Ep 42-Ruby McCollum And The Price Of Survival

A snowstorm, a noisy house full of pets, and then a hard turn into a story that still shakes the walls of medicine and justice: Ruby McCollum. We walk through Ruby’s path from a disciplined childhood in segregated Florida to a marriage that brought visibility and risk through the Bolita economy. When a respected physician blurred professional lines and used social power to control her body, Ruby learned to live in two worlds—outward composure and private calculation. Years later, a single moment in a doctor’s office revealed the truth no one with power wanted to face.

Stick around for a listener medical mishap that adds levity without losing sight of the stakes. If this story moved you, share it with a friend, follow the show, and leave a review—your support helps more people find conversations that challenge power and champion dignity.

Sources: 

1. Thompson-Miller, Ruth. “The Trial of Ruby McCollum: The Consequences of Trauma: Segregation Stress Syndrome.” Journal of Community Medicine & Health Education 7, no. 7 (2017): Article.
   • Link: OMICS / Open Access Journal Omics Online Publishing
2. Lynn, Denise. “Silencing Black Women in the White Courtroom: The Case of Ruby McCollum.” African American Intellectual History Society (AAIHS), February 6, 2019.
   • Link: AAIHS article AAIHS
3. Adekunle, Toluwani E. “Reproductive Coercion, Medical Mistrust, and Black Women’s Health from the Antebellum Period to the 21st Century.” International Journal for Equity in Health 24 (2025).
   • Link: PubMed / NIH PMC PMC+1
4. H

Chapters

• 0:00 Snow, Pets, And Chaotic House Sounds
• 7:27 Sponsor Shoutouts And Light Banter
• 9:57 Ruby McCollum’s Early Life And Jim Crow Florida
• 18:02 Coercion, Bolita Money, And Dr. Adams’ Control
• 26:27 The Shooting And Media Narratives Diverge
• 31:42 An Unfair Trial And A Silenced Defendant
• 39:12 Psychiatric Confinement And Erasure
• 45:42 Legacy, Release, And Scholarly Reckoning
• 50:12 Chart Note: Black Maternal Health Today
• 57:12 What Justice Might Look Like Now
• 1:03:42 Listener Medical Mishap And Closing Calls

Transcript

SPEAKER_00: 1:25

Amanda.

SPEAKER_02: 1:31

That was very coded of like the cha cha cha chia.

SPEAKER_01: 1:35

I know. I was like, it's either chia or oh god, there was a song. Okay, well, anyway, I won't go there. How are you?

SPEAKER_02: 1:47

Oh, let's talk about you. How are you?

SPEAKER_01: 1:49

Let's talk about me. Well, okay, so today is the first snowfall. Like significant snowfall. And me being up north, Minnesota, you know, we've got a good six to eight inches already, and it's still going. But the problem is the wind. So I have like a 12-minute commute, which is not a commute under normal circumstances. But when it's a two-lane highway with a steep ditch and a lake on either side, and no streetlights, and the wind blowing the snow, so you don't know where you're going, it's a little hair-raising, a little butt clenching, I will say. So uh instead of 15 minutes, it took me 40 to get home. So thank goodness I was lucky enough to find a place to rent that's this close to where I work. So yay. But I do have to say correction section ahead of time. Have we ever done that? Like a proactive correction. There are going to be yeah, there are going to be tweets and clickety clacks, potentially barks and squeak dog toy squeaks. For toys that I haven't realized that I needed to confiscate. Because since this is Thanksgiving week, my daughter is up here with me with two dogs and a parrot. So and in our small little place. So apologies to the pants.

SPEAKER_02: 3:23

I was like, pre-corrections section? What? And I was like, I don't know. We have corrections. What happened? Oh, okay, I get it. It's a pre-apology for animal clickety-clacks.

SPEAKER_00: 3:35

And squeaks and whatnot.

SPEAKER_02: 3:37

And and all the things, all the noises that come with having animals.

SPEAKER_01: 3:42

But you know what's great about having my Corgi and my Chihuahua here this week? Everything. Well, and guess what they love to do? Snuggle. What do we no? Guess well, that too. But guess what we've what I've been complaining about the last two episodes? The ladybugs. Guess what they like about the ladybugs?

SPEAKER_00: 4:03

They like to eat them? No way. It's so gross.

SPEAKER_01: 4:09

But especially the chihuahua, she likes to like wrangle them all in a pile and then put them in her kill zone and she just eats them.

SPEAKER_02: 4:18

Okay, I hate that, but also love them for you. Like such a longer conversation about the ladybug situation before recording last week. And I was telling my parents about it when they were here last weekend. And I was like, no, I'll just play the beginning of the pod for you. And then I was like, oh no, that didn't even touch half of it. So I had to like tell them my dad was like, Oh my god.

SPEAKER_01: 4:46

So gross. And then my daughter, who this is her first time up here seeing where I'm, you know, parked during the week for work. And she's like, if you she's a really great baker, and she's already basically won over all the nursing station because she made these fantastic chocolate chip and Reese's Christmas tree cookies with like salted stuff on top. Oh my god. So they're like, Well, if this is your daughter, you must be okay. I was like, Thanks, Sabanna. If you're like, Thank you so much, Sabanna. But mom, if you smell a weird, like a weird, unfamiliar smell when you turn the stove on, the stovetop. So it's an old-fashioned electric stove with the coils, you know, the heat up. It's because of ladybugs. Oh my god.

SPEAKER_02: 5:40

You know what? It has snowed now, so the ladybugs should cease, plus the animals helping you out.

SPEAKER_00: 5:46

Gosh, yeah.

SPEAKER_01: 5:47

So I hope this is the last time I have to bring this up. Speaking of banter and whatnot, we I attended this most beautiful baby shower with a most glowing, beautiful mama and excellent uh last weekend, and it was wonderful to see you.

SPEAKER_02: 6:05

So it was so good to see you in person too. Miss you.

