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 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.