Legacy: A Black Physician Reckons with Racism in Medicine - Hardcover

Blackstock MD, Uché

Hardcover

ISBN 10: 0593491289 ISBN 13: 9780593491287

Verlag: Viking, 2024

Inhaltsangabe

AN INSTANT NEW YORK TIMES BESTSELLER

ONE OF TIME’S 100 MOST INFLUENTUAL PEOPLE IN GLOBAL HEALTH

“This book is more than a memoir—it also serves as a call to action to create a more equitable healthcare system for patients of color, particularly Black women.” —Essence

One of NPR’s 11 Books to Look Forward to in 2024

One of Good Morning America’s 15 New Books to Read for the New Year

“Legacy is both a compelling memoir and an edifying analysis of the inequities in the way we deliver healthcare in America. Uché Blackstock is a force of nature.” —Abraham Verghese, MD, New York Times bestselling author of The Covenant of Water

“[An] extraordinary family story.” —Dr. Damon Tweedy, The New York Times Book Review

“This book should be required reading for all medical students.” —Gayle King, CBS Mornings

The rousing, captivating story of a Black physician, her career in medicine, and the deep inequities that still exist in the U.S. healthcare system

Growing up in Brooklyn, New York, it never occurred to Uché Blackstock and her twin sister, Oni, that they would be anything but physicians. In the 1980s, their mother headed an organization of Black women physicians, and for years the girls watched these fiercely intelligent women in white coats tend to their patients and neighbors, host community health fairs, cure ills, and save lives.

What Dr. Uché Blackstock did not understand as a child—or learn about at Harvard Medical School, where she and her sister had followed in their mother’s footsteps, making them the first Black mother-daughter legacies from the school—were the profound and long-standing systemic inequities that mean just 2 percent of all U.S. physicians today are Black women; the racist practices and policies that ensure Black Americans have far worse health outcomes than any other group in the country; and the flawed system that endangers the well-being of communities like theirs. As an ER physician, and later as a professor in academic medicine, Dr. Blackstock became profoundly aware of the systemic barriers that Black patients and physicians continue to face.

Legacy is a journey through the critical intersection of racism and healthcare. At once a searing indictment of our healthcare system, a generational family memoir, and a call to action, Legacy is Dr. Blackstock’s odyssey from child to medical student to practicing physician—to finally seizing her own power as a health equity advocate against the backdrop of the pandemic and the Black Lives Matter movement.

Über diesen Titel

Über die Autorin bzw. den Autor

Dr. Uché Blackstock is a physician and thought leader on bias and racism in health care. She is the founder and CEO of Advancing Health Equity, appears regularly on MSNBC and NBC News, and is a former associate professor in the Department of Emergency Medicine and the former faculty director for recruitment, retention, and inclusion in the Office of Diversity Affairs at NYU School of Medicine. Dr. Blackstock received both her undergraduate and medical degrees from Harvard University, making her and her twin sister, Oni, the ­first Black mother-daughter legacies from Harvard Medical School. Dr. Blackstock currently lives in her hometown of Brooklyn, New York, with her two school-age children.

Auszug. © Genehmigter Nachdruck. Alle Rechte vorbehalten.

Introduction

When I was a little girl, my twin sister, Oni, and I used to visit our mother at work. Her name was Dr. Dale Gloria Blackstock, and in the 1980s and ’90s she was an attending physician at Kings County Hospital Center, one of the public hospitals affiliated with SUNY Downstate Health Sciences University, in Brooklyn, not far from our home in Crown Heights. Our mother worked long hours at her job and so sometimes we’d head to the hospital after school to see her and do our homework. Walking down the disinfectant-scented hallways, our shoes squeaking on the linoleum floors, we’d make our way to the large, echoing cafeteria, where we’d pull out textbooks from our backpacks and settle down to work alongside the physicians, nurses, technicians, and aides taking a break. The staff behind the counter knew us well, especially because we strongly resembled our mother, and would smile warmly and ask, “Visiting your mother today?”

After homework was done, we’d sneak into her clinic to ask for small change to spend on our favorite red Jell‑O. She’d hand it to us and, if we were quiet, let us stay and observe for a minute or two as she examined a patient. Our mother was warm, but serious with those in her care. Occasionally, her face would reveal a smile, but more often than not, she was extremely focused on what they were saying and what was going on in their lives. She’d grown up in the same Brooklyn neighborhood where the hospital was located. The daughter of a single mother from New Jersey, raised on public assistance, she’d become the first person in her family to graduate college, and after graduating from Harvard Medical School in 1976, she’d returned home to her community. At Kings County/ SUNY Downstate, she wasn’t just taking care of patients; she was tending to her neighbors. In her interactions with them, she always seemed to know as much about their children and families as she did about their respective medical problems. When you came in for a visit with Dr. Blackstock, you weren’t only having your blood pressure or cholesterol checked, you were also meeting with someone who was going to assess how your whole being was faring. I believe our mother practiced what is now known as structurally competent and culturally responsive care, which means that the entire complex nature of the patient’s background and the social context in which they live, work, love, and pray is considered during evaluation. And her patients loved her for it. She was always bringing home little gifts from them—a knitted shawl, homemade cookies or cake, tokens of appreciation.

