u're watching booktv on location in new york >> booktv is on twitter and facebook, and we want to hear from you. tweetit us, tritt.com/booktv, or post a comment on our facebook page facebook.com/booktv. >> host: damon tweedy, what's your day job? >> guest: i'm a psychiatrist at duke medical school, and i divide that time between treating patients psychiatry, and teaching medical students and residents. >> host: what made you go into psychiatry? >> guest: great question. when i was in medical school, i was deciding between psychiatry and cardiology, which are two very different fields, and i actually was leaning towards the cardiology part initially. so then as i was just, you know, getting to see patients and really getting into the nitty-gritty of being a doctor i found i liked the idea of talking to people and helping people through their problems in that way more so than the more

mechanical side of treating their heart disease. so that's sort of how it all unfolded. >> host: you're also an author now. what possessed you to write a book? >> guest: well, so this book that i've written basically, it's a memoir of my journey through medical training, but it's written through the lens of race. there are a lot of physician authors out there and a lot of books out there, but i feel like race is a really important issue in medicine, and these authors largely overlook this subject. so i think that's a really, that's an omission because so many of the leading medical schools and teaching hospitals all across america are situated in communities with large black populations. and in many cases, there's been historical tensions between the communities and these large institutions. but that's a story that really hasn't been told in a narrative way. and so that's, so writing this book i was trying to really tell two stories my own personal journey of becoming a young black man from a working class background scaling this sort of

academic medical ladder but at the same time telling the stories of everyday black people facing serious health problems and trying to weave those two stories together. >> host: what is your background? >> guest: i grew up in maryland, suburban maryland kind of on the corridor between washington, d.c. and baltimore. working class community all black, you know? not segregated, but that's how it played out. that was my background growing up. >> host: were your parents educated? >> guest: well -- >> host: did they support, did they encourage your education? >> guest: yes, they did encourage my education absolutely. so my parents grew up in the kind of time of segregation, my dad in a very rural part of virginia. didn't get a chance to finish high school. he went into the military and worked as a at a food store in a sort of job in a typical grocery store and worked there as a meat cutter for several years until he retired.

my mom didn't finish high school, didn't have a chance to go to college and she worked for the federal government for many years. i did have an older brother and he was really the first person in our family who went to college and graduated from college, so he was that sort of role model in a way. the community we grew up in, it was almost like the way to get out was to be an athlete. as is the case in so many african-american communities. and he was a living example of someone who could succeed in this other way and that really was an important part of my development. >> host: at what point in your life did you decide you wanted to go into medical school? >> guest: probably high school. i was a good student at an early age, but when i got to high school i was able to test into this magnet program that was in our school district. it was a science and technology magnet program. i almost didn't -- a teach basically, made me do it. i didn't want to do it at first and that really was transformative. i was able to get exposed to

people who came from different backgrounds, whites asian people, and it really helped me see another world and another opportunity. and as i was seeing i could do really well medicine seemed like a good way to give back to the community and make a difference in a positive way. i certainly didn't have any of those sort of examples in my own life up until then. >> host: "black man in a white coat" is the name of the book and on page 3 you write: being black can be bad for your health. >> guest: yes. that's very i -- very true. basically any health measure, number that you want to look at whether it's life expectancy which is considerably shorter in african-americans, particularly in men infant mortality rates death rates from all sorts of cancers, all of them are considerably worse in black people than in white people and really any other group you can compare them to in america. there are a lot of reasons why that is. i would say there's probably

three ways of looking at that. there's structural, kind of system-based factor, things like black people being less likely to have health insurance, more likely isolated in geographic areas where there's less access to good quality medical care. that's one factor. then there's the sort of doctor/patient relationship factor where black people often for many reasons of history are kind of more wary of seeking treatment and also that means they present to health care much later, and preventable diseases are now more advanced and that's certainly a big factor. and thirdly, there's community-level factors in terms of diets and exercise, and these are all factors as well. so there are many ways of looking at it. >> host: how many black psychiatrists are there in america today? >> guest: i don't have an exact number, but in general there are probably about 5-6% of physicians as a whole are african-americans. in psychiatry, it's a little bit

less, maybe anywhere from 3-4%. the numbers vary depending on what data set you look at, but it's pretty small. >> host: your patients black? your patients white? your patients a mix? >> guest: mix. mix. and that leads to some interest things. so in a place like -- as i mentioned earlier many of these medical schools they're located in these communities that have large black populations. for instance durham, where duke is, it's about 45% black. and johns hopkins, which is closer to my hometown in baltimore, you know, 65% black. so you have large groups of black patients and very small numbers of black doctors, there's no doubt about that. >> host: so what's the reaction you get from a white patient from a black patient? >> guest: from a white patient, so when i was younger and starting out most people had very positive reactions but there are many people who are wary of you, and they're not sure what to make of you. there's some people who, i would say maybe they harbor some

