Uché Blackstock, LEGACY: A Black Physician Reckons with Racism in Medicine
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[0:33]UTA Blackstock is the author of Legacy, a black physician reckons with racism in medicine.
[0:39]Dr. UTA Blackstock is a physician and thought leader on bias and racism in health care.
[0:43]She appears honor regularly as an MSNBC medical contributor and is the founder and CEO
[0:48]of Advancing Health Equity, as well as a former associate professor in the Department
[0:52]of Emergency Medicine and Legacies from Harvard Medical School.
[0:56]Dr. Blackstock currently lives in her hometown of Brooklyn, New York, with her two small
[1:00]children.
[1:01]UTA, thank you so much for coming on Mom's longtime treat books to discuss Legacy, a black
[1:06]physician, reckons with racism in medicine.
[1:08]Thank you so much for having me on, City.
[1:11]I really loved your story and your personal story and you're really like this love letter
[1:17]to your mom and the legacy that she left and your relationship with her and how she sort
[1:22]of informed the lives of you and your sister and I don't know, it was such a wonderful
[1:28]sort of even framing device of a book to have your mom there.
[1:31]So maybe just tell listeners a little bit about the story and her and I want to talk
[1:36]about your own health issue that you tried about and just so much more.
[1:39]Right.
[1:40]Yeah, yeah, there's so much to talk about, but yeah, actually, like when I thought about
[1:44]writing the book, it really was an opportunity to get my mom, most of you always had a
[1:48]voice, but to share that voice with others, like people who didn't know her or didn't
[1:53]have the fortune to interact with her and she just had such a different upbringing
[1:59]than I did.
[2:00]She had a really challenging upbringing, single mom, born on public assistance and they
[2:06]moved a lot, changed schools.
[2:08]It was really rough, but despite all of that, she was the first person in her family to
[2:12]go to college, joined to Brooklyn College and then had a chemistry professor who saw
[2:18]all the potential in her.
[2:19]Sarah was like, easy to biomedical school.
[2:21]So she applied to medical school and got into all her med schools and ended up in Harvard
[2:25]Medical School and like, you know, she obviously felt like up the shadow of water there
[2:28]because there were kids who was one kid, whose parent had won the Nobel Prize in biology
[2:35]and other relative of Jackie O'Nazis, but you know, she found her friends there and she
[2:40]made it through.
[2:41]But what was really, I think most important was she came back to the same community.
[2:45]She grew up in to practice, so she took care of her friends and neighbors and I think
[2:50]she was super, like super purpose driven, like the work, the work was more than just work.
[2:55]It was really, you know, how do I show care or how do I work in service to my community?
[3:00]And so she made such a tremendous impact on my sister and me as a result.
[3:04]Well, you talked about how there's almost like a new name for the type of medicine she
[3:08]practiced because she took into consideration really the whole person and all of the environmental
[3:12]factors and everything about them, not just like the one tiny complaint of the skin
[3:17]knee or whatever it might be.
[3:19]Yeah, exactly.
[3:20]And I feel like so much of like what we learned in medical school, it's about like, you
[3:24]know, the patient position relationship and just what happens between the two of us as
[3:29]opposed to like when you're in, you know, the exam room or clinic room with your patient,
[3:34]you really are in the room with like all their family, their friends, their employer,
[3:38]like, I mean, it literally because all of that we know now, like, now we know it impacts
[3:43]how healthy people are.
[3:45]And so I feel like my mom really got to know her patients on a very, very intimate level
[3:50]so that she could provide the best care possible to them.
[3:53]And yeah, it's a now that has like, it's called culturally responsive care and structurally
[3:57]competent care.
[3:58]But I feel like my mom was practicing that in the 80s and 90s before there were these sexy
[4:03]terms for it.
[4:05]Oh, and you, uh, you paint such a picture of you and your sister, like, doing your homework
[4:10]there at the desks and like, of course, then the two of you go on to Harvard Medical School,
[4:15]yourselves and both become doctors in different neighborhoods, which is amazing.
[4:19]I mean, I have to, like, I have to, I'm like, oh my gosh, like, what's going to happen
[4:26]with them?
[4:27]Like, well, I always joke that like we were fun mothers, little projects, like, I mean,
[4:31]she put, I think it's because of her upbringing, you know, I think because she grew up
[4:36]in poverty, like, she wanted to give up so much.
[4:39]And so it exposed us to everything, like, everything was a learning experience, like, going
[4:44]to the Brooklyn Botanic Garden, like, looking at the different flowers, going to museums
[4:48]and introducing us to artists when we were, you know, artists like most people don't
[4:51]know about until they're adults, but when we were young, you know, taking us traveling.