SPEAKER_01: 6:10

I miss you too. Okay, there's a ladybug on my script. Get off. Goodbye. You know it's snowing outside. How are they? How am I gonna tell them? This is done now. You guys should be what are they hibernate? They should be hibernate. I don't know. Hopefully they just uh good, yeah. Go we're all right. Go to the body lesson, right? All right, well, um, did we have a correction for last week? I don't think so. I don't think so. Yeah. So that leads me into a very non-graceful correct uh sponsorship. Shout out to Tona T-O-N-A Activeware. They were created by one of Lulamon Lululemon La la la la la la la la la la There was a murder there. Lululemon's original designers, you know about the Lululemon murder, right? Murders? No. Oh gosh, okay. Well, that's not medical, but I was gonna say, is it medically at all?

SPEAKER_02: 7:16

Yeah, tragic. But anyway, into their primary care religiously, and that's how it ties in.

SPEAKER_01: 7:22

No, no, no. It was a murderous employee of another employee. So nothing to do with Lululemon, but tragic. Anyway, so built from the chief design officer's experience as a competitive athlete who understood exactly what serious female athletes needed. Side note, I really wish I knew what serious female athletes needed, but I do know a girl needs premium black leggings. And when they're designed for, quote, girls who gym TM, quote, that'll be the last pair you ever need. They're made with moisture-wicking fabric and four-way stretch technology. Tona leggings deliver a secure, flexible, and ultra-flattering fit that moves effortlessly effervescently, effortlessly.

SPEAKER_02: 8:11

This is turning out great. With every in all the right ways.

SPEAKER_01: 8:16

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SPEAKER_02: 9:01

She I can't wait to hear her review.

SPEAKER_01: 9:03

Exactly. She is a definitely a performer who needs a secure, flexible, and ultra-flattering fit. So stay tuned. Yay! So today I really don't have any trigger warnings. I mean, I suppose sexual harassment um would be one, but my resources for this episode are going to be listed on the show notes.

SPEAKER_02: 9:35

I just noticed this is 19 pages.

SPEAKER_00: 9:39

19. Is a girl tired when she's pregnant and it's late of an evening?

SPEAKER_02: 9:44

I would be tired even if I wasn't pregnant because it's 7.08 p.m. But I was just like, holy guac. You guys, for reference, if mine gets over like nine pages, I'm like, it should be a two-parter for me. Jenna comes in with like 13 to 19 pages.

SPEAKER_01: 10:02

Listen, I'm gonna some of it's fluff. I'll talk fast. The margins are narrow. It's good. We'll be all right. We're gonna talk about Ruby Jackson.

SPEAKER_02: 10:11

Ooh, Ruby I don't know why I sounded so excited.

SPEAKER_01: 10:13

I don't know who you should be excited. She's wonderful. You'll love her.

SPEAKER_02: 10:17

I mean, I am excited, but I said it like I know who Ruby is and I don't. So please tell me.

SPEAKER_01: 10:23

Ruby? I'm glad you asked. She was born in 1909 in Zuberg, Florida, into a family that valued education, self-respect, and dignity. Her upbringing was unusual for the time and place. While most black families in rural Florida struggled to achieve basic literacy under Jim Crow law, Ruby's parents placed great importance on schooling and the cultivation of intellect. They encouraged their children to read widely and engage in careful speech and carry themselves with a sense of purpose and poise. I mean, that's beautiful, isn't it? Especially since they were in a society that would not always respect their humanity, which is disgusting, but true. So these lessons that they were taught were essential for survival. It was a world defined by racial hierarchy where the law and custom worked against them at every turn. The ability to navigate social spaces with intelligence and grace would mean the difference between safety and vulnerability. From a young age, Ruby exhibited a sharp mind and keen awareness of the social structures around her. She learned earlier that the world of adults was rigid, stratified, and unforgiving. The southern town she grew up in was a microcosm of the broader racialized society. White men wielded disproportionate power, shocker, and their authority extended into every institution, law enforcement, courts, schools, and medical facilities. For a black girl, knowledge and comportment were protective tools, but they couldn't shield one from the more intimate forms of coercion that often went unrecorded in public life. Ruby's childhood awareness of hierarchy and power would serve her well, but it also foreshadowed the painful negotiations she would have to navigate as an adult. Ruby married Sam McCollum, a man whose charisma and ambition would eventually place the family at the center of Live Oaks' social and economic activity. Sam became a prominent figure in the local Bolita gambling network. And Bolita is an underground lottery system common in Florida's black communities. While it allowed the McCollum's a measure of economic independence unusual for black families in the region, it also attracted scrutiny from white authorities and created opportunities for exploitation. The financial resources that Ruby helped manage were a rare advantage, and they afforded her some leverage in navigating her environment. But in a town defined by strict social and racial hierarchies, even financial independence could not guarantee autonomy. My oak itself was a study in contradictions. Its streets and architecture were calm and orderly, but beneath the surface, social control was absolute. White men, like Dr. Clifford Leroy Adams, dominated the medical, political, and social arenas. Dr. Adams was a physician of considerable skill and a man of political ambition, later elected to the state legislature. To the public, he was a respected family man, a civic leader and a professional authority whose reputation extended throughout the county. But beyond the veneer of respectability lay a pattern of coercion and exploitation, particularly towards black women. Adams, like many men in his position of unchecked power during the era, acted on the assumption that his social status granted him rights over women in his community. Rights that extended beyond friendship, professional care, or social acquaintance, if you know what I mean. By the way, when I said Adams, I was like, it's not Adam, because your husband is lovely. So this is Dr. Adams just pointing that out. Couldn't be like night and day. Okay. So Ruby's first interactions with Dr. Adams were framed by these power dynamics. What might have appeared as a root as routine medical care was in practice a mechanism through which he asserted control. He delivered one of her children, he treated her for minor ailments, and consulted with her in ways that would seem innocuous to a casual observer, but with the dynamics of race, gender, and power, these interactions were coercive by their very nature. According to later accounts, Ruby experienced repeated advances, visits, and demands that placed her in a position where refusal was dangerous, if not impossible. In a society where legal recourse for black women was virtually nonexistent, Ruby's consent was effectively nullified, and the boundaries of professional ethics were routinely violated by Dr. Adams. I hate this. I hate this too. I hate this so much. By the early 1940s, Ruby's life had become increasingly constrained by the social and sexual pressures imposed by Dr. Adams. She bore multiple children, and one of whom, widely believed by her community to be fathered by Dr. Adams, embodied the coercive and intimate control that he exerted over her.

