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.
Sonja Lyubomirsky thinks the Valentine’s Day cards have it wrong. Most, argues the researcher, a distinguished professor of psychology at UC Riverside, say some variation of “I love you.”
Shelf Help is a wellness column where we interview researchers, thinkers and writers about their latest books — all with the aim of learning how to live a more complete life.
“We think all the cards should say, ‘I feel loved by you.’ Or, ‘You make me feel loved,’” says Lyubomirsky, co-author of the recent book “How to Feel Loved: The Five Mindsets That Get You More of What Matters Most.”
The difference is key, and vital, says Lyubomirsky, to our happiness. Being in love, for instance, is not the same as feeling loved, and “How to Feel Loved” documents the latter. For to feel loved is to truly be seen and embraced by another. It’s deeper, and greater, than passion. And we desire it.
Lyubomirsky, a longtime researcher in the field of happiness, together with Harry Reis, a dean’s professor in the University of Rochester’s department of psychology, have written a treatise on how to bring more compassion, acceptance and vulnerability to our relationships.
The bad news: We often go about it incorrectly. The good news: It’s fixable.
Sonja Lyubomirsky, co-author with Harry Reis of the book “How to Feel Loved.”
(Taea Thale Photography )
Too often, they write, we obsess over making ourselves more appealing to others — or more “lovable” — when we should be striving for stronger communication. “How to Feel Loved” outlines multiple mindsets to up our conversation game, each springing off of what they call the “sea-saw method.” Yes, “sea” rather than “see.” We unpack that and more with Lyubomirsky, below.
This interview has been condensed and edited for clarity.
A core tenant of the book is that sometimes we’re our own worst enemies. Things we think may help us feel more loved ultimately work against that goal.
Many of us are loved, but we don’t feel loved. Harry Reis and I created a survey expressly for the book, and we found that 70% reported wanting to feel more loved in at least one of their significant relationships, and 40% wanted to feel more loved by their romantic partner. That’s a problem. Feeling loved is so important to happiness. What are the barriers? Why don’t people feel more loved, and what do they do when they aren’t feeling loved? What we discovered through research is that we kind of go about it the wrong way. We think, “If I don’t feel loved, I need to change myself. I need to make myself more lovable. I need to get more attractive, richer, more accomplished and have more power, status, fame and beauty. I need to show the other person my wonderful qualities and hide my shortcomings and weaknesses.” It turns out that’s backward. That will not make us feel more loved. Our message is empowering. You don’t need to change yourself. You don’t need to change the other person. You just need to change the conversation.
I want to get into changing the conversation, but curious, is a reluctance to do so driven by a fear of rejection?
There’s something called the vulnerability paradox. We think being vulnerable and admitting our mistakes will make people like us less. But actually, often people like us more. So that doesn’t mean just go tell everyone your weaknesses. A lot of emotional intelligence is involved here. You have to read the person — at what point to be a little vulnerable? But right now, I want to impress you with this interview. I want you to think I’m smart, knowledgeable and a good person. That might succeed in impressing you, and maybe you might admire me, but it’s not going to forge a connection. It’s really that vulnerability of going deeper that makes us feel more loved.
“How to Feel Loved” from Sonja Lyubomirsky and Harry Reis.
(Harper Collins Publishers)
So how do we go about that? What’s the first step in feeling more loved?
If you want to feel more loved, you need to make the other person feel loved first. How do you do that? You show genuine curiosity in their day, in their inner life and what they’re all about. We all crave that. The key to feeling loved is truly being known. If you’re hiding your shortcomings and only showing your highlight reel, you’re not going be known. So, Todd, let’s say you only show me very positive sides of you, and never anything vulnerable. Then I express love to you. How can you trust that? What am I loving? I’m just loving this little piece that’s being shown to me. So you’ll always wonder, “Oh, if they only knew A, B, C or D about me, they wouldn’t love me so much.” So the first step to make the other person feel loved is to show radical curiosity. For example, I’ll ask, “Tell me about the last time you cried.”
And yet to ask that question — or to answer it — we need to feel that we’re in a safe space. The concept of radical curiosity seems to create that.
You feel safe because I’m really genuinely interested and I really care. We talk about the open-heart mindset, which is warmth and kindness. I really care about you. I believe in you. We call this the listening to learn mindset. I’m not just trying to respond or turn it back to me, like, “Oh, that reminds me of my story.” Most of us are not good listeners, me included, because we’re formulating an answer instead of just totally taking it in. Listen like you’re watching a film. When you’re watching a film, you’re just taking it in. You’re not formulating an answer when you’re watching a movie.
Some of these tips sound simple but they’re difficult to implement.