[4:56]And so I feel like we were a little project and even on Saturdays, we literally Saturday
[5:00]morning to be full of activities, gymnastics, modern dance, you know, reading comprehension
[5:06]because, like, she really had this drive, like, I want my kid, I want these girls to have
[5:11]a totally different life than I had.
[5:13]And that's a say, and actually when we went off the college at 18, she's like, you
[5:16]know what?
[5:17]I'm really tired.
[5:18]She said that even before she got diagnosed, and maybe as part of, you know, the leukemia
[5:23]that just touched her is tired, but she said, I'm really tired, I put so much, I put
[5:27]so much into you, girl, but we didn't do too shabby, but, you know, but actually, you
[5:32]know, conversations I had with her when she was sick, she told me, you know, I want, you
[5:36]know, I asked her, like, what are things I should know, you know, when I knew that she wasn't
[5:39]going to, you know, wanting to live much longer.
[5:42]And she's like, I want you to, you don't want you to have your kid, I want you to still
[5:45]take care of yourself.
[5:46]And that has always stayed with me.
[5:48]I was so struck by that scene in the book, too.
[5:50]And I'm like, wow, that is the parting advice, like, from a 47-year-old mom, and I'm 47
[5:56]now, and I was like, and at first, sometimes I read it, I'm like, oh, 47, well, that
[5:59]was old.
[6:00]And I'm like, wait, I'm 47, like, that's not old at all.
[6:03]It's so young.
[6:04]And I'm so sorry that you lost her and just sounded terrible and the way it had, you
[6:10]know, how quick.
[6:11]Just the whole thing.
[6:12]I'm so sorry.
[6:13]I mean, obviously, there's no, no good way, but yeah, that she was, that that was the
[6:18]parting advice.
[6:19]Like, I'm not sure, like, what my parting advice would be to my kids, I don't think
[6:23]it would be that, but maybe it should be, maybe it should be, maybe I'm going to
[6:25]learn from her.
[6:26]Yeah.
[6:27]You know, I think it was that, like, she kind of, I think she might maybe had some time
[6:31]just to look back and was like, you know, maybe I should have, like, she was so present
[6:36]for us, so present for her patients, so present for everyone in her life that it's like,
[6:41]okay, to like, people a little bit for yourself.
[6:44]And I think that's kind of what she was trying to tell us and, you know, interestingly,
[6:49]like, we were only 19.
[6:50]And at the time, I didn't feel like a little girl, because I was like, again, you know,
[6:54]I guess you had a woman, but in retrospect, now it's 46, I was six, I was back.
[6:59]And I'm like, we were just babies, like, we literally were just babies.
[7:03]And I even thought, like, once I had my own kids that I would stop, like, the pain of losing
[7:08]her would lessen, but actually, no, it's got even more because I said, wow, my kids
[7:15]could have had this whole other, you know, grandparent here who would love on them and be
[7:21]sweet to them and also help support me as a parent, you know, just like, because you always
[7:25]need, you always need mothering, that's the other thing.
[7:28]Like, it doesn't matter how old you are, like, you always need mothering, you need someone
[7:33]who is going to like see for who you are, you can be vulnerable with, you know, and who
[7:37]like, literally looking out for you and only you.
[7:41]It's true.
[7:42]I mean, what you say is just so poignant, because it is the people that you lose, you lose
[7:47]the love they had for you that's in the world.
[7:50]Where does that go?
[7:51]Like, how do you get that feeling?
[7:52]When I lost my grandmother, I was like, she had that unique love for, you know, just that
[7:56]special thing.
[7:57]And like, where did all those rays of, you know, like where did I go?
[8:02]Like, where did it anyway?
[8:03]Exactly.
[8:04]Sounds silly.
[8:05]No, I know.
[8:06]So you also wrote in detail about a time when you were misdiagnosed, which sounded horrific
[8:10]and your appendix ended up getting in fact, you know, bursting and infected, you were
[8:15]misdiagnosed.
[8:16]You know, the thesis of the book is that there is a lot of racism in medicine and how
[8:21]do we reduce that and all of that.
[8:23]And, you know, part of every story told takes that view, but also like, how could they,
[8:30]how could it not have been missed?
[8:31]And was it that?
[8:32]Was it not that?
[8:33]Anyway, so looking back on the whole thing, like what do you make of it now?
[8:37]Yeah.
[8:38]I think at the time I didn't really like, I didn't really understand what was going
[8:41]on.
