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

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One doctor's passionate and profound memoir of his experience grappling with race, bias, and the unique health problems of black Americans

When 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 center. The recipient of a scholarship designed to increase black student enrollment, Tweedy soon meets a professor who bluntly questions whether he belongs in medical school, a moment that crystallizes the challenges he will face throughout his career. Making matters worse, in lecture after lecture the common refrain for numerous diseases resounds, "More common in blacks than in whites."

Black Man in a White Coat examines the complex ways in which both black doctors and patients must navigate the difficult and often contradictory terrain of race and medicine. As Tweedy transforms from student to practicing physician, he discovers how often race influences his encounters with patients. Through their stories, he illustrates the complex social, cultural, and economic factors at the root of many health problems in the black community. These issues take on greater meaning when Tweedy is himself diagnosed with a chronic disease far more common among black people. In this powerful, moving, and deeply empathic book, Tweedy explores the challenges confronting black doctors, and the disproportionate health burdens faced by black patients, ultimately seeking a way forward to better treatment and more compassionate care.

294 pages, Hardcover

First published September 8, 2015

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About the author

Damon Tweedy

2 books60 followers
Damon Tweedy, MD is a professor of psychiatry at Duke University School of Medicine and staff physician at the Durham Veteran Affairs Health System. His first book, Black Man in a White Coat, was a New York Times Bestseller, selected by TIME magazine as one of the Top 10 Non-fiction books of that year. He has also published articles about race, medicine and mental health in medical journals and print publications including The New York Times and The Washington Post. His new book, Facing the Unseen: The Struggle to Center Mental Health in Medicine, will be published in April 2024.

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Displaying 1 - 30 of 579 reviews
February 7, 2017
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 High Price: A Neuroscientist's Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. 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.
___________________

Notes on reading the book 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.

Profile Image for carol..
1,625 reviews8,817 followers
June 8, 2017
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:

"This all seemed callous, to be sure. I was looking at George's diagnosis as I would a TV mystery, while Adam was focused on the soap opera element. Our medical student, well into her year of clinical rotations, shared our curiosity... trapped inside the hospital vortex where disease, disability, and death were constant companions, our reactions passed for normal behavior."

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.

"Further, my medical education revealed a certain commonality shared by all people. Even if one sexual, racial, or gender group got a given disease more frequently than another, all of us were vulnerable to sickness, injury, and ultimately, death."


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 he 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 not 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 Evicted 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.
Profile Image for Barbara.
303 reviews320 followers
June 22, 2021
Dr. Damon Tweedy reflects on his experiences as a black medical student at an elite southern university. The many experiences at Duke: his anxieties, encounters with racism, and his frustrations with the limitations of the healthcare system that hurt the black communities disproportionately, are honest and powerful but never preachy.

Tweedy grew up the younger son in a religious, working-class family. He did his undergraduate work at a college not far from his black community. Always striving for academic excellence, he rarely socialized nor dated. Arriving at Duke on a medical school scholarship for promising black students was a shock in many ways. Most of his classmates had wealthy parents. They had attended prestigious private schools. They were also white. Racism in mid-1990s North Carolina (and elsewhere) was alive and well.

I was particularly interested in Tweedy's interactions with individual patients, some exhibiting blatant racism and some just poignant stories. His experience working at a rural clinic, open to all, but visited only by poor blacks, was enlightening. I knew the U.S. healthcare system was lacking. Without healthcare, check-ups and early symptoms are ignored. I didn't realize how many people work full-time without any healthcare benefits. I didn't know all the reasons why obesity, high blood pressure, heart disease, etc, are more common among blacks. Answers are not necessarily given in this book, but becoming aware of the problem, admitting there is a problem, will lead to solutions.

I was so captivated by the experiences of this aspiring medical student. From his feelings of inadequacies as a first year student through his decision to specialize in psychiatry, from a 1st year professor asking him if he was in the room to fix the lights to the patients who wanted a real doctor, Tweedy's heartfelt accounts completely enthralled me. Never the angry black man, he is always humble, introspective, looking to defuse a situation or see how he may have contributed to it. His compassion and humanity exemplifies what every doctor, every human, should strive for.