SPEAKER_02: 15:35

Do we know is her husband, Sam, the same race as her? Is that why there was speculation? I guess I'm just oh yeah, we know that she's saying that. Yeah, her husband was black.

SPEAKER_01: 15:47

Yep. Mm-hmm. Oh, I love this. Ruby. I know, poor Ruby. So the situation was compounded by the expectations that were placed upon her as a married woman, as a black woman, and as a mother. Her husband Sam, while he was influential and wealthy, couldn't protect her from the abuses that she endured because he was black. Ruby's reproductive, not just because he was black, but also because he wasn't, you know, a physician. He didn't and he didn't have a have political stature, you know.

SPEAKER_02: 16:20

Yeah.

SPEAKER_01: 16:20

All those reasons.

SPEAKER_02: 16:21

But it sounds like he knew this was happening. Oh, how horrible for them as a couple.

SPEAKER_01: 16:31

So Ruby's reproductive autonomy was systematically undermined. Her body was a site of contestation between her own will and the demands of an entrenched social hierarchy. This period of her life illustrates not only the personal trauma that she experienced, which I can't imagine, but also the broader societal forces that enabled and concealed sexual exploitation within Jim Crow, Florida. The pressure Ruby faced was not merely personal, it was structural. In addition to sexual coercion, she navigated the complex networks of economic and social surveillance that characterized her community. The McCollum's involvement in the Belita gambling operation placed them in proximity to wealth and influence, but it also made them subject to scrutiny by the law enforcement and the white elite. Their independence and visibility disrupted the expected social order, which heightened the tension between Ruby's agency and the mechanisms of control around her. The dynamics of coercion were therefore multifaceted, intertwining personal, economic, and racialized forms of power in ways that left Ruby with limited options for resistance. Accounts collected by journalists and historians indicate that Ruby's attempt to resist Dr. Adams' control were constrained by fear, shame, and the potential repercussions for her family, of course. When she confided in friends or neighbors, her disclosures were cautious, fragmentary, and indirect. It was an adaptive strategy in a society where speaking openly could have fatal consequences. Her awareness of the threat posed by Dr. Adams was acute. She understood that in a legal system designed to privilege white men, her voice would be marginalized and her experience likely dismissed. These constraints created an environment in which Ruby's options were so limited and every decision carried potential consequences, not only for herself but her children and her husband. So her early encounters with Dr. Adams combined with her navigation of the social and economic networks of Live Oak, illustrate the intersecting pressures that shaped her life. She was a participant in and a victim of a complex power dynamic where race, gender, and class intersected to limit her autonomy. Her story at this stage is one of survival within constraints, an ongoing negotiation of risk, and the careful balancing of personal agency against systemic oppression. Her intelligence, dignity, and resourcefulness were essential tools in managing these pressures, but they couldn't eliminate the coercive forces that defined her interactions with Adams and the broader social hierarchy of Live Oak. So, as we said, their their McCollum's financial independence offered some protection, but it also intensified the scrutiny. It kind of put the spotlight on them because Sam, her husband's position within the Bolita network was providing wealth that other black families couldn't access and positioned the family as an anomaly within this segregate, segregated town. So the wealth and the visibility made Ruby vulnerable to manipulation by Adams and more capable of resistance in some subtle ways. So her ability to navigate the tensions demonstrates that she was so intelligent and aware, but also underscores the limited avenues for meaningful autonomy available to these women in the Jim Crow South. So her early adult life is marked by this delicate tension between agency and constraint, resilience and vulnerability.

SPEAKER_02: 20:05

Are you going to tell us about this Jim Crow thing? Because I don't know what that is.

SPEAKER_01: 20:10

Basically, the the segregation era where, you know, the law was that, you know, blacks and whites should not mingle. They should not go to the same school. They should you know, yeah.

SPEAKER_02: 20:23

I feel a little embarrassed. I don't know what that is. But if anyone else also didn't know what that was, you're welcome. No question is dumb question.