We have the “sea-saw” metaphor. The idea: Say you and I are talking. We’re sitting on opposite ends of an underwater “sea-saw.” The reason we’re underwater is because most of us is hidden. I only see the tip of you and you only see the tip of me. But when I’m showing curiosity in you, it’s as though I’m pressing down on my end of the “sea-saw.” I’m helping to lift you up and I see a little more of you. Then when you start talking, I don’t just listen to learn, I listen with warmth and acceptance — without judgment. That’s hard to do, because we’re all judgmental. But that lifts you up even more. Then this is the hard part, but the idea is you will reciprocate. Then you show interest in me and ask me questions and get me to open up. Feeling loved is being known, and you do that through a “sea-saw.” It’s a back and forth.
I like the “sea-saw” idea because a lot of times I get in my head, like, “Say something interesting.” But it’s really more about being interested?
It’s incredibly hard to really cultivate curiosity in someone else’s inner life. It has to be genuine, but it really makes people feel seen, heard and loved. Remember the last time someone was so curious about you. Maybe you’re telling a story and they can’t wait for you to finish a sentence. They’re leaning in. Their eyes are bright. Charismatic people have that. It’s compelling. But we’re not going to feel loved if we don’t share something of ourselves with others, but you want to start small. Pacing is critical. You don’t want to overshare and trauma dump. Maybe start with a little thing. They say, “How are you?” Instead of saying fine, say, “I had a rough morning.” Or, “I’m struggling with a little thing today.” It doesn’t have to be negative. It can be, “I didn’t really like that movie that everyone loved.” That’s a little bit vulnerable.
And it’s letting go of a fear of being judged.
One of my favorite mindsets is the multiplicity mindset. It comes from trauma research. The idea is when we have a trauma in our life, it’s part of you, but it doesn’t define you. We’re a quilt of positive and negative traits. I’m generous at times, but sometimes I’m selfish and sometimes I’m loyal and sometimes I’m narcissistic. That’s true about me, and it’s true about everyone. But one trait doesn’t define us. So use a multiplicity lens when you’re talking to someone, and use it on yourself. Humans are messy, very complex, and full of bad and good traits. The opposite of that is to be judgmental. Being judgmental is something we have to overcome, so using a multiplicity lens takes some effort. So when you want to make someone feel loved, when they’re revealing something about themselves that they may be afraid to reveal, you make them feel accepted and that you see them in all that complexity. You feel loved when a person knows your secrets and still loves you.
And the book provides valuable insight into those moments when maybe you didn’t feel loved.
A couple of early readers of the book — we had finished the book but it wasn’t published yet — shocked me. They were both friends of mine. They said they loved it, but both of them decided to break up with their girlfriends after reading the book. One said to me, “I read your book and I realized she’s not sharing and I’m not sharing.” The other person said, “I realized my girlfriend stopped asking me questions.” We thought of this as prescriptive. “Here are the steps you can take.” They used it as a diagnostic. Were both of you sharing? Were both of you listening? Were both showing an open heart? And multiplicity: If you reveal something negative, is it seen with compassion? This really breaks it down. I don’t want people to break up with people, but if this sheds a light on a relationship, hopefully that means they can talk about it and improve it.
(Maggie Chiang / For The Times)
Comedian Richard Pryor performs on stage at the Los Angeles Hollywood Bowl on Sept. 19, 1977.
Lennox McLendon/Associated Press
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Lennox McLendon/Associated Press
Historian Elizabeth Stordeur Pryor has spent much of her career tracing the N-word through slavery, Jim Crow, the civil rights movement and hip-hop. But what she didn’t tell her audiences was that her father, Richard Pryor, was the comedian who put the word at the center of American comedy in the 1970s.
“I was a scholar of the N-word — and so was he,” Pryor says of her father.
As the child of a white mother and a Black father, Pryor describes her own relationship to the N-word as a “super complicated” one. She remembers teaching a college class in which one of her white students used the word while quoting Blazing Saddles — a film her father co-wrote. Pryor froze: She had vowed never to use the word in her classroom, but suddenly there it was.
“I [was] just kind of like like a deer in the headlights,” Pryor says. “I was really worried about the Black students. … Something I had never considered when I thought about teaching is what happens when the racism that we study and we teach comes in? … How do I work through that in the moment?”
Pryor’s new book, Something We Said: Richard Pryor, A Notorious Word, and Me, is part memoir and part history of one of the most divisive words in the English language. Late in his career, after spending time in Kenya, Richard Pryor vowed never to use the word again.
“One of the things I admire about that moment when he disavows the word is he said, ‘This is for me. I’m not telling you what to do,’” she says. “There is a piece [of him] where he understood that the word had a function in Black culture. He does talk about, though, as an artist, losing control of what the word was doing.”