Currently a professor of psychiatry at Duke and a staff physician at Durham V.A. Hospital, Tweedy ends his memoir on an upbeat note. There are many black doctors in prestigious positions at Duke Medical School now. Admissions of black students is substantially higher in all U.S. medical schools. Indicators show significant gains in longevity for black males. There are some improvements in healthcare too, although far too few.

This was such an enjoyable book -equally educational and compelling. It is definitely one I will recommend to all my friends.











Profile Image for Jessica Woodbury.
1,715 reviews2,466 followers
December 14, 2015
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.
Profile Image for Traci.
47 reviews15 followers
July 3, 2015
*Thanks to NetGalley and Macmillan-Picador for the opportunity to read and review an ARC of this book.

Black Man in a White Coat: A Doctor's Journey Through Race, Medicine, and Inequality 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 “The role of lifestyle in health disparities cannot be overstated,” 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, “But why did it matter so much whether the patient was white, black, or something else? Did this way of presenting cases assume that race should automatically color the way a doctor approached a patient’s chest pain or achy stomach?” 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, “As many people do, I had countered prejudice with prejudice. In my eyes, Chester and his family were high school dropout, Dixie-waving trailer-park trash. From childhood, the black community and the broader society had nurtured these feelings. Without much thought, I had adopted them as my own.”

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 “According to Shelby Steele, a self-described black scholar at Stanford University’s Hoover Institution, this is one of the costs of affirmative action: It ‘nurtures a victim-focused identity in blacks’ and increases their self-doubt as ‘the quality that earns us preferential treatment is an implied inferiority.’

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.
Profile Image for Emma Deplores Goodreads Censorship.
1,221 reviews1,374 followers
March 14, 2021
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.
Profile Image for Sarah Weathersby.
Author 6 books90 followers
January 13, 2016
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.

Profile Image for Joy D.
2,276 reviews259 followers
February 19, 2020
“By sharing my story, as well as the stories of some of the patients I’ve met over the past fifteen years, I hope to humanize the dire statistics and bitter racial debates and paint a fuller picture of the experiences of black patients, as well as that of the black doctors who navigate between the black community and the predominately white medical world.” – Damon Tweedy, M.D., Black Man in a White Coat

Memoir about Damon Tweedy’s journey in medicine, from his college enrollment through internship and selection of a field of specialization. This book combines a personal story of navigating medical school with accounts of (mostly) black people facing significant health issues. He recounts stories of his memorable patients, the impact of race on their treatment, and racial biases he encountered personally. He also challenges his own perceptions of race and engages in self-reflection.

Many of the difficulties in the medical field have to do with the socioeconomic background of the patients and the US healthcare system. Tweedy cites many statistics (with sources and notes cited in the appendix) to highlight some of the primary areas of concern, such as:

“As with so many societal problems, blacks as a group suffer to the largest extent, being nearly twice as likely as white Americans to live without health insurance. And while obtaining health insurance alone does not fix the health problems of the poor, it makes a real difference. A 2007 study found that previously uninsured adults, in particular those with cardiovascular disease or diabetes, reported improved health over a seven-year follow-up period after obtaining Medicare coverage at age sixty-five.”

Aside from informative statistics, he makes a strong case for lifestyle choices as a primary factor in longevity. He points out the need for more black doctors, and the importance of making a human connection with the patient, regardless of racial background: “A big part of the solution is discarding your assumptions and connecting with each patient as a person. Race, while certainly a powerful influence, by itself doesn’t guarantee a human connection any more than any other factor.”

While it is impossible for one individual to solve racial prejudice and the US healthcare woes, he points out areas where awareness can make a difference. I feel books like this are valuable in helping view the world through the lens of another person’s experience. It is written in a manner easily understood by a person without a medical background. I found it enlightening and worthwhile.
Profile Image for La'Tonya Rease Miles.
326 reviews10 followers
March 6, 2016
No lie: after reading this book, I went and had my blood pressure and cholesterol checked. Tweedy makes a very compelling case for the interconnectedness between poverty, racism and communal health. You can tell that he probably has spent some time around either low-key racists or skeptics because he builds his points quite carefully. He's definitely not a ranter.