[8:42]It was really frustrating that no one kind of, you know, what was going on and I was
[8:46]feeling sicker and sicker and that like, also I was being questioned about things like
[8:51]multiple times, like, my pain was being down to like, it was not in that much pain.
[8:56]And then he had, and then I kind of was just like, okay, and then my twin sister thought
[9:00]she's like, I think you have a pen to cite it.
[9:02]And you know, she was in that school with me, but we didn't feel like comfortable enough
[9:06]to like tell the doctors that, you know, something, even if medical students, we didn't
[9:10]feel comfortable.
[9:11]And so, you know, it really was like looking back after the fact that I was like, could
[9:15]have been because I was a young black woman, could not have been.
[9:19]But like, we know there's a lot of data out there that shows like, for women or black
[9:23]people often in healthcare settings, people are not, you know, you're not listened to
[9:28]as much or your pain is minimized, like there's a lot of gaslighting that happens.
[9:32]And so it kind of just made me later on as a practicing position, reflect on that experience.
[9:37]But actually at the time, what it did for me was it just made me more understanding of
[9:41]my patients.
[9:42]And one thing is like listening, like listening, listening, listening to my patients because
[9:46]I wish those doctors had listened to me.
[9:48]And when you talked about your experience in the pandemic, and you had that one scene where
[9:52]you're wearing all the PPE and everything, and you had a young black girl as your patient.
[9:56]And she said to you, like, can I ask you something?
[9:58]Like, are you black?
[9:59]And you're like...
[10:00]Like, yes, I am.
[10:00]And she was like, and you could see her like, relax, right?
[10:03]Yeah.
[10:04]And tell me about that moment and just like,
[10:06]the fact that there are so few black doctors
[10:08]in the world like percentage-wise
[10:09]and give all the statistics and everything,
[10:11]it's really insane.
[10:12]It's really great.
[10:13]Yeah, I mean, like in that moment,
[10:16]like I was glad that I could be the doctor she needed,
[10:19]but at the same time it made me feel sad
[10:21]because it made me realize that like,
[10:23]she had had these experiences before
[10:26]where she didn't feel listened to.
[10:27]And so like the fact that she'd be like,
[10:29]oh, I think God, you know?
[10:30]And so like ideally we want to have like,
[10:33]health professionals and physicians
[10:34]that could take care of everybody.
[10:35]Like and give everyone the best care possible, right?
[10:38]And what everyone to feel,
[10:40]all patients that feel seen heard and appreciated
[10:43]when they go to see a doctor, right?
[10:45]So one thing I talk about in the book is just like this report
[10:47]called the Flexner Report that came out in 1910
[10:51]that was commissioned by the American Medical Association
[10:53]and Carnegie Foundation.
[10:55]And that actually led to the closure of five
[10:57]out of seven of the historically black medical schools.
[11:00]And there was a study that came out in 2020
[11:03]that showed those schools would have trained
[11:05]between 25,000 and 35,000 black physicians.
[11:08]So I think for me, a lot of the book is like using my story,
[11:12]my mother's story, bringing in history
[11:14]to like help kind of explain like how we got to where we are
[11:17]today in 2024 where we have like such a small percentage
[11:21]of black positions where we have these racial health inequities
[11:24]that they did just come out of nowhere.
[11:26]Like there are, you know, policy decisions and practices
[11:29]that actually have created this environment we're in now.
[11:33]So what, what now?
[11:34]What are our next steps?
[11:36]Do you say, yeah, we'll finish reading the book.
[11:37]They're totally inspired for so many months.
[11:40]They're your cheerleader from now on.
[11:42]What now, what can we do?
[11:44]Yeah, so like, you know, in the last chapter,
[11:46]I have a call to action because I knew that people would be like,
[11:48]okay, so what now, it's like the different groups.
[11:51]I think like for like positions and like in medical school,
[11:56]but really to think about how we're teaching our students
[11:59]to care for patients and really to listen to them, you know,
[12:02]very, very well to think about what's in the curriculum.
[12:05]And then also recognizing that, you know, being a great doctor
[12:08]is like continuing medical education.
[12:10]Like you're, you're always going to be learning something.
[12:12]That's actually love about being a doctor,
[12:14]but also addressing some of these issues as people go on
[12:17]in their career.
[12:19]And I think also the other thing is holding hospital accountable,
[12:21]like making sure that they're tracking metrics to make sure
[12:24]that every patient is getting the best care possible
[12:26]if they see any discrepancy in, for example,
[12:28]who's being prescribed pain medications, who's not
[12:31]that they are keeping track of that and that they can
[12:33]intervene as needed.