SPEAKER_01: 20:30

And that's probably not the best. Like I we could do a whole episode on Jim Crow, and I probably didn't describe it. I'm not trying to be flippant about it, but it was just a terrible time that really emphasized the lack of rights that the black community had. By the time Merby reached her early 40s, she lived through a decade of sustained coercion and complex social negotiation and economic management within this racial and stratified environment. So the pressures of these experiences created an environment in which her eventual actions, though legally framed as murder, spoiler alert, oh must be understood within a broader context of systemic oppression. So Ruby's story at this juncture, she's in her 40s, is one of the constrained, a person with constrained agency, someone who was desperate to survive and present a moral imperative. And also negotiate her power in a dis in a society that was designed to suppress her voice. So as we talked about, the pressures on Ruby McCollum in the 1940s were progressing and progressing, and Dr. Adams' demands were more frequent and more invasive. So at one point their interactions might have seemed limited to professional care, but they evolved into a dynamic in which she had little ability to assert control to the point where obviously, you know, she was having his child. According to oral histories collected decades later, Ruby's visits to Dr. Adams' office were fraught with tension and fear. She learned to navigate his demands with precision. She was careful not to provoke him, but simultaneously tried to protect her family and her own sense of self. Every trip to his office carried the unspoken threat that if she refused him or defied him, it would have devastating consequences on her or her family. So during this period, Ruby gave birth to several children, and one, Loretta McCollum, is widely understood to have been fathered by Dr. Adams. The circumstances surrounding this child revealed the intersection of sexual coercion and reproductive control due to her gender and race. She had no meaningful recourse. Black women were denied legal protections, so she had no bodily autonomy. And even if she sought to confront Dr. Adams, the social and political structures ensured that any attempt at accountability would have been futile or even dangerous. Meanwhile, Ruby and Sam had to manage a local Bolita operation, which again, as we mentioned, created a precarious balance between independence and vulnerability. So they were worried that authorities would threaten exposure or legal action if anything were to happen, especially if she were to, you know, push back against Dr. Adams, or just that white elites would manipulate the family's wealth to exert control over the family. So Rudy seemed to understand this delicate equilibrium. She was very, very careful and within this context developed coping strategies. She maintained a careful facade of compliance in public and medical settings while internally trying to manage her fear, anger, and moral tension. Her intelligence allowed her to navigate the demands placed on her, but it made her acutely aware of the limitations of her abilities and her power. So observers like Zora Neil Hurston, author, noted Ruby's outward calm and measured speech during early interviews and hearings, emphasizing the contrast between her composed demeanor and the intense psychological pressures that she faced. This juxtaposition underscored the complexity of her experience. She was outwardly orderly and compliant, but inside she was navigating a constant state of turmoil between coercion and threat. The burden of maintaining her family's safety weighed heavily on her. She was deeply aware that any disruption to this delicate balance would invite retaliation, but at the same time, she had the psychological burden of repeated sexual coercion, and that's a nice way of putting rape and the realities of living in a society that expected her not to protest. Her position was compounded by her role as a mother. Protecting her kids from exposure to Dr. Adams became an imperative. It shaped her decisions and constrained her options. Every pregnancy, every visit to Dr. Adams, and every interaction with the broader community was infused with a risk and the need for strategic thinking. Her life at this stage was defined by constant calculation. How do I comply? How do I survive? How do I maintain dignity in a world that systematically sought to strip me of it? By the late 1940s and early 1950s, things reached a critical point. She had had enough. She was tired of the legal and social mechanisms that protected her abuser. So she began to explore more decisive actions, but always tempered by the knowledge of potential consequences. In August 1952, these pressures culminated in a single transformative act. Ruby carried a small caliber pistol to Dr. Adams' office. The choice to bring a weapon was not impulsive. It was a result of years of strategic calculation in an environment where traditional avenues of protection and justice were not available to her. The shooting itself was swift. There were four bullets fired, one striking Adams in the chest and ending his life. Observers later described Ruby as composed, almost attached. It was a demeanor shaped by years of coping with this and his coercion and threat and abuse. So her actions weren't characterized by emotionless malice, but it was from profound calculated response to years worth of exploitation. You can imagine the aftermath of the shooting was quite something, and it definitely revealed the stark inequities of justice and media representation in this racist South at the time. Local authorities responded promptly, framing the event in neutral and racially coded terms. Newspapers described the killing as an act of an unstable black woman while suppressing the critical context of Dr. Adams' nefarious deeds. The white press erased Ruby's lived experience and the systemic oppression that precipitated her act by presenting a narrative that served the social hierarchy rather than the truth. By contrast, the black press, including the Pittsburgh Courier, highlighted the coercion and social constraints that shaped her life and offered a more nuanced account of her actions and circumstances. Author Zora Neil Hurston's reporting brought attention to Ruby's condition during the hearings. Hurston observed that Ruby had been heavily sedated and medicated prior to her testimony, and she highlighted the ways in which her mental state was manipulated to portray instability. These dynamics reflected the broader societal patterns in which black women's voices were undermined, particularly when they challenged white authority or social norms. So the trial itself exemplified the intersection of race, gender, and power in mid-century Southern justice. Ruby's defense faced formidable obstacles. The jury was all white and all male. Can you imagine? No.

SPEAKER_02: 28:12

I wouldn't even want that for me now.

