Legacy: A Black Physician Reckons with Racism in Medicine (Penguin, 2024) is a memoir by Uché Blackstock, an American physician specialized in emergency medicine, a healthcare advocate, and founder and CEO of Advancing Health Equity, an organization that partners with businesses and individuals to embed equity into healthcare, and in the organization’s words, help create “inclusive care environments and improve equitable community health outcomes.”
Blackstock’s memoir narrates her journey of self-discovery and empowerment through the process of constructing her identity as a Black female physician within the historical and social context of the legacy of racism in the United States, as she argues in the book. The storyline is organized chronologically from her origins as a child, growing up with her twin sister in Crown Heights, New York, in a family in which she felt privileged, and in a community environment where neighbors cared for each other.
But, as in all narratives, there is a complicating event. In her case, we learn of a significant loss when Blackstock was a premed student at Harvard University, which would inform her life decisions henceforth. Her career path evolves as socially and professionally expected: She completes her residency as an emergency care doctor, becomes an ultrasound fellow, gets married, has children, and decides to undertake a competitive career in academic medicine as a full-time faculty at New York University School of Medicine. The professional struggles she endures during her tenure at NYU would motivate her to launch her own company Advancing Health Equity, with goals “to drive sustainable change in health outcomes ensuring high quality, culturally responsive care for all.”
Blackstock’s memoir has an emotional tone that does not hide her righteous indignation about the injustices of racism in medicine and healthcare. She legitimizes her passionate advocacy for healthcare equity by providing plenty of examples and documentation drawn from her own experience as a practicing emergency care physician in New York City, and as witness to her patients’ predicaments from the vantage point of having worked in public and private hospitals as well as Urgent Care facilities. Her academic perspective as a professor informs the story as well. The narrative tone also displays her vulnerability as she acknowledges, “I laid myself bare. I told deeply personal stories about my family, my patients, and my career” (273). The book presents in-depth documentation as can be seen in the notes section. The documentation helps the reader understand the complex interplay between the person’s historical and sociocultural context and their illness story. The strength of the memoir, I would say, is how in every chapter it skillfully integrates Blackstock’s personal story with the social history of racism in healthcare in America, as a segregated system with a double standard; the standard that applies to the insured patient and the standard that applies to the uninsured patient. “We are living in two Americas because of systemic racism” (261), she states.
As the United States ranked first in number of fatalities associated with COVID-19, especially among the working-class populations, the urgent healthcare and public health needs exposed by the pandemic only reinforced Blackstock’s commitment in her advocacy for a solution in the form of a universal single-payer healthcare system in the country. Also, it amplified her voice as a healthcare educator and communicator. As she acknowledges it, the book is the result of the media exposure she gained during this time, which ended up providing her with the audience she needed. The memoir also offers an antidote to the systematic practice of racial injustice as she describes it. The antidote takes the form of various open letters to collectives—“you” as her addressees, such as “To My Black Patients and All Black Patients” (254) or “To People of Color Who Are Not Black” (255). It is up to the reader, though, to assess whether the appellative tone of the letters is meant for them, given the inevitable generalization involved in addressing people as uniformed, collective groups. Will the reader take the responsibility that Blackstock expects?
The title of the memoir Legacy is polysemic. It may not only refer to the personal legacy of her loving mother to whom the book is dedicated but also to the inhumane institutional legacy of racism, whose “weathering” effects shape the health outcomes and life stories of millions of people in the country, including the author’s. The third type of legacy might be found in the value of Blackstock’s memoir as a testimony to the United States healthcare politics. In Blackstock’s voice:
Even though my children are still young, my life has surpassed my mother’s in some ways. I have gone down the road she didn’t get to go down…. I have found my voice outside of medicine as a health equity advocate and social impact entrepreneur. Even though she didn’t get to have those experiences, … I’ve gotten to do it for her—and for myself. I learned from her early death that life is unpredictable, and you have to take chances. In fact, you must take chances. The same determination that motivated her drives me to continue where she left off, to use my voice in ways that I never thought I would or could, and to take a leap of faith because I knew in my heart, I could make a larger impact on the issues that are important to me, to us, to our communities (270)
To conclude, the book aligns with narrative medicine’s commitment to social justice. I highly recommend this memoir not only to healthcare professionals but also to medical/health humanities and public health practitioners, as well as to anybody who believes that equal access to healthcare is a human right. —Roxana Delbene
Roxana Delbene
Roxana Delbene, PhD, holds a doctorate in linguistics from the University of Pittsburgh with a specialization in discourse analysis and sociolinguistics. Her research in linguistics led her to complete an MS in narrative medicine at Columbia University and a DMH at Drew University. She teaches courses in literature and medicine, anthropology of health and healing, medical Spanish and medical interpretation at Montclair State University and The College of New Jersey respectively.
She serves on the editorial board of Intima: A Journal of Narrative Medicine. Her research focuses on the discursive features that characterize patients’ narratives about invisible illnesses.
Her latest publication, “The uses of dialogical strategies to construct credibility in narratives of contested illnesses,” appears in the Journal Communication and Medicine, May 2025, published by the University of Toronto.