One of the most compelling moments arrives right at the beginning when he recalls one of his medical school professors who mistook him for a maintenance worker. It was the first day of class, too! And Tweedy describes how that encounter shook him to his core and made him doubt himself. To that end, this is also a good read for first-gen students (like the author) who want to pursue medical school.
Profile Image for Kristin.
527 reviews7 followers
August 4, 2015
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.
Profile Image for Mary.
445 reviews51 followers
November 30, 2019
He offers a good basic overview of the issues that contribute to health disparities between whites and people of color, particularly Black people. But his scope is a little too limited for me. I would have preferred that he spend more time on issues of systemic racism. Instead he spent a lot of time on the personal -- doctor's own biases, patient lifestyle choices, etc. His thinking seems very literal and surface-based. His discussions about empathy seemed weirdly stiff, but earnest. I was thinking, "This guy needs to read more novels and practice the art of imagining yourself in someone else's shoes." I mean, he decided to become a psychiatrist and says he takes a "biochemical approach" to the practice, and until he started practicing psychotherapy in his residency, sort of poo-pooed the value of talk therapy. What?!? Dude.

Still, I appreciated some of his insights and reflections. It can be very powerful for those in the dominant culture to hear about the more subtle forms of racism that people of color experience, because many do not see the pervasiveness of such things.
Profile Image for Melody.
149 reviews7 followers
December 23, 2015
_Black Man in a White Coat_ is my favorite kind of memoir: simultaneously introspective and socially aware. Tweedy's life experiences shed light on the complexities of being a Black doctor in a system characterized by racial disparity. However, he also allows his research about these disparities to shape the way he understands his own experiences.

The book is scrupulously researched, and well-written (though not poetic: it is written in a journalistic style, without literary aspirations). What most recommends this book, in my opinion, is its non-partisan willingness to distribute responsibility for health disparities between all responsible parties: culture, government, and individuals. He accounts for the impact of both personal choices and systemic problems. In this way, the book offers a model of intellectual honesty about complex social problems. Tweedy's is a refreshing voice in the often highly polarized shouting match about health care in the U.S.
115 reviews11 followers
June 12, 2015
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.
Profile Image for Book Riot Community.
953 reviews203k followers
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April 25, 2017
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


from The Best Books We Read In February 2017: http://bookriot.com/2017/02/28/riot-r...
Profile Image for  Sarah Lumos.
127 reviews116 followers
July 19, 2018
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 “too sensitive” . 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.
Profile Image for Darius Murretti.
417 reviews62 followers
June 16, 2021
This is a special book .
They don't mass produce these .
Get them when you can!
Profile Image for Daphyne.
504 reviews22 followers
April 7, 2021
This is a terrific medical memoir by a black doctor who clearly feels passionately about medicine and his patients. I appreciated his unique perspective on issues that pertain directly to race and medicine such as medical deserts, insurance disparities, & unexamined biases that wind up impacting level of care and trust. Terrific read. Highly recommend.
Profile Image for Kolumbina.
838 reviews25 followers
July 24, 2019
An interesting and a well written memoir by Dr Damon Tweedy, a youngish, black, medical doctor. A rich book, a lot of information about common health issues affecting black and white people but in a different way. It seems that black people are weaker and more vulnerable to heart problems, hypertension... I learned quite a bit.
Also a personal memoir, unfortunately a lot of racial discrimination for the young fellow which he luckily overcame thankfully to his knowledge and dedication as a medical doctor.
Profile Image for Jean.
1,745 reviews761 followers
June 5, 2016
Tweedy tells the story of his life in medical school, residency and in medical practice as a black man. He attended Duke University Medical School in 1996. He tells the story of his humiliation of being mistaken for a maintenance worker by his professor. He says he felt uncomfortable and like an outsider all during his schooling at Duke. He also discusses the affirmative action and how helpful it has been to the minority.