SPEAKER_01: 28:15

No, no, ever. There's no diversity or, you know, chance for an opinion that might not be homogenous, you know? The judge systematically excluded testimony regarding Dr. Adams' coercion, rape, and physical abuse, and instead used psychiatric evaluations that were framed to cast doubt on Ruby's credibility. Every attempt to introduce context that could explain her motivations was met with censure or suppression. The legal system operated not merely to adjudicate the killing, but to preserve the social hierarchy, protect the reputation of white authority figures, and silence inconvenient truths about racialized sexual exploitation. He's a bloody rapist. Yeah. You guys. So Ruby's defense attempted to frame her actions within the broader context of the abuse and coercion, but the prosecution reduced her complex experience to a simplistic narrative of premeditated murder. Witnesses were instructed to emphasize her alleged instability rather than the threat she'd endured. And the court proceedings, as Hurston noted, resembled a performance scripted to uphold societal norms and protect the entrenched power rather than a genuine attempt to deliver justice. What a surprise. Ruby's story, the coercion, the rape, the reproductive exploitation, the years of fear was excluded from the official record. So how is this justice? In the weeks following the trial, public perception of Ruby was shaped by the media, which still happens today. The white press emphasized hysteria. She's a woman, she's hysterical, instability, moral failing. You know, how dare you get pregnant when you're raped by your doctor? While downplaying or ignoring the coercion that led to the shooting. Meanwhile, the black press and community advocates sought to contextualize her actions, highlighting the systemic pressures that she faced, the abuse she suffered, and the courage it took for her to act in defense of her dignity and her children's safety. So this bifurcation of narrative underscores the broader societal failure to recognize black women's agency and the selective application of justice in the Jim Crow South at the time. Her case also illuminates the gendered dimensions of systemic oppression. Her experiences show how black women were rendered vulnerable not only by racialized power structures, but by gendered expectations of compliance and propriety. The combination of Dr. Adams' professional authority, political influence, and social status created conditions in which she was not allowed to refuse. That was not an option. And the consequences of any resistance would be catastrophic, as she knew. So her calculated actions must be understood as both a personal response to this and a challenge to entrenched social norms that sought to control black women's bodies and choices. And with this very profound and important and serious note. Going to go to our section. Welcome to the chart note where we learn about what's happening in medicine and healthcare. So, given that we're talking about Ruby McCollin's story, we're gonna fast forward from 1952 to 2025 where we still see the lingering shadows of historic injustices, particularly in how black maternal health outcomes remain alarmingly unequal. Right now, did you know that black women in the U.S. are two to four times more likely than white women to suffer serious pregnancy complications? Everything from preeclampsia and gestational diabetes to postpartum hemorrhage and even maternal death, their babies are almost more than twice as likely to die in the first year of life. And these disparities aren't simply due to biology, they reflect a web of systemic problems, under-resourced clinics, implicit bias in clinical care, gaps in insurance coverage, and long-standing distrust of medical institutions. But likely for good reasons. A powerful new report from the McKinsey Institute published in 2025 underscores just how much is at stake. Closing the black maternal health gap could restore 350,000 healthy life years among black mothers and infants. Economically, that translates into an estimated$24.4 billion boost to the US economy through fewer avoidable health programs, higher workforce participation, and lower long-term medical costs. Even scaling back unnecessary C-sections, which is a frequent intervention, could save hundreds of millions of dollars every year. So what is changing? How are people pushing back? Well, there's a renewed focus on community-based and culturally grounded care. Doula's midwives and birthing centers that are rooted in black communities are gaining traction. These are care models that emphasize trust, respect, and personalized support. Exactly the kind of patient clinician relationship that Ruby was denied. And second, policymakers are stepping up. Advocates that are are pushing to extend insurance coverage farther into the postpartum period because many complications emerge after birth when too many new mothers are left uninsured or under-supported. There's also growing momentum to increase funding for maternal health in historically underserved areas, especially what we call deserts, maternity care deserts. So it's like an area that is just the resources are too they're not in the community, they're they're far away. Third, medical education is evolving. Hospitals and training programs are increasingly embedding anti-biased training in historical context into curriculum. Physicians and nurses are being taught to recognize how racism and sexism have shaped medical practice and how to dismantle those harmful patterns going forward. Fourth, data is playing a central role. Health systems are investing in metrics that track racial disparities in outcomes like preeclampsia, hemorrhage, and maternal readmissions. By shining a light on these gaps, providers can target interventions more precisely and hold themselves accountable. Fifth, technology is being leveraged thoughtfully. Some advocacy groups are working on resource allocation tools to direct reproductive health support where it's needed the most. Meanwhile, telehealth and mobile health programs are being designed with equity in mind, ensuring that black birthing people can access reliable prenatal and postpartum care regardless of geography. All of this matters deeply in light of Ruby McCollum's legacy. Her life was a powerful example of what happens when a medical system dehumanizes and controls a black woman's body. Today, the movement to improve black maternal health is an effort to repair those harms, to restore agency, dignity, and access that Ruby was denied. This takeaway is urgent and hopeful. Closing the black maternal health gap isn't just about better statistics, it's about justice. It requires structural change, accountability, and community-led solutions. Ruby McCollum's story reminds us why this work matters and the slow but growing progress shows that the fight for reproductive reproductive equity continues. Back to the story. By the time Ruby was sentenced, the systemic pressures that she had endured had shaped every aspect of her life. Her death sentence was later I know, was later committed through a plea agreement. But this was just as much a reflection of societal fear of black female agency as it was a response to the shooting itself. The legal and institutional responses to her actions illustrate how societal structures of power prioritize the protection of entrenched authority over the recognition of systemic injustice. So the trial of Ruby in 1952 became a flashpoint not only for the town of Live Oak, but for the nation's understanding of race, gender, and justice. From the outset, the proceedings were steeped in inequities that defined Ruby's life. The courtroom itself was emblematic of segregation and inequality that all-white, all male jury presided over the case, which was a configuration that virtually guaranteed the verdict that she received. Every procedural decision by the judge was designed to marginalize Ruby's voice and diminish the relevance of her lived experience and preserve the social authority of Dr. Adams, the white man whose death had catalyzed the trial. Defense attorneys attempted from the beginning to frame Ruby's actions within the context of her abuse, coercion, and psychological duress. They sought to prevent to present evidence regarding Dr. Adams' sexual abuse, uh, rape, coerce pregnancy, and psychological toll that these violations said exacted on her. They argued that her actions were not the full result or were not the result of cold-blooded premeditation and isolation, but it was a response of years of living under fear, intimidation, and threat. But their attempts were repeatedly blocked. There were many objections from the prosecution, and the judge ruled systematically, excluding testimony that would actually illuminate Ruby's lived reality. And then the use of psychiatric testimony further complicated the proceeding proceedings. Experts testified regarding her mental state, often emphasizing that she was unstable, emotionally fragile, blah blah blah. We've heard this before. Yeah. In defense, Ruby's team sought to introduce evidence of broader social and economic pressures. The fact that her family participated in the Bolita network, her attempts to protect her children, and the general threat posed by these racial hierarchies should be relevant to they posed to understanding her actions, but the judge didn't care. Similarly, the media coverage would depend whether you were a black newspaper or a white newspaper. Language choices, words like Negro woman, hysterical woman, worked to dehumanize her on the white newspaper route, whereas the black reports emphasized how she was coerced and abused and pressured, and how this uh underscores the ways in which she was uh, you know, basically set up to fail. She had no recourse. So, despite the efforts of her defense and any a few sympathetic journalists, the jury deliberated for only 90 minutes before they returned a verdict of first-degree murder. And Ruby was sentenced to death by electric chair. So, before this could be carried out, the state intervened and committed her to the Florida State Hospital in Chattahoochee under the pretext of psychiatric instability. So this institutionalization served multiple purposes. It silenced Ruby, it removed her from public view, and it allowed the state to avoid addressing the problem, which was the systemic, which was the systemic exploitation that had precipitated her actions in the first place. Her confinement was just one more example of how legal and medical institutions could reinforce these aberrant social hierarchies and margin, continue to marginalize individuals. So inside the hospital, Ruby's experience was marked by intense medical intervention. She was heavily medicated. She was subject to treatments that were designed to suppress her behavior. They gave her sedatives, electriconvulsive therapy, and other interventions that were just basically torture and form of control. This effectively attempted to erase her voice within the institution and reflected how black women's experiences were invalidated, pathologized, and controlled so that we can maintain the order of white authority. During this period, journalists and scholars started to reconstruct her story, preserving fragments of her experience and starting to contextualize the legal, social, and psychological dimensions of her life. Zora Neil Hurston, in particular, conducted many interviews that emphasized Ruby's awareness, intelligence, and strategic thinking. She noted the subtle ways in which Ruby navigated power and managed to stay composed under duress and protect her family. The broader implications of her case were increasingly apparent as her story began to circulate again. Scholars picked it up and started examining the intersection of race, gender, and legal authority in Ruby's case. And the McCollum case emerged as an early illustration of what would later be framed as reproductive coercion. Unfortunately, Ruby was institutionalized for decades. She was released in the early 1970s and was finally allowed to return to her family with her voice fractured by years of enforced silence, sedation, and social erasure. But even after release, her story continued to resonate, and it challenged legal scholars, historians, and cultural analysts to confront the complexities of power, coercion, and systemic injustice. She is the picture of the resilience required to survive within oppressive social circles. The institutional response to Ruby's act, the combination of legal prosecution and psychiatric institutionalization, also underscored the mechanisms by which society controls the narratives of resistance. By framing her as mentally unstable and removing her from public life, authorities ensured that her story would just be suppressed. But thanks to I mean the media, the media has its purpose. So thanks to these persistent journalists that were able to gain oral histories, accounts, and historical information about Ruby's narrative, they were able to offer insights and continued to press her narrative forward and push it into the public eye. Ruby's reintegration into family like life was complex. She lost significant time with her family, and the psychological effects of the sedation, the electric convulsive therapy, and prolonged isolation left indelible marks. But even so, she was dignified. She navigated a world that had long suppressed her, but she had the ability to survive, adapt, and persist. She is a hero, and she was able to later in her life provide a presence within her family that offered continuity and connection, a living testament to survival in the face of adversity. Ruby passed away in 1992, her life spanning decades defined by courage, systemic injustice, and resilience. By the time of her death, her story had been preserved in fragments of journalistic accounts, oral histories, and scholarly analyses. Then the efforts of authors Zora Neil Hurston, William Bradford Huey, and subsequent historians ensured that her narrative would endure and not die. Her story is a focal point for understanding the intersection of race, gender, and institutional power in mid-20th century America.

