Free Black Man in a White Coat by M.D. Damon Tweedy Page A

population of two thousand citizens, every person who trekked up the creaky stairway that day was black. This was where the poorest residents came to get care.
    Duke’s relationship with the town and clinic dated back nearly fifteen years. For Duke, the project served two purposes: helping patients in an area chronically underserved by doctors, while at the same time giving medical students a practical way to build their clinical skills. For the patients, in a town with no physician and many people without health insurance, the clinic offered some residents their only opportunity to see a doctor. One Saturday each month, these two worlds joined hands.
    Earlier that morning, I’d met Mike and Sharon, both third-year medical school classmates, in a parking lot adjacent to Duke Hospital.
    â€œIs there a first-year student coming with us?” I asked Mike.
    He shook his head. “It’s just us. They’re all too stressed about their micro test.”
    At Duke, third-year medical students formed the backbone of clinic operations. After an intense, compressed beginning to our education—we accomplished in two years what students at other schools did in three—the third year was pretty much ours to do as we wished. Most worked in research labs, as I did, to build our résumés for residency training. Several others went to UNC to earn a master’s in public health, or to Duke’s business school for an MBA.
    No matter the choice, life was much less hectic than in those first two pressure-packed years. We worked between forty and fifty hours a week, with weekends and holidays off. We had time for sleep. Time for exercise. Time for travel. It was the closest most of us would come for many years to living a normal life.
    Nonetheless, we were still medical students, and that meant we felt compelled to do at least some extra work to avoid losing a competitive edge. If we went a year without seeing any patients, many of us feared we’d be at a disadvantage when we returned to hospital duties as fourth-years, so we sought out clinical opportunities. It was easy enough to shadow doctors around the hospital, but with many years of specialty-based training ahead of me, I wanted to try something different—away from the high-tech world of what is called tertiary care medicine. The rural clinic, with its opportunity to learn outside Duke and with greater autonomy to build practical medical skills, seemed a perfect fit. Mike, the student leader for the group and future family physician, traveled there most months. Sharon and I were first-timers.
    Within a few minutes, two others had joined us: Dr. Watson, a senior medical resident, and Dr. Kelly, a faculty member and supervisor for the day’s activities. The group did not ordinarily include a resident doctor, but Dr. Watson, in the final months of her residency, was preparing to become a supervisor at the clinic. As we clustered around him, Dr. Kelly, a trim, graying endocrinologist, briefly explained our mission. “This is not like anything you’ll see at Duke. Here you are treating people in their own community, without the luxuries we take for granted. Working in a place like this is part of what it means to be a doctor too.”
    The clinic was about five hundred square feet, the size of an urban studio apartment or a small single-wide trailer in this part of the world. It had been efficiently divided into three compartments: a makeshift waiting area in the front where a few patients could sit while the rest stood, a central space crowded with medical supplies and a cluttered desk for our supervisors, and two small examination rooms separated by dilapidated curtains.
    The first person I saw was Pearl, a woman in her early fifties. She wore a baggy plaid dress that came down to her ankles. Tiny black moles were sprinkled across her forehead. Her eyes lit up as they met mine: “It’s so good to see a young brother in a white