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

coat,” she said. “That don’t happen much ’round here.”
    I smiled. In the two-plus years I’d been at Duke, I’d often gotten this reaction from black receptionists, nurses, phlebotomists, cafeteria workers, and cleaning service crew. They shared in my achievements and promise like an extended family. Along with the racial pride that came with their praise and adulation, however, I felt an added weight, as if my success or failure would reflect not just on me, but on those who had come before and those who would follow me.
    â€œWhere you from?” she asked. “You look like a boy from the suburbs.”
    The implication, as I heard it, was that a black person like me—clean-cut, college-educated, studying to be a doctor—did not come from an area like hers. Nor from the inner city. The odds stacked against those children—bad schools, broken families, negative peer pressure—were, with rare exceptions, too great. While I had grown up in a suburb, it probably wasn’t the kind she had in mind. Mine was the segregated, working-class variety where some of my peers became teenage moms while others got busted for dealing drugs.
    I politely answered Pearl’s questions about my background and career interests before turning my attention to her: “So what brings you here today, ma’am?”
    â€œI need my sugar checked,” she said, holding up her calloused hand, pointing to the fingertips where diabetics prick themselves for blood. “I also wanna see if my blood’s high.”
    She was referring to screening for diabetes and hypertension. I’d learned these colloquial references from extended family long before discovering the proper medical terminology. My maternal grandmother and her younger sister, both of whom lived in Washington, D.C., often talked about their health problems and those of other family members, gossiping that so-and-so had “high blood” and his wife “had sugar” and how they ultimately “weren’t doing right.” Listening to Pearl was like hearing an old recording after many years.
    â€œHave you been diagnosed with either disease?” I asked her.
    â€œThe last time I was checked, they said I was on the borderline for both.”
    â€œWhen was that?”
    â€œAbout a year ago. Maybe two,” she admitted. “But I’ve been feeling fine.”
    â€œSo what made you decide to come today?” I asked.
    â€œMy brother just started dialysis. His doctors said it’s ’cause of his sugar and high blood, so I figured I better get checked out again.”
    â€œDo you take any medications?” I asked.
    â€œI take a water pill once in a blue moon. When I start to feel my legs are swole up. They gave it to me when I came here the last time.”
    â€œDo you know the name of it?”
    She shook her head. “It’s a small orange circle.”
    That meant nothing to me. I said the names of some common medicines that are described as “water pills,” diuretic drugs that make patients urinate and reduce bodily fluid volume, but Pearl looked at me as if I were speaking Chinese. While we shared the same skin color and lived in the same region, we were communicating in different languages. I knew the textbook names, while she knew what the pills actually looked like.
    Unlike other clinics I’d rotated through up to that point, we worked without nurses, so I had to check Pearl’s vital signs. I started off by measuring her height and weight. She was five foot four and weighed 210 pounds, her body mass index far above what my pocket guide listed as ideal. I was more than a foot taller, yet we made the same imprint on the scale. Her blood pressure and blood sugar were both high, measuring 160/100 and 275, respectively. After a physical exam—listening to her heart and lungs with my stethoscope and checking her feet for signs of swelling or poor blood