish healthcare institutions and supply medical training. A new society required social welfare programs, including a public health infrastructure.91 More particularly, and writing somewhat metaphorically, he described the job of health workers in the postrevolutionary moment as being “to find out what diseases [the people] have, what their sufferings are, what have been their chronic miseries for years.”92 After revolution, Guevara maintained, “the doctor, the medical worker, must go to the core of this new work, which is to treat “what has been the inheritance of centuries of repression and total submission.”93 The Argentinean doctor–activist drew an inextricable link between individual health and collective health, writing that
the principle upon which the fight against disease should be based is the creation of a robust body; but not the creation of a robust body by the artistic work of a doctor upon a weak organism; rather, the creation of a robust body with the work of the whole collectivity, upon the entire social collectivity.94
Guevara thus established health work as a bedrock of social transformation, and his observations resonated in the Party’s activism beyond standard depictions of his Guerrilla Warfare and its influence on seventies radicals. Guevara’s writings expressed a political-cum-medical philosophy of well-being that would be refracted in the Party’s activism as its social health perspective.
Like Guevara, Fanon conveyed the social and political import of health and medicine.95 His observations also offered an intellectual template for the Party’s critique of medicine. Fanon’s trenchant dissection of racialized medical oppression in colonial Algeria, detailed in The Wretched of the Earth, inspired the Panther organization’s analogous critique of the U.S. medical–industrial system as an instrument of social control.
Members of the Black Panther Party were profoundly affected by The Wretched of the Earth: Newton, who was first introduced to Fanon’s ideas by Seale, insisted that Party members be close readers of the book, and Cleaver referred to the text as “the Black bible.”96 Hilliard claims that “Fanon—and the Algerian Revolution—has provided our most important theoretical model.”97 In considering Fanon’s influence, standard histories of the Party have focused almost exclusively on the author’s advocacy of violence. Yet, as Party members attest, close readings of The Wretched of the Earth also informed the Panthers’ health politics.98 In addition to the discussion of violence with which much of The Wretched of the Earth is admittedly concerned, the book contains a seminal discussion of the role of medicine in the colonial situation. Too infrequently discussed by Party scholars—but notably referenced by Cleaver in his book review of The Wretched of the Earth for Ramparts magazine—is a portion of this work in which Fanon conducts medical diagnosis as political theorizing.
Born in Martinique, Fanon was trained as a physician in Lyon, France, and subsequently practiced psychiatry in the Antilles. In 1953, as an employee of the French government, Fanon was assigned to lead the psychiatry department at a colonial hospital in Algeria. While he was working there, the Algerian war for independence from France began. Fanon’s experiences treating Algerian nationals traumatized by colonial oppression, as well as his observations of the devastating psychological effects of war, compelled him to resign his post and begin working on the side of Algerian liberation.
According to the medical sociologist Jock McCulloch, The Wretched of the Earth, written in 1961 shortly before Fanon’s death, exemplifies a final transition in the author’s writing “from psychiatric practice to political theory” and, more specifically, a move toward a “mature theory of decolonization.”99 Nevertheless, as McCulloch explains, a “sociology of mental illness” and a “critique of ethnopsychiatry” run parallel throughout Fanon’s oeuvre. Building on work established in two of his earlier books, Black Skin, White Masks and A Dying Colonialism, in the last chapter of The Wretched of the Earth, “Colonial Wars and Mental Disorders,” for example, Fanon details how the colonial administration used medical science to classify the colonized population as pathological. He writes, “It was confirmed that the Algerian was a born criminal. A theory was elaborated and scientific proofs were found to support it.”100 In Fanon’s sarcastic formulation, “The hesitation of the colonist in giving responsibility to the native is not racism nor paternalism, but quite simply a scientific appreciation of the biologically limited possibilities of the native.”101 During times of war, a more insidious form of ethnopsychiatry emerges: doctors were explicit “agents of colonialism” who administered torture disguised as medicine, which Fanon called “subversive war.”102 The medical “warfare” described by Fanon included administering medication to induce confessions from Algerian prisoners and deploying categories of medical pathology to mark the colonial subject.
