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Legacy: A Black Physician Reckons with Racism in Medicine

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Legacy is an illuminating and stirring journey of a book.” —Ibram X. Kendi, #1 New York Times- bestselling author of How to Be an Antiracist

The rousing, captivating story of a Black physician, her career in medicine, and the deep inequities that still exist in the U.S. healthcare system

Growing up in Brooklyn, New York, it never occurred to Uché Blackstock and her twin sister, Oni, that they would be anything but physicians. In the 1980s, their mother headed an organization of Black women physicians, and for years the girls watched these fiercely intelligent women in white coats tend to their patients and neighbors, host community health fairs, cure ills, and save lives.

What Dr. Uché Blackstock did not understand as a child—or learn about at Harvard Medical School, where she and her sister had followed in their mother’s footsteps, making them the first Black mother-daughter legacies from the school—were the profound and long-standing systemic inequities that mean just 2 percent of all U.S. physicians today are Black women; the racist practices and policies that ensure Black Americans have far worse health outcomes than any other group in the country; and the flawed system that endangers the well-being of communities like theirs. As an ER physician, and later as a professor in academic medicine, Dr. Blackstock became profoundly aware of the systemic barriers that Black patients and physicians continue to face.

Legacy is a journey through the critical intersection of racism and healthcare. At once a searing indictment of our healthcare system, a generational family memoir, and a call to action, Legacy is Dr. Blackstock’s odyssey from child to medical student to practicing physician—to finally seizing her own power as a health equity advocate against the backdrop of the pandemic and the Black Lives Matter movement.

304 pages, Kindle Edition

First published January 23, 2024

About the author

Uché Blackstock

2 books109 followers
Dr. Uché Blackstock is a physician and thought leader on bias and racism in healthcare.

She appears on air regularly as an MSNBC medical contributor and is the founder and CEO of Advancing Health Equity, as well as a former associate professor in the Department of Emergency Medicine and the former faculty director for recruitment, retention, and inclusion in the Office of Diversity Affairs at NYU School of Medicine.

Dr. Blackstock received both her undergraduate and medical degrees from Harvard University, making her and her twin sister, Oni, the first Black mother-daughter legacies from Harvard Medical School.

Dr. Blackstock currently lives in her hometown of Brooklyn, New York, with her two school-age children.

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5 stars
1,039 (55%)
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143 (7%)
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Displaying 1 - 30 of 270 reviews
Profile Image for Traci Thomas.
699 reviews11.9k followers
January 12, 2024
I liked the book and think its a good personal entry into racism in medicine. It is a surface memoir but really illustrates and overview into medical racism.
Profile Image for Amber.
612 reviews73 followers
January 31, 2024
A great blend of personal stories and research of healthcare inequalities. Idk if the parts of the author explaining her medical training will be too technical for layperson but I LOVED every moment of it!

My only note is the audiobook she mispronounced JohnS Hopkins as John Hopkins 🤣🙈 not sure if the print version has a typo lol
Profile Image for Deb.
231 reviews4 followers
March 17, 2024
During my anesthesia training, we were lectured that our black patients had “thicker skin” so we were to use more pressure when starting IVs and other invasive procedures. We were lectured that black patients had “higher pain tolerance” and that requests for pain medications were usually “drug-seeking behaviors”.
This was all presented as scientific fact.
It’s horrifying that in 40 years, these outdated and dangerous perceptions haven’t changed and in many ways, have gotten worse. As medicine becomes more corporatized, the focus on profit endangers us all, but the racist assumptions underlying corporate culture make healthcare even more fraught for the black community.
I knew about Tuskegee and Henrietta Lacks, Dr Blackstock tells more horrifying stories. Sadly, the people who most need to read this book probably won’t.
Profile Image for Lori.
1,523 reviews
November 12, 2023
I received a print copy of this book from the goodreads giveaways. Uche Blackstock is a physician who writes about the inequalites that black people face in medicine. Her Mother was a physician who tragically died when she was in her forties. Uche and her twin sisters both went to Harvard to become doctors.
The author writes about the racism black people face in medicine. She writes in this book about how black people die more than white people for many reasons. From lack of insurance or poor health insurance. Black people are not taken seriously when they go to a doctor so symptoms are ignored. Black women have a higher chance of dying in childbirth. During the Covid more black people died than other races.
the author also devotes a chapter to the many innocent black people who have died at the hands of police officers or other people who kill them just for walking in a neighborhood.
the author Uche Blackstone urges others to pay attention and support black lives matter. an interesting book that is well written by Uche Blackstone.
Profile Image for Emily Funari.
17 reviews1 follower
January 27, 2024
A really important and challenging book. I had heard about this book from NPR and immediately knew this was going on my to-be read list.

