A Physician Asks: Is Being Black Bad For Your Health? : Code Switch Damon Tweedy discusses race and medicine in his new memoir Black Man in a White Coat. "There's been a long history of African-Americans being mistreated by the health care system," he says.

A Physician Asks: Is Being Black Bad For Your Health?

A Physician Asks: Is Being Black Bad For Your Health?

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Black Man in a White Coat
A Doctor's Reflections on Race and Medicine
By Damon Tweedy

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Black Man in a White Coat
Damon Tweedy

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As a medical student, Damon Tweedy noticed that many of the diseases he learned about in class were more prevalent among black people than white people, and that the black patients often fared worse than their white counterparts.

Tweedy, now a psychiatrist and the author of the memoir Black Man in a White Coat, theorizes that those differences spring from the fact that many black patients feel shut out and distrustful of a health care system that has a history of mistreating them.

"The Tuskegee Study ended in 1972; that's over 40 years ago — but a lot of the people are still living from back then," Tweedy tells Fresh Air's Terry Gross. "I'll see patients now [who] have diabetes and high blood pressure and they're wondering [if they] are getting the right treatment, [or] they feel they're getting some lower level care, when in fact, often times, they're not."

When he treats black patients, Tweedy says he sometimes feels like a translator whose job it is to bridge the gap between his patients and a medical establishment that can sometimes be alienating. "I think many black doctors find themselves in that same situation," he says.

Noting that "the general African-American population is about 13 percent of the country — among doctors, it's about 4 percent," Tweedy advocates for more black doctors as a way to improve the outcomes for African-American patients.

"You'll find that many young black doctors are more likely to express a desire to be in a setting or career where they're actually helping the black community itself," he says.

Interview Highlights.

Damon Tweedy is an assistant professor of psychiatry at Duke University Medical Center and a staff physician at the Durham VA Medical Center. Picador hide caption

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Damon Tweedy is an assistant professor of psychiatry at Duke University Medical Center and a staff physician at the Durham VA Medical Center.


On his experience as a patient

I had a knee that was sore. I'd been playing tennis and tweaked it in some way, and I went to an urgent care clinic after about a week or so. ... The doctor walks in the room, and, first of all, he doesn't make eye contact, doesn't really talk to me, just looks at my leg and has me stand up and down a couple times, then just says, "Oh you're OK, you're fine."

But being a doctor, I knew that there were a lot of pieces missing. For instance, the doctor didn't know the work I did ... he didn't actually touch the knee or examine the knee ... and so I made the point to the doctor [that] I know a little something about medicine. Normally I don't do that when I'm the patient, but in this case, I felt I had to and the doctor was taken aback and suddenly it was like a light went off in his head. Suddenly he looked at me, he made eye contact, he started to engage me in the conversation. He then examined my knee, touched my knee, moved it back and forth and said, "Let's go get an X-ray. Let's make sure everything's OK."

It was like I was two different people at the same time. The first person was Damon Tweedy coming off the street. ... He may have had certain assumptions that were negative about me. But then once he learned I was a doctor, I'm suddenly this other person worthy of a whole different level of care. So I think it really illustrates how these things can interject in the exam room.

On becoming a psychiatrist

Growing up, [psychiatry was] something for "other," for white people primarily, that black people don't go to a psychiatrist or a therapist and talk about their problems. You deal with them yourself, or within family or within a church ... so the idea of me being a psychiatrist, my mom was incredibly surprised ... [because] that is definitely not something that I grew up with at all.

On patients who perceive psychiatry as a weakness

It tends to be more common in men ... and I think it's more common in African-American people. There is this perception that it's just not something you do or need to do, [that] those are largely white problems, and so you can't afford to have problems like that. You have all these other real-world things to deal with ... so that's a huge issue. It's a barrier I encounter a lot.

People have all sorts of ideas when they come to see a psychiatrist. First they think you're gonna tell them they're crazy and that you're gonna lock them up in the hospital. People are just really worried about those sorts of things. I try to normalize it as much as possible and say that everybody has stress. I use the word "stress" because that's something people can relate to and I try to use that as an entry to get people talking about what's going on.