prejudices. there's some cases i had pretty frank cases or accelerately prejudiced -- overtly prejudiced, and i write about some of them in the book. i think on average most people are wary but after you get to know them and talk to them, they kind of come around. there is this sort of idea of having to prove yourself which is a challenge to present. maybe the expectation at first that you're not as good as another doctor can, and you have to kind of work with that. >> host: and that's something you get from your white patients or patients across the board? >> guest: i think across the board, but it's more pronounced in white patients. i've certainly had black patients where i had to overcome the perception that i would be less qualified. it's more common with white patients, but it's happened with all. >> host: has it changed over the years, in the last 20 years the perception of a black doctor? and how people view them? >> guest: i think there actually, are more black

doctors. you go back 40, 50 yearsing a, there were -- years ago, there were very very few black doctors. i think that has affected perceptions some. it's still a battle, though because in many parts of the country there's still very few black doctors. people may have never seen a black doctor in their life. >> host: why'd you write the book? >> guest: i felt like there was this untold story is, you know? there's a lot of actually, there's a lot of talk about disparities and inequality, but not as much about that in the health realm. and each more so not in a way -- even more so not in a way that's accessible where you're telling it through the story of everyday people. certainly, one important way of getting information, telling stories is also a way to really capture the essence of what that really means to people on the ground. >> host: give us one example from the book of a patient's reaction to you positive, negative whatever. >> guest: one story that i think really kind of stands out, this

is when i was an intern. this was my first year as that brand new doctor, that really most difficult year as a young doctor. and i was on a medical team medical service, and an elderly white gentleman came in. and when he came to the hospital he saw black nurses black nurses' aides, several black staff in the hospital. and he made a comment in not-so-uncertain terms that he did not want a black doctor. he didn't use that word, but he did not want a black doctor. and it just so happened that he had the misfortune if you will, of being assigned to the one team in the hospital that had a black doctor, which was me. so it had already worked out that way. and you can imagine that's probably not the best way to start a doctor/patient relationship. in this case. so he came, he had his perception. and because he had that perception, i in turn had negative thoughts about him as you can imagine. so this gentleman was very sick, and he was old and really towards the end of his life. and his family had kind of

similar approach to life in terms of the way they responded to me initially. but over the course of several weeks in the hospital, hour by hour, day by day i was able to chip away at this sort of huge racial divide that we had. and by the end, he was really very resent e to me -- receptive to me, his family was receptive to me. it was an amazing transformation. and it made me think about how when someone is really sick, you kind of strip away some of the superficial barriers that we all seem to have and really make a human connection and allow it to flourish. i think that's a lesson that we can learn for everyday life. it's a lesson from the medical world, but it can be applied to everyday life. nowadays we're in a time where there's so much racial discussion that's often so unpleasant. >> host: isn't there an unfairness to that, that you have to work at chipping away the prejudices before you can treat the patients? >> guest: sure, sure. i mean, i talk about that in the book. there's a lot of aspects of it, and that's part of why i wanted

to write the book, because very few black doctors have written about this perspective and this experience. i think it is, there are certainly -- there's unfairness to it, but i think it's more important to focus on how i dealt with it and how i overcame it. but it's certainly not fair. >> host: "black man in a white coat" comes out in september of 2015. the author is dr. damon tweedy. you're watching booktv on c-span2. >> booktv recently visits capitol hill to ask members of congress what they're reading this summer. >> i'll probably read some more novels. i've read recently a couple by joel rosenberg. they're kind of in brad thor genre of international terrorism and those kind of things so i'll probably read a few more of those. haven't decided what kind of biography i'll read, but probably will look at someone in history and grab one of those and read it as well.

>> and booktv wants to know what you're reading as well. tweet us your answer @booktv or you can post it on our facebook page, facebook.com/booktv. >> booktv continues with a two-part event on health care. first, phillip kline author of "overcoming obamacare." he moderates a panel discussion on what can be done to reverse the affordable care act. then louisiana governor bobby jindal provides commentary on the aca and answers questions from audience members. >> i just wanted to start with some brief opening comments to frame today's discussion. when it comes to health care, those on the right are often defined more by what they're against than by what they're for. the truth is that there have been a lot of plans that have been offered on right as alternatives to obamacare, but