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The second response is a reply to @Sam01’s post, forgot to put that in my response.
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.
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.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.
