Patricia Bath (1942-2019) Representation matters. Case in point: Dr. Patricia Bath, the first Black female doctor to patent a medical device in the US, whose work both inside and outside the operating room literally saved the sight of many. In addition to inventing a revolutionary cataract conquerer called a Laserphaco probe, she “invented” a revolutionary healthcare strategy called community ophthalmology, which brings eye care to all who need it. And her work was driven by observing disparities in her own community and doing everything she could to address them.
Bath was born in Harlem, New York in 1942 and showed an early aptitude for science, which her parents encouraged, even though it required her mother saving up her salary from domestic housework in order to pay for a quality education for her. After undergrad-ing at Hunter College, Patricia received a medical degree from Howard University and went on to specialize in ophthalmology. During a fellowship at Columbia University, she observed that Black patients were disproportionally affected by preventable and/or treatable eye problems. And when I say disproportionately, I mean it. It was pretty glaringly obvious but also pretty easy to ignore if you are a White person working in a system and society which was basically built for you.
Instead of simply “not noticing” or noticing but blowing it off as a curiosity, or getting concerned but doing nothing, Bath went after the data and used it as fuel for change. In a retrospective epidemiological study (looking back at what (disease-wise) was occurring in a population) she went through the records of treatment of patients treated at Columbia University and Harlem Hospital (she was working back and forth at both as part of her internship). When she took race into consideration, she found that Black patients were 2X as likely to suffer from blindness than other patients, as well as 8X more likely to develop glaucoma. https://bit.ly/3dcuqIO
While some scientists might have jumped to trying to find genetic roots to this disparity, Bath took a more holistic view. Having grown up dealing with poverty and racism, she was all too aware of how they could affect access to care. She also knew that without prevention information, early detection, and medical treatment, curable eye ailments could lead to irreversible blindness.
After she found that this was the case for her African American ophthalmology patients, she founded a discipline called Community Ophthalmology to provide access to basic eye care treatment and education to everyone. Community Ophthalmology has since become a worldwide discipline that has saved the sight of countless people, including through the work of the American Institute for the Prevention of Blindness (AIPB), which she co-founded in 1977.
So what is Community Ophthalmology? The discipline includes a lot of outreach to communities, both in terms of treatment and education. As part of their global initiatives, they make sure that children have access to vaccines to prevent diseases such as measles that can lead to blindness; provide vitamin A supplements as part of malnourishment treatment (your eyes need it); and give eyedrops to newborns to prevent infections that can lead to vision loss.
Even in “developed” nations, where it all began, the work is as important as ever. Bath found those racial disparities in one of the “greatest nations” in the world, remember (greatest for whom is a different story…). And that was just in the late 1960s. Problems haven’t gone away, and neither has the need for Community Ophthalmology. Thankfully, neither has the AIPB and other initiatives Bath started. For example, volunteers go out to daycare centers to test kids’ eyesight and make sure that kids with vision trouble get glasses ASAP so that they have the best possible chances to succeed in school and life. And they go out to senior centers to screen for common eye ailments that afflict the elderly, such as glaucoma and cataracts.
Speaking of cataracts, In addition to expanding access to care, Bath also worked to improve the care patients received, inventing a method to remove cataracts, which is still used around the world. As part of this, she patented a probe called the laserphaco Probe in 1988, making her the first female African American doctor to patent a medical device. She would go on to get a total of 5 US patents and 3 international ones, but this laser cataract ablation one (U.S. patent No. 4,744,360) is the major one she’s known for.
I looked a bit into how it works but I know eyes make people squeamish so I’m not going to elaborate too much. But basically one of its key benefits is that it makes the teeniest possible cut. It’s able to do this because it uses a super thin optical wire. This wire gets inserted into the clouded-up lens, where it lets off radiation (light waves) to break up the lens and all its cloud-causing-clumps of proteins. Into really really tiny pieces. And then it sucks those pieces out and washes things out. And then a keratoprosthesis (artificial lens) can be inserted. And, voila! Vision!
She was a bit ahead of the technology when she first thought it up in 1981. So it took almost 5 years to actually bring it into being, but now it is widely used around the world, restoring sight to individuals – even some who had been blind for more than 30 years!
But revolutionary medical technology, as great as it may be at treating individual patients, often has its greatness limited by unequal access to it. When it comes to healthcare inequities, you often hear about price gouging and lack of insurance. These are real problems – but they’re not the only ones. Sometimes there aren’t even any surgeons around!
You know how I was telling you about the disparities Bath found in patients at Columbia and Harlem? Well, part of the problem was that Harlem Hospital’s Eye Clinic, where more of the Black patients were being treated didn’t even perform eye surgery – at least not before Bath came along and convinced them to. She got her Columbia professors to operate on blind patients (with her acting as assistant surgeon) at Harlem – free of cost. (The first major eye surgery there was in 1970, so this is before the whole Laserphaco thing, but you *know* that inequalities in access to care persist to this day…)
Bath joined the faculty at the University of California Los Angeles (UCLA) in 1974. She was the first female faculty member in their ophthalmology department, and overcame discrimination to become the first female Ophthalmology Chair in the US and the first Black female surgeon at UCLA. She retired from UCLA in 1993, but continued to advocate for access to eye care, which she considered a basic human right. In an effort to expand this access, she taught telemedicine at Howard University and Grenada’s St. George University. Yup, Bath was into telemedicine before COVID-19 made it “cool.”
I was saddened to hear that Dr. Bath passed away May 30, 2019. I hope people will remember her and what she showed us – you can’t just be “race-blind” or you’ll miss why people are literally going blind. It’s time to stop pretending that racial inequities are not evident to see all around us. It’s time to follow Bath’s lead and draw attention to inequality – and do something about it.
And, in particular, it’s time for the people in power to do something about it. All too often, initiatives to address these problems come in the form of unpaid labor of the very people who are being mistreated. The people in power, and society at large, need to listen to these people and amplify their voices. But not force them to keep doing all this outreach work unpaid. It’s so incredible to see the amazing work that Bath did. But you can’t help but wonder how many obstacles she had to overcome, how much pushback she received, and how many more technologies she might have been able to develop if she hadn’t been having to fight against systemic racism every step of the way.
a few sources for people wanting to learn more:
NIH, Changing the face of medicine, Dr. Patricia E. Bath https://bit.ly/2Y8ovjH
NY Times obituary: https://nyti.ms/3ec6JSf
#365DaysOfScience All (with topics listed) 👉 http://bit.ly/2OllAB0