Damon Tweedy was a smart, ambitious young African American when he was accepted to Duke Medical School in 1997. He was about to learn a lot --- about the practice of medicine and what it’s like to be the “black man in a white coat.”

The first harsh lesson in store for him was the attitude of a certain instructor. A doctor who would later express astonishment at Tweedy’s high grades and offer him a place on his research team initially approached him with “Are you here to fix the lights?” Battling both spoken and tacit racism while keeping up a grueling academic and work schedule, Tweedy also realized that many people would assume he got where he was only because of some special university admissions program.

"Already creating a stir, BLACK MAN IN A WHITE COAT will doubtless cause thoughtful readers to feel the pinch of their own unquestioned assumptions about race and its relation to health care in America."

But it was not the mere fact of racial bias that gave the med student, later psychiatrist, incentive to write this important memoir. He saw prejudice at every level, in a variety of settings. It was evident among doctors treating black patients, making assumptions such as that “most” black men are hypertensive, or that “most” poor black females having problems during pregnancy are cocaine users. He noted that at times he was “paired” with other black staff, for no other reason, it seemed, than skin color. Inevitably, there were patients who simply refused to be treated by a person of his color. As a patient himself, he received breezy advice, and his sprained knee went untouched --- until he revealed that he was a doctor. Then he observed a sudden dramatic upgrade in his treatment.

Tweedy also examines his own misconceptions. He came to understand, for example, that HIV sufferers, like civil rights advocates, have a valid cause and deserve support. Working in “safety net” clinics for the disadvantaged, he saw close up the toll that lack of adequate health insurance takes on the poor (of all races), who consistently receive lower tier medications and fewer services than more privileged patients. With each scenario taken from his student days and years of medical practice (he is an assistant professor at Duke Medical Center and a staff physician at the Durham VA Medical Center), Tweedy offers supporting statistics and quotations from earlier sources, such as Ben Carson, Sandeep Jauhar and Victoria Sweet.

While stating that “poverty topped the list of culprits” in the pervasive health problems of African Americans, Tweedy also puts blame on factors like poor eating habits and heavy smoking that contribute to illness among people of color. And he recounts breaking barriers, having patients who at first refused his care growing to respect and trust him.

Already creating a stir, BLACK MAN IN A WHITE COAT will doubtless cause thoughtful readers to feel the pinch of their own unquestioned assumptions about race and its relation to health care in America.