Black Man in a White Coat: A Doctor's Reflections on Race and Medicine

Black Man in a White Coat: A Doctor's Reflections on Race and Medicine

One doctor's passionate and profound memoir of his experience grappling with race, bias, and the unique health problems of black AmericansWhen Damon Tweedy begins medical school,he envisions a bright future where his segregated, working-class background will become largely irrelevant. Instead, he finds that he has joined a new world where race is front and cent...

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Title:Black Man in a White Coat: A Doctor's Reflections on Race and Medicine
Author:Damon Tweedy
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Black Man in a White Coat: A Doctor's Reflections on Race and Medicine Reviews

  • Sarah Weathersby

    This was a book club selection for one of my Book Clubs. I would call it an outstanding book to read. When Damon Tweedy entered medical school at Duke University, he expected a promising career which would give him the opportunity to serve the community. What he learned repeatedly is, "Being Black is bad for your health." His professors highlighted the instances of poor blacks with no health insurance who can't afford the treatments they need, as well as the lack of health services for blacks in

    This was a book club selection for one of my Book Clubs. I would call it an outstanding book to read. When Damon Tweedy entered medical school at Duke University, he expected a promising career which would give him the opportunity to serve the community. What he learned repeatedly is, "Being Black is bad for your health." His professors highlighted the instances of poor blacks with no health insurance who can't afford the treatments they need, as well as the lack of health services for blacks in the rural South. In addition, the southern diet of over-salted fried foods, and the lack of exercise, cause hypertension, and heart disease.

    Tweedy chronicles how during his internship, he met people waiting for hours for appointments in rural clinics, where patients often can't afford the medications prescribed, and doctors have to resort to samples to help their patients with limited income. While Tweedy had expected a career in cardiology, he actually transitioned to a practice in psychiatry, where he was able to provide talk therapy as well as prescription treatment for patients.

    This was an impressive book, covering matters of health and race, as well as discrimination in the practice of medicine.

  • Petra-XoPlanet

    This is the second book I've read recently about African-American men from backgrounds where people do not traditionally become professionals, becoming successful doctors and professors. Both were addressing the racism inherent in the medical school acceptance system and in health care itself. Both books were interesting and hardly overlapped. The other book was

    . Both are very worthwhile

    This is the second book I've read recently about African-American men from backgrounds where people do not traditionally become professionals, becoming successful doctors and professors. Both were addressing the racism inherent in the medical school acceptance system and in health care itself. Both books were interesting and hardly overlapped. The other book was

    . Both are very worthwhile and enjoyable reads. It's always interesting to read different points of view.

    The dissolution of Obamacare will mean that the numbers of people who cannot afford health care despite being in employment will increase enormously. There is no safety net in the US for the poor and uneducated who don't know where to turn and tend to accept rather than explore every avenue to get what they need, and so suffer needlessly and die. It doesn't make any except short term economic sense as whole families will be left without any means of support - except the Government.

    Rant, contraception, abortion etc.

    Healthcare in the US will never be available at a high level to those without money because medicine isn't seen primarily as Care but as a Business. And therein, no matter whose viewpoint you read, lies the rub.

    ___________________

    I did learn one interesting thing from this book so far. Affirmative action for African-Americans is a double-edged sword. Without it it might be very difficult for one to get into a top medical school not having either the money, nor attended the top-of-the-tree universities for their first degree and therefore having both lower educational backgrounds and qualifications. But then they may have to repeat years as they didn't quite keep up with their better-educated (White) peers, which feeds into the prejudice that they have lower intelligence by race.

  • Emma Deplores Goodreads Censorship

    Lately I have been reading a number of books about medicine and about race in America, so this one hit a sweet spot for me, although I am neither African-American nor in the medical field. But this book is particularly good, as a memoir, as it deals with medicine and medical training, and as it deals with race, so I would recommend it to a wide audience.

    When Damon Tweedy started medical school, he was disheartened to hear of nearly every disease, “more common in blacks,” and soon saw heal

    Lately I have been reading a number of books about medicine and about race in America, so this one hit a sweet spot for me, although I am neither African-American nor in the medical field. But this book is particularly good, as a memoir, as it deals with medicine and medical training, and as it deals with race, so I would recommend it to a wide audience.

