Week 13: Black Man in a White Coat

[brookeni]

Wow…these first chapters of Damon Tweedy’s book are so powerful and connect many of the concepts we have already discussed in class to a personal story very close to UNC. The introduction and first chapter immediately reminded me of the article by Linda Villarosa, “Why America’s Black Mothers and Babies are in a Life or Death Crisis”, because Tweedy explains that for almost every type of disease or health problem, he almost expected his professors to say that the disease was more common in African Americans that White Americans because he heard it so often. In the second chapter, Tweedy describes his experience with his patient’s stories and chart talk. He states, “I’d grown far too comfortable categorizing people as organ systems or diseases. Much of it was simply modeling what I saw senior medical students and doctors do” (Tweedy, 32). Tweedy explains that when he was a student in medical school, he had just been following his professors and limiting patients down to their ‘chart talk’. He is able to understand Cheryl Mattingly’s idea of narrative reasoning in his experience with the patient Leslie. He learns that there is so much more to her than her chart and that her care was understood by knowing her story. His patients stories become more important to him as he works with young, pregnant girls. He states “the more patients I saw, the stronger my desire was to learn more about their surrounding worlds and how their environment influenced their overall health” (Tweedy, 49). This connects to the importance of narratives and storytelling in helping patients. It also brings up the importance of Jonathan Metzl and Helena Hansen’s idea of structural competency. Tweedy mentions that he strove to understand the relationship between health and environmental/structural factors his patients were in and this is exactly what Metzl and Hansen were also discussing.

[kcl]

I loved all the connections you made to other works we’ve read and discussed. I also thought there was a deep connection between the first chapters of the book and the NYT article, “Why America’s Black Mothers and Babies are in a Life or Death Crisis,” the contrast between Leslie’s outcome and Landrum’s was very stark. Your point about Tweedy’s “chart talk” made me think about the disparity between the over-medicalized language of doctors and the actual symptoms and suffering of their patients, i.e. the “disease” vs. “illness” conversation in Kleinman’s work. I feel like we also see the “sickness” portrayed in the conversation between the nurse and doctor, the former being immediately dismissive and condescending when regarding Leslie because of her substance use. It’s interesting to see how these difficult experiences in his medical education impacted Dr. Tweedy’s growing role as a healer. Although shocked by the system and its inner workings, Tweedy is able to transcend these limitations by harnessing the power of narrative reasoning and structural competency, as you mentioned in your analysis.

[Author]

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