SPEAKER_02: 44:11

So did she not? I thought she was sentenced to death by electric chair, but she just ended up in the second room.

SPEAKER_01: 44:19

The state intervened and overturned it to a life sentence in a psychiatric hospital. Yeah. Yeah.

SPEAKER_02: 44:27

Okay. Still, like I'm like, tragic both outcomes, but you're just sitting there tortured for decades. Did your family even get to visit you? If they did, do you even know, you know, that your family was visiting you?

SPEAKER_01: 44:43

Yeah, because she was so drugged and abused, and yeah, she tort just being silent. Right? Elective shock therapy. Well, you know, first of all, she's a woman, she's black, and she had the audacity to shoot her oppressor, her rapist. So she's obviously crazy.

SPEAKER_00: 45:02

You know?

SPEAKER_01: 45:03

We're not gonna listen to her. We're gonna have people like Dr. Adams judge her. And the fact that they took 90 minutes to come back with I mean, we're talking decades of abuse. Kids that she that were his, you know. She didn't, I mean, she took care of them and she loved them as all of her other children, but she did not have any agency to say, I want another child, and also I don't want it for my rapist. I would rather have it from a child from my husband. Yeah. My husband, absolutely crazy to me. But yet it's not so sad. It's like, oh hopefully, we're farther ahead, but I don't know how much farther.

SPEAKER_02: 45:44

Well, I don't know how much farther because in your chart note, you were like, This this is 1952, and here we are in 2025, and we're still working on these things.

SPEAKER_01: 45:54

Yeah, like there's still a lack of, but I mean, some of it's from lack of trust, and some of it's from lack of privilege or resources. But the lack of trust historically, can you blame them? Like, as white people, we need to be have some humility and some understanding about that generational trauma and really kind of look at that. How do we gain trust with the population that has every right to not trust us? And why are we still the majority in terms of the people who have these positions of power? Um, what are we doing? I mean, I think we're doing a lot, but are we doing enough to ensure that we're not just equal and equitable, but we're welcoming and embracing, you know, the our differences. So I you know, I mean, this is America. We're we love America, and we're all we're all different. So just because somebody's you know black doesn't mean they're any different, but to them, they're coming to it with this history, generational trauma. I keep pulling that out as a hot buzzword, but the more I learn about it, the more I'm yeah, the more I'm like, yeah, I mean, I would bear that on my shoulders. My ancestors were treated this way, and I'm supposed to go and just open arms, embrace that I'm gonna get an equitable and welcoming opportunity, you know, with this healthcare white man healthcare provider. I as an example, not to pick on the well, and especially when the medical statistics are still showing that. So some of it's trust and some of it's just access and privilege, you know.

SPEAKER_02: 47:40

So yeah, I mean well, honestly, go Ruby for shooting that motherfucker.

SPEAKER_01: 47:49

I don't blame I don't blame her. I don't want to shoot him too. But we can see how I don't know, I know you're not. But like I'm not saying that she shouldn't have consequences, but I think nowadays it's that abuse But like can he also have had a consequence for raping over the years.

