Lifestyle
Following in her mom's footsteps, a doctor fights to make medicine more inclusive
Dr. Uché Blackstock is the author of Legacy: A Black Physician Reckons With Racism In Medicine.
Diane Zhao/Penguin Random House
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Diane Zhao/Penguin Random House
Dr. Uché Blackstock is the author of Legacy: A Black Physician Reckons With Racism In Medicine.
Diane Zhao/Penguin Random House
When Dr. Uché Blackstock was a medical student at Harvard, she had a near-death experience that gave her a sobering outlook on the state of medical care in the U.S. Suffering from excruciating stomach pain, Blackstock took herself to the E.R., where, after hours of waiting, she was told she had a stomach bug and sent home.
But in days that followed, Blackstock felt worse; it would take two more E.R. visits before she was diagnosed with appendicitis. Because it took so long for the diagnosis, her appendix ruptured, requiring emergency surgery, followed by a painful recovery that sent her back to the hospital. Later Blackstock was left to wonder: Would her treatment have been different if she weren’t Black?
“It really took a few years of processing what had happened for me to recognize that it may have been because I was a young Black woman that this diagnosis got missed,” Blackstock says.
Blackstock is the founder and CEO of Advancing Health Equity. In her new book, Legacy: A Black Physician Reckons With Racism In Medicine, she explores systemic inequity in health care, tracing its origins back to the beginnings of Western medicine and to her own experiences as a medical student and doctor.
In March 2020, during the early days of the COVID-19 pandemic, Blackstock was one of the first medical professionals to raise the alarm that the virus was having a disproportionate impact on minority communities.
“For years, we’ve been talking about the Black maternal mortality crisis. But in terms of COVID’s impact on Black communities, that conversation had not started yet,” Blackstock says. “So I wrote my first op-ed on what I was worried about would happen to our communities from COVID within the first two weeks – before the end of March.”
But Blackstock is optimistic about the next generation of Black medical students, who she says are pushing for changes to the existing system.
“With the killing of Mr. George Floyd and Ms. Breonna Taylor … a lot of medical schools received demand letters from their Black students about what those students thought we should be learning,” Blackstock says. “I would say medical schools are on their way. They have a tremendous amount of work to do.”
Interview highlights
On her mother, Dr. Dale Gloria Blackstock, who died of leukemia at age 47
My mother was a brilliant woman. She was amazing. She was a trailblazer in her own right. She grew up in central Brooklyn. She had a single mom, she had five siblings, and they grew up in public assistance and so life was always very, very difficult for her. She was the first person in her family to graduate from college and then go on to Harvard Medical School, which is something that she never even probably had thought of as a little girl. But I celebrate her and I celebrate her accomplishments. But I also recognize how both racism and poverty makes the road so much harder, and that there were other brilliant, brilliant children that she grew up with that I’m sure also could have made it to Harvard Medical School and beyond, but did not because of the practices and policies that we have in place that chronically deprive our communities of the resources that they need.
On always wanting to be a doctor because of her mom
This is what happens when you have the most loving mother who is also incredibly well respected by her patients and by her colleagues. So it was sort of like, I think both Oni and I looked at her and said, you know what? We want to be just like her. We also want to be a doctor. And I think also, we were surrounded by Black women physicians: Our pediatrician, all of my mother’s friends, on our block we had other Black women physicians. So it was a reality to me. …
Dr. Dale Gloria Blackstock with her twins, Uché and Oni — both of whom followed in their mother’s footsteps by graduating from Harvard Medical School.
Courtesy of Uché Blackstock
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Courtesy of Uché Blackstock
Dr. Dale Gloria Blackstock with her twins, Uché and Oni — both of whom followed in their mother’s footsteps by graduating from Harvard Medical School.
Courtesy of Uché Blackstock
I’m getting a little emotional, but this book is also an opportunity to give her a voice to people who may not have heard of her or have met her. I always say that when people meet [my twin sister] Oni and me that they’re meeting our mother, because this woman literally poured blood, sweat and tears into us. I think because she had grown up in poverty, because she was the first to go to college and med school, she wanted a very different life for us than she had for herself. And sometimes I worry. I remember when we turned 18, she said, “I’m so tired,” and I don’t know if she may have been in the early stages of her illness then, but she said, “I am so tired. I put so much into you both.”
