★ ★ ★ 1/2
If there is one thing that can pull me out of my traditional genres, it’s a meditation on modern medicine. Combine that with a memoir from an under-represented demographic, and it was only a moment before I grabbed it off the library display.
I’ve been working in the hospital setting in the upper midwest for over fifteen years, and I can count on one hand the number of black doctors I’ve met (interestingly, the two that first come to mind are surgeons), so I was particularly interested in what I thought was a memoir from a black physician. Except it wasn’t, not really; it was exactly what it says, a reflection on race and medicine. Tweedy draws from his own experience, but he also connects his book to other autobiographies and comments of notables in medicine, as well as integrating studies and statistics to lend support to his observations. As a result, it felt less intimate to me and more like an overview of public health from a consciousness-raising perspective. On the one hand, this approach might lend itself to encouraging the reader to come along a similar journey of discovery. On the other hand, for people in the field it might lack the breadth and insight that make it a truly moving read.
The book is divided into three sections that roughly mirror Tweedy’s own journey through the medical schooling system. I found I most enjoyed the stories that were about Tweedy’s own experiences, enjoying recognition of a particularly medical-hospital mentality. His story about a puzzling case of weight loss and wasting in a man faithfully married for 25 years and denying all drug use, and was likely HIV, was telling:
“This all seemed callous, to be sure. I was looking at George’s diagnosis as I would a TV mystery, while Adam was focused on the soap opera element. Our medical student, well into her year of clinical rotations, shared our curiosity… trapped inside the hospital vortex where disease, disability, and death were constant companions, our reactions passed for normal behavior.”
Yeah, that happens. Some of us like the puzzle or detection of disease, the process of ferreting out an explanation, some like the human stories, and some–as Tweedy eventually does– discover that there, but for the Grace of God, go I.
“Further, my medical education revealed a certain commonality shared by all people. Even if one sexual, racial, or gender group got a given disease more frequently than another, all of us were vulnerable to sickness, injury, and ultimately, death.”
But I think that quote was one of the most telling parts of Tweedy’s reflections, that he viewed much of this from a uniquely physician (medical school?) perspective, the idea of responsibility, of causality, and of the illusion of control over illness and death, and not that each person had a personal story.
One of the hardest things about memoirs is to critique the work without condemning the author. Tweedy’s approach feels very familiar–the very ‘thinking-centric,’ introverted, and intellectual approach to the world that reminds me of early college, before consciousness-raising days. You know, the days before I actually studied systemic repression and oppression, class consciousness, colonialist mentality, -isms, and all that jazz. His words bring a feeling of naivete to what he discovers, and I found myself surprised that he was surprised. For instance, when it came time to pick medical schools, he choose Duke University in Durham, North Carolina, largely because of a full-ride scholarship. I’m not criticizing him for that, but I admit when he tells his tale about a professor mistaking him for a custodian, I wasn’t surprised. I mean, North Carolina. The Confederacy. Maybe providing full scholarships is a way to increase diversity of an enormously white, upper class school, and maybe there’s a reason for that lack of diversity, from applicants and students who did not feel welcome. In essence, I don’t feel like there was a lot of critical thinking applied to his situation.
My sense was, actually, that he really wanted to fit in, and thought intellectualism and work was the way to do that, and that good recommendations were more important than conflict and confrontation. It alarmed me quite a bit when I ran into a number of references to Ben Carson (he of notorious 2015-16 presidential aspirations). I supposed–because I don’t think Tweedy ever directly acknowledges this–that he was looking for role models that might reflect his experience as a black man, but it disappointed me that he seemed to cite these stories without analysis (Ben, for instance, likely two decades older and seemingly crazy-pants). I think I get what he’s doing–one, as a medical professional, he’s citing other sources to support his own statements. Two, and this is guessing, he’s linking his own work into a community of other works. Both of which are admirable. But… Ben Carson. And dude–maybe look outside your gender for role models. Free your mind. Dr. Joycelyn Elders?
The strength of the book is in his integration of statistics and studies that connect to his experiences as a black man to health care. Instead of using footnotes, as Evicted did, he has a section at the end where he states the relevant sentence fragment and then provides the citation for it. I suppose it is less intimidating for non-academic readers, but it’s a little weird when you realize some of his statements in the chapter needed ‘proof.’ After a rather recent foray into Public/Community Health, I took all his assertions as givens.
For the general public, this book is probably a solid four or five stars. For the medical professional knowledgeable about disparities and biases (admittedly, not as many as there should be), there’s not a lot new here. The most interesting parts are when Tweedy explores his own -isms, and in how he negotiates that boundary with other professionals and with patients. There’s an interesting story where a black man feels he’s getting short-changed by getting a black doctor. Another story where once Tweedy identifies himself as a doctor when he’s a patient at urgent care, and gets a more thorough treatment (That, my friend, was not racism as much as the white coat fraternity in action). Sadly, I think his reticence prevents him from sharing more beyond a single example for each case, or at really sharing the details that would make his story unique. For me, well-written and interesting, but more a three-star book.