[12:35]But another thing I talk about is some time the problem seems so big
[12:38]that there's a lot of things happening on a hyperlocal
[12:41]and local level.
[12:42]So I talk about there's a birthing center in Minneapolis
[12:45]called the Roots Birthing Center that's owned by a black midwife.
[12:48]And she created the birthing center specifically to care for
[12:52]black birthing people just to make sure that we're honoring their
[12:55]dignity and respect.
[12:56]And they've actually shown that they've had great health outcomes.
[12:59]And so there are things that we can invest in that we can like,
[13:02]you know, maybe volunteer there or donate there
[13:05]or see what's happening in our own communities where we can help
[13:08]to advance health equity.
[13:10]I love that.
[13:11]So your mom made you do all these activities as kids.
[13:15]What in all of that do you still do or do you are you glad that you
[13:20]possess the skills for?
[13:22]You know what?
[13:22]I have to think that all of those classes, like, you know,
[13:26]all of those practices made.
[13:28]So some have created the person I am today where like I'm super,
[13:31]super purpose driven, like very passionate.
[13:35]I don't play the violin anymore.
[13:36]I definitely feel too gymnastics.
[13:39]But I think all of that was like, you know,
[13:42]kind of my mother's love showing up in different ways.
[13:45]And so I always say like when people meet me, they meet her.
[13:50]Even though she's not, she's no longer physically here.
[13:53]But like this like my sister and I are the
[13:55]them manifestation of like the kind of mother she was,
[13:58]the love that she gave us, the experiences that she gave us.
[14:01]Well, I am so sorry that you don't have her.
[14:03]It's totally not fair.
[14:04]And I'm sure she would be so proud of you.
[14:06]Tell me about deciding to write this book and how long that took
[14:10]and what that was like.
[14:11]I know.
[14:12]So interesting because people, I still I have this whole experience
[14:16]like when I was, I was in academic medicine.
[14:19]I wasn't happy there.
[14:20]Just if I felt very excited once and muggled.
[14:22]So I left to start my company and I was working her time
[14:25]in urgent care and then the pandemic happened in 2020.
[14:28]And I all of a sudden got this like increased platform.
[14:32]And my agent heard me on a local radio show.
[14:37]And she's like, I've been seeing your tweets.
[14:39]I've been hearing about you as a health communicator.
[14:42]And she's like, you know, I read about you,
[14:43]I read about your mom, I read about the advocacy you do.
[14:46]And I think you should write a book and I feel like there's a
[14:49]book out there and you're the only person to write this book.
[14:53]And she had so much, you know, it was like so amazing.
[14:56]And so we worked on the proposal together.
[14:58]But really, I thought it would be a great opportunity.
[15:01]Again, to share my mother's story, to share my experiences,
[15:04]but to use that story telling as a way of talking about
[15:07]this really difficult topic for sharing some of the history,
[15:10]social commentary.
[15:12]And so I worked for a year and a half on the book.
[15:14]I would say like it was, you know, it's a dosting.
[15:17]It's a memoir, we know part memoir, part advocacy history.
[15:22]It was like, you know, emotionally, psychologically draining.
[15:25]I have to admit like right before it came out,
[15:28]I was like, oh, my feeling incredibly vulnerable also,
[15:32]because I'm sharing my family's story.
[15:34]And I actually had my twin sister, like she read all through it.
[15:37]And gave me feedback and everything.
[15:39]I wanted to make sure that she also was pleased or satisfied
[15:42]with how we were presenting our family.
[15:45]But I feel like it's such an honor to be an author.
[15:48]Like I feel like this is my gift to the world.
[15:50]Like sharing about my experiences, my mom, sharing this history,
[15:54]sharing how people can make a difference all in one book.
[15:58]Amazing.
[15:59]Wow, a year and a half is not bad, by the way,
[16:01]to write a whole memoir.
[16:02]Oh yeah.
[16:03]Oh yeah.
[16:04]Sometimes it's like seven years, eight years.
[16:06]13 years, you never know.
[16:08]Well, you know, like, you know, I'm a mom, I'm a doctor,
[16:13]I'm a business owner, so I feel like I'm really efficient.
[16:16]I'm super efficient.
[16:17]Like if you give me a chance to do, I'm going to do it.
[16:20]So I have, next time I have something to do,
[16:22]I'm calling you, Uche, I'm sure you're the same.
[16:27]I'm sure you're the same.
[16:28]I know, I am pretty efficient.
[16:30]I have to say, but like, it's like, how do you get it?
[16:33]You just do it.
[16:34]You don't even have a choice.