On how students in medical school are often taught that there is an essential biological difference between Black and white bodies — and how that teaching impacts care
That is sort of the take home-message we get. We’re taught that there are different normal values for kidney functions, that Black patients have a certain set of normal values than non-Black patients. We’re told that about lung function; that there’s a difference between Black patients and non-Black patients. And this isn’t something that is necessarily recent. A lot of these beliefs are centuries or decades old. …
So often you would read a textbook and it would say that the risk factor for diabetes or the risk factor for high blood pressure is race. Race cannot be a risk factor because it’s a social construct. What is the factor is racism or the impact of the practices and policies of systemic racism on our communities and on our health. … A lot of these studies have come out more recently to show that that so-called “race correction” factor that is used for kidney function has actually led to a delay in Black patients being referred to for specialty kidney care. Also, it’s led to delays in putting them on kidney transplant lists. So it’s compromised their care even further. They have not gotten the health care that they need for this chronic and potentially deadly disease. It almost compounds the everyday racism that they face, that there are these beliefs that are inherent within the health care system that prevent them from getting the resources that they need.
On the 1910 Flexner Report, which closed most of the historically Black medical schools in the U.S.
The Flexner Report was a report that was commissioned by the American Medical Association and the Carnegie Mellon Foundation. And essentially they commissioned an educational specialist named Abraham Flexner to go around to the 155 medical schools in the United States and in Canada, and to essentially standardize them, compare them to the standards of Western European medical schools. And so, of course, the Black medical schools, because of the legacy of slavery and the lack of wealth and resources, did not have the resources to remain open. So, essentially, Flexner recommended that five out of seven of those Black medical schools be closed and they were closed, leaving Howard and Meharry. …
In a study that came out in 2020, in the Journal of American Medical Association, it was estimated that those five schools, if they had remained open, would have trained between 25,000 and 35,000 Black physicians. When I read that, I started crying because that is such a large number of health professionals that could have cared for hundreds of thousands, probably even millions of Black patients, who could have mentored medical students, who could have done research in our communities. And so it is a tremendous loss when you think about the closure of those schools. But it also makes sense when you look at the percentages today of Black physicians. We are less than 6% of all physicians in the U.S. – and that is one of the reasons.
On how the Supreme Court’s 2023 ruling against affirmative action may impact Black medical students
I compare it to the Flexner Report. So you have a policy that impacts schools, led to the closure of schools, led to that tremendous number of Black physicians not being educated, essentially eras[ing] them. And I thought about the recent SCOTUS decision, it’s going to affect academic medical centers, it’s going to affect medical schools, and, I think that, long term, if it’s going to affect the diversity within medical schools, then we know that ultimately [it] will affect the number of Black physicians. And we are actually more likely to go back to our own communities to care for patients. We are more likely to work in underserved areas. … We may not see it for generations, but I think that SCOTUS’s decision is going to have a long-term impact on Black health, if medical schools and other higher-education institutions are not able to … have legal workarounds to address those changes in race conscious admissions.
On tangible ways to improve the system
Academic medical centers and medical schools … need to work on focusing on how to train students and residents to adequately and competently care for a diverse patient population. That is your priority, whether it’s in terms of developing curriculum that is focusing on anti-racism, or making sure your faculty understand how to teach in a way that really respects the honor and dignity of all the students that they’re teaching and the patients that they’re going to serve, or even to policymakers, making them understand that health is in all policies. … So I tasked different groups, even white health professionals. I said, this is not just our problem. This is not just the problem of your Black colleagues. This is not just the problem of your Black patients. They are dying prematurely. It is up to you also to speak up. It’s also up to you, to us to work on behalf of our communities. I think ultimately every health professional would say I want the best for my patients, right? But that is not happening.
Sam Briger and Thea Chaloner produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Carmel Wroth adapted it for the web.
Lifestyle
George Saunders thinks ambition gets a bad rap : Wild Card with Rachel Martin
A note from Wild Card host Rachel Martin: George Saunders is considered one of the master storytellers of our time. He uses humor and empathy to draw readers into characters and situations that stick deeply in the imagination.
He also seems like a guy totally preoccupied with the liminal space between the living and the dead. And I dig this because I am also preoccupied with this in-between-space. It was the setting for his best selling book “Lincoln in the Bardo” and of his newest novel, “Vigil.”
Lifestyle
L.A. Affairs: I told my husband that something had to change. I just didn’t know what would come next
As he rolled up in front of my Van Nuys duplex, his teal Ford Tempo shimmering in the speckled fall sun, a wave of first-date excitement flooded my system.
Leaning across the center console, he flung open the passenger door.
“Sorry,” he said brightly, “I threw up in that seat on the 405 yesterday, but I think I mostly cleaned it up.”
I paused, looked at the seat and then back at his hopeful, earnest face.
“I ate vitamins on an empty stomach then sat in traffic,” he said with a shrug.