Interview highlights
On her father’s use of the N-word
[In] one of the first meaningful conversations I ever had with [my dad] as a little girl, he told me, “Don’t let nobody ever call you that.” And then he used it, and then his friends used it. …
I think it’s really important to emphasize that when I’m saying that he used the word that it was in the subversive way, that it was the language of protest, and that he was building on a Black tradition of protest, that Black people had used this word kind of as a slap in the face to white racism. You know, “We know how to take our punches and our knocks, and we’re not afraid of this thing that you’re trying to demean us as.” And so bringing that use, the way that Black people perceived of the N-word, onto stage was really powerful in the 1970s.
On talking about the N-word with her college students
Teaching the word is still incredibly difficult. I have to say, the conversations are always hard, but I feel like it’s important because my students walk away knowing that this is not a conversation, like I said, about free speech. It’s really about how how we interact, how we want to bring as many people as we can to the table. And if we do that, that means that we’re going to be thinking about who we’re sitting at the table with and how things will impact them.
On meeting her dad for the first time when she was 6
We were in Newark, New Jersey, … and my mom is acting kind of … nervous. And we knocked on the door of a hotel room, and he opened in a towel. And I was like, this is my father. Like, not only do I get a father, but I get this guy. What? I just felt like I won. I loved him immediately. Instantly. His eyes were so warm, and he was so handsome. And I just fell head over heels. … I saw my face [in his face]. … He created a bridge immediately between us and invited me to cross over.
On vying for her father’s attention as a kid
I wanted to be smart enough and creative enough, and I would try to show off. I did theater. I did improv. He would come to my plays and come to my performances. [I] tried to get intellectual with him, like when I was in college. And I had a Black awakening and he basically, like, sent me some stuff so I could awake Blackly, I guess. … He sent me the documentary on Malcolm X that had been filmed, I think, in 1972. And then he sent me The Last Poets’ [song] … “N-words are Scared of Revolution,” to listen to. And I did. I felt like he was inviting me into a secret world, and I wanted to go there. …
At the end of his life, when he couldn’t speak anymore, I would go over and read from the narrative of Frederick Douglass to him, and I could see that he was feeling proud … of being read Frederick Douglass by me.
On Richard Pryor’s upbringing with a sex worker mother and the first laugh that changed everything.
Oh, my dad. He told me a story about being 5 years old and, I don’t know why, but he’s wearing a little cowboy suit, and he was in front of the house and all the people were there, his grandmother, all the sex workers, and his father and his uncle. And he slipped in dog poop and they just start cracking up. And so he got up and he made himself slip in it again, and they couldn’t stop laughing. And so he did it again and again. And it’s pretty painful to think of the lengths that he felt that he needed to go to get their adoration and attention.
Anna Bauman and Thea Chaloner produced and edited this interview for broadcast. Bridget Bentz, Molly Seavy-Nesper and Meghan Sullivan adapted it for the web.
Nope, it’s not AI. It’s just a really big flag with bright lights, draped on Hoover Dam for the next several weeks.
As a display to mark the 250th anniversary of U.S. independence, the states of Nevada and Arizona and the federal Bureau of Reclamation teamed up to hang and illuminate an enormous American flag on the dam on Memorial Day.
The display, scheduled to be in place through July 4, is visible to anyone crossing between Arizona and Nevada on U.S. Route 93, which goes across the top of the dam. The flag is 150 feet tall and 300 feet long, spread on the south-facing side of the dam and lit by 550 LED lights (powered by dam-generated electricity).
A wider view of the illuminated U.S. flag at Hoover Dam.
(Michael Bittle)
It’s a spectacle that comes at a challenging moment for Hoover Dam, as experts warn that Lake Mead’s dwindling water levels could threaten the dam’s ability to generate hydropower. “Slap a flag on it, that’ll fix it,” suggested one of several Reddit commenters who were moved to snarkiness by the flag image.
The dam, a frequent day-trip destination from Las Vegas, stands 35 miles east of the Las Vegas Strip, about 295 miles northeast of Los Angeles. The site features a visitor center and overlook, and guided and self-guided tours.
Installation of the display involved dozens of riggers and two cranes. The flag, which is roughly the dimensions of a football field, has been previously used for celebrations at Indianapolis Colts and Las Vegas Raiders football games.
Within two days after it was hung, gusts of wind up to 50 mph prompted organizers to lower the flag last Wednesday as the National Weather Service declared a wind advisory for the area. Organizers raised the flag again late Friday.
Strong winds are not uncommon in the area. Organizers said weather “may periodically require the flag to be temporarily lowered.” Updates on the flag’s status can be found on the Hoover Dam Facebook page.
The Las Vegas Convention and Visitors Authority paid for the display. A spokeswoman said the cost, including flag, production, installation costs and six weeks of lighting, will be between $750,000 and $1 million.
The dam, a five-year construction job that was completed in 1936 during the depths of the Great Depression, is often hailed as one of the nation’s most impressive works of infrastructure. Though this is not the first time a flag has been draped on it, organizers have called the display “the most ambitious long-duration installation ever attempted at Hoover Dam.”
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