SPEAKER_02: 48:11

And like and you're in the position of you're supposed to be a trusted person.

SPEAKER_01: 48:17

I mean, it was calculated, but it exactly worse. So it's it's it's and and there have been some interesting true crime cases that have come up with this abused or battered woman syndrome, where it's like, okay, so if it's manslaughter, it's done in passion of the moment, right? But these women who have had years of abuse and finally just had it, and it's self-defense by every stretch of the imagination, because they are getting rid of their abuser, their torturer, the person that hurts them and their family, or worse, it's them or you know, it's it's like survival, it's defense.

SPEAKER_02: 48:57

And when there are no other options, because she was in a system that set her up to fail no matter what she did.

SPEAKER_01: 49:03

Yeah, but because it was calculated, then that can't be manslaughter. And so that's where this whole, well, it was self-defense, but it was calculated. So it's murder, but is it murder in the first degree? I mean, do we can we maybe pull back and look at the the whole picture? And I'm not a lawyer, so if we have any lawyers listening, but you know, how does this work? Could Ruby, if Ruby was 2025 figure who'd undergone this now, would things be any different? Obviously, we'd have probably have a more mixed. I was gonna say the jury definitely be different. But would she be able to claim, which would be true, but claim like a battered or abused woman abused person syndrome, like self-defense?

SPEAKER_02: 49:56

Obviously, there would be women on the jury. Like, because yes, at the end of the day, you did still kill someone and you shouldn't kill anyone, killing someone is wrong, but she had the record, like the she couldn't go to the cops, she couldn't go to anybody.

SPEAKER_01: 50:14

There was nobody to protect her. Right.

SPEAKER_02: 50:16

And I'm and so I'm thinking, like, if we're placing ourselves in 2025, what does that look like now? Yeah, you know, like hopefully there's more systems in place to protect or stop that behavior, so it wouldn't have to come to murder. I don't know.

SPEAKER_01: 50:32

Maybe there'd be simply more healthcare providers and and and a woman physician that she could go to. And I'm also not sure how much of this Bolitas, which seems like a gambling operation that may or may not have been legal. I'm guessing not legal if that was a made her vulnerable.

unknown: 50:52

Yeah.

SPEAKER_01: 50:53

Yeah, because they made a lot of money with that, so they probably had to like she had a lot of of of eggshells to tiptoe over, I think.

SPEAKER_02: 51:04

Well, that was a tragic tale. Great coverage. Thank you for sharing it. I'd never heard of that before, and I honestly hope that someone out there can confirm it's at least somewhat better. Obviously, we can't deny that.

SPEAKER_01: 51:24

I forgot to mention one of our sponsors, Jillian Tonnell, recommended this episode. So thank you, Jillian, for yeah, no, this is important information and it does raise some questions that we're important asking. Yeah, absolutely.

SPEAKER_02: 51:43

I just have to say this has nothing to do with the case, but the fact that her name was Ruby Jackson reminded me right away of Shannon's cat, Ruby, and she met Ruby before she was married. So Ruby's last name might be Jackson.

SPEAKER_01: 51:59

Shannon! This is a Ruby Jackson. Yes, and she's named after a badass.

SPEAKER_02: 52:07

Well, right, right, you know what? And Ruby, her cat is kind of a badass woman, too.

SPEAKER_01: 52:13

She is, she's forced to be reckoned with. So, but also highly spoiled. Sorry, Shannon. I'm just saying, well, we should spoil our babies, right? Yeah, we should spoil our babies. Oh, speaking of spoiling, I was just I'm going to have to spoil myself and order some Molly Bees gourmet cookies. They're available at MollyBZ.com and they are these artistic, you've talked about them, small batch craft cookies that are like your neighbor just made them for you, and or in my case, my daughter, she makes good cookies. But these cookies are they melt in your mouth, they're high-quality ingredients with really crazy exciting flavor combinations and layers and all kinds of things. So I cannot wait to try the tea cookies, smooth lavender goodness with white chocolate and delectable lemon gloves.

SPEAKER_02: 53:17

Oh, it sounds so good.

SPEAKER_01: 53:19

Oh my god, I'm just like and the B Cordials, perfect blend of chocolate and cherry. And they called Every Bite an Adventure, which I just love for myself and anyone else eating a cookie. I'm just a cookie fiend, I'm a cookie monster. And this company is so cute. This mom, Molly, she's from Alaska, started a brand and it became a national sensation in just three years. So she's been featured on the Food Network, Martha Stewart Living, and even the Grammy Awards, like girl, you've arrived. You're making cookies for the Grammy Awards show. Some of her signature creations include the The Cordial, which is the milk chocolate, maraschino cherries, and amaretto, the Big Joe, Big Joe, which is coffee, milk chocolate, and rum. I mean, who doesn't put a little rum in their coffee of a morning? Wowser, boba doodles, which were snicker, which are snickerdoodles with boba pearls, hot mess, which got us laughing last week. Mango, white chocolate, and hot Cheetos, baby. I mean, and there's the pimi coladas have white chocolate, coconut, and fruity pebbles. I just love that. That one sounds so good. I know. There's even one called Straight Fire that has marshmallows, chocolate, cinnamon cereal, and cinnamon whiskey. Or if you're my dad who always does his WHs, it would be whiskey. Whiskey. What? Yeah. So listen, if you want some cookies like I do, you can find them. MollyB Z dot com and enjoy 10% off big just because you know us. So you let them know we sent you with our code stay suspicious. S-T-A-Y-S-U-S-P-I-C-I-O-U-S.

SPEAKER_02: 55:08

Thank you for that. Yay. Okay, time for a little uh medical mishap, shall we?

SPEAKER_01: 55:17

It reads sorry. Did you just say medical mispap? That would be so funny. I don't think so. Oh my god, medical mispep.

