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.
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.
Such incidents of overt racism are rare, at least among the professionals Tweedy works with, but a lot of prejudice is flying around. Some patients flatly declare that they don’t like black doctors; even a black patient once snaps that he doesn’t want to be treated by a “country-ass doctor.” Tweedy feels annoyed at the uneducated black patients who sabotage their health and then feels irritated at himself for his annoyance.
But he feels implicated in that, too. When he sees blacks with health problems he identifies as typically black, he also sees himself. His family, too, has been plagued by poor habits and poor health. Before he sets out to change his ways, he says, he’s rarely eaten a fresh vegetable.
There are some things Black Man in a White Coat doesn’t do. It doesn’t offer much in the way of useful policy suggestions about issues like the cost of medical care or how to handle uninsured patients, for instance. And, because of Tweedy’s diffidence, his fear of being seen as “hypersensitive on racial matters,” as he puts it, we are robbed of the satisfaction of watching him face down bullies and bigots. But this is not that sort of book, and he is not that sort of person.
Tweedy is an unusual doctor in that he seems genuinely humble, not just faking modesty to make himself look better. As specific as his story is, he broadens it by citing works by other black doctors who have been through all this before; the book comes with extensive endnotes and a helpful bibliography.
With his ability to see all sides of a question, his endless quest to plumb emotions and motivations and his great generosity of spirit, it seems absolutely fitting that Tweedy chose psychiatry as his specialty. In an outpatient clinic toward the end of the book, he acquires a patient, Keith, who shows up in sweatpants and a camouflage jacket and whose interests include “guns, motorcycles, pickup trucks and race cars.” (Tweedy wears a suit and tie, plays tennis, drinks fruit smoothies, drives an SUV and listens to classical music and rap.)
The two reach a lovely understanding when both put aside their prejudices and really talk. “It’s up to us, as doctors, to find the commonalities and respect the differences between us and our patients,” Tweedy writes.
It’s simple common sense, but it bears repeating at a time when medical care seems increasingly impersonal. Tweedy is rewarded when the patient ends the treatment by thanking him. “Maybe we’ll get a chance to shoot some pool one day,” Keith says.
May 11 to May 18 The original Taichung Railway Station was long thought to have been completely razed. Opening on May 15, 1905, the one-story wooden structure soon outgrew its purpose and was replaced in 1917 by a grandiose, Western-style station. During construction on the third-generation station in 2017, workers discovered the service pit for the original station’s locomotive depot. A year later, a small wooden building on site was determined by historians to be the first stationmaster’s office, built around 1908. With these findings, the Taichung Railway Station Cultural Park now boasts that it has
Wooden houses wedged between concrete, crumbling brick facades with roofs gaping to the sky, and tiled art deco buildings down narrow alleyways: Taichung Central District’s (中區) aging architecture reveals both the allure and reality of the old downtown. From Indigenous settlement to capital under Qing Dynasty rule through to Japanese colonization, Taichung’s Central District holds a long and layered history. The bygone beauty of its streets once earned it the nickname “Little Kyoto.” Since the late eighties, however, the shifting of economic and government centers westward signaled a gradual decline in the area’s evolving fortunes. With the regeneration of the once
The latest Formosa poll released at the end of last month shows confidence in President William Lai (賴清德) plunged 8.1 percent, while satisfaction with the Lai administration fared worse with a drop of 8.5 percent. Those lacking confidence in Lai jumped by 6 percent and dissatisfaction in his administration spiked up 6.7 percent. Confidence in Lai is still strong at 48.6 percent, compared to 43 percent lacking confidence — but this is his worst result overall since he took office. For the first time, dissatisfaction with his administration surpassed satisfaction, 47.3 to 47.1 percent. Though statistically a tie, for most
In February of this year the Taipei Times reported on the visit of Lienchiang County Commissioner Wang Chung-ming (王忠銘) of the Chinese Nationalist Party (KMT) and a delegation to a lantern festival in Fuzhou’s Mawei District in Fujian Province. “Today, Mawei and Matsu jointly marked the lantern festival,” Wang was quoted as saying, adding that both sides “being of one people,” is a cause for joy. Wang was passing around a common claim of officials of the People’s Republic of China (PRC) and the PRC’s allies and supporters in Taiwan — KMT and the Taiwan People’s Party — and elsewhere: Taiwan and
RSS