It’s easy to become complacent, but the truth is there is urgent action needed to be taken as healthcare workers to combat systemic racism. Dr. Blackstock has worked tirelessly to make her community better and her story should be read by those outside of healthcare as well.
Profile Image for Megan Michelle.
203 reviews1 follower
September 13, 2023
Great biography type opinion piece. Not my usually read but a good palette cleanser that talks about the racial divide in medicine and gives an anecdotal stories to give more depth.

Profile Image for Kenzie | kenzienoelle.reads.
579 reviews117 followers
March 19, 2024
*I love a medical memoir (looking at you WHEN BREATH BECOMES AIR and THE BEAUTY IN BREAKING.) However, I do come into this book with some more biases reading it now than I may have a few years ago. As I have been going on my own journey looking for health answers, I have been repeatedly ignored, gaslit, talked down to and quite honestly just given horrible care from many in the traditional medicine and healthcare world. That being said, I have also had the privilege of working in this field and gotten to work alongside some of the most kindhearted, loving and smart humans I know and watching them interact with patients was a true joy. So many emotions, feelings and thoughts as I entered into this book…

*Uché Blackstock was a joy to read from. I loved looking at the world of medicine through the eyes of a Black woman and the role race has and does play in this world. As much of her career has been in the ED, she has stories to tell! But those personal antidotes balance well with her research and history.

*There is a fair amount of this book that centered around C*vid which wasn’t my fave. But I loved how she talked about her own experience being a patient and having her children and how much she advocated having a midwife and/or a Doula. I may not agree with everything in traditional medicine, but you can tell Uché cares about her patients and truly wants to help. Overall, really enjoyed this book and hearing Uché’s story!
Profile Image for Sahitya.
1,120 reviews239 followers
February 6, 2024
I just happened upon this memoir a few days before its release and decided why not give it a try. The memoir part of the book was interesting, getting to know Dr. Blackstock’s personal background and family history, the legacy of her mother which inspires her and the kinds of challenges she faced as a Black woman physician, both while in university and when working. I also liked how she correlates her personal experiences with racism to the history of medicine itself in this country; the dark relationships between medical breakthroughs and unethical experimentation on enslaved people and later other Black folks; and how this internalized racism in the teaching of medicine results in physicians with bias, negative outcomes for Black patients, and mistrust between the communities.

This is a well written and easy to read book, especially if one wants to learn about the basics of the topic of racism and medicine. I can’t say I got to know a lot of stuff I didn’t already know, but as a beginners book on the theme, this will work in a very accessible manner. And I really appreciate the advocacy work the author is doing through her organization, Advancing Health Equity - it’s much needed in a country that outspends all developed countries in healthcare but with much lesser positive outcomes.
Profile Image for Me, My Shelf, & I.
1,029 reviews130 followers
May 19, 2024
While I was in college maybe 1-1.5 decades after the author, I'm happy to say that my university experience was different than hers. She often laments that Tuskegee, HeLa cells, maternal mortality being highest for Black women, and "thicker skin"/"higher pain tolerance" being a falsity were not parts of her education, but they were definitely part of my learning. (Note: I studied on the West Coast while she studied in New England and those geographic circumstances may have lead to the divergence, especially since she mentions her students still advocating for learning this in the years past when I graduated.)

I can't say that this book was particularly useful to me on an individual level, but I do think the information within is well-supported and will be new to people outside of this sphere. There is a major institutional racism issue in this country that needs to first be known before it can be dismantled. I think that the way she writes this book as a memoir and reflection on her own personal life and medical career will make the book more approachable to those without a scientific background.

For my own anecdotal experience-- I started my studies and career in California, and then moved to work at Yale New Haven Hospital (YNHH) as it was one of the most premiere hospitals, a level 1 trauma center where I could be exposed to some of the most complex patients and feel confident moving on to any patient population after that. One of the factors that lead to my disenfranchisement was seeing that the janitorial and food staff were >90% Black, while I only met two Black physicians in my year there (one was a med student in pediatrics, another was an African immigrant who did not grow up in the US). I loved attending the biomedical ethics seminars while I was there (and that I've been able to do a few over Zoom since they opened that option during the pandemic), but I couldn't help but feel overwhelmed by the glaring inequality that seemed to go unacknowledged and with nothing being done.

This work is important and the author seems incredibly brave for taking on this exhausting and often thankless job.

