In “Legacy,” a physician explores the obstacles keeping Black Americans out of medicine

When Dr. Uché Blackstock and her twin sister graduated from Harvard Medical School in 2005, they became the school’s first Black mother-daughter legacies. Their mother had received her medical degree three decades before and had an enormous influence over Blackstock’s career ambitions.

“She was a leader of a black woman physician group in Brooklyn. And so for many years, I thought that most physicians were Black women,” Blackstock said in an interview with “Marketplace” host Kai Ryssdal. “Until I got to college and medical school, and I realized that we actually are only about less than 3% of all physicians.”

In her book “Legacy: A Black Physician Reckons With Racism in Medicine,” Blackstock looks at the historical and systemic reasons there are so few Black physicians. She also traces her own family’s multigenerational experience in the field. The following is an excerpt from the book looking at the influence her mother, Dr. Dale Blackstock, had on her career.

From an early age, my twin sister, Oni, and I loved to play with our mother’s doctor’s bag. It was an old-school, heavy black leather bag, worn and cracked around the edges, that snapped open from the top to reveal the medical instruments inside. Her full name was written in faded golden uppercase letters across one side of the bag, followed by “M.D.” The bag lived in her bedroom, under her bureau. As children, we were always getting into her business, whether it was looking through old papers and photographs in the small file cabinet in her room or pulling out shoes and scarves from her closet. We knew that the medical bag was important to her, so that made it important to us.

Whenever we could, we snuck up into her room, emptying out the contents of the bag on the floor: her stethoscope, with its long rubber tubing, the little hammer to test reflexes, the otoscope for ear exams, the ophthalmoscope for looking at the eyes. Then we’d sit and play doctor together. I’d listen to the thump, thump, thump of my sister’s heart with the stethoscope in my ears or I’d hop up onto the bed so Oni could hit just under my knee with the reflex hammer, making my leg flip up quickly. If our mother came in and found us mid-game, she would smile warmly. She was a petite woman who wore her hair natural and in a small Afro.

“Girls, please be careful with those. They’re all quite delicate,” she warned us.

Except for the stethoscope, I didn’t know any of the names of the precious contents of the bag, but I understood these were the tools of our mother’s trade. By the time my sister and I got to Harvard Medical School, the instruments were as familiar to us as the forks and spoons in our kitchen.

The children’s advocate Marian Wright Edelman once famously pointed out, “You can’t be what you can’t see.” Growing up in Brooklyn in the 1980s and ’90s, we saw Black women who were physicians all around us. Our mother practiced medicine at Kings County Hospital Center and its state affiliate, SUNY Downstate Health Sciences University, not far from our home in central Brooklyn. Our own pediatrician, Dr. June Mulvaney, was a Black woman. We loved going to see Dr. Mulvaney, even if vaccinations were involved, because she was a bespectacled, kind older woman with soft hands and an even softer smile, who was a good friend of our mother’s. Another Black physician, Dr. Mildred Clarke, an obstetrician-gynecologist, lived on our block. We would often see Dr. Clarke while out running errands, stopping to chat about the most recent neighborhood news. Our mother was the president of an organization of local Black women physicians that included Dr. Clarke and Dr. Mulvaney. They were all very put-together, fiercely intelligent women who held themselves with pride and devoted their little spare time educating their community through holding events like local health fairs.

From the day she gave birth to us at Columbia-Presbyterian Hospital in the Washington Heights section of Manhattan, our mother was determined that my sister and I should have every opportunity she had lacked. We grew up in the home our family owned on St. Mark’s Avenue in Crown Heights, Brooklyn. Back then, Crown Heights was a bustling neighborhood that was home to many middle-class and working-class families, a uniquely Brooklyn mix of Black Americans and immigrants from the Caribbean like our father, Earl Blackstock, who was born in Jamaica. Our mother was constantly reading to us as small children, bringing us to the library for story time or taking us on educational adventures in Prospect Park and the Brooklyn Botanic Garden. When we got older and entered grade school, she was the kind of mother who didn’t hesitate to give us extra assignments if she felt our teachers weren’t assigning enough challenging work. If we had friends over for sleepovers, she’d cue up the movie and popcorn, and when the movie was over, she’d announce it was time to do our math worksheets. Our friends, who also had to do the worksheets, didn’t seem to mind too much—somehow, she made it all seem like part of the fun. Saturdays were for a host of extracurricular activities: violin lessons, music theory, modern dance, and gymnastics. I can still picture her, leaning against the sink in our old kitchen, scouring the newspaper for educational activities while we were on vacation from school. Her goal was to keep us stimulated—always. Much to our dismay, we were rarely allowed to watch television. On weekends and holidays, we went to the most popular NYC museums, the United Nations, science exhibits, with our mother narrating, explaining, pointing things out as we went along. Even a walk around our neighborhood was an educational adventure, with her perusing her pocket-size book on flowers and pointing out the different types in our neighbors’ front yards.