In The Wretched of the Earth’s concluding chapter, Fanon’s critique of colonial medicine and the effects of colonial war in Algeria take the form of medical case histories. Fanon offers these studies as proof of the ravages of colonialism and as confirmation of the abuses of politicized, colonial medicine. By way of introduction to the medical case studies that follow, Fanon writes, “Clinical psychiatry classifies the different disturbances shown by our patients under the heading ‘reactionary psychoses.’ In doing this, prominence is given to the event which has given rise to the disorder . . . [which] are chiefly the bloodthirsty and pitiless atmosphere [and] the generalization of inhuman practices.”103 After these opening comments, the chapter quickly moves to Fanon’s recounting of his specific experiences with French and Algerian patients during the war. In each account, Fanon describes the patient’s symptoms and then diagnoses the condition as deriving from extramedical or social, rather than biological, origins. Strident political analysis, critiques of the subjectivity of medical professionals under colonialism, and anticolonial sentiment bracket the case studies in the chapter.
As part of its health politics, the Party took up the Fanonian tactic of the political diagnosis of medical cases in its own publications. The weekly newsletter of the Southern California chapter of the Party, the People’s News Service, frequently printed articles about health issues of concern to black communities in Los Angeles.104 A March 1970 issue recounted in detail the experience of a black Angeleno suffering from second-degree burns, attributing his inability to get adequate care to the fact that a capitalist imperative in the healthcare system had overtaken the medical mandate to do no harm. In particular, this man’s condition went untreated because he could not afford to pay for ambulance service to the hospital.105 Another article, titled “Legal and Medical Genocide,” told of the experiences of Ronald Freeman, a Party member who was incarcerated in New County jail in Los Angeles and suffered from an undiagnosed and untreated chronic illness.106 Excerpts from Freeman’s medical history were framed by a discussion of what the Party described as the politically fraught and uneven character of health services, and critiques of the treatment of blacks in prison and of the medical–industrial complex.107 In addition to the medico-political case study, Fanon’s influence arguably was present in the Party’s 1972 challenge to a psychiatric center proposed by medical scientists at UCLA who planned to investigate biological models of violence with research that focused disproportionately on black and Latino male youth.
A second notable intersection between Fanon’s ideas and the Party’s health politics was the complex perspective that the theorist brought to his understanding of the social power of medicine. McCulloch argues that the radical psychiatrist believed that “pure” medical science was impossible to achieve in the colonial context.108 Fanon appreciated that pathology could be constructed to advance the colonial enterprise.109 At the same time, however, Fanon also understood that ethical medical practice was necessary for healing the wounds that resulted from racism and colonial war. While critical of medicine, Fanon was not anti medicine. Extrapolating to the Party’s health politics, we can see a Fanonian perspective in its politics of health and race: the activists apprehended the dangers of biomedical power for impoverished blacks living in America’s “internal colonies” and, at the same time, sought to extend healthcare services to them—from trusted sources, including itself and its allies.110
The People’s Doctors: Maoist Health Politics
The impact of Mao’s ideas on Party political ideology is often narrowly attributed to its uptake of his adage that “political power grows out of the barrel of a gun.”111 This is somewhat fitting as Newton and Seale famously earned money to build up the Party’s coffers and weapons arsenal by selling copies of Quotations from Chairman Mao on the campus of the University of California at Berkeley.112 However, the “little red book” was to provide more than finances and guns.113 The historians Robin D. G. Kelley and Betsy Esch propose, in particular, that Mao’s “China offered black radicals a ‘colored,’ or Third World, Marxist model that enabled them to challenge a white and Western vision of class struggle—a model they shaped and reshaped to suit their own cultural and political realities.”114 In addition, the Party borrowed, sometimes verbatim, many of its principles and tenets from Mao.115 One name for its community programs—serve the people—was adapted from a chapter in “the little red book” titled “Serving the People.”116 Also included in this brief chapter were aphorisms that offered guidelines for the relationship of the political vanguard—which the Party considered itself to be—to the community. According to Mao, though it was the vanguard’s responsibility to lead, political and epistemological authority was vested in “the people.”117 By inaugurating the practice of using the phrase the people to refer to the legitimate political actors of Chinese society, Mao aimed to do away with the stratification that he felt characterized prerevolution China, which was organized into classes of peasants, the proletariat, and the bourgeois—the latter group including bureaucrats and other technical and knowledge elites. In a related gesture, the Party adopted the practice of referring to its many social programs as the people’s programs, as in the People’s Free Medical Clinics and the People’s Free Breakfast for Children Program.
