INTRODUCTION
In 2005, BiDil became the first drug ever approved by the U.S. Food and Drug
Administration (fda) for use in a specific race: it was indicated for heart
failure in ‘‘self-identified black patients.’’ As such, it became fodder for both
popular and academic debate about the role of race in medicine, and the nature
of racial di√erence more broadly. As novel as its fda indication was, this drug
represents just one moment in a long-standing and dynamic interplay of race,
pharmaceuticals, and heart disease in America. Medicating Race examines these.
In the wake of BiDil’s commercial failure, this analytical contextualization
helps to account for its allure and its unpalatability, as well as to open larger
questions of medicine and American identities.
My analysis of race in medicine focuses on heart disease categories and
their treatment. It highlights the complicated roles that physicians have long
taken, advocating for the urgent needs of black patients on both scientific and
social justice grounds. Whereas most scholars have situated BiDil within dis-
cussions of race and genetics and pharmaceutical marketing, I see the drug as
part of narratives that precede and exceed any of these things. Enlarging the
framework to pay attention to the intertwined trajectories of medical research
and advocacy situates BiDil within a wider set of medical and racial ideas and
practices.
The intersecting and mutually constituting trajectories of race, heart dis-
ease, and pharmaceuticals provide an excellent site to analyze what I concep-
tualize as the durability of preoccupations with race in medicine. Race in heart
disease research and practice is durable: it cannot easily be gotten rid of. It is also
a preoccupation: it cannot easily be let go. Durable preoccupation thus o√ers a dual
concept with intrinsic tensions. Race in medicine provokes appeal and aver-
sion, disassociation and solidarity, displacement and investment. In tracking
the continuities and discontinuities of racialized heart disease discourses since
the founding of American cardiology, we can see that the promise and danger
heralded around BiDil tap into something deeper. Arguments over how to
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