Week 13 Reading: Black Man in a White Coat

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    The first 53 pages of Dr. Damon Tweedy’s book, Black Man in a White Coat, were both extremely powerful and difficult to digest. Tweedy’s revelations about feeling conflicted about confronting a professor who clearly demonstrated his own bias (asking him if he was there to fix a light) felt like a sucker punch to the gut. To succeed at the highest level in academia (getting accepted to Duke Medical School) and then to be put down in that way by a person Tweedy potentially looked up to was heart-wrenching. I thought it was very insightful and interesting when Tweedy compared his own biases to those of his contemporaries, noting that he too brought certain preconceived notions about sexuality to work. The disparity between Leslie’s life and Tweedy’s echoed discussions we have had about structural competency and helped me understand how environmental factors and institutional practices factored into her pregnancy outcome. Recalling the NYT article we read about black mothers and babies, I have to imagine the guidance of a doula like Latona Giwa would have helped. I also think back to my search for a job in the substance use disorder field when I first moved to North Carolina. In comparison to other states I’ve lived and worked in (FL and NY) it seemed as if treatment centers were a scarcity. I was fortunate to find work at one of the few residential programs in the Triangle but was shocked at the lack of resources available to our patients, not to mention the state of the building they lived in. The program shut down later that year, in the middle of winter, forcing many of the people who lived at our facility back to the street (many were homeless prior to admission). As someone in recovery, I know how much support is needed during the process and feel that our state’s response has been and continues to be inadequate. The conversation between the nurse and doctor discussing Leslie as a patient also reminded me of conversations I heard between coworkers and superiors working at multiple treatment centers: placing blame on the patient for moral shortcomings, rather than viewing substance use disorder as a disease that needs to be treated. It’s disheartening that in a field dedicated to helping people, moralizing and demeaning people who need help is so prevalent (both in Tweedy’s hospital and my experience). I look forward to reading the rest of the book as it has already had an impact on me.


    I love your insight on Tweedy’s piece as it is quite interesting to put into perspective. I once did research under a Internal Medicine doctor and a host of Nurse Practitioners and the racial disparity in the workplace is quote disparaging. There was a large tendency to ask minority patients what prescriptions they were taking, if they were abusing any medication or taking any other drugs as well as where their daily activities. I cannot recall one event of asking any other patients these questions. One part of the forum post that really stuck with me is how you found a lack of facilities and work in North Carolina in relation to healthcare services. I have lived in NC my whole life and anytime my mother has had an appointment for thyroid cancer treatment and/or Leukemia testing she has had to either travel to UNC or Duke or travel out of state (with a three day trip to the Mayo Clinic costing $494,000). The medical fields main focus should be demarcated to bettering the lives of patients but with problems like cultural competency as we previously discussed too much time is being allocated to studying diversity, but in all actuality teaching stigma and not enough time is being spent on learning empathy.


    This is a fantastic forum post and I really enjoyed reading your analysis on Leslie’s life. You did a great job relating it to structural competency and other topics discussed in class. I loved the personal anecdote you provided and the insights you provided about supporting people with drug abuse, or lack thereof. I also feel that we should perceive drug abuse as a disease, rather than a moral decision that does not warrant medical treatment. I feel that drug abusers are very likely to also suffer from mental disorders and that supportive treatment is essential to their recovery and detox. This was a very great forum post. Keep up the great work!

    Hannah Evans

    I really enjoyed reading your post on Black Man in a White Coat; it was incredibly insightful and well-written! The way that you interwove your own personal experiencing working in a substance abuse facility with Tweedy’s story of Leslie was such a unique way to understand what the book was saying at an even deeper level. It was definitely clear that the doctors’ prejudice toward Leslie’s decisions and disorder obstructed them from seeing her as a young mother who lost her child; this prevented them from giving Leslie the full amount of care that they could’ve and lessened the amount of pain they could have alleviated. The patient had just lost her child, and this would undoubtedly cause her anguish for the rest of her life; she needed doctors who would help her when she needed it most, not practitioners who judged her as an immoral, two-dimensional crackhead stereotype and failed to connect with the young woman they were treating. Your own experience in this field and recognition of this unfortunate prevalence in care providers puts even more weight on it; it’s easy to forget that this isn’t just a fictional story in a book but rather a real experience, and your own exposure to similar occurrences shows just how weighty, terrible, and unresolved this issue is. Again, great post!

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