One additional factoid that I learned in my coursework (I want to say Community Nutrition circa 2015-2016) that was not contained in this book: Black women are more likely to get a C-section in the US. This isn't because of complications or illness or risk factors but one simple thing: performing a surgery is an additional, lucrative line item the hospital/surgeon can charge. Since they're more likely to have an insurance that will cover the procedure and less likely to give pushback, more Black women are given C-sections. The fact that they're more likely to be deemed "high-risk" and less likely to be able to cover the out-of-pocket expenses associated with an at-home birth also contribute to this.
You can read more here: https://www.opendemocracy.net/en/why-...
Profile Image for Chaya.
248 reviews13 followers
March 4, 2024
My first five stars of the year!! I always tend to think I'm not interested enough in non-fiction and that that's the reason I struggle to read it. But then I stumble upon a book like this one and I realise that it isn't that I don't like non-fic but simply that they're often not written well-enough. This was so well written. One part was more memoir like and the second felt more essay-ish. It touched upon important issues while also having a very story like way of presenting the information.
It kind of reminds me of invisible women, only better written and focused on racism in healthcare.
This is a must read for everyone!!
Profile Image for Black Book Witch .
43 reviews1 follower
January 28, 2024
This book is necessary reading material for all Americans. Thank you Dr. Uché Blackstock for shedding light on something that has been happening for so long in this country. This book gave voice to why I still insist on seeing Black female physicians even though they are so difficult to find even in a city as diverse as Brooklyn. This book provided a concise map directly back to our Black ancestors who we have to thank for current advances in medicine ranging from vaccines to doulas who have a track record of keeping Black birthing people alive when our hospitals cannot. This book thoughtfully explains how racism prematurely ages Black people and the fight against it has been unfairly placed on the shoulders of the very people it sickens. I am in awe still of this book and its author and Dr. Uché’s mother — her legacy is all up in through this book ❤️🙏🏾
Profile Image for Sarah.
343 reviews1 follower
May 3, 2024
A review doesn’t do this justice. A must read for everyone.
Profile Image for Rebecca Shrader.
153 reviews9 followers
March 22, 2024
For anyone in the medical field, this is a MUST read. I work in a high risk OB office and this book will change the way I practice. I work with amazing doctors who are very aware of bias and strive everyday to challenge their own perspectives. 2.8% of physicians are Black women. This is why Black women and Black babies face extremely high mortality rates for a developed nation.

Dr Blackstone and her sister became doctors after their mom modeled it for them. They graduated from Harvard med school and worked in Brooklyn hospitals just like her. She passed from a blood cancer at 47 and I resonated deeply with them following in her footsteps and wanted to retain her legacy as that mirrors my own story.

I learned that Raleigh, NC had a medical school in the south that trained Black medical students during Reconstruction that was shut down along with several others. If they weren’t shut down, they would have trained over 35,000 Black physicians.

Dr Blackstone lays out the systemic racism in med schools, hospitals, and society at large that keeps more Black people in poverty and less healthy than their white counterparts. There is severe distrust in Black communities due to the blatant racism and malpractice historically. COVID caused disproportionate deaths in Black and Latinx communities and vaccine hesitancy followed. Here are some impactful quotes:

“Her life couldn't have been more different than theirs. While she wanted to believe that she deserved to be there, she wasn't always certain. Her own claim to fame was that her mother had received her LPN degree after raising six children, attending school full-time, working full-time, taking care of the family, and getting off welfare. Our mother was very proud of her mother's achievements, but they weren't a Nobel Prize in Medicine.”

“Today, studies show that your zip code is a much bigger determinant of health outcomes than your DNA. Your zip code determines where you go to school, and your access to decent food, health care, and secure, affordable housing. It affects the kind of jobs and transportation that are available to you, all of which are major determinants in health outcomes.”

“In fact, the pulmonary function test dates back to the 1850s when a plantation physician from Louisi-ana, Dr: Samuel Cartwright, insisted that he had proved that Black people had a lesser lung capacity than white people. According to Cartwright, the only cure for this deficit was "forced labor." This was not his only outrageous claim in the name of science-he also believed that Black people who fled their masters were suffering from a mental illness he dubbed "drapetomania." Yet Cartwright's legacy lives on. The spirometer, a device we still use to measure pulmonary function in patients, was actually invented by none other than Cartwright-and modern versions of the device still include software that adjusts for the assumption that Black people have lesser lung capacity than white people.”

“In 1900, the United States had 100,000 midwives who attended 50 percent of all births. At the time of the writing of this book, there are only 15,000 midwives in this country, and fewer than 1,000 are Black; midwives attend only 8 percent of all births.
An abundance of studies show that out-of-hospital births are associated with lower C-section and maternal mortality rates and that if we increased midwife-delivered births, we could actually avert 40 percent of maternal deaths. Midwifery has been shown to reduce the use of medical interventions such as epidurals and C-sections, which are associated with greater risks than vaginal deliveries. In 2018, however; nearly 40 percent of all deliveriesin the US were by C-section.”