Mao, following Marx, also stressed that “the people’s” privileged knowledge derived from their experiences as workers. Such a perspective underlay communist China’s “barefoot doctors” program under which urban physicians were compelled to effectively trade places with rural peasantry, with the former required to divide their time between medical practice and agricultural labor (among other projects), and the latter receiving accolades for expertise in traditional healing practices such as acupuncture as well as their acuity with “Western” medicine.118 The effect was a blurring of boundaries between laypersons and expert elites.119 Party members received firsthand exposure to the deprofessionalization of medicine in China during two visits there in the early 1970s. In March 1972 a Panther contingent of eighteen persons visited the country by way of Seattle and Tokyo, after being denied entry into Vancouver, Canada, the activists’ original jumping-off point to China. The group included the Party’s minister of culture Henry Douglas; L.A.-based minister of justice Masai Hewitt; Branch, who helped establish the Los Angeles Party chapter’s health clinic; Angela Davis; “Doc” Satchel, who began his days in the Party in Chicago; and Panther medical adviser and physician Tolbert Small. Small learned acupuncture and other traditional Chinese healing practices during this tour; on his return he authored two articles in the American Journal of Acupuncture that detailed the physiological bases and uses of this technique in China and its potential implementation in the United States. Small incorporated acupuncture into his medical practice. The China tour also inspired the Party to begin to use vans to bring healthcare services out into the community. “They came back with all the ‘barefoot doctor’ techniques,” Norma Armour explained. “That’s where we got the idea for the mobile unit.”120
The Party and other health radicals embraced this “red versus expert” perspective modeled in Mao’s China.121 Kelley and Esch explain the concept in this way: “The idea that knowledge derives from a dialectics of practice and theory empowered radicals to question . . . expertise . . . Maoists—from black radical circles to the women’s liberation movement—sought to overturn bourgeois notions of expertise . . . [and] saw themselves as producers of new knowledge.”122 Hilliard expressed such sentiment in a 1969 interview about the Party’s foray into health politics. He remarked that the Party’s aim was to cultivate “revolutionary medicine” by “unlock[ing] [the] secrets . . . kept hidden” by medical professionalization.123 “Doctors are not servants of the people,” Hilliard declared, “but professionals.” “We want to do away with the bourgeoisie concept of medicine. It should be brought down to the community to teach the people how to practice medicine,” he continued.124 With statements resembling the ideas of Mao and Guevara, Hilliard’s comments suggest how political theory conditioned and informed the Party’s health activism. The valorization of experiential knowledge and lay perspective was a significant facet of the Party’s fight against medical discrimination.
Within several years of its founding, the Party expanded its purview considerably to include a range of service programs. Several factors contributed to the evolution of its health politics. As previously discussed, the Party was successor to a tradition of civil rights health activism that spanned Marcus Garvey’s UNIA to SNCC’s Freedom Summer. In the next chapter I describe how activists from this and other SNCC campaigns linked the health activism of this southern student organization with that of the Party.
There were institutional and ideological factors organic to the formation of the Party that moved the organization toward community service programs, and health politics more particularly. The Party’s commitment to action over black cultural nationalist rhetoric, its rejection of state control, and its service vanguard position vis-à-vis its constituents remained in place, but were reoriented—shifting registers from self-defense to self-determination (via the creation of an array of community programs).
