Thu, Sep 17, 2015 - Page 11 News List

Book review: A doctor navigates bruising Terrain

Damon Tweedy discusses what it means to be black in a predominately white profession

By Sarah Lyall  /  NY Times News Service

Black Man in a White Coat:
A Doctor’s Reflections on Race and Medicine
, by Damon Tweedy.

As a student at Duke University Medical School in the mid-1990s, Damon Tweedy once treated a black teenager who was hysterical and having a late-stage miscarriage. He made a flailing attempt to take her history — she denied being pregnant and said she had no bad habits — whereupon his supervisor barreled in and barked, “When is the last time you smoked crack?”

The patient was indeed an addict, and the nurse on duty said later that she should have her tubes tied because “I don’t think people like her should be allowed to get pregnant again.”

Tweedy was filled with unpleasant, uneasy questions, and not just about his own newbie incompetence. Were the white doctor and nurse making racist and class-driven assumptions? Was he? What did that say about him as a black man?

He felt superior to the patient; he identified with the patient. “I suddenly felt naked, as if someone had stripped me of my white coat and left both of us to share the same degraded spotlight,” he writes.

He wrestles with similar doubts throughout Black Man in a White Coat, an account of his admirable and often lonely path from working-class Maryland — his father cut meat in a grocery store — to his current life, as an assistant professor of psychiatry at Duke.

On one level the book is a straightforward memoir; on another it’s a thoughtful, painfully honest, multi-angled, constant self-interrogation about himself and about the health implications of being black in a country where blacks are more likely than other groups to suffer from, for instance, heart disease, diabetes, stroke, kidney failure and cancer. “Being black can be bad for your health,” he says.

All this adds up to a lot of self-questioning. African-Americans making their way in predominantly white fields have written before about feeling out of place wherever they are. African-American doctors have written before about the challenges of working in a profession where few colleagues share their skin color. But it’s rare to find anyone willing to examine the vicissitudes of their own feelings so rigorously, like someone constantly unpicking pieces of clothing to see the stitches.

Publication Notes

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

By Damon Tweedy

294 pages


Hardback: US

And rarely have the authors of these books begun from such a position of sheltered naivete as Tweedy.

At first, he seems to know less about the world than we do. The son of socially conservative churchgoing parents in an abstinence-preaching home, Tweedy arrives at college without ever having kissed a girl. (His lack of sexual experience, he says, makes for an awkward OB/GYN rotation.) In the emergency room, he confesses that, “despite enjoying crime and medical shows,” he has no idea that the notation “GSW” means “gunshot wound.” Answering a call at a rough housing project, he admits that previously he’s only seen such neighborhoods “from inside a moving car” or as the sort of thing that turned up on The Wire.

As a medical student at Duke, he feels underprepared among the privileged graduates of fancy schools like Harvard and Yale. (He attended the University of Maryland, Baltimore County.) On a scholarship for black students, he frets about being written off as a product of affirmative action.

In one chilling incident, a professor mistakes him for the handyman come to change the classroom light bulbs. Rather than making a fuss, Tweedy triumphs by earning the second-highest grade on the final exam and then declining the startled teacher’s offer of a job.

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