Profile Image for Danielle.
6 reviews
May 25, 2024
10 10 10s across the board. Excellent memoir and a great introduction to the history of medical racism. I’ve already shared information that I learned with people that I interact with daily. I also love the background of why Dr. Uché Blackstock got into DEI / health equity and the importance of her and her twin sister being legacies at Harvard Medical School ❤️.
Profile Image for Sandra.
12 reviews10 followers
February 5, 2024
I was filled with so many emotions while reading this book. As someone who work in the Pharmaceutical industry and who has had to advocate for myself during medical incidents this book was on the top of my TBR list for 2024. Hearing the stories first had from the eyes of a physician, mother, patient, and daughter was beyond touching. This book touched my heart as we hear first hand stories of medical disparities from a doctor. I loved this book so much and would definitely recommend this read.
Profile Image for Molly Firth.
145 reviews2 followers
February 2, 2024
This is a 4.5 only because some of the sentences felt clunky and hard to read. But the messages are critical - the medical field needs to change to better care for people of color. There is a lot of work to do and I love that Dr. Blackstock is helping to change it.
Profile Image for eliiizabethrae.
204 reviews35 followers
February 18, 2024
this was eye-opening, heartfelt, unapologetically truthful, and made me think more about the way i react to certain news articles and arguments
15 reviews
July 16, 2024
A book everyone should read who cares about justice in this country. This specifically focuses on health injustices and highlights her lived experiences and how we can move forward.
Profile Image for Brenna.
58 reviews1 follower
August 1, 2024
Learned so f****** much, made me so f****** angry.
July 9, 2024
Dare I say best book of the year so far?? Legacy was an exquisite mix of informative memoir and medical exposé. This book exposes many of the heinous racial inequities in the American medical system. Still, Blackstock has a way of writing that makes it easy to devour and leaves you with a hopeful feeling about the work there still is to do. Cannot recommend enough!
Profile Image for Isabelle.
595 reviews52 followers
June 16, 2024
Wow. This book was something. It made me cry and rage so much. It just made me so so so angry on the behalf of so many people. It had a good balance of being a memoir but also added in a lot of information about history, procedures, research, etc. in healthcare. I highly recommend this one and thought the audiobook was really well done.
7 reviews
January 28, 2024
me too

Dr b needs to do more research
The ob complications she refers to can happen to any woman
I am a white college educated health care professional who also had a forceps delivery but unlike the doctor I did not get an epidural despite asking many times over my 24 hour labor. I had 2 health insurance plans so surely it would have been covered. I had a 4th degree laceration and required over 300 sutures to repair it. I was given no special discharge instructions and one week post partum I experienced stool coming thru my vagina. I had a fistula, a complication common in sub Saharan Africa but not Evanston, Illinois.
Like the doctor I had no support except my husband and he had to return to work after only one week.
293 reviews4 followers
December 10, 2023
Wow. Eye-opening look at how racism impacts medicine across all fronts: patient experience, outcomes, and for physicians themselves. The sincere, plaintive writing reads like sitting down to coffee with my mentor, and inspired me to go out and do the work. The only authority I have to write a review for this book is as a woman in medicine; I cannot begin to know the experiences of Dr. Blackstock or the black community intimately, and can only attempt to learn…her book was a great start. Thanks for the opportunity to read this book.
Profile Image for Jai.
465 reviews27 followers
March 25, 2024
"Living in this country has made Black Americans sick " --Dr. Uche Blackstock
Legacy was part memoir, part coming of age and part call to action. Dr Uche gave so many examples of medical racism in history as well as on a personal level that she experienced. She also talked about growing up with a mother that was also a Black physician. I'm happy I picked this to listen to as my Audible selection. She also reminded everyone in this book that combating racism isn't on Black/POC to do but the work falls on White people ultimately.
Profile Image for Joe.
98 reviews2 followers
February 29, 2024
This would be a fine book if racism were a completely new idea for you
Profile Image for LaShanda Chamberlain.
443 reviews16 followers
May 22, 2024
A Must Read!!

Dr. Uche Blackstock's book, Legacy, is a powerful and brave account of racial oppression in American healthcare, resonating deeply with both doctors and patients. She shares stories from her Brooklyn upbringing, her mother's influence, and the challenges of combating racism in academic medicine without support.

Dr. Blackstock highlights the severe impact of COVID-19 on Black communities and the delayed reckoning with racism after George Floyd's murder. She links the hostility in healthcare toward Black people with violence in the criminal justice system, showing connections to high Black maternal and infant mortality rates and overall health disparities.

This book is essential for anyone wanting to understand systemic healthcare challenges and advocate for themselves or loved ones. Dr. Blackstock's honesty and bravery in sharing her journey and exposing flaws in the U.S. healthcare system are both moving and enlightening.
Displaying 1 - 30 of 270 reviews

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