[16:35]You just throw it in the mix and it gets done.
[16:36]It's like, we're like, squeeze an arts.
[16:38]You know, like, you just keep putting stuff in it.
[16:39]It's going to work just as fast.
[16:41]Yeah, exactly.
[16:43]But what I was going to share is that like,
[16:44]I really enjoyed recording about audio book.
[16:46]I didn't think I was going to,
[16:47]yeah, I didn't think I was going to enjoy it as much as I did,
[16:50]but it was really, really wonderful.
[16:52]I almost would tell people, like,
[16:54]listen to the audio book over reading the book
[16:55]just because it's me talking about my experiences
[16:59]and it made me fall in love with the book again.
[17:03]Oh, that's so nice.
[17:04]Are you doing a big marketing at Regid hospitals
[17:06]and the hospital gift shops and all of that?
[17:08]Yeah, yeah, like with a lot of large hospitals
[17:12]organizations, but actually, you know,
[17:14]you wrote the book for a broad audience.
[17:16]Like I kind of feel like, yeah, yeah, yeah, yeah, yeah.
[17:18]But, but I still, yeah, definitely
[17:20]we're doing the health focus, but in hospital focus,
[17:23]but I would love for even people, you know,
[17:25]anyone to read the book,
[17:27]because I think there's something in it for everyone.
[17:29]I just meant from a marketing perspective.
[17:31]Of course, this is a book for everybody.
[17:33]I was just thinking, like, you know,
[17:35]to reach some of the other doctors and hospitals,
[17:40]you know, administrators and just everybody
[17:42]should be aware of some of the things in there
[17:45]that they might not have known.
[17:46]Yeah, but I'm getting a lot of requests, definitely,
[17:50]to come and speak about the book
[17:53]to help related organizations.
[17:54]And I'm really happy about that.
[17:56]That's great.
[17:57]So what is still on your wish list of life?
[18:00]My bucket list.
[18:01]Yeah, like your, yeah, your bucket list,
[18:03]your wish list of life are the things you want to achieve.
[18:05]Like you wrote the book.
[18:06]You did this, you did that.
[18:07]Now, what else is that?
[18:08]Yeah, I would love to get the point
[18:11]where I could have a philanthropy
[18:14]and actually help support some of these small community
[18:18]based organizations that are doing such beautiful,
[18:22]wonderful work, but kind of like are unknown and unseen.
[18:26]So I would love, I know, I look to get to a point
[18:28]where I can actually help them thrive.
[18:31]That would be amazing.
[18:33]Wow.
[18:34]And it's a good message for the world,
[18:37]even in the wish list.
[18:38]So there you go.
[18:38]Yeah, it's amazing.
[18:41]Would you ever write another book?
[18:43]Oh, you I definitely want you.
[18:44]I'm not sure what it would be.
[18:45]I was thinking maybe a children's book with my sister.
[18:48]Like, you know, like for, you know,
[18:50]two twins that have a mom who's a doctor.
[18:53]I'm so like a children's book
[18:54]and then, you know, her mom's a big inspiration to us.
[18:57]So that's something.
[18:58]And then I'll see what happens, you know,
[19:00]after, you know, the book is this book,
[19:02]like it's used out for a while
[19:03]and see what kind of feedback there is
[19:04]and see if there's been for another book.
[19:06]But right now, I'm just enjoying having it out.
[19:09]Has he shed?
[19:10]Has he shed?
[19:11]Well, congratulations.
[19:13]And thank you for sharing your story and your experiences.
[19:15]And there's really no better way to inspire change
[19:19]than to share from the most person to person deeply
[19:23]personal, experiential.
[19:25]Like, it's one thing to get facts and figures,
[19:26]but it's another to be like, listen, here's what happened to me.
[19:28]And let me tell you this and let me tell you that.
[19:30]It's a lot of impact.
[19:31]So anyway, thank you.
[19:32]Thank you so much for having me.
[19:34]It's my pleasure.
[19:35]Good luck.
[19:36]Okay, take care.
[19:37]Bye bye.
[19:38]Bye bye.
[19:40]Thanks for listening to this episode of Moms Don't Have Time
[19:43]to Read Books.
[19:44]Don't forget to follow me on Instagram,
[19:46]at Zebioans and at Moms Don't Have Time to Read Books.
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[19:51]and sign up for my virtual book club
[19:53]and meet lots of authors on Zoom every other week.
[19:56]Thanks so much to Steve and Ryan
[19:57]at Textures Sound for the Sound Editing.
[20:00]And thank you to Morning Moon Productions for providing this fantastic intro and outro music.