Skip to main content
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.

Community Reads

Community Reads are partnerships between Eccles Health Sciences Library and the Office of Health Equity and Inclusion.

The Book

About the Author

 

Author Photo

DAMON TWEEDY, M.D., is a graduate of Duke University School of Medicine. He is an associate professor of psychiatry at Duke University School of Medicine and staff physician at the Durham Veteran Affairs Health System. He has published articles about race and medicine in the New York TimesWashington Post, Chicago Tribune, and Raleigh News & Observer, as well as in various medical journals. He lives outside Raleigh-Durham, North Carolina, with his family.

Author Website

About the Facilitators

Jen Wilson, Program Manager, Office of Health Equity, Diversity & Inclusion

Joan M. Gregory, Associate Director for Access & Inclusion, Spencer S. Eccles Health Sciences Library

As white women facilitating the discussion on this book, we understand there will be blind spots. However, our intention for this Community Read series is to establish that the onus of racial education is on white folks. We cannot continue to ask those we have historically and currently marginalized to also now be our educators on the impacts of our marginalization and oppression. Our intention will be to center Black voices and perspectives. We welcome all comments, feedback, and criticisms but would also like to create the understanding that for any Black folks attending, you should not feel as if it is your duty or obligation.

Additional Related Events


Registration for Dr. Damon Tweedy’s Virtual Lecture “Reckoning with Race and Medicine in 2020 and Beyond”    Friday, February 19, 2021 via Zoom

 

Screening and film panel for Black Men in White Coats   -  February 15-18, 2021

Join the School of Medicine Office of Health Equity, Diversity, and Inclusion in partnership with Office for Health Equity, Diversity, & Inclusion – University of Utah Health and Spencer S. Eccles Health Sciences Library for a special virtual screening of the documentary, Black Men in White Coats Film Screening and Panel. You can learn more about Black Men in White Coats HERE

The documentary aims to raise awareness around the disparities and systemic barriers preventing Black men from becoming medical doctors and provide a collective space to elevate and discuss the experiences of Black identified medical students and physicians. 

Attendees will be given a unique streaming code to use anytime between February 15th, 16th, and 17th. We will then be hosting a virtual panel discussion after the film on February 18th from 6:00PM – 7:00PM.  Registration links below.

BMWC Screening. Register HERE to receive your streaming code.

Zoom Panel Discussion Meeting ID: Register HERE

Chapter Summaries

Part 1: Disparities

  • Chapter 1, ‘People Like Us’ - explores Dr. Tweedy’s experiences with the tensions of being a black medical student and recipient of a diversity scholarship to Duke University School of Medicine.
  • Chapter 2, ‘Baby Mamas’ - Tweedy explores the complex interactions of health disparities though the stories of black mothers Tweedy met as a second-year medical student.
  • Chapters 3, ‘Charity Care’ documents the socioeconomic challenges of access to health insurance and health education that patients faced during Dr. Tweedy’s time at a rural community health clinic
  • Chapter 4 ‘Inner-City Blues’ documents the socioeconomic challenges of access to health insurance and health education that patients faced during Dr. Tweedy’s time at inner-city emergency department.

Part II: Barriers

  • Chapter 5, ‘Confronting Hate’ prejudice against doctors
  • Chapter 6, ‘When Doctors Discriminate’ prejudice against patients
  • Chapter 7, ‘The Color of HIV/AIDS’ prejudice against the LGBTQ community

Part III: Perseverance

  • Chapter 8, ‘Matching,’ Tweedy describes his interactions with black patients for whom it made a difference that he, too, was black.
  • Chapters 9, ‘Doing the Right Thing’ - The choices we make have a profound impact on our health.
  • Chapter 10, ‘Beyond Race’ focuses on counseling patients and making good choices as equitably as possible within the American healthcare system

