Black Man in a White Coat, 1-53

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    Grant Glass

    Black Man in a White Coat, 1-53


    I think Tweedy does an amazing job tying race not only to medical care, but also to medical education. African Americans receive a vastly different quality of medical care in comparison to whites, and this stems from cultural biases as well as structural hurdles. Tweedy conveys multiple times the anxieties that he feels each time in the lecture when he hears that African Americans live at a greater risk for many diseases and conditions. I think that the great disparity in quality medical care necessitates a discussion of structural competency. Many of the students in medical schools were historically, and remain today, largely white. Tweedy mentions being one of approximately six black students in his class at Duke, one which was praised as their most diverse and talented classes yet while anyone can see that clearly that class was dominated by one or two racial groups. The doctors that are subsequently put out into the world then don’t reflect the diversity of the citizens they serve. I think it’s really important that our medical system and its values reflect those of the individuals placing their trust in it, both in racial and ethnic diversity and ideologically


    Reply to courtab,

    Hi! I definitely agree with you and I think that you wrote a very thoughtful forum post. I really like how you referenced structural competency and how applicable this concept is to Dr. Tweedy’s book. I think that structural competency is indirectly referenced time and time again throughout these first couple chapters. For instance, Dr. Tweedy references the structural and social restrictions that stem from the history of slavery in the South. Dr. Tweedy states on page 4, “While the civil rights movement ultimately stirred remarkable racial progress in various areas of American life, many of King’s concerns about health and healthcare remain valid to this day”. As seen in this quote, social stigmas and structural restrictions from before the civil rights still linger today, affecting both the health and education of African Americans. I definitely agree with your closing point, that in order to combat this structural inequality our medical system’s demographics and values need to reflect the diverse nature of the people it serves.

    I hope you are doing well and staying safe! Thank you for your post!


    Tweedy did an excellent job articulating his experience with discrimination as a black doctor and seeing racism in the medical field. It takes a lot of emotional regulation, self reflections and self control for a person to be able to see a situation as it truly is and choose not to react to it. As someone who identifies as a white female, it opened up my eyes to the fact that this constant emotional regulation, self reflection and self control is something that black Americans have to face every day. I think the best example of Tweedy’s strength was presented when his professor asked Tweedy what he was doing in the professors class room and asked him to fix the lights and didn’t apologize for doing so. The way Tweedy articulated his inner dialog, was cool and collected, but he did not down-play his anger, disappointment and frustration.
    It was eye opening to learn about this professors reaction when Tweedy received the 2nd highest grade on the class final and had the nerve to ask him to do research for him. I can still see this happening in class rooms and universities today. I believe this type of response is common with first generational colleges students and students with disabilities. How can we bridge the gap between students with traditional backgrounds and students who face other challenges within a university?


    An aspect of Tweedy’s book that makes it so unique to me is that the narrative is from a black person’s perspective; this perspective is something that I have not yet found in other readings from doctors’ talking about their experience in medicine. Most of the books from doctors’ perspectives I have read are either by white doctors with the exception of Atul Gawande. Granted, I am sure there may have been cases in Gawande’s career where he has experienced racism, however his experience with racism is completely different than Tweedy’s. Tweedy’s perspective allows the reader to see the negative aspects of cultural competency, as seen through the way the patient Leslie was treated, with the doctor treating her in a less respectfully than other patients, demanding to know if Leslie was using cocaine. Something else that arose from Tweedy’s perspective also brings up a hatred towards those who embodied aspects of the negative stereotypes of the black race, which he mentioned when learning about Tanya’s boyfriend, who abandoned Tanya and her daughter.


    Reply to emmakik,

    Hi! I totally agree with you that there is a need for more perspectives from people of color in all genres but especially in the medical narrative sphere. I like that you acknowledge that there are different forms of racism and that everyone’s experience with racism is different. I think that Tweedy takes a unique approach when discussing race and discrimination in his book. He focuses on the social determinants of health that unequally affect people of color. His approach to race in the medical world both as a patient and practitioner reveals that there is much to be improved upon in our health care systems.

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