My sister and I were only nineteen years old in 1997 when we lost our mother to leukemia—and she was just forty-seven. She died too young, but by then her influence had indelibly rubbed off on us. Our mother’s passion for learning, her dogged persever­ance, and her commitment to serving her community heavily in­fluenced our own decisions to become physicians. Oni and I both graduated from Harvard University and then attended Harvard Medical School, the school’s first Black mother-daughter legacy graduates. Like her, we both went to work with historically un­derserved populations after graduating, my sister at a hospital in the Bronx, while I went to train at Kings County/ SUNY Down­state in Brooklyn, following in our mother’s footsteps. In the years since then, I have felt her by my side in so many of my own inter­actions with patients: her ability to listen to and truly care contin­ues to be a model for me. And it’s something that our patients are crying out for, now more than ever.

During the height of the COVID‑19 pandemic, in spring 2020, I found myself working at an urgent care center in Brooklyn, see­ing in the region of eighty to ninety COVID patients per twelve-hour shift. One day, I remember walking into one of what seemed like an endless number of patient exam rooms to find a young Black woman in her early twenties waiting for me. She was hunched over and staring at her restless fingers, but when I said hello, she glanced up at me and gave me a quick once-over. The electronic chart said that she was visiting for shortness of breath after being diagnosed with COVID‑19 a few weeks earlier. Although she was wearing a mask, I could tell from the look in her eyes that she was scared.

In those pre-vaccine days, I spent the twelve hours of each shift covered head‑to‑toe in layers of personal protective equip­ment (PPE): gloves on my hands, my bulging surgical cap barely containing my locs, a surgical mask over the N95 covering my nose and mouth, and a clear plastic shield that would often fog up over my eyes. Not only did the heavy PPE make it difficult to move and breathe in the small airless clinic rooms, there was no way for me to express my encouragement to a patient, offer a smile of reassurance or a look of sympathy.

That day, I introduced myself and then asked the young woman to tell me about why she had come in. But before I got the chance to continue, she stopped me.

“Can I ask you something?”

I told her yes, of course, nodding vigorously in case my voice was muffled through the double mask and shield.

“Are you Black?”

I realized she couldn’t see my skin color under all the layers of PPE.

“Yes, I’m Black,” I replied, hoping she could see the smile in my eyes.

I could sense the tension leaving her body.

“Thank you, doctor,” she sighed. “At least I know you’ll listen to me.”

“I promise.”

In that moment, I knew that I was the physician she needed—someone who looked like her and whom she could instinctively trust.

The reality is that patients like the young Black woman in my clinic have much reason to be suspicious of a medical profession that continues to minimize their concerns and, intentionally or not, cause harm. One of the promises in the Hippocratic oath is “do no harm”; however, we know from multiple studies that clini­cians have repeatedly caused harm to Black patients by dismiss­ing their concerns and undertreating their pain. The good news is that racial concordance in clinician-patient interactions—the kind that my young patient craved and that my mother experi­enced with her patients—has been shown to actively improve health outcomes, particularly among Black patients. Studies in­dicate that Black babies who are cared for by Black neonatologists and pediatricians in their first year of life are more likely to sur­vive than those treated by white neonatologists and pediatri­cians. What’s more, Black physicians are more likely to specialize in primary care and practice in underserved communities where patients are most vulnerable and in need of expert care. Racially concordant care for Black people is a matter of life and death!

The bad news is that there aren’t enough of us. Although I was fortunate to grow up with a Black physician mother, it’s impor­tant to understand that our mother was a rarity, as are my sister and I. The number of Black physicians in this country remains stubbornly low, with only 5.4 percent of all US physicians identi­fying as Black, 2.6 percent as Black men, and 2.8 percent as Black women—although Black people make up 13 percent of the popula­tion. There is actually a smaller percentage of Black male phy­sicians now than there was in 1940, when Black men made up 2.7 percent of Black physicians.

Training more Black physicians is only one of the many solu­tions needed to address the glaring and persistent health inequi­ties that exist,...

Details zur Ausgabe

• Verlag: Viking
• Erscheinungsdatum: 2024
• Sprache: Englisch
• ISBN 10: 0593491289
• ISBN 13: 9780593491287
• Einband: Gebundene Ausgabe
• Anzahl der Seiten: 304
• Kontakt zum Hersteller: VIKING; https://www.penguin.com/overview-vikingbooks/; ; Attn: Andrea T Sheridan 1745 BROADWAY; New York; NY; 10019; USA
• Verantwortliche Person: Zeitfracht Medien GmbH; info-medien@zeitfracht.de; ; Ferdinand-Jühlke-Straße 7; Erfurt; 99095; Deutschland