America's health care system.

She's seen it# both as a physician and as a patient.

She's## dedicated her career to work at the intersection# of medicine, health equity and systemic racism.

She's an emergency medicine physician and is# CEO and founder of Advancing Health Equity,## an organization which works to dismantle# racism in health care.

And now Dr. Blackstock## has written a memoir entitled "Legacy:# A Black Physician Reckons with Racism## in Medicine," details both historic health# care inequities and her own family history.

Dr. Blackstock, thanks for joining us.

I love# the title Legacy because there are really two## legacies that run through this book.

I want to# start with the family legacy.

Your mother was## what was very rare in the 80s and 90s.

A black# female physician, how did watching her work## seeing her go to work every day and actually# seeing her at work?

How did that affect your## decision to become a physician?

We should# mention your twin sisters also a physician UCH# BLACKSTOCK, CEO and founder of# Advancing Health Equity: Yes obviously she wa we did.

She was born in poverty and# public assistance the first person in## her family to graduate from college and then# she went to medical school, then she came back after medical school to# practice in the community in which she grew up in.

And so that was a powerful message for us that# you know, you go, and you know, you get a great## education, you come back and bring those resources# back, and you help -- you help those that are your## family and neighbors.

And that's exactly what# she did.

And she would get together with other## black women, physicians in our community and# hold community health fairs, really to help## out the folks who lived in our neighborhood.# And I love that message that she sent to us.

JOHN YANG: Your mother died relatively young,# she was 47.

She died of leukemia.

And also## you had an experience that you detail# in the book where you had appendicitis## that was misdiagnosed and became very,# very seriously, your appendix burst.

Do you think the outcomes or the treatment might# have been different if you weren't black women?

UCH# BLACKSTOCK: I think it's very, very likely.# And it's not just because of my own anecdotal## experiences.

It's because we have we have a lot# of data that shows when black people, when women,## when black women go to seek care, often, their# concerns are ignored, dismissed or minimized.

When I had appendicitis, I was a first# year medical student.

And I went to## the ER three times, my appendix ended up# rupturing.

I had long term complications,## I have to be out of school for a month.

And# after that happened, I looked back and said,## but that had happened if I wasn't a# young black woman.

I have to think## that the fact that I was a black woman# really impacted how I was cared JO HN YANG: The first physician you saw# the emergency underestimated your pain,## so that's can't be appendicitis.# She's not in that much p UCH# BLACKSTOCK: Exactly.

And that's something# that patients are cared for.

There is something# called pain in equity, where we have seen## a trend and it's in the research that black# patients their pain is often undertreated.

And that connects to really deep rooted# systemic beliefs back from slavery days,## that somehow we are biologically different, that# we feel pain differently than other people do.

JOHN YANG: Leads me perfectly into# my next question is the two legacies## sort of come together at Harvard Medical School,## you and your sister with your mother became the# fi UCH# BLACKSTOCK: Yes.

that date back to the 19 century, or# to Jim Crow, talk about some of those?

UCH# BLACKSTOCK: Yeah, you know, and I talked# about this idea that whether explicitly or## implicitly, in medical school, where we're# taught this idea that our patients who are black are biologically different.

So for# example, there's something that is called## the race correction factor that is associated# with assessing or measuring kidney function.

And for a very long time, up until# very recently, there was a different## set of normal values for black patients and# non-black patients.

And that was ba this myth, this idea that black# people had higher muscle mass,## which somehow translated into a different# set of normal values for kidney But anyway, what that has led to is black# people being deferred to or to having delayed## specialty care for their kidneys are not placed# on transplant list.

So these ideas that are deeply## rooted that we are taught in school actually end# up having a detrimental impact on our patients.

JOHN YANG: And it's also -- the# sort of institutional racism or## systemic racism also has that effect# on the number of black UCH# BLACKSTOCK: Yes.

Yes.

And so I write# about in the book, the Flexner Report,## which came out in 1910, that was actually# commissioned by Association and Carnegie Mellon Foundation, they# sent an educational specialist, Abraham to assess all of the medical schools in the# U.S. and Canada, and to hold them against## the standards of Western European medical# schools are in the U.S., Johns Hopkins.

And that led to the closure of five out of# seven of the historically black colleges and## universities that up to that point had trained# about 1,600 students.

But it's esti five medical schools at the turn of the century,# those black medical schools had stayed open,## they would have trained between# 25,000 and 35,000 black physicians.

That is such a tremendous loss not only# in the workforce, but the patients they## could have treated the students they could have# mentored the research that could have been done.

JOHN YANG: Back to the title# Legacy, we see your mother's## legacy in your work your sisters work,# wh UCH# BLACKSTOCK: My legacy I would love to# be able to, especially with this book to## help connect the dots for people in# terms of how did we arrive in 2024,## to the place where we have these very# horrific racial health inequities?## How can people do better and I have a# call to action at the end of the book,## how different groups of people even in their# personal lives can help addres JOHN YANG: Dr. Uché Blackstock,# the book is "Legacy: A Black## Physician Reckons with Racism in# Medicine."

Thank you v UCH# BLACKSTOCK: Thank you for having me.