Newton and Seale were Oakland college students when black cultural nationalism was ascendant. The Black Panther cofounders regarded this focus on black consciousness-raising as at odds with what became the Party’s Marxist-Leninist politics. The activists’ aspirations for the Party—as articulated in its ten-point platform—partly emanated from their disappointment with the cultural politics practiced by student groups. Concomitantly, they desired a realpolitik that could yield practical benefits—better housing, economic conditions, and health-care, for example—for the urban poor of Oakland and, eventually, oppressed groups globally.
On the other hand, the Party was partly constituted in contradistinction to what some blacks regarded as the thin democracy of the War on Poverty and, to some extent, the lack of efficacy of these programs. While the Johnson administration conceived of antipoverty programs as being operated with the “maximum feasible participation” of the underserved communities in which they were located, in practice this involvement was curtailed by government officials and often politically moderate blacks as well. Given their political commitments to black self-determination and Marxist-Leninism, Newton and Seale wanted poor people to take a leading role in the CAPs. The Panthers’ array of “serve the people” programs was instituted as a more democratic and participatory alternative to federal ones. Despite the ideological differences between how the Party and CAP administrators viewed “community control,” several key members of the Panther organization cut their teeth as social activists working in these federal antipoverty programs or being served by them. In this way, the War on Poverty was a condition of possibility for the Party’s health politics.
The shift in emphasis from self-defense to self-help in the Party was also a manifestation of dynamics that occurred after the Party was inaugurated. Although the organization was established to furnish protection to the poor and black communities most vulnerable to police brutality and social welfare programs, the relative importance of these two foci shifted in light of law enforcement reaction and state repression.
The Party’s health “turn” was also augured in the writings of the political theorists who are known to have greatly influenced the activists in other ways. As I have shown here, the impact of Mao, Guevara, and Fanon on the Party was more extensive than typically thought. From these thinkers, whose writings were required reading in the Panthers’ political education classes, the Party also received health political tools. The works of Mao and Guevara aided activists in conceptualizing how health and medicine fit with broad political aims. Fanon exposed how medicine was used to repressive political ends in colonial Algeria; the Party found in this an analogy to the healthcare of institutionalized blacks in the United States as well as the medical mistreatment experienced by the larger African American community. At the same time, the ideas of Fanon and Mao suggested that medicine, in the right hands and in an equitable society, could have healing and perhaps even revolutionary potential, and in this way prefigures the Party’s social health frame. This dual discourse about medicine was given voice by the Party, when it amended its ten-point platform of 1972 to elaborate and declare, in no uncertain terms, the activists’ commitment to health politics and its demand for healthcare access. Part of the new language, the modified point 6, read:
We believe that the government must provide, free of charge, for the people, health facilities which will not only treat our illnesses, most of which have come about as a result of our oppression, but which will also develop preventative medical programs to guarantee our future survival. We believe that mass health education and research programs must be developed to give Black and oppressed people access to advanced scientific and medical information, so we may provide ourselves with proper medical attention and care.125
Calling for universal healthcare, asserting a social health perspective, and noting the import of health education and research, this declaration was a landmark in the Party’s health politics. The addition of this elaborated statement on health in the Party’s revised platform—in contrast with lesser mention of the issue in the original platform—was the culmination of a process through which the Panthers carried on as community service radicals but did so also as committed health activists.
Now-standard narratives of the Black Panthers’ formation privilege a combination of structural factors and political forces. Yet as is demonstrated here, this standard accounting can obscure rich veins of insight about the Panthers. The Party’s health activism also emerged at the intersection of the institutional, tactical, and ideological processes. These dynamics paved the way for the specific health outreach, screening programs, preventive care initiatives, and challenges to biomedical authority that the activists undertook. From this revised narrative about the organization, fresh observations about its mission and course are possible as well as evidence of the relevance of the Party’s work for present-day concerns about race and health inequality. In the next chapter, I describe how the Party and its collaborators in the radical health movement worked to erect the essential infrastructure of the Party’s health politics—its national network of People’s Free Medical Clinics.