Week 14 readings- Black Man in a White Coat

[Anna Wakita]

Dr. Tweedy’s Black Man in a White Coat has offered a further, more personal perspective on the plight of the poor, particularly of the poor black communities, under racism, structural racism, and cultural habits shaped and largely controlled by years of state sponsored racism. It is a continuation on Metzl and Hansen’s idea of structural competency in understanding patients’ situations leading to health complexities and inabilities to follow standard medical advice. Again, the power of narrative serves a greater role in understanding how structural institutions bar people from escaping poverty and ultimately leading them to health issues. Particularly, Dr. Tweedy’s focus on implicit biases and assumptions before taking in the whole “social history” showed structural competency in practice. Because we can’t necessarily escape our biases and assumptions, it’s important to take a step back and evaluate oneself of these things before making decisions about another person’s life. Dr. Tweedy’s experience with Tina in chapter 3, “Charity Care” in part I of the book provides an example for this, when he had assumed, based on the environment and patients he had seen during the day at the clinic, that Tina was jobless and single without actually knowing her situation. Dr. Tweedy’s approach in telling the readers his own questions, his honesty with his inner dialogue has helped with assessing myself in different situations, not necessarily medical, on how my first impressions of people were shaped on appearance. Dr. Tweedy has taught that even the most conscious people still have these tendencies, and the thing that differentiates people with others is that one is aware of the fact and constantly works to uncover them, understand them, and correct them with facts (including narrative facts). As one planning on going into the healthcare sector and hopefully working with older age populations for healthy aging, racial and societal disparities is something I am and will be more aware of in thinking of different ways to help people achieve a better quality of life.

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