    When Damon Tweedy started medical school, he was disheartened to hear of nearly every disease, “more common in blacks,” and soon saw health disparities firsthand, in the understaffed charity clinics and overfull emergency rooms where many black patients received care. He also encountered racism, through some alarming comments made by other professionals about patients, as well as in his own life – from being taken for a maintenance worker by a professor after a full month in his class, to hostility from patients both black and white who doubted his competence because of his race. This book is a reflection on the author’s career in medicine and battle with his own health problems, through the lens of stories that touch on race in various ways.

    Dr. Tweedy is a good storyteller and writes in a clear, engaging style, so I was immediately drawn in to the book. I suspect readers uninterested in racial issues would enjoy this book simply as a medical memoir: each patient story is fully and thoughtfully developed, and the reader quickly becomes invested in the lives of the patients. Though most of the stories in the book come from Dr. Tweedy’s training in outpatient clinics and hospitals, his interest in people ultimately led him to become a psychiatrist, and that shines through in the writing. And then the stories fit together well, forming a more cohesive whole than other medical memoirs I’ve read; the difference here is that there is a purpose beyond simply relating interesting anecdotes from the ER.

    That purpose, of course, is an examination of how race affects both doctors and patients. The author’s scope is broad: it’s not a book only or even primarily about racism, but looks at a variety of factors that influence health, including poverty, culture, and lifestyle choices (and how those choices are influenced by all of the above). He writes, for instance, about the changing face of AIDS – now primarily a killer of black people – how homophobia in the black community may contribute, and his own journey to overcome that prejudice. He also writes about the many ways people without health insurance fall through the cracks. A few times early on, I thought, “but that’s because of poverty, not race,” before realizing that’s beside the point – the author isn’t attempting to isolate the influence of various factors on health, but to describe the situation as it stands, and black people in the U.S. are disproportionately poor.

    And I think this will be a great book for starting discussions, because its conclusions are always well-supported and its goal isn’t placing blame. The author supplements his own observations with other research, which is well-integrated into the book and gives readers a view of the larger picture. If anything, I might have liked the author to make more suggestions for improvement; the book peters out at the end, with Dr. Tweedy recommending that doctors treat each patient as an individual rather than a stereotype. This is good advice for everyone, certainly, but it isn’t new. By the end, the author seems to have laid to rest his concerns about his own place in the system and has encountered situations in which his race is an asset in treating patients, so it is at least a hopeful ending. My one other criticism is that the 40 pages of endnotes are not actually referenced in the text; I support not making readers feel they have to flip to the back of the book on every other page, but not knowing when to check for additional information meant I didn’t read most of them.

    Overall, then, this is an excellent book, both thoughtful and entertaining, both personal and addressing issues of broad importance. It is guaranteed to provide plenty of food for thought. Highly recommended.

  • Tamar

    A quick, easy, and educational read about the ramifications of being black, be it a patient or doctor, in the US medical system. Not likely to get any awards for best book of the year due to its simple writing style. It's not a bad book, it's just not particularly enthralling in the way that a book like The Immortal Life of Henrietta Lacks (which dealt with similar/overlapping topics) was. However, I (a public health grad student) would definitely recommend it to students of public health and me

    A quick, easy, and educational read about the ramifications of being black, be it a patient or doctor, in the US medical system. Not likely to get any awards for best book of the year due to its simple writing style. It's not a bad book, it's just not particularly enthralling in the way that a book like The Immortal Life of Henrietta Lacks (which dealt with similar/overlapping topics) was. However, I (a public health grad student) would definitely recommend it to students of public health and medicine for the questions it raises about systemic racial and socio-economic issues and individual patient care.

    Note: I received an ARC of this book at BookCon 2015, New York.

  • Kristin

    I received a copy of this book in exchange for an honest review. Race has become a huge issue over the past year. After the church shootings at the AME church in Charleston, South Carolina, some of the women of our church decided to get together and read. Each of us would read a different book on the subject of race and report back in a month. It would open a discussion for us on the different aspects of racism in our society, and how we can effectively combat it. Having my career in the medical

    I received a copy of this book in exchange for an honest review. Race has become a huge issue over the past year. After the church shootings at the AME church in Charleston, South Carolina, some of the women of our church decided to get together and read. Each of us would read a different book on the subject of race and report back in a month. It would open a discussion for us on the different aspects of racism in our society, and how we can effectively combat it. Having my career in the medical field, it was a blessing to find this book on Netgalley. Reading this book truly opened my eyes to see how our society has molded, not only whites’ vision of blacks in a professional field, but blacks’ vision as well. It was refreshing to read that the author not only experienced racism of whites against him, automatically assuming he was a janitor instead of a medical student for instance, but also blacks against their own race, like when the black patient didn’t feel he would get the highest level of care from a black doctor versus a white one. The author also shows how affirmative action has not only helped the black people get better educations and better careers, but it has also set them up for failure unless they work twice as hard due to them not having the same high level of education (Ivy league schools versus state colleges). This book was very easy to read, the author has a very conversational style of writing which makes it enjoyable, though it can be a difficult subject to read about.

