In Memoriam: H. Jack Geiger
On Tuesday, December 29, 2020, the world learned that “H. Jack Geiger, Doctor Who Fought Against Social Injustice” had died at 95. The New York Times obituary included quotes and anecdotes from an interview with Jack, conducted years earlier, and updated by Jack. Dr. Geiger was passionate about submitting his views on emerging health issues (the public health crisis in Flint, Michigan, for example), knowing that he was the driving force of the story that would carry his work, and us, into the future. It happened that, on the morning of the NYT obituary, the National Medical Fellowships (NMF) Board of Directors met to chart the future of NMF. Focusing on the future of NMF was something that Jack had helped us write in advance. Jack was NMF’s longest-serving board member. We observed a moment of silence, but knew we would not be silent about Jack, or what he has asked us to do.
NMF celebrates the life of Dr. H. Jack Geiger, a beloved colleague and friend.
For more than 40 years Jack inspired and supported NMF’s mission—to foster the next generation of healthcare leaders, by supporting medical and health professions students from communities that are underrepresented in medicine,” said Sandra B. Nichols, MD, FAAFP, MHCDS, MS, Chair of the Board of Directors of NMF. “Well before others, Jack understood that minority physicians are “frontline heroes” in our efforts to bring about health equity and reduce devastating health disparities. Jack spent his career witnessing and challenging these inequities and disparities. Jack’s legacy has never been more important, and will continue to inspire us, and shape our actions, as NMF begins its 75th year of service.”
Jack Geiger’s story—and the mission of NMF
H. Jack Geiger was a physician who fought against social injustice wherever he encountered it, from Mississippi to New York, to Boston, and all around the world. It is easy to see, in retrospect, how the trajectory of his life brought him to NMF. His activism began early. As a college student at the University of Wisconsin, he co-led a campaign to end the university’s practice of racially and religiously segregated off-campus housing. He soon found himself working alongside leaders of the civil rights movement. In 1943 he met James Farmer, the founder of The Congress of Racial Equality and established one of its earliest chapters. Upon graduating, Jack signed up with the U. S. Merchant Marines–because it was the only military service that was not racially segregated during World War II. During his years of service, he decided to pursue a career in medicine. Upon discharge, Jack enrolled at the University of Chicago as a premed student.
“Almost at once,” he wrote, “my colleagues and I discovered that the University of Chicago hospitals had both announced and informal rules of racial segregation. The Lying-in Hospital had a flat-out policy of admitting no Black women. At . . .other hospitals, admitting clerks were told to lie to Black patients arriving for outpatient appoints and try to send them to Provident Hospital, the primarily Black hospital on Chicago’s South Side.” Significantly, the medical school had not admitted a Black candidate in years, claiming that they couldn’t find qualified minority applicants. Notes obtained from admissions committee told a different story: “This candidate is qualified, but we are just not ready to admit blacks at this time.” It was 1947, and this was perfectly legal.
Jack and his like-minded colleagues began an intense campaign to address these injustices, which culminated in a large student and faculty protest. In response to this activism, the American Medical Association sent a letter to every medical school in the country, calling attention to Jack’s “extracurricular activities.” After that, no medical school would accept him. For five years he worked as a journalist, reporting on medicine and science, until he gained admittance to the Western Reserve School of Medicine in Cleveland, Ohio (now Case-Western Reserve School of Medicine)—at the age of 29.
Jack’s story has inspired generations of medical students seeking a way to put idealism into action. It’s a story that speaks to our mission at National Medical Fellowships. Jack understood that the lack of Black physicians was directly related to substandard care provided to Black patients, and poor health outcomes in the Black community. Due to social injustice and health inequity, it was a matter of life or death to increase the participation of minorities in medicine. This was a novel idea at the time. There was, however, one key organization that was beginning to work in this area. The organization that would become NMF had been founded in 1946, only one year earlier, to provide training and support for Black physicians as a way of improving the health of minorities and all Americans. Years later, in the late 1970’s, Jack would become a member of the NMF Board of Directors, as NMF expanded to provide scholarship support and other opportunities to medical and health professions students from groups underrepresented in medicine.
Community Health Centers – and NMF programming
Jack Geiger is perhaps best known for creating the community health center model in the United States. In 1965 he convinced the federal Office of Economic Opportunity of the need for a new model of health care for poor and underserved communities. He and a colleague, Dr. Count Gibson, made history by launching the Delta Health Center in rural Mound Bayou’s cotton fields in Mississippi, and at the Columbia Point Health Center, in a Boston public housing project.