Discussion Questions

Chapters 1 & 2

  • What story made the biggest impact on you?
    • To dig further: why did you have the reaction you had (i.e. shocked, saddened, angered) – what experiences, privileges, etc. come into play?
  • Leslie’s story brought up the history of “the crack baby” which was later widely disproven and the racial disparities in policing drug use. The nurse, Carla, suggesting that Leslie get her tubes tied afterward is a reflection of our country’s history with forced sterilization on Black women and other populations that were deemed “undesirable”. 
    • How does the news and politics around us as well as recent history continue to inform our biases?
  • Today there are currently 4 historically Black medical schools in operation. Dr. Tweedy mentioned in his book the “expectation” that those graduates would take care of the Black community. This is due in part to the 1910 Flexner Report. The American Medical Association (AMA) funded this report and advanced its findings to shut down 82 of the nation’s 148 medical schools. And the 7 schools serving Black students, 5 were shut down leaving just Howard and Meharry.
    • What impact has this had on medical education and health care?
      • Think about how Dr. Tweedy was treated in his first year by a white professor; the racial health disparities that persist; number of Black physicians in practice (5%) vs. white physicians (56.2%) as of 2018 per AAMC
  • Statistics from the book compared with U of U and contemporary stats:
    • Class of 1968
      • University of Chicago – 1 Black medical student
      • Harvard 2
    • University of Utah today – 4 total medical students, all in first year (and intentional recruitment efforts were made for most recently admitted class)
    • Black physicians in the US
      • 2% prior to Civil Rights Movement in 1960s
      • 5% as of 2018
  • Do you think Nurse Carla would have handled Leslie’s case differently if she had been older, white, presented as more middle or upper class? As a 20 year veteran of nursing in obstetrics, do you think she would have taken this situation more seriously? Would she have insisted in getting the resident to see her sooner rather than rely on an inexperienced 2nd year medical student?
    • Despite SES, many Black women face maternal health care disparities (i.e. Serena Williams)

Chapters 3 & 4

  • Going back to the beginning of the book, which of Dr. Tweedy’s self-reflections has stayed with you?
    • Think about why it has – what introspection, perspective, information did it bring to light?

  • Many leaders across the nation, including the American Public Health Association, declared in 2020 that racism is a public health crisis. Racist systems, actions, policies—like police brutality, environmental racism, redlining, etc.—create toxic stress and inter-generational trauma that causes mental and physical health issues. Yet, “…the medical system itself is sometimes just as sick as its patients.”
    • What “sicknesses” do you see in our medical system that perpetuates health disparities? What actions can we take to remove the inequities?
    • Does a sick healthcare system prevent practitioners from meeting their responsibility to the Hippocratic oath? If yes, how? If no, why not?
    • How do you think access to a program like Medicaid could have helped Tina?

  • How does the intersection of racial identity with different class and education levels affect the doctor-patient relationship in these chapters? What implicit and explicit biases are shown?

Chapters 5 & 6

  • Stereotypes. Dr. Tweedy wrote:  At least once a day during my rotations, my race would come up on an interaction with patients.  Usually implied instead of explicit.  The insults didn’t stop once he became a doctor
    • What were your thoughts as you read about these encounters and interactions? 
    • How was Dr. Tweedy stereotyped?  How were the patients Dr. Tweedy stereotyped?
    • Thinking about your own practice – Have you ever found yourself stereotyping a patient, a colleague?  
    • Have you ever been the recipient of stereotyping by a patient, physician or colleague?
  • Chester hated black doctors, and female doctors.  Yet Dr. Tweedy turned this situation around.
    • What do you think were the factors that turned that situation around?
    • What was the impact on Dr. T when Chester responded to the question: how are you feeling today:  “Okay, doc,” he said.   “I think I’m gettin’ better.”  
    • What strategies are you learning as you read this book that you might incorporate into your own practice?
  • The harm that race-based medicine causes - watch and then discuss this TEDMed video as the speaker discusses the harm that race-based medicine causes as well as the modern, common biases that still exist in medical practices today.   
  • Chronicling the abuses that black people have faced from the medical profession dating back to slavery.
    • Was this history covered in any formal way during med school?  During your professional training?
    • How are you learning this history now?
  • Different Identities … In Chapter 6, Tweedy describes an interaction in which he went to an urgent care for his own knee pain, and the physician who saw him did not examine his knee until Tweedy revealed that he, too, was a physician. Tweedy writes, ‘I couldn’t get out of my mind how I’d been treated as two entirely different patients. Damon Tweedy, the unknown black man, dressed like he was about to mow the lawn, couldn’t get the doctor to look him in the eye or touch him.
    • What impact did this story have on you?
    • How did you react to this reflection?

