One doctor’s journey

The National Underground Railroad Freedom Center recently hosted influential surgeon Dr. Alvin Crawford to reflect on a trailblazing life in conversation with UC medical student Abraham Araya. The event coincides with the release of Crawford’s memoir The Bone Doctor’s Concerto: Music, Surgery and the Pieces in Between.

Crawford is one of Cincinnati’s most influential leaders in medicine and his story is one of resilience and ambition. Growing up in the segregated South, he overcame systemic and very personal incidents of racism. He spent years playing in jazz bands throughout the Jim Crow South, making a music degree as appealing as a medical degree. He became the University of Tennessee College of Medicine’s first African American student in 1960 and then traveled the world as a surgeon for the U.S. Navy before settling in Cincinnati, where he established the Comprehensive Pediatric Orthopedic Clinic at Cincinnati Children’s Hospital, the first in the region. Alvin Crawford, MD, the now retired orthopedic surgeon and founder of Black men in Medicine Cincinnati (BMIMC), often contrasts his own journey in medicine with the experience of younger Black men of today. It is part of what drives him.

“My journey (detailed in his memoir) has been unique,” says Crawford, a native of Memphis, Tennessee. “I majored in music and didn’t feel I would make it where I was since I was at a state school and not a conservatory. My brother said you like challenges, why not consider medicine?”

Crawford ended up graduating with degrees in music and biochemistry from what was then known as Tennessee Agricultural and Industrial State University, an all-Black institution and the forerunner of Tennessee State University. He decided to take his brother’s suggestion and pursue medicine and enrolled in Meharry Medical College, one of four historically Black medical schools.

It was 1960 and while legal segregation in the South was starting to fall it wasn’t going away quietly or easily. Crawford completed a quarter at Meharry Medical College when the Tennessee NAACP challenged practices that kept Black residents out of state-supported medical schools. His mother, a nurse, was very proud of her son’s accomplishments, and she worked with a physician who happened to be president of the NAACP, says Crawford.

“My mother could tell you how I was doing, well, anytime you saw her,” says Crawford. “She bragged about how well any of her children were doing. So much so, you would get out the way when you saw her coming.”

The University of Tennessee had been instructed to find a Black student to admit to its medical school, but the retort was they could find none qualified, says Crawford. That’s when the NAACP president approached Crawford’s mom.

“So the doctor said, ‘I hear your son is in medical school,’” says Crawford. “She told him yes, but we had to mortgage the house to get him there.”

The NAACP then submitted Crawford’s MCAT scores and other academic information to the University of Tennessee. The reply was that a qualified Black applicant had been found, but since he was in medical school elsewhere the case for admitting this student was closed, explains Crawford.

“Then we started thinking about it,” explains Crawford. “Meharry is a private school and much more expensive than the University of Tennessee which is a state school. We looked at it, and my mother said, ‘Well, you have always been up for challenges.’”

Crawford left Meharry after his first quarter and interviewed at the University of Tennessee for medical school. His meetings with the dean and provost were far from reassuring. 

“The dean said, ‘Son, if my daddy, God rest his soul, could hear me now speaking to you he would turn over in his grave,’” says Crawford.

The dean acknowledged that Crawford graduated top of his class at Tennessee State, and was a ranked student at Meharry, but his medical school credits at Meharry would not be accepted by the University of Tennessee which didn’t recognize Meharry, a private school, as a “qualified accredited” medical school. 

Crawford would have to take his initial classes over, and the provost offered a more blunt assessment.

“I think you will flunk out, but if you want to try we are mandated to accept you,” recalls Crawford.

He enrolled but not before explaining to the dean of Meharry Medical College why he was leaving, and that opened another conundrum.

“The dean at Meharry said, ‘Son, you are number two in your class. If you go to the University of Tennessee they will flunk you out and we will lose a good doctor,’” says Crawford.  