The author also delves into his health problems. He goes into depth about his diagnosis of hypertensive kidney disease which is very common among the blacks. He moves back and forth between anecdote and analysis. He reviews the health problems of blacks and how this relates to poverty and ignorance. He discusses the past history of medical experimentation on blacks without their knowledge or consent. He also delves into the “two-tiered system” where blacks are less likely than whites to have access to quality health care. Unfortunately, Tweedy offers few opinions or ideas on how to eliminate racial disparities in health care. He does advocate for more black physicians and nurses. The memoir is well written and quite interesting. I read this as an audiobook downloaded from Audible. Corey Allen did a good job narrating the book.
Profile Image for Rebecca.
23 reviews43 followers
November 15, 2016
Extraordinary!! Everyone should read this book. Moving and very thought-provoking memoir from a black doctor who grew up in DC area, went to medical school at Duke, and worked in rural clinics, Duke hospital, and inner city Grady hospital (trauma center in Atlanta). A lot to learn here about medical education, communication between doctors and patients, and effects of race and socioeconomics on health and health care delivery. Insightful, poetic, self-aware about the judgments we make about ourselves and others, the judgments they make about themselves and us, and how all of that shapes our health and our relationships.
Profile Image for Fares.
150 reviews
February 8, 2021
This is such an eye opening book and narrative of this wonderful psychiatrist. We all know and hear about the horrible effects of racism on almost every facet of life, yet there's always more to know, more to feel, and more to do. It is very interesting seeing the blind spots we as humans, as well as the systems in place, have with regards to racism as well as counter-racism. Highly recommended!
283 reviews3 followers
November 15, 2020
This is an important book. The author reflects on his time as a medical student, resident and now an attending physician at Duke University Medical Center. There are also some parts of the book when he was visiting at Grady Medical Center in Atlanta. The racism and injustice and prejudice that he experiences is quite recent -- within this century -- as this top notch medical center strives to move into the 21st century. I trained at Duke 10 years before Dr. Tweedy but his narrative runs totally authentic to my experiences there as well. It's a fast and sobering read -- we have a long ways to go to eliminate racism in this important profession of medicine.
Profile Image for Sue.
262 reviews37 followers
February 18, 2017
Damon Tweedy does not have suggestions about how to organize the American health care system. He does not have suggestions about how to make the society more equitable racially. This is not that kind of book. Whatever political fights there are around the issue of health care, they are not here.

The subtitle says it: “A Doctor’s Reflections on Race and Medicine.” Like any good memoir, there is insight aplenty into the implications of one person’s thoughtful recollection of experience.

I should say upfront that I stumbled onto this book because I met the author. He was the interviewer at an author event, the author being Jody Picoult, who wrote Small Great Things, a current best seller with the following premise: a white supremacist with a newborn instructs the hospital that the baby is not to be touched by an African-American nurse. Then the baby goes into cardiac distress, and no one else is around. The novel takes on issues of race, privilege, and compassion.

Picoult’s book interested me, but I found myself more intrigued by the interviewing author, who had actually had the experience of being rejected by a patient. When people lined up to get Picoult to sign their books, I went to talk with the interviewer and bought his book.

In his memoir Tweedy tells the story of his training, from the medical school years through residency, with the variety of experiences that those years bring to a physician-in-progress. During that time he did indeed encounter patients who did not want to be treated by a black physician, or to be seen by a black medical student. It’s worth noting that sometimes over the course of treatment, a supremacist family could become more accepting. A small shift in hostility brought no great epiphany, but it could be a tiny victory.

This kind of encounter is part of the narrative but is not the book’s primary topic.

He is much more concerned with an examination of how race affects both doctors and patients. He considers the variables that influence health, including poverty, class, and lifestyle. Tweedy observed that blacks all too often do not have good access, and even more often are stereotyped as patients. He writes poignantly about the fact that black patients feel the need to dress up for an appointment, to look like someone deserving of attention. They were often assumed by medical personnel to have bad diet habits, for example, without really checking.

Most frustratingly, too often a person unable to pay for preventive treatment got help only when it became a crisis. This problem was a condition of poverty, but black patients were much more likely to be poor.

Then he kept looking at his patients and wondering why he had been lucky. He’d managed to make his way in part through affirmative action, but his performance at every level justified the opportunities that came his way. As a successful physician, he has not forgotten his own past nor lost his empathy. His personal interest in patients led him eventually to become a psychiatrist.