Chapters 7 & 8

  • What parallel can we draw to HIV/AIDS epidemic and the COVID-19 pandemic? What lessons have we learned (or not learned)?  

  • In chapter 7, we see not just how those diagnosed with HIV/AIDS are affected by the diagnosis but how partners are affected and impacted as well either by becoming HIV+ themselves (as Monica was diagnosed after her previous partner’s transmission) or suddenly finding themselves in a serodiscordant (mixed status) relationship.

  • Mental health inequities are a wide gap. Health insurance, if you have it, does not always cover or sufficiently cover mental health services. Public facilities are underfunded, overcrowded, and placement of patients with addiction in same treatment as those with schizophrenia does not lead to great outcomes. How can we better advocate for proper mental health services and treatment for our patient populations?
  • What were your takeaways from Dr. Tweedy’s examples of patient-provider matching and the pros and cons associated?
    • How does a more diversified provider population benefit the providers themselves, patients, and the health care system as a whole?

  • Throughout the book, Dr. Tweedy displays an enormous amount of vulnerability to showcase his own professional and personal growth. What lessons can we take away from Dr. Tweedy’s example of this into our own lives?

Presentations by Dr. Damon Tweedy

Black Man in a White Coat | Damon Tweedy | 46:59   Dr. Damon Tweedy visited Google's office in Cambridge, MA to discuss his book "Black Man in a White Coat” Sep 28, 2015 · Uploaded by Talks at Google

A Conversation Between Duke President Brodhead and Duke Assistant Professor Dr. Damon Tweedy | 1:00:51   Nov 2, 2015 · Uploaded by Duke University

Inclusion in Health Care: A Conversation with Dr. Damon Tweedy | 15:02   ChristianaCare welcomed Dr. Damon Tweedy Feb 27, 2020 · Uploaded by ChristianaCare

Damon Tweedy, "Black Man in a White Coat: A Doctor's Reflections on Race and Medicine | 3:26   Duke University Medical Center psychiatrist Damon Tweedy discusses his book, "Black Man in a White Coat” Sep 27, 2015 · Uploaded by BookTV

A doctor's memoir shows race matters in the hospital room | 6:28  Black Man in a White Coat | Damon Tweedy | Talks at Google Sep 15, 2015 · Uploaded by PBS NewsHour

Damon Tweedy, "Black Man in a White Coat" - YouTube | 1:00:04  Black Man in a White Coat | Damon Tweedy | Talks at Google Sep 23, 2015 · Uploaded by Politics and Prose

Dr. Damon Tweedy - "Reflections on Race and Medicine" - YouTube | 1:00:37  Damon Tweedy, MD, associate professor of psychiatry at Duke University School of Medicine.  Nov 3, 2020 · Uploaded by Candice Kosanke

The mental health stigma in African American communities | 5:26  Damon Tweedy, a Duke University professor and author of “Black Man in a White Coat"  Apr 29, 2020 · Uploaded by ABC News

Damon Tweedy, MD - YouTube | 1:10:20  Damon Tweedy, MD, Professor of Psychiatry at Duke University and author of “Black Man in a White Coat"  Oct 20, 2020 · Uploaded by Center for Bioethics and Humanities

Race and Medical Education: Narrative Reflections of a Black | 1:12:32  Race was never far from front and center for Damon Tweedy as a medical student at Duke University.  Aug 29, 2017 · Uploaded by Practical Bioethics

Related LibGuides

EHSL Subject-Based LibGuides

Antiracist Resource Guide

Skin of Color Resources for Higher Education

 

EHSL Community Read LibGuides

Spring 2020            Battling Over Birth: Black Women and the Maternal Health Care Crisis

Summer 2019         White Fragility

Spring 2019            Waking Up White, and Finding Myself in the Story of Race

Fall 2016                The Immortal Life of Henrietta Lacks

Spring 2016           Class Matters

Additional Resources

Chapters 1 & 2  

Chapters 3 & 4  

Chapters 5 & 6

Chapters 7 & 8

Selected Bibliography - Books available at libraries at the University of Utah