SPEAKER_02: 55:30

I don't think so. Uh it's very possible. And also if anyone has a medical mispap story missed, then sorry if that happened to you.

SPEAKER_01: 55:45

What are you gonna do? Sorry, okay.

SPEAKER_02: 55:47

Okay, the email reads, Dear Jenna and Amanda, big fan of your podcast. I'm going to pee my pants if you read this on the pod. Well start peeing, girl. Or god, or whoever you are. I'll pee with you because I'm pregnant now I have to pee all the time. Um I'll start by telling you that a friend of mine, let's call her Sarah, had to go to her primary care clinic for a routine checkup. Nothing traumatic, just blood pressure, weight, heart rate, the usuals. She had a full day plan, so she expected it to be quick. But what happened was, well, memorable. She sits down in the exam room, and a young, very eager nurse comes in with a blood pressure cuff the size of a small backpack. We're going to make sure we get the perfect readings today, the nurse said. Sarah nodded politely, thinking, okay, standard procedure. First, the cuff was wrapped around her upper arm, tightened, and inflated. The nurse left the room briefly to grab a clipboard. Then a small alarm goes off, and Sarah looked down and realized that the cuff was still inflating and inflating and inflating. And by this point, it felt like her arm was being squeezed by hydraulic press. And those suckers do get tight. Yeah. The cuff hits a level that is very clearly not normal, and Sarah starts flailing slightly, half panicked and half laughing. The nurse rushed back in and says, Oh, sorry, I left it in an automatic mode. I don't know, I'm reading it like that, but it just seems fitting. Apparently, the machine had an overzealous monitoring mode that she forgot to disable. Yeah, now the blood pressure cuff is cycling every 30 seconds, inflating and deflating while Sarah tries to calm herself, which I'm like, that is not how I did. Every time it tightens, she yelps. Each time it releases, she sighs, and the nurse apologizes profusely but cannot stop laughing. It gets better. The doctor arrives, notices Sarah's arm is bright red and slightly bruised from the repeated squeezes, and says, Wow, that's a new record. Usually we don't get vitals that dramatic without a marathon or a fight with a bear. Everyone laughs, including Sarah, though her arm is still throbbing. By the end of the visit, her vital signs are finally stable. Well, stable enough. And she leaves the clinic with a funny story and a newfound respect for automatic blood pressure cuffs. She swears she'll never underestimate a piece of medical equipment again. The takeaway? Even routine visits can turn into small adventures, especially when enthusiasm meets technology. Clinics are full of competent staff, but human error plus automated machines can quickly create a perfectly harmless yet hilarious spectacle. And for Sarah, it was a reminder that human nope, human, humor is the best companion for navigating the strange little quirks of healthcare. Thanks again for reading this. If you do, and keep podcasting so we can learn about the true crime in healthcare and stay suspicious. Love Abby. Well, thanks, Abby, for sending in Sarah's story.

SPEAKER_00: 59:18

Abby, I feel bad. Why didn't they just rip that sucker on the street? I know and just keep laughing and let it go up and down, up and down, up and down.

SPEAKER_02: 59:26

I'm like, it sounds like Sarah was also laughing, but I definitely would have removed the calf.

SPEAKER_01: 59:33

I would have been like, dude, this I've had it inflate so much that it explodes. Have you ever had that? Oh no. Yeah, no, explodes. By explodes, I don't mean like ruptures, but like the it pushes the velcro open.

SPEAKER_02: 59:46

So you can oh, sure. Okay.

SPEAKER_01: 59:51

Especially if your arm's bent. Like if you've ever been in the hospital where they you have to have one on your arm the whole time and every half an hour the thing goes off. Yeah. And if you have your arm like bent or whatever, then it's like really the thing is really struggling to figure out what to do with you.

SPEAKER_02: 1:00:09

And then God forbid you take off the pulse socks for like one second. Oh my god.

SPEAKER_01: 1:00:15

Oh my gosh. Wow, that was a good one. Listen, Amanda, it's past your bedtime. I kept you up because it took me forever to get home and safe. Me too. Oh my gosh, it was it was butt clenching to say the least.

SPEAKER_02: 1:00:32

So Jenna's still clenching her butt. My body tumbled baby moving trampoline.

SPEAKER_01: 1:00:42

Happy Thanksgiving, everybody.

SPEAKER_02: 1:00:44

Oh my gosh, Thanksgiving week. When you guys listen to this, it's going to be Black Friday shopping if you do that. So maybe you'll be listening to us on your way to get some good deals.

SPEAKER_01: 1:00:54

And we could give you a pillow box if you want to get your girls from Dr. We're not, you know, opposed. Yeah.

SPEAKER_02: 1:01:08

Um, but what can we expect to hear next week, my love? Well, it's gonna be surprise. Woohoo! Because I'm either going to finish one of my things that I started, one of four or five, or it'll just be like last week where I'm Like, yeah, I'll just stare at a new one. And I haven't decided.

SPEAKER_01: 1:01:30

Well, that leaves us all on the edge of our seats. I can't wait till then.

SPEAKER_02: 1:01:34

Well, until then, I hope you're all on the edge of your seats because me too. Don't miss a beat. Subscribe or follow Doctoring the Truth wherever you enjoy your podcast for stories that shock, intrigue, and educate. Trust, after all, is a delicate thing. You can text us directly on our website at doctoringthetruth at buzzsprout.com. Email us your own story ideas and comments at Doctoringthe Truth at Gmail. Sorry, I've got wicked heartburn. And be sure to follow us on Instagram, Doctoring the Truth Podcast, and Facebook, Doctoring the Truth. We're on TikTok at DoctoringTheTruth and ed oddpod e-ud. Don't forget to download rate and review so we can be sure to bring you more content next week. And until then, stay safe, drive safe, and stay suspicious. Suspicious. Bye, bye, bye, bye.

SPEAKER_01: 1:02:33

Three, two, one. One off.