Best of all, he tells lots of stories about patients and doctors, and he is a natural storyteller. The issues of medical care abound, but the thing I’m going to remember is Dr. Tweedy and his patients.



604 reviews13 followers
September 23, 2015
Заявленная тема книги "негров угнетают в американском здравоохранении" для меня так и осталась недоказанной.
Автор - врач и негр.

Пример истории, их в книге много. Автор рассказывает, как он пришел на прием к врачу, одетый как гопник - треники, яркие носки не в цвет. Врач пренебрежительно(? или на основании своего опыта) сказал ему про проблему, с которой он пришел, "само рассосется".
После того, как автор сказал, что он тоже медик, отношение переменилось - врач отправил на рентген (который ничего не выявил), прощупал (ничего не нашел), и по сути вердикт-то остался тот же - само пройдет (но врач сбегал для него за какой-то особо удобной повязкой, чтобы ускорить выздоровление).
При этом автор признает "конечно, врачи всегда лучше обслуживают других врачей".
Так где в этой истории угнетают негров?!
Автор несколько страниц после этой байки пытается убедить, что в этой истории цвет его кожи был важен. Чем - я так и не понял.

Две звезды ставлю только за единственную, но очень здравую мысль книги.
Автор говорит - приходя к врачу, задумайтесь о том, что вы пока своими ногами пришли, у вас просто ерунда, а не проблемы. В большинстве случаев вам надо не к врачу идти, а в спортзал, обходить стороной фастфуд, меньше пить, не колоться. Это в 99.999% случаев вылечит вас гораздо эффективнее, чем таблетки.
А вот когда вы заедаете таблетки фастфудом, если у вас случится инсульт, и вы сядете на всю жизнь в кресло пускать слюни изо рта и питаться по трубочке, вживленной в желудок, вот тогда вам реально потребуется врач. Но он уже мало что сможет изменить.

В книге много раз повторяется, что негры в среднем более бедные, больше колются, курят, едят фастфуд, и в итоге страдают от ожирения, сердечных приступов, диабета. И продолжают есть пончики, даже когда им отрезают один за другим отмершие из-за диабета пальцы.
Автор логично объясняет, что это из-за того, что негры менее мотивированы чего-то достичь, и в итоге получают обратный результат - они хотят ничего не делать, но ничего не делая в начале жизни, оказываются на низкооплачиваемой и тяжелой работе, на которой сложно следить за здоровьем (на физкультуру надо время, "зеленая" пища сильно дороже фастфуда).

Я выше передал суть, в книге же все это каждый раз с приговариванием "негров поставили в такие условия". Кто поставил и как - трудно понять, автор же сам стал врачом, родившись в бедной семье и проведя детство в бедном районе.
Конечно, для этого надо было вкалывать сменами по 30 часов в интернатуре. Но он также постоянно приговаривает про свои комплексы, связанные с гигантскими послаблениями для негров от правительства - главное чтобы негр просто захотел, после чего ему везде обеспечивают послабления, по сравнению с белыми. И автор комплексует, что "он сам умный", а не потому, что ему везде помогали как негру.
Но это не отменяет тот факт что неграм уже сделаны максимально возможные преференции.

Английский в книге очень простой, медицинские термины почти не используются. В нескольких местах используются слова которые можно угадать по смыслу но ни в одном словаре я их быстро не нашел (книгу покупал, так что вряд ли опечатки при оцифровке).
Profile Image for Rachel.
63 reviews21 followers
June 21, 2020
I enjoyed this book, a reflection on race and medicine from Black physician Dr. Damon Tweedy. I also found it frustrating at times. Dr. Tweedy seems to have been quite conscious of the largely white audience who would read this book, and takes great pains to pull them along very slowly to the idea that worse outcomes for Black Americans may be related to more than individual poor choices. Throughout the book, when discussing health outcomes affected by systematic racism and other structural issues, he almost always begins with commentary on how the patient being described may have made poor choices (such as in diet and exercise) before a gentle nudge that suggests perhaps racism and related factors may be in play. Dr. Tweedy also makes a point to describe his own biases, such as those against the LGBTQ+ community and the uninsured. These feel at times like more coddling of the likely white readership, a kind of "Look! You don't have to be uncomfortable that you may need to work on your racism or other biases. We all have things to learn!" This may work well for certain audiences, while being frustrating for others who have already acknowledged the reality of systemic racism. In the final chapter he does become more explicit about systemic racism, addressing it outright - for a paragraph or two. All of this makes "Black Man in a White Coat" a good read for a white audience that hasn't thought much about its assumptions about Black health outcomes. Dr. Tweedy's tactics may be very appropriate for pulling this general readership along a tiny bit at a time, including many white physicians who may be unaccustomed to questioning their own knowledge or biases.
Profile Image for Chanel.
393 reviews5 followers
April 11, 2017
Very touching and a candid look regarding being African American male in a largely white medical field. I shed a few tears but it was extremely informative and moving. The main takeaway was that an Ivy League education does not isolate an ethnic group from bias or racist viewpoints from both the industry, co-workers or patients. But through a willingness to be the best that you can be, you can make a difference. Excellent:)

