Given the disparities African-Americans face compared with whites in overall well-being, in treatment by doctors and in treatment of themselves, Dr. Damon Tweedy, an African-American, has built his new memoir on a bleak truth: Being black in America can be hazardous to your health.
Ostensibly a memoir about his journey from working-class roots to Duke University's elite medical school and into the highly esteemed medical profession, his new book, "Black Man in a White Coat," is fundamentally a ground-level look at the complex intersection of race and health.
In just under 300 pages, Tweedy lays out what's pretty well known, at least to anyone who's paying attention. Studies show that African-Americans tend to die at a substantially earlier age than whites; they're more likely to suffer from debilitating, chronic and often fatal illnesses — diabetes, hypertension, HIV and AIDS and cancer.
At the same time, other studies show, black patients routinely get unequal treatment in the majority-white medical profession that's sworn an oath to treat anyone who needs it. Taking that oath as a black doctor in a predominantly white profession, Tweedy writes, means solving the complicated Rubik's Cube of racism in medicine and in America; a patient's life can hinge on the result.
The tone is set with an anecdote from his first year at Duke when Tweedy, an insecure public-college graduate, feels the sink-or-swim pressure to compete with med school classmates from privileged Ivy League backgrounds. One of a relative handful of black students, Tweedy feels the sting of racism on the first day of his first class when an elderly white professor thinks he's a janitor and asks him to change the classroom's light bulbs.
In med school, Tweedy volunteers at a rural free clinic, where a long line of poor African-American patients haven't seen a doctor since the last time the monthly clinic was open. As an intern, he witnesses a condescending debate between white caregivers about a pregnant black crack addict. The big picture emerges in an Atlanta emergency room, where he sees how the everyday stress of race and poverty, coupled with a lack of access to quality health care (and subtle bias in treatment), helps to perpetuate disparities between blacks and whites.
At the same time, Tweedy writes of his own "physician, heal thyself" moments.
He acknowledges personal biases treating black and white patients. A personal health crisis forces him to make serious lifestyle changes — something, he writes, not enough African-Americans do to avoid getting sick in the first place. Yet the good doctor also knows he has privileges many don't, such as a fully stocked neighborhood supermarket and a gym. A visit to a white doctor for a weekend-warrior sports injury gives him firsthand experience with the unequal treatment others received.
Tweedy's prose isn't dull, but it's not flashy, either; readers shouldn't expect drama ripped from an episode of "Grey's Anatomy," and his self-reflection can get a bit distracting. He does, however, make a powerful case on how, in the era of Obamacare and the nation's first black president, race can still determine who gets sick and lives, or dies.
"By putting human faces on these serious dilemmas," he writes, "I hope to contribute to a much-needed public dialogue on improving the health of black people."
Joseph P. Williams, a former assistant managing editor at the Star Tribune, is a senior news editor for U.S. News & World Report in Washington, D.C.