Well, I thought, at least it was just partially digested vitamins and not a carne asada burrito. It could be worse.
Deciding to be the cool girl, I slid into the not-quite-clean seat and took a deep breath.
Brian was 6 feet 4 and a moppy-haired brunette musician with magnetic stage presence. We’d met through a mutual friend from his band, a guy who made me laugh by drawing inappropriate images on my spiral notebooks in my theater classes at Cal State Northridge.
The week before, I’d watched them play a show in Calabasas and felt something shift. Onstage, Brian closed his eyes when he sang, swaying slightly offbeat as his wild waves caught the light. I was smitten.
Our first date unfolded on a stylish vintage couch in a cafe rumored to have once belonged to someone from punk-rock band NOFX. We sipped tea. This man had never had a sip of alcohol in his life, by choice, which felt both bizarre and wildly exotic to me at the time. I worried the absence of cocktails might make the night awkward. Instead, we talked for hours, our words tumbling over each other like we’d been rehearsing for years.
Within six months, he’d moved into my apartment. From there, we leapfrogged to Venice, then Marina del Rey and finally to Mar Vista, where we bought our second home and planted ourselves like people who understood picket fences. Two extraordinary children later, we had built something that looked, from the outside, like a Hallmark movie with much better music. I would stand in our kitchen at dusk, the marine layer settling in, peaceful as I loaded the dishwasher in a life I hadn’t necessarily seen for myself.
Then life, because it always does, began to press.
In 2019, my mother-in-law suffered a stroke and moved into our home while she recovered. I love her deeply and was grateful we could care for her. However. Caregiving inside a tiny West L.A. “bungalow” (as my MIL kindly referred to it) magnified everything from love to exhaustion. We survived it, yet hadn’t fully exhaled when the COVID-19 pandemic arrived like a cosmic reminder of how life loves a dramatic arc.
Suddenly, we were always home. Always in each other’s line of sight, always negotiating space that didn’t exist. I would often escape to our tiny yard for another DIY project, clutching coffee or whiskey like a flotation device and internally screaming in his direction: “Why are you always here?”
My chronic illness flared, and fear hovered over me like smog. Both sets of our parents were aging rapidly and reminding us of our own mortality. Grief layered itself over everything, but we kept the children steady and the house functioning. We kept showing up as best we could.
Yet somewhere along the way, large pieces of ourselves went missing.
In 2023, I fled to Mexico City with a friend. In photographs from that week, I barely recognize the woman staring back at me. She was heavy, pale; her eyes dulled and vacant. I realized I had become a highly efficient machine for other people’s needs and had lost track of my own.
Months later, on a routine mental health walk near the Mar Vista park, I heard a podcast clip that stopped me in my tracks. “Life is a melting ice cube,” Mel Robbins said casually.
I physically froze on the sidewalk.
A melting ice cube.
Every time I passed that corner I thought about it, how this life was dripping away whether we were awake inside it or not.
That night I told Brian something had to change. I didn’t know what it meant. I just knew I could not continue living a version of life that felt like survival instead of participation.
As the friend he has always been, he listened.
Over the next year, we experimented. We tried reshaping our marriage into something more expansive. We tried an open relationship. We tried to rediscover the spark that had once felt effortless. What we discovered instead was that the truest thing between us had always been friendship.
So we separated.
Here’s the part people don’t expect to hear: It didn’t destroy us.
Somehow, without the pressure of being everything to each other, we became better. We are kinder and more honest. We parent as a team who spends holidays together and we will head to Coachella soon to complain about the bus lines amid total exhaustion yet again.
I turned 50 in the middle of the unraveling, sandwiched somewhere in the chaos of a second painful surgery and my mother’s death. To mark the end of a massive season in my life, I went to Spain for two months. I walked unfamiliar streets with music carrying me on its wings, ate dinner at 10 p.m. and remembered who I was when no one needed me to be anything in particular.
I came home a different person.
Now, Brian and I date other people. We talk on the phone most days about the kids, life and whatever absurd situation the world has thrown at us. We take it day by day, week by week, like adults who have finally accepted that certainty is an illusion.
Someone recently called our story “so L.A.”
I smiled.
Los Angeles has always been a city of reinvention, of artists and dreamers, and of people brave enough to admit when something needs to evolve. This city taught me how to chase a musician in a teal Ford Tempo. It also taught me how to build a family and how to let go without burning everything down.
Love does not always look the way we expect. Sometimes it transforms and sometimes it softens into something steadier and less cinematic.
Evolution is not failure; it is movement, and movement (even when it hurts) is proof you are still alive inside your life.
