Black Man in a White Coat

July 27, 2015
In this eye-opening memoir, Tweedy, a black psychiatrist who interned at Duke University Medical School in the mid-1990s, vigorously confronts his profession and its erratic treatment of African-American patients. Tweedy, raised in a segregated working-class neighborhood, gets a full scholarship to the white academic world of Duke, where he's challenged on every level, including by a professor who wrongly assumes he's a janitor. Though Duke, like many elite colleges, tried to recruit minority students, Tweedy notes that the constant subliminal and overt racism at the schoolâwhich former professor Henry Louis Gates Jr. termed "the Plantation"âcaused many non-white recruits to suffer self-doubt and anxiety. His painful anecdotes, both as an intern and physician, show the critical health crisis within the black community; his patients included a drug-addicted girl pregnant with a dead infant, an older woman suffering from high blood pressure and diabetes, a man struggling with mental illness, and a young woman who contracted AIDS from her boyfriend. Tweedy nicely unravels the essential issues of race, prejudice, class, mortality, treatment, and American medicine without blinking or polite excuses.

July 1, 2015
An arresting memoir that personalizes the enduring racial divide in contemporary American medicine. When North Carolina physician and psychiatry professor Tweedy first entered Duke University Medical School as one of only six black students on a full-tuition scholarship, he was already well-aware of the vast health disparities between black and white populations, where lack of insurance and "poverty topped the list of culprits." Throughout grueling years of intensive schooling and patient care, the doctor repeatedly pondered his role as a black physician in a predominantly white medical community. Tweedy devotes equal time to his academic term in medical school, to a yearlong clinical apprenticeship where he swiftly became "consumed by the broader health problems of my race," and to his former psychiatry practice. Early on in his career at Duke, his resolve was tested when a professor mistook him for a janitor, yet he remained committed. Tweedy's tenure throughout his hospital internship forms the memoir's riveting centerpiece. Structured around fast-paced, eye-opening medical cases encountered on clinical rotations, many episodes are tainted with the stigma of social, racial, and economically charged misconceptions and biases. The author includes anecdotes featuring prejudiced patients and discriminatory doctors as well as one about a longtime-married Christian man's shocking HIV seroconversion. Tweedy also shares his own battles with inherited kidney disorders and hypertension along with lucid thoughts on a physician's obligation to community health and the liberating power of tolerance. Clearly at odds with the racial and class-stratified machinations of the medical industry, the author writes with dignified authority on the imbalances in opportunities and available social and medical service platforms to the many African-American patients seeking clinical care and of his pivotal role in making a difference. In this unsparingly honest chronicle, Tweedy cohesively illuminates the experiences of black doctors and black patients and reiterates the need for improved understanding of racial differences within global medical communities.

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Starred review from August 1, 2015
Tweedy, an African American psychiatrist at Duke University, expertly weaves together statistics, personal anecdotes, and patient stories to explain why being black can be bad for your health. The son of a grocery-store meat cutter, Tweedy grew up in a working-class neighborhood and attended Duke on a full scholarship, where he faced prejudice from some white patients and medical-school professors (one doesn't realize he is a student and asks him to fix the lights in the lecture hall). But he also runs across less-than-welcoming African Americans, including one patient who says, Go tell your boss I don't want no black doctor. . . . I could have stayed home if I wanted to see a country ass doctor. Tweedy organizes his story into three themes. Under disparities, he says that blacks represent 13 percent of the U.S. population but only 7 percent of medical students and that black men are 7 percent more likely than white ones to get a diagnosis of HIV. In barriers, he notes that some doctors assume black patients are poorly educated, drug abusing, and less likely to comply with treatments. And in perseverance, he calls for improving access to quality medical care and getting African Americans to address unhealthy behaviors that contribute to their higher rates of obesity and hypertension. In all, a smart, thought-provoking, frontline look at race and medicine.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)

July 1, 2015

Being black can be bad for your health in various ways, notes Tweedy (psychiatry, Duke Univ. Medical Ctr.), as he narrates experiences, observations, and lessons from his career since entering the Duke Medical School, class of 2000. Mixing personal reflection on race as an important issue in his life, schooling, and medical practice, Tweedy discusses racial disparities and barriers in health care delivery, while also reprising a long, sad, and too common history of black professionals in a mostly white world, discounted and dismissed, as demonstrated in Yale Law School professor Stephen L. Carter's 1991 Reflections of an Affirmative Action Baby. Tweedy shows the recurrent role race plays in doctor-patient interaction as prejudices and tensions raise cross-cultural challenges to diagnoses and delivery, but he also prescribes hope to improve doctors' focus on practicing medicine as an endeavor of caring for patients holistically rather than as stereotypes or abstracted conditions. VERDICT A must-read for anyone interested in improving medical care from training to delivery in a world where race persists as a factor in life and death. [See Prepub Alert, 3/9/15.]--Thomas J. Davis, Arizona State Univ., Tempe

Copyright 2015 Library Journal, LLC Used with permission.

April 1, 2015

When Tweedy entered Duke Medical School on a full scholarship (he also has a degree from Yale Law School), one professor mistook him for a maintenance worker. Here he examines his bumpy path as a black man moving from the working class to student to physician while clarifying the socioeconomic factors that impact the health of many blacks--even as he's diagnosed with one of the diseases he learned typically strike blacks more than whites.

Copyright 2015 Library Journal, LLC Used with permission.