In the midst of the coronavirus’ devastation and the aftermath of George Floyd’s murder in 2020, America was confronting a reckoning on race, and Dr. Uché Blackstock emerged as an authority on how racism was affecting health outcomes.
COVID-19 was disproportionately burdening Black communities across the country, and the data shocked some Americans. Black people were dying at twice the rate of white Americans, and it was the first time many were being introduced to the health equity work Blackstock and her twin sister, Oni, had dedicated their medical careers to.
She is, in many ways, picking up the legacy of her mother, becoming a second generation Black woman physician in a country where only 2% of doctors look like her.
Her recently published memoir, Legacy: A Black Physician Reckons With Racism in Medicine, is a love letter to her mom, she said: “It’s really a tribute to her and the kind of barriers, like racism and poverty, that she had to overcome.”
In the book, Blackstock recounts her journey from seeing systemic inequities as a child to her career as an emergency room physician and academic professor.
“Writing this book was my opportunity to speak truth to power,” Blackstock said.
Capital B spoke with her about the book’s biggest themes, from feeling silenced in mostly white academic and professional spaces to the lessons medical school never taught her about practicing medicine within a racist health care system. The conversation has been lightly edited for length and clarity.
Capital B: We can start where the book begins, which is with a dedication to your mother. You are the child of a Black woman physician, and now you’re combatting the same issues of health inequities that she was working to solve. What has changed since your mother started practicing?
Uché Blackstock More should have changed. When I worked in academia, I was silenced. I was undervalued and underappreciated, and I felt very isolated in those moments, not realizing that there were so many other Black faculty who felt that same way. These are systemic issues.
I think about the Supreme Court decision striking down race conscious admission, then thinking about the recent lawsuits against Black-led organizations that are doing health equity work. It feels like we’re backsliding. There have been all these advances in innovation, research, and technology within health care over the last few decades, but at the same time, we still are seeing worsening health outcomes for Black people in this country. It doesn’t make sense. It’s because of anti-Black racism.
I’m saddened. I’m frustrated. We have to help people connect the dots as to why we are in a situation in 2024 where Black birthing people are three to four times more likely to die than their white peers. The book helps connect the dots for readers. It’s not because there’s something inherently biologically wrong with Black people. There are discriminatory housing policies that emerged decades ago that still have impacts on our neighborhoods today. If people don’t have access to safe green space, if they’re living in a high crime area, and don’t feel safe enough to go outside and work out, if they’re living in a chronically disinvested area, that has implications for how healthy our communities are. It’s deeply rooted in the legacy of slavery in this country.
What are you hoping that readers are able to take from the book, and how does that intersect with your broad goals for health equity?
I wrote the book for our broad audience. Even though it is my story, and the personal narrative of a Black physician, the book is not just for people in medicine and health care. It’s for everyday Americans to understand our history and, in the last chapter, I have a call to action. I talk to Black health professionals. I talk to the medical schools. I talk to policymakers. I want people to understand that there are actions and decisions they can make in their daily lives that will make a difference. Ultimately, what I would love is for policymakers to read this book. In order to make Black communities healthier, invest in our communities. We need reparative policies that will correct the wrongs that have been committed against our people in our communities for centuries.
In the book, you talk about what it’s like being a patient yourself, and also experiencing the health care system on the other end as a doctor. What are some of the lessons you’ve learned as a practicing physician that medical school never taught you?
Being a Black physician is a unique role. We have our lived experience. I’m a Black woman, I’m a mother of two little Black boys, but I was also educated and trained in these predominantly white environments and practice in them. There probably were times when I bought into common myths and false beliefs about our people. That was in the medical school curriculum. I was taught that there were differences in kidney function between Black people and non-Black people. When you’re taught that, you absorb that there is something biologically different. That is also one of the challenges for Black physicians. We have to be really mindful that we’re not committing the same harm because we are being educated and trained in an anti-Black environment.
And also, when a patient is in the exam room with their physician, it’s not just the two of them. Their families, their co-workers, and their living environment, it’s all in there with them. Is the patient experiencing housing insecurity or food insecurity, or experiencing discrimination at work? All of that has implications for how healthy someone is.
Talk to me about the title of the book, “Legacy.” What does the word mean to you?
It has a double meaning. It’s the legacy of me being a second generation Black woman physician. But also, it’s the legacy of racism in medicine. I have a degree from Harvard, but I don’t come from generational wealth. I think about legacy as the opportunity my mother had, in spite of the barriers that were present for her, being born into poverty, dealing with systemic racism. I think about what the obligation is for me and my sister, Oni, who was also a physician. For us, it is to make the journey easier for those who come behind us. It is also to continue the work that my mother was doing on a community level with other Black physicians in our neighborhood. When health equity wasn’t this sexy term, they were making sure people were getting diabetes screenings, checking their blood pressure, and connecting them with social services. I see it as continuing the work that my mother and her colleagues were doing. It’s also an opportunity to make the road less challenging for folks who come after us.