In Los Angeles of all places, I know how to begin again.
The author is a Los Angeles–based novelist and essayist. She writes about love, reinvention and modern relationships. Find her on Instagram: @marykathrynholmes.
L.A. Affairs chronicles the search for romantic love in all its glorious expressions in the L.A. area, and we want to hear your true story. We pay $400 for a published essay. Email LAAffairs@latimes.com. You can find submission guidelines here. You can find past columns here.
Lifestyle
‘Stay Alive,’ about daily life in Nazi Berlin, shows how easy it is to just go along
It’s been 80 years since Adolf Hitler shot himself in his bunker, yet our fascination with the Nazi era seems eternal. By now I’ve read and seen so many different things that I’m always surprised when somebody offers a new angle on what the Nazis wrought.
Ian Buruma does this in Stay Alive: Berlin, 1939-1945, a new book about living in a country where you have no control over what happens. Inspired by the experience of his Dutch father, Leo, who was forced to do factory work in Berlin, Buruma uses diaries, memoirs and some personal interviews — most of the witnesses are dead, of course — to explore how it felt to be in Berlin during World War II. He weaves together a chronicle that carries Berliners from the triumphant days when Germany steamrolled Poland and daily life felt almost “normal” (unless you were Jewish, of course) through the end of the war when bombs pulverized the city, and Soviet soldiers arrived to rape and pillage.
As he writes of air raid drills, food shortages and the incessant deluge of rumors, Buruma has to deal with the difficulty that most ordinary Germans left behind very little record. They kept their heads down and tried to stay alive. And so the book moves among more interesting characters whose multiplicity gives dimension to our usual flattened sense of Nazi Germany.

We meet Coco Schumann, a young Jewish guitarist who risks his life to play the jazz music that Nazis considered degenerate. We meet 15-year-old Lilo, who starts off thinking that Nazi ideals make life beautiful, but comes to admire the greater nobility of those who tried to assassinate Hitler. There’s the dissident intelligence officer Helmuth von Moltke, a conservative who seeks to work from inside against the Nazis (he gets hanged for his trouble). And there’s Erich Alenfeld, a Jew who converted to Christianity and remained a German patriot: He sent a letter to Reichsminister Hermann Göring asking if he could serve.
We also encounter several of the usual suspects, most notably propaganda minister Joseph Goebbels who, when not coercing young actresses into sex, is busy generating false headlines, ordering movie spectacles to distract the masses (he loved Disney films), and monitoring the city’s morale. Always laying down edicts — like ordering Jews to wear the yellow star — he’s the Nazi who may have done most to affect Berlin’s daily life: He even keeps banning and reinstating dancing.

Along the way, Stay Alive is laced with nifty details. How one family trained its parrot to say “Heil, Hitler” to fool the Nazis if they came to arrest someone. How, a crew of filmmakers kept shooting a movie with no film in the camera so they wouldn’t be drafted to fight doomed last ditch battles. How Jewish villas in the posh Grunewald area were bought up or seized by Nazi bigshots, but now belong to Russian oligarchs. And how some of those trying to elude the Nazis became known as U-boats, because they dived into the city’s murky underworld, even hiding out in brothels.
As one who’s written well for decades about historical guilt and denial, Buruma is too savvy to belabor familiar Nazi horrors. That said, he offers two dark truths that strike me as being especially apt in these days when authoritarianism is making a worldwide comeback.

The first is that you can’t live in a dirty system without somehow being corrupted. Whether you were a famous symphony conductor or a cop on the beat, Nazism tainted virtually everyone, forcing people to do and say abhorrent things they often didn’t believe in, and weakening their moral compass. As von Moltke wrote his wife: “Today, I can endure the sufferings of others with an equanimity I would have found execrable a year ago.”
He wasn’t alone. The second dark truth is how easy it is to simply go along. Most Berliners — and even Buruma’s own father — did their jobs, took their pleasures and preferred not to think about the evils under their noses. This, Buruma says, “is disturbing but should not surprise anyone. Human beings adapt, carry on, turn away from things they don’t wish to see or hear.”
If the book has a hero, it’s probably Ruth Andreas-Friedrich, a journalist who didn’t turn away. Along with her partner, the conductor Leo Borchard, she ran a resistance group named Uncle Emil, risking her life to protect Jews, help them escape, and support other groups battling the Nazis. All this makes her much braver than I’ve ever been. But I equally admire her refusal to be sanctimonious about those who, fearing prison or worse, didn’t rise up against the dictatorship. She had the rare virtue of being righteous without being self-righteous.


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