>> i really think you. i thank you for your patience and thank you for coming. and thank rob and thank public citizen. [applause] >> this is the book, "why not jail?: industrial catastrophes, corporate malfeasance, and government inaction." rena steinzor, cambridge university press. make sure you get it, and thank you all very much. [applause] [inaudible conversations] >> you are watching of tv, television for serious readers. you can watch any program you see here online at booktv.org.

spent what is your day job? >> i'm a psychiatrist, medical school and i defy the time between treating patients, psychiatry and teaching medical students and residents. >> what made you go into psychiatry? >> good question. when i was in middle school school i was deciding between psychiatry and cardiology which is to very different fields. actual slang for -- so then as i was just getting to see patients and get into the nitty-gritty of being a doctor i found i really like the idea of talking to people and helping people for the problems in that way more so than the more mechanical sightreading heart disease. that's how it all unfolded. >> you're also an author now. what possessed you to write a book? >> this book that i've written is basically it's a memoir of my journey through medical tent the

written through the lens of race. there's a lot of physician office after a law books out there but race is in important asian medicine at these authors really largely overlooked because of their i think it's really of mission. because so many of the leading medical schools and hospitals all across america are situated in communities with large black populations but in many cases -- and these large institutions. that's a story that hasn't been told in a narrative way. so writing this book i was trying to tell the story through my own personal journey of becoming a young black man from a working-class background scaling this sort of medical latter but the same time telling the stories of everyday black people facing serious health problems. >> what is your background? >> i grew up in maryland, suburban maryland on the corridor between washington, d.c. and baltimore.

working-class community, all black, not safety but that's how it all played out the that was my background growing up. >> were your parents educated? >> well, they did encourage my education, absolutely. my parents grew up in the time of segregation, in a very role part of virginia, didn't get a chance to finish high school. you went in the military and worked at a food store in sort of a job a typical grocery store, was 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. family couldn't afford that and she worked for the federal government for many years. i do have an older brother and he was like the first person in our family who went to college and graduate from college but he was that sort of role model.

because the community where we grew up in it was almost like the way to get out was to be an athlete. as the case of some african-american communities. for he was a living example of someone who could succeed in other ways and that was an important part to my development. >> at what point in your life you decide you wanted to go into medical school? >> probably high school. i was a good student at an early age but why can't i school is able to step into this program that was in our school district. and besides technology and the teacher basically may be due to i didn't want to do at first and it really was informative. i was able to get close to people who have different backgrounds like asian people. it really helped me see another world and another opportunity. i said medicine seemed like a good way to really get back to commute and give back in a positive light and make people

in my community -- i did not as examples in my own life up until then. >> "black man in a white coat" is the name of the book and on page three you write been blocked can be bad for your health. >> yes. that's very true. basically any health measure number that you want to look at, whether it's life expectancy was is considerably shorter, particularly enn, infant mortality rate, death rates of all sorts of cancers, all are considerably worse than black people then invite people. really any other group you can compare the two in america. there are a lot of reasons why that's why did i would say despite three ways to look at that. there's a structural system based factors, things like black people having, less likely to have health insurance, more likely isolate in geographic areas where the us access to good quality medical care. one doctor.

and there's a sort of doctor-patient relationship doctor where black people often for many reasons through history are kind of wary of seeking treatment and often things that present to health care much later when preventable disease are now more advanced. that's a big factor. thirdly, there's committee level back in terms of individual health choices in terms of diet and exercise, all factors as well. there are many ways of looking at it. >> how many black psychiatrist father in american? >> i don't have an exact number, but in general, probably about five or 600 positions as a whole are african-american and psychiatry it's a little less. maybe anywhere from three to 4% the numbers vary but it's pretty small. >> aroccupations black, white, next? >> next, next. that leads to some interesting things. as i mentioned many of the

medical schools have large black populations. for instance, endure him, 45% black. take johns hopkins, if 55% black. you have large groups of black patients and a very small number of black doctors, no doubt about that. >> so what's the reaction you get from a white nation, from a black patient? >> from a white nation, so when i was younger and starting out, most people, very positive reaction by many people are wary. they are not sure what to make of you. there's some people who underestimate the they harbor some prejudice. in some cases i have pretty frank cases that were overtly prejudice. i write about some of those in the book. but i think an average most people are kind of a little wary but have to get to know them and they do talk to them they kind of, rather there's this idea of

having to prove yourself which is its own challenge. made the expectation at first you're not good as another doctor. you have to work with that. >> that's something you get from your white patients or patients across the board? >> across the board. particularly it is more pronounced in white patients but black patient, having overcome this perception that i would be less qualified. this happens but more commonly with white people. >> has it changed over the years in the last 20 years, the perception of a black doctor? >> i think there our actual black doctors did you go back 40, 50 years ago they were very, very few doctors. the numbers have increased i was at the last 30 or so so and that has affected perception some. still a battle. in many parts of the country they're still very few black

doctors. people may have never seen a black doctor in their life. spin why did you write the book's? >> i felt like there was this untold story. is a lot of talk about disparities and inequalities but not as much about that in a health realm. even more so not in way that sort of the success of where you're the story of everyday people. telling stories as a way to really capture the essence of what it means to people on the ground. >> give us one example from the book of a patient's reaction to you, positive, negative, whatever. >> one story but think really kind of stands out, this is when i was an intern, this is my first year as a branded doctor beverly most difficult year as a young doctor. i was on a medical team, medical service and an elderly white gentleman came in. when he came to the hospital he

saw black nurses, black nurses aides, several black staff and hospital and he made a comment in a not so unturned he did not want a black doctor. he didn't use that word but he did not want a black doctor. it just so happened he had the misfortune if you will hav being assigned to the one kingdom hospital that had a black doctor, which was me. it already worked out that way. you can imagine that's probably not the best way to start a doctor-patient relationship, so he had his -- perception. i have negative thoughts about him. you can imagine. this gentleman was very sick and he's old and really towards the end of his life. his family had kind of similar concerns the way they responded initially. over the course of several weeks in the hospital, hour by hour, day by day i was able to chip away at this huge racial divide that we had. and by the end he was really very receptive to me.

family was very receptive to me. it was an amazing transformation. think about that, kind of chip away at these superficial barriers that we all seem to have and really kind of make a huge connection. i think that's a lesson that we can learn for everyday life. as a lesson from the medical work and the it can be applied o everyday life. nowadays there's so much racial discussion that often is to unpleasant. >> isn't there an unfairness to that, that you have to work at chipping away the prejudices before you can treat the patients? >> sure. i talk about that in the book. there's aspects of it as part of what i wanted to write the book because very few black doctors have written about this perspective. i think there are certainly, i think it's more important for me to focus on how to deal with it and how i overcame it. it's certainly not