The two centers, one rural, one urban, were designed to deliver high-quality primary care to individuals, while focusing on factors that influenced the population’s overall health status. This meant working across sectors to address malnutrition problems, housing, environmental exposures, lack of education, and other effects of poverty and racial discrimination. At the Delta Health Center, an Environmental Management Department dug protected wells, constructed safe outdoor toilets, repaired crumbling housing and organized a 500-acre cooperative vegetable farm, among other initiatives. Much was achieved through community organizing and empowerment (including ongoing efforts at voter registration!). This holistic approach to healthcare has most recently been associated with a focus on social determinants of health. At the time it required some explanation. When Jack was asked by a federal official why he was using his pharmacy budget to write prescriptions for food, he famously replied “The last time I looked in my medical textbooks, they said the specific therapy for malnutrition was food.”
The community-based model of care pioneered by Jack and his colleagues has been widely adopted across the United States. Over the years, with significant support from Presidents, Congress, and Federal Agencies, a national network of Community Health Centers (CHCs) has grown to serve more than 30 million people, in more than 13,000 rural and urban communities. CHCs provide a safety net to low-income families, the underserved, and the uninsured; more than two-thirds of CHC patients are members of racial or ethnic minorities.
Under Jack Geiger’s leadership, Community Health Centers have come to play an important role in NMF’s programming. NMF’s mission is to nurture and support aspiring physicians and health professionals from groups underrepresented in medicine. Not surprisingly, many of our NMF scholars come from the low-income communities served by CHCs and other safety net providers. And many of these students pursue careers in medicine with the goal of returning to practice in their communities. Jack has helped NMF form a partnership with CHCs as service-learning sites for these students.
“Jack was a drum major in combining both public health and clinical medicine to improve the health of those who live in rural and urban underserved communities. Before the term was coined, he foresaw the importance of addressing Social Determinants of Health as part of treatment and prevention of disease. And above all else, Jack Geiger was a role model, a friend and colleague. I truly miss him”, said NMF Board Member Stephen N. Keith, MD, MSPH.
In the 1990s, NMF developed the W. K. Kellogg Community Medicine Fellowship Program for Minority Medical Students. This groundbreaking program placed medical students in CHCs to experience the rewards and challenges of community medicine. Jack was the creative force behind this program, and served as the Chair of its National Advisory Committee. Fellows in the program completed an 8 to 12 week rotation where they provided health education and preventive or primary care to a community as part of a multidisciplinary team.
The Kellogg Community Medicine Program, which extended over 11 years, became the model for other NMF service-learning programs, including the NMF Primary Care Leadership Program (PCLP), founded in 2012 and now in its tenth year. PCLP’s mission is to develop a pipeline of primary care professionals from diverse backgrounds who are committed to serving underrepresented communities. The program was inspired and initially funded by the GE Foundation, and its success soon attracted other funders. Jack played a crucial role in developing PCLP and served as the Chair of the PCLP National Advisory Committee. To date, PCLP has placed 565 health professions students from underrepresented groups at 57 partner CHCs and has earned overwhelmingly positive recognition from NMF Scholars and site partners. From the beginning, Jack was actively involved with PCLP students, as a model for leadership and a mentor. Jack has also helped NMF develop programs serving minority medical and health professions students interested in public health and health policy. A goal of all these programs, he has said, is to train and prepare those who will be leaders and decision-makers in government agencies and organizations of every kind.
Dr. H. Jack Geiger’s remarkable career spanned more than five decades and changed our world in more ways than we can recount here. Dr. Geiger was a founding member of Physicians for Social Responsibility, which shared the Nobel Peace Prize in 1985, and Physicians for Human Rights, which shared the Nobel Peace Prize in 1997. He was a founding member and past president of the Committee for Health in South Africa and traveled internationally for human rights work. He was a founding faculty member, and then a professor Emeritus, of the Sophie Davis School of Biomedical Education at City College of New York, which became part of the CUNY School of Medicine. Dr. Geiger received the highest awards bestowed by the Institute of Medicine/National Academy of Sciences and the American Public Health Association. He has received honorary degrees from five universities and medical schools. These recognitions are testaments to Jack’s work in advancing health equity and addressing the health of poor and disadvantaged communities in the US and across the world.
“Jack Geiger was a long-term friend and supporter of NMF. His life of commitment to and leadership in social justice and health equity for all is the example that all of us should aspire to follow. God bless him” said NMF Chair Emeritus, Daniel T. McGowan.
In 2012, NMF was honored to present Jack Geiger with the NMF Founder’s Award, in gratitude for his leadership and monumental contributions to NMF. But our gratitude is infinite; and so, like all others who have been inspired by Jack Geiger, we will continue to honor and remember him always, in the never-ending work of social justice, and especially, in our efforts to achieve health equity. We look forward to celebrating Dr. Geiger and his legacy as part of NMF’s 75th Anniversary, and our vision for the future. As a part of these celebrations, NMF will be establishing the Dr. H. Jack Geiger Scholarship to honor his remarkable life, work, and legacy.