When I think about what “legacy” means, I think about what we owe to those who came before us. “Legacy” is both a gift and a responsibility. It’s the history of humanity distilled into a few words. When I think about “legacy”, I think of us as river stones, carving out the path through which the water flows. I think of us, most often, as part of a community.

I don’t think of Harvard.

I do think of mothers. My own, who taught me to give without boasting, without expecting anything in return. I think of other mothers, the Blackstock mothers.

I think of my grandfather, of the gifts of silently keeping company, of learning to swim in a muddy, powerful river. When I think of “legacy,” I think of medieval churches and how people built them for everyone, not just to see them finished. When I think of “legacy,” I also think of heroes. (And this will become important further down the line: I think of heroes, but not superheroes.)

“Legacy” is also a profession passed down since childhood, passed down as vital knