April 8, 2020 at 12:59 pm #871Grant GlassKeymaster
Black Man in a White Coat, 153- 245April 20, 2020 at 12:30 pm #999sam01Participant
I particularly like the focus of the chapters in this reading section on all the intersections that can impact health and healthcare, like race and social class, and I particularly liked reading Tweedy’s discussion of the social implications of having an HIV/AIDS diagnosis. While these are important factors to take into consideration in order to understand illness, it is really refreshing to read an account of medicine where they are very prominently focused upon. Many medical narratives focus upon the diagnosis, treatment, and care of a patient, with a heavy basis in Mattingly’s “chart talk”. Berger’s A Fortunate Man follows this medical narrative well, where the story follows the country doctor as he goes about finding, diagnosing, and treating patients, some with more luck than others. In this section of Black Man in a White Coat, Tweedy not only acknowledges some of his own social prejudice about illness, in this case particularly HIV/AIDS, but also challenges those prejudices in himself. That is particularly important in a medical professional, not only to acknowledge your own biases, but to work towards challenging them in order to ensure you provide the best medical care for your patients.April 20, 2020 at 12:32 pm #1000
I really enjoyed reading about Damon Tweedy’s perspective on HIV as both a doctor and a black man. One important aspect of HIV that the author brings up is that a diagnosis of HIV is perceived as either as a lapse in judgement or a lack of morality; this is demonstrated through George’s wife’s reaction to finding out about her husband’s diagnosis. In one of my other medical anthropology classes at UNC, we have discussed the concept of an illness career, which is defined as “the culturally-influenced path that individuals move along in association with an illness”.
Tweedy also managed to incorporate how the environment he grew up in conditioned him to think that being gay is one of the worst things someone could be. It was refreshing that Tweedy did not try to pass himself off in his book as morally better than the other doctors by recounting aspects of his childhood and even his adulthood where he heard other people around him using gay slurs or saying they would “beat the gay” out of their son ever came out. As a result, this leads to so many black people in his community not coming out as gay, which as a white woman, is something I have never really thought about it. I think it is easy yet dangerous to think that because it is 2020 and we live in a much more socially progressive society, everything is socially acceptable by all groups of people.
Another dangerous misconception that is rather common is that because HIV has become treatable, people who are on HAART will always live completely normal lives, unaffected by HIV. This misconception is cleared up when Tweedy mentions one of his patients, Monica, who ends up developing lung cancer from her HIV. Also, while it is rare, there are people who are resistant to HIV drugs; it is so important to remember that we have not yet found the cure for HIV.April 20, 2020 at 12:43 pm #1001
I also really enjoyed how Tweedy incorporated social factors when looking at illness, as demonstrated in this chapter; I think it is so vital to look at medicine as something beyond science. In the past, doctors have been trained as scientists (chart talk) which is a rather narrow lens to use when attempting to heal someone. Medical schools seem to be adopting a social approach as well when educating medical students, but it is hard to tell if this enough to help our healthcare system. I want to go to pharmacy school after I graduate from UNC, but as I was shadowing hospital pharmacists, I couldn’t help thinking that practicing medicine was just supporting our broken system.April 20, 2020 at 12:54 pm #1002
The second response is a reply to @Sam01’s post, forgot to put that in my response.April 22, 2020 at 3:12 pm #1026Lauren SmithParticipant
I thought Tweedy’s reflection on the two patients Henry and Adrian toward the end of the book was really interesting. On one hand, Adrian had a history of alcohol and cocaine abuse. While Adrian had been clean and was taking daily aspirin and blood pressure medication, he didn’t improve his diet or stop smoking cigarettes. As a result he had a mini-stroke that left him disabled. On the other hand, Henry had been diagnosed with schizophrenia and his medication caused excessive weight gain. When Tweedy saw him after losing so much weight, he had worried that Henry went off his meds but Henry had made “real, positive health changes” like exercising and eating healthier (208). Tweedy noticed that “on this day, one man had made good choices and increased his odds of a healthy future. The other hadn’t and, at least partly for that reason, faced a heartbreakingly new life” (209). These two cases just go to show the profound impact that our daily choices can have on our health, but, like Tweedy says “the reasons we make those choices are more complex” (210). I think it’s really interesting how, aside from socioeconomic settings, the doctor-patient relationship can be one of those reasons. Tweedy suggests that he could relate more with Henry and his struggles than he could with Adrian’s. This is similar in the case of Keith, a patient Tweedy was able to find common ground with, despite being of a different race.April 22, 2020 at 6:04 pm #1032aleks474Participant
Like Lauren, I was thinking about Dr. Tweedy’s relationship with Adrian and Henry and how he writes about it. Just like when describing his teenage homophobia, Tweedy is so self-reflective and ready to change for the better, both in his private and professional life. When writing about Adrian, wondering if he could’ve done anything else to help him stop smoking, Tweedy thought that maybe he became cynical. He is constantly questioning himself, looking for ways to be a better physician – I find that truly admirable. I think that’s what makes him a great doctor and storyteller – he has so much empathy and is ready to reflect on his actions. The self-reflective moments in the book were my favourite ones. Reading about Tweedy’s own struggles with patients and the emotions he experienced was so helpful in understanding his point of view as a black doctor. I think Dr. Tweedy inspires not only other doctors but all of his readers to self-reflect and be more empathetic. After reading some chapters, I found myself wondering what kind of patient I was during my doctor visits and if (especially as a teenager) I was a difficult patient.
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