But that was just part of the problem, the Meharry dean explained. His respectable school trained scores of Black physicians, largely at the time because aspiring Black medical students were denied entry to White state schools across the South. If these students could now attend cheaper state-supported, predominantly White institutions, Meharry would be at risk of losing its best students.

That said, the Meharry dean still understood the need for an end to segregation in medical schools. Crawford settled in for a solitary journey at the University of Tennessee.

“I told my brother ‘you didn’t tell me how much of a challenge this would be,’” recalls Crawford. “Everyone expected me to fail. I never had an adviser and was never allowed to go into the major community hospitals where most of the clinical training occurred in the junior and senior year because they were all segregated. It was quite a unique experience.”

“There were no class parties, no picnics, no social life or get-togethers that I could attend primarily because Jim Crow laws at that time did not allow social integration in any form,” says Crawford.

The young medical student told the University of Tennessee medical school dean during an interview he would pass as long as he was given the same exam as others.

“My mother was a strange lady,” says Crawford.    “She said, ‘Never let your oppressor know you are a victim. I don’t want any of my children to be victims.’ As a result, there were no outward protests or outcries.

Crawford did graduate, and he was in the top of his class. He went on to train at residencies in the U.S. Naval Hospital and Massachusetts General Hospital both in Boston. He received the outstanding resident’s award from the Boston Orthopedic Club in 1970, while a Harvard Medical School senior resident.          Crawford also did fellowships at the New England Baptist Hospital and Children’s Hospital Medical Center, both in Boston, and at Alfred I. DuPont Institute in Wilmington Delaware. During all of this impressive training, Crawford was the only Black.

Crawford joined the UC College of Medicine faculty in 1977 and continued until becoming an emeritus professor in 2013.    

Crawford is best-known for his tenure at Cincinnati Children’s where he spent 29 years as chief of orthopedic surgery. He has also practiced orthopedic surgery at good Samaritan, Jewish and Christ hospitals along with UC Health. His tenure in medicine has spanned five decades. Upon retiring, he was awarded academic chairs in pediatrics orthopedics and the Spine Center became the Crawford Spine Center.

But his experience as a young medical student isn’t one he would want others to repeat. He says that while the legal and social barriers he faced during his day are significantly different, other obstacles for Black men completing medical school remain today.

“The obstacles are binary,” says Crawford. “We like to think that it is about prejudice, and we have to do something about it. There is a decrease in males going into medicine even from legacy families in which the grandfather and father were physicians. The extent for entrepreneurship is dwindling as medicine is now controlled and the indemnity fee for service model has more or less disappeared.”

“Black males aren’t applying as much to medical school even though their grades have increased dramatically since the 1970s and 1980s,” says Crawford. “Other fields are now open to these academically-talented individuals today.”

He says the rigors of medical school aren’t insurmountable, but that persistence even with a few stumbles is crucial. Crawford, who participates in an academic appeals, review committee for the UC medical school, describes a difference in students who have encountered difficulties and had to repeat courses through summer study or other means. He noticed that when this has occurred for Black students, the paths for Black men and Black women can differ.

“The females will usually trudge persistently along and get it done, but the males will look for other opportunities and leave,” says Crawford. “It is my desire that our mentoring program will give our most at risk group for failure a more nourishing and supportive environment.”

“It’s comforting to think of changing the dynamic of ‘you can’t be what you can’t see’ to ‘I see and will be,’” says Crawford.

Crawford said some of the take always from his career are:

     — Don’t let your birth determine your life.

     — Never let yourself become a victim or be defined by anyone but yourself.

     — Focus on your goals and aspirations.

     — Resiliency, tenacity and commitment.

     — Patients will forget what you said, what you did, but will never forget how you made them feel.

In what he calls a “Crawfordism,” he adds, “I wish that all of you could experience the joy of a life serving humans that mine has been. This becomes a nonissue if you exercise the F2 principle, which is to treat all humans as if they were either Family or Friend.”

Crawford’s autobiography is available online or at local bookstores.