  • Jessica Woodbury

    I love medical memoirs, and right now I am constantly reading about the state of race in the US so this book hit a real sweet spot for me. Tweedy may not be the same kind of writer as Atul Gawande, he is more straightforward and simple, but that makes him a great source for a book like this.

    Tweedy has broken down the issues facing Black Americans as patients and as doctors so that each chapter examines one in detail. It also follows him through his training and practice chronologically so that

    I love medical memoirs, and right now I am constantly reading about the state of race in the US so this book hit a real sweet spot for me. Tweedy may not be the same kind of writer as Atul Gawande, he is more straightforward and simple, but that makes him a great source for a book like this.

    Tweedy has broken down the issues facing Black Americans as patients and as doctors so that each chapter examines one in detail. It also follows him through his training and practice chronologically so that you get to know him and trace the story of his life. Tweedy isn't afraid to tackle difficult subject matter in a very personal way, through himself and his patients. There is much here about the disparities between White and Black people in how they receive health care, there is the fuzzy area between race and class, there is the troubling statistics on HIV and how they tie into Black attitudes on homosexuality, there's even affirmative action which Tweedy was a direct beneficiary of at Duke.

    This is a book with a measured approach, one that is determined to present plenty of facts to support its conclusions. It's a book you can give to your parents without worrying about whether it'll lead to political arguments. Tweedy often uses stories similar to his own that come from other memoirs (from people like Wes Moore and Ben Carson) to show that a situation isn't unique. (This irked me sometimes, but I totally understand the impulse as a person who relies heavily on evidence myself. And I can't deny that it gives you a great reading list for when you're finished.)

    If you want a book that can introduce someone to discussions on race and privilege, this book certainly helps you open the door. Tweedy's style is straightforward, but his medical stories are very compelling. This book can start a lot of necessary conversations.

  • carol.

    If there is one thing that can pull me out of my traditional genres, it's a meditation on modern medicine. Combine that with a memoir from an under-represented demographic, and it was only a moment before I grabbed it off the library display.

    I've been working in the hospital setting in the upper midwest for over fifteen years, and I can count on one hand the number of black doctors I've met (interestingly, the two that first come to mind are surgeons), so I was particularly interested in what I

    If there is one thing that can pull me out of my traditional genres, it's a meditation on modern medicine. Combine that with a memoir from an under-represented demographic, and it was only a moment before I grabbed it off the library display.

    I've been working in the hospital setting in the upper midwest for over fifteen years, and I can count on one hand the number of black doctors I've met (interestingly, the two that first come to mind are surgeons), so I was particularly interested in what I thought was a memoir from a black physician. Except it wasn't, not really; it was exactly what it says, a reflection on race and medicine. Tweedy draws from his own experience, but he also connects his book to other autobiographies and comments of notables in medicine, as well as integrating studies and statistics to lend support to his observations. As a result, it felt less intimate to me and more like an overview of public health from a consciousness-raising perspective. On the one hand, this approach might lend itself to encouraging the reader to come along a similar journey of discovery. On the other hand, for people in the field it might lack the breadth and insight that make it a truly moving read.

    The book is divided into three sections that roughly mirror Tweedy's own journey through the medical schooling system. I found I most enjoyed the stories that were about Tweedy's own experiences, enjoying recognition of a particularly medical-hospital mentality. His story about a puzzling case of weight loss and wasting in a man faithfully married for 25 years and denying all drug use, and was likely HIV, was telling:

    Yeah, that happens. Some of us like the puzzle or detection of disease, the process of ferreting out an explanation, some like the human stories, and some--as Tweedy eventually does-- discover that there, but for the Grace of God, go I.

    But I think that quote was one of the most telling parts of Tweedy's reflections, that he viewed much of this from a uniquely physician (medical school?) perspective, the idea of responsibility, of causality, and of the illusion of control over illness and death, and not that each person had a personal story.

