# Main Argument
Washington's writing about "black iatrophobia." This is a cultural
history, so she wants to elaborate why African-Americans have developed
this fear from the history of American medicine. Her argument is about
class and race divisions between physician practitioners and "subjects"
(patients or experiment victims). The book probably argues that white
doctors' destructive experiments and discriminatory treatment to blacks
has developed cultural adversity to modern medicine.

# Anarcha Speaks barbarism
The doctor pursues progress, for personal gain/egotistical reasons, but
he ignores Anarcha's suffering, compartmentalizing it as "sacrifice."

Anarcha is focused inward on her suffering. Unlike the doctor who wants
to defeat God, Anarcha prays to Him. The only thing she wants is out,
and the only way out is death because she has no freedom.

The doctor's "document of civilization" is the speculum, the fistula
operation, and evidence, but it's backed by this horrific underclass,
the dark history Anarcha lives through, and much medical progress was
discovered this way---admirable ends with abhorrent means.