Altha Stewart Reflects on Solomon Carter Fuller’s Legacy

Solomon Carter Fuller, M.D., recognized as the first Black psychiatrist in the United States, was born shortly after the Civil War ended and died a year before the Brown vs. Board of Education Supreme Court handed down its decision to declare segregation in public schools was unconstitutional.

“His entire life was encompassed by a structural system that limited his opportunity,” said Past APA President Altha Stewart, M.D. “Despite the system that was in place and designed to stop him, he made major accomplishments in medicine and psychiatry.”

Stewart was the recipient of this year’s Solomon Carter Fuller Award and presented the corresponding award lecture at APA’s 2021 online Annual Meeting. The name of her lecture, “The Caravan Moves On,” was inspired by the title of a Fuller’s biography by Mary Kaplan, Where My Caravan Has Rested.

During her talk, Stewart focused on Fuller’s contributions to medicine and the field of psychiatry specifically. He played an important role in early research of Alzheimer’s disease and worked closely with Alois Alzheimer, but his contributions to that research are often overlooked, Stewart said.

A further underrecognized aspect of Fuller’s life was his role as an advocate, she continued. He was what Stewart described as a “protest” psychiatrist, meaning he often acted in a manner of protest against the mores of his day. For example, though he was one of the most accomplished psychiatrists among his colleagues, he was once passed over for the role of chief in favor of a White, less experienced man. “He decided he would not accept that, and he left his position,” Stewart said.

“I cannot imagine the pressure he must have felt as the first Black psychiatrist in many settings,” she continued. “He was limited, in many respects, by the segregationist policies that existed throughout his life.”

At the end of her lecture, Stewart was asked about Fuller’s persistence in his work and how Black psychiatrists today can similarly advocate for their colleagues and patients without wearing thin or burning out.

Fuller’s work resonates with Stewart, she said, because his manner of protesting echoes her own. “We want to stay involved, even when we wear thin and we’re exhausted,” she said. “I’m sure he had moments in which he wondered if it was worth it, as I have. But you have to persist.”

Psychiatry is not welcoming to the Black community, Stewart said. The field often claims that it is working toward doing better, “[w]hen, in fact, our behavior suggests we are not,” she said. She quoted the author James Baldwin: “I can’t believe what you say because I see what you do.” Psychiatry is, quite often, centered in a White context, in that being White is considered the norm.

“That centering has to be reversed,” Stewart said. “For many Black psychiatrists in the field, it’s the lack of intentionality in developing anti-racism approaches to the practice of psychiatry that really makes our work difficult.” She explained that she holds Fuller in such high esteem because he made achievements that few would have expected of Black people during his time, considering the barriers he had to overcome. “Yet he did it with grace, style, and a presence that belied what many would like to think is representative in the Black community,” she said.

Another audience member asked Stewart what she thought Fuller would say about the growing awareness of systemic racism in medicine.

“I imagine he would say, first, that it’s about time,” Stewart said. “He’d say that, finally, we can get down to the real work at hand of figuring out how to give good service, improve quality of care, and train people in a way that allows them to appropriately and adequately—and in the context of the patient’s culture—approach treatment.” ■