    One of the hardest things about memoirs is to critique the work without condemning the author. Tweedy's approach feels very familiar--the very 'thinking-centric,' introverted, and intellectual approach to the world that reminds me of early college, before consciousness-raising days. You know, the days before I actually studied systemic repression and oppression, class consciousness, colonialist mentality, -isms, and all that jazz. His words bring a feeling of naivete to what he discovers, and I found myself surprised that

    was surprised. For instance, when it came time to pick medical schools, he choose Duke University in Durham, North Carolina, largely because of a full-ride scholarship. I'm not criticizing him for that, but I admit when he tells his tale about a professor mistaking him for a custodian, I wasn't surprised. I mean, North Carolina. The Confederacy. Maybe providing full scholarships is a way to increase diversity of an enormously white, upper class school, and maybe there's a reason for that lack of diversity, from applicants and students who did

    feel welcome. In essence, I don't feel like there was a lot of critical thinking applied to his situation.

    My sense was, actually, that he really wanted to fit in, and thought intellectualism and work was the way to do that, and that good recommendations were more important than conflict and confrontation. It alarmed me quite a bit when I ran into a number of references to Ben Carson (he of notorious 2015-16 presidential aspirations). I supposed--because I don't think Tweedy ever directly acknowledges this--that he was looking for role models that might reflect his experience as a black man, but it disappointed me that he seemed to cite these stories without analysis (Ben, for instance, likely two decades older and seemingly crazy-pants). I think I get what he's doing--one, as a medical professional, he's citing other sources to support his own statements. Two, and this is guessing, he's linking his own work into a community of other works. Both of which are admirable. But... Ben Carson. And dude--maybe look outside your gender for role models. Free your mind. Dr. Joycelyn Elders?

    The strength of the book is in his integration of statistics and studies that connect to his experiences as a black man to health care. Instead of using footnotes, as

    did, he has a section at the end where he states the relevant sentence fragment and then provides the citation for it. I suppose it is less intimidating for non-academic readers, but it's a little weird when you realize some of his statements in the chapter needed 'proof.' After a rather recent foray into Public/Community Health, I took all his assertions as givens.

    For the general public, this book is probably a solid four or five stars. For the medical professional knowledgeable about disparities and biases (admittedly, not as many as there should be), there's not a lot new here. The most interesting parts are when Tweedy explores his own -isms, and in how he negotiates that boundary with other professionals and with patients. There's an interesting story where a black man feels he's getting short-changed by getting a black doctor. Another story where once Tweedy identifies himself as a doctor when he's a patient at urgent care, and gets a more thorough treatment (That, my friend, was not racism as much as the white coat fraternity in action). Sadly, I think his reticence prevents him from sharing more beyond a single example for each case, or at really sharing the details that would make his story unique. For me, well-written and interesting, but more a three-star book.

  •  Sarah Lumos

    I appreciated Dr. Damon Tweedy’s willingness to address this difficult and uncomfortable topic with poise. He gives readers an inside scope on the role race, prejudice, and bias plays in medicine. Since Tweedy grew up in an impoverished neighborhood, nobody expected him to become a working professional. Though he was able to beat the odds, his road to psychiatry was rough. He recounts being discriminated against at the Duke University School of Medicine. For example, there was an incident where

    I appreciated Dr. Damon Tweedy’s willingness to address this difficult and uncomfortable topic with poise. He gives readers an inside scope on the role race, prejudice, and bias plays in medicine. Since Tweedy grew up in an impoverished neighborhood, nobody expected him to become a working professional. Though he was able to beat the odds, his road to psychiatry was rough. He recounts being discriminated against at the Duke University School of Medicine. For example, there was an incident where a professor confused him for the maintenance guy. Though he was upset, he never reported the incident because he was afraid of coming across as

    . His experiences both during and after medical school taught him that we do not need doctors with stellar test scores. Rather, we need doctors who embody and understand the diverse communities they serve. Much of the prejudice Tweedy witnessed in his medical career was from doctors who were not inherently racist. Many of them were just unaware of their own prejudices. However, biases like these are dangerous because in medicine the stakes are high. It is scary to think a doctor might not give their patient adequate medical care because of their race, gender, dress, or socioeconomic background. By reading books like these, medical professionals can become aware of and decrease their own biases.