A few interesting quotes:
A patient at one of the local clients meeting, Dr. Tweedy for the first time, " Where you from?" she asked. "You look like a boy from the suburbs." Page 57

Historical perceptions within the medical industry: Various medical scholars and authors have provided historical context to the anecdotes, chronicling the abuses that black people have faced from the medical profession dating back to slavery.

In trying to help a family that have held racist views on Dr. Tweedy as a doctor,
"As many people do, I had countered prejudice with prejudice." Page 128

In how appearance matters, "Appearance and dress matter from everyone in how they're perceived but the prevailing wisdom among black people is that it's much more important for us than it is for others." Page 151

In regards to HIV/AIDS in how it was once a white guy man's disease, "What had once been seen as a white disease has turned black and brown." Page 155

On assuming that HIV/AIDS only affected gay men, a counselor tells Dr. Tweedy and friends, "Stupidity can ruin your life."

There were many factors regarding the contracting of HIV/AIDS. Dr. Tweedy's observation after leaving a practice, "But I left the general medicine service stuck by the impact of another factor, sexual dishonesty."

Profile Image for yasmeen.
301 reviews8 followers
September 4, 2023
Dr. Tweedy has an amazing way of narrating his life, the whole book just flowed so well and was so easy to read. Each chapter was an emotional rollercoaster for me, very heavy and serious topics that I am pleased to see talked about! Health disparities, and racism, within the Black community has been occurring for decades, with minimal change over the years. When will we finally see long-term improvements?
This memoir had an array of topics, such as: stereotyping, racism, mental health, physical health, financial burdens, demographics, and much more. Yes, the book mainly revolves around these topics faced within the Black community, but Tweedy does an amazing job addressing everything and connecting it to other communities.
I am so sorry for all Dr. Tweedy has gone through, but am so happy to see him persevere through all of it and succeed, for himself, for his family, for his patients, and for his community.
Profile Image for Maggie.
134 reviews
February 9, 2022
I feel like this book was over as soon as it started?

This was honestly a pretty easy read although not light in content. Tweedy examines how his patients stories represent a larger story in America's racist history. Each of these connections was made thoughtfully albeit obviously.

I think this book had 10 chapters, and though we sort of drag through the beginning and end, the middle is really good in it's reflectiveness paired with interesting stories.

Overall this was good, and has propelled me into an era of medical memoirs/other medical nonsense books.
Profile Image for freddie berg.
2 reviews
January 26, 2019
Had the good fortune of attending a presentation by the author, who also submitted to Q&A format, and questions and comments from the audience. Immediate reaction, this is not just the author's story. He is also telling the stories of colleagues, teachers, and patients. Listening to questions, both formal and informal, realized the author has more to express than on the pages of his current book. Could not stop myself from emailing and contacting friends and others who could relate to my reactions from my reading. Every now and then, can open the book to almost any section, and even a page or two gives inspiration, and informs my thinking about healthcare, and those in the field who work every day to heal others.
Profile Image for Douglas Graney.
490 reviews5 followers
June 29, 2019
Interesting combination of race and medicine. Dr. Damon Tweedy’s career has many situations where differences between black and white affects the treating of patients. If you’re not afraid to confront the race issue vis-a-vis medicine, get this.
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