“Girls, come over here. Look at these gorgeous azaleas,” she’d say to us, bending down to touch the flowers lightly with her slender fingers. “They bloom only in the springtime,” she’d continue as we peered over her shoulders.

Looking back, I think she understood that this world was going to be tough on us and she needed to make sure we were fully prepared, but also that we experienced moments of joy.

For our mother, science was part of that joy. Once we went to a science exhibit where there was a real cow’s eyeball on display so that kids could pick it up and see how an eye worked. At first, my sister and I recoiled from touching the large white eye with its spidery blood vessels, but our mother persuaded us to cradle the strange object in our hands, then she leaned in close and explained the mechanisms of the eye to us in great detail. What had scared us a few moments before became a way to introduce us to the wonder of sight.

When summer came around, she signed us up for science programs, including one at her hospital, where she taught some of our sessions. Her specialty was nephrology, the study of the kidneys, and I have a clear memory of sitting in class at age twelve, with a small group of other students, watching her standing in front of the chalkboard, wearing her long white coat over her small frame. I felt so proud to have her up in front of the room teaching a classroom of my peers.

As she took a big piece of white chalk, she asked us, “Did you know that the kidney is one of the most sophisticated organs in our bodies?”

She drew a long looping shape on the board, exclaiming, “And this is the nephron, the smallest unit of the kidney! It’s a powerhouse.”

I remember her pulling a cylinder-shaped filter from a dialysis machine, to show us how it processed the blood from patients. She explained to us, in easy-to-understand terms, how this plain looking filter saved lives. It was in that moment, sitting in that classroom as a twelve-year-old on a hot summer day, that I realized the power of my mother’s work—to heal, to repair, to care. To be the difference between someone living and dying. I felt in awe of her.

I later learned that our mother chose her specialty, nephrology, because it’s one of the most difficult specialties in medicine—the kidneys are incredibly complex organs, and she loved a challenge. But I believe she also went into the field because kidney disease disproportionately affects Black people, and she wanted to help in some way. Because poorly controlled blood pressure and blood sugar negatively impact the kidney’s function, many of her patients also had these conditions, which were the result of lack of access to quality care and the chronic pressure of living with racism and other structural inequities. In her work, my mother was determined to address these entrenched health problems to the utmost of her abilities.

It wasn’t only patients who benefited from her time and attention. Black medical students and junior faculty at Downstate sought her out for inspiration and advice and she became a mentor to a generation of Brooklyn physicians, even inspiring those in health care who weren’t physicians, but physician assistants, nurses, and social workers. Many years later, as an adult, I ran into a former student of my mother’s at a medical conference in the city. We made eye contact across the room, and she smiled and made her way toward me, later saying that she had recognized me because I looked so much like my mother. She immediately introduced herself, hugged me tightly, and told me that when she was a third-year medical student doing her clinical clerkship, she had gone to see my mother and confessed how nervous she felt about presenting patient cases. She had explained how she was immobilized with fear and anxiety when it came her turn to describe the patient’s medical history and plan for treatment to the team. From then on, my mother met with her every morning, before the start of the day, so they could practice her oral presentations together. This wasn’t part of my mother’s role or responsibility at Downstate—she wasn’t even on the woman’s team. But my mother knew how it felt to be a student looking for that kind of support, and so she became the mentor she wished she’d had. Today, that student is the associate dean in the Office of Diversity Education and Research at a New York City medical school.

Our mother was tireless in her work ethic. Even after she left the hospital, her work wasn’t done. Back then, she was president of the Susan Smith McKinney Steward Medical Society, a local organization of Black women physicians named after the third Black woman to obtain a medical degree in the US and the first in New York state. During the society’s regular meetings, Oni and I would sit in the back of a large conference room, doing our homework, whispering, or passing silly notes back and forth, as my mother and her colleagues handled their serious business. They spent considerable time planning community health fairs, where they would dispense information about diabetes, high blood pressure, and other health issues rampant in our community. At the fairs, they would take people’s vital signs, recommend follow-up services, and counsel neighbors about healthy diet and exercise. Our mother and the other women in her organization were our role models. They worked, they raised children, they took care of their households, and they gave back to their communities.

I don’t think it ever occurred to Oni and me to do anything else with our lives but to follow in their footsteps.

From Legacy by Uché Blackstock, MD, published by Viking, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2024 by Uché Blackstock, MD.

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