  • Traci

    *Thanks to NetGalley and Macmillan-Picador for the opportunity to read and review an ARC of this book.

    is a memoir by Damon Tweedy, a black male who gre

    *Thanks to NetGalley and Macmillan-Picador for the opportunity to read and review an ARC of this book.

    is a memoir by Damon Tweedy, a black male who grew up in a largely blue collar family, and went on to pursue higher education and ultimately medical school (*Note: throughout this review, I am using the same terms as the author, who used the terms “black” and “white” primarily rather than “African-American” and “Caucasian.”). He depicts his experiences both in medical school, throughout his residency, and later in his employment as a psychiatrist, focusing on his observations of treatment of black individuals in healthcare settings (from hospitals to free clinics). Due to working in healthcare for many years, I seem to gravitate toward books about all sorts of health-related topics, and found this book very interesting. The author touches on multiple subjects, from medical school demographics, health disparities and racism to socioeconomics/class and affirmative action. There were so many thought-provoking bits in this book (some I agreed with, and some I didn’t entirely agree with), but that’s why I enjoy reading so much – it exposes me to all sorts of viewpoints on any subject that I choose to explore!

    Some reflections:

    1) Medical school demographics: Tweedy talks about medicine being largely white, however, essentially includes all non-black individuals in that category. For example, he states that Asians are not included as minorities in medical school due to being represented in high numbers. While 14 minority students (13 being black) appears to be a very small number out of a class of 100 in medical school (the author’s class at Duke University), it is roughly the percentage of the overall population of black individuals in the US.

    2) Health disparities: Tweedy mentions health disparities of black individuals throughout the book and details various research regarding why many medical conditions affect blacks in greater numbers than other races. For example, he examines possible reasons why hypertension is approximately 50% more common in black individuals than white. He is particularly interested in hypertension (even stated it became an obsession) due to being diagnosed with it himself when he was in his 20s in medical school, having gotten into the habit of a poor diet and no exercise. He stated

    and actually went on to overhaul his lifestyle, thus managing to lower his blood pressure and avoid medication.

    3) Racism: Tweedy examined racial stereotypes, stating,

    He finds himself wondering many times if white physicians make certain patient-based decisions based on racial bias, as well as if he also is guilty of similar bias when treating white patients. While considering the motivations of white physicians in their interactions and diagnoses of black patients, he also writes about several instances where he was ashamed to have stereotyped white patients based on initial perceptions. For example, with one patient, he indicated,

    4) Class and socioeconomic status: Throughout this book, I found myself thinking that many issues discussed could be attributed to class/socioeconomic factors as well as race. For example, he describes his feelings about not fitting in at Duke due to his background in a working class family. As someone who is white, yet grew up in a very blue-collar small town in the rural South (where I would guess the majority of residents would qualify as poverty level), I could identify much more with his feelings than I can identify with many individuals who are white and grew up in affluence. Still to this day, I often feel as if I’m stuck between two worlds – even though I also pursued higher education, including eventually obtaining a doctorate degree, I don’t feel entirely comfortable with affluent individuals or those who grew up in upper-class families, and yet, I find I have little in common with family who have remained in the small town and maintained blue-collar jobs. Tweedy lists an article in his reference section that I thought was very fascinating (Medical Schools, Affirmative Action, and the Neglected Role of Social Class, Journal of Public Health, August 2000, Volume 90, Number 8). The article outlines reasons for including socioeconomic status as a factor in medical school admissions and states that “improving care for disadvantaged patients might be one justification for recruiting more medical students from lower-SES strata.”

    5) Affirmative action: Tweedy is somewhat conflicted on the subject of affirmative action, thinking that it could be the reason he secured a full-tuition scholarship to medical school, and wondering if he would succeed or fail due to his working class background. He has a lot of anxiety regarding this and states

    All in all, this was definitely a worthwhile read and one that I would recommend for anyone interested in issues related to healthcare, or those who enjoy memoirs in general.

  • Book Riot Community

    A look at one man’s experiences as a black doctor and how the issues of race have influenced him. For example, on his first day at Duke University medical school, one of his professors assumed he was a custodian and asked him to fix the lightbulbs. This was in the 1990s. WTF. It’s been a really interesting book so far (I’m not quite finished). I like that Tweedy doesn’t shy away from his own prejudices that he had and learned to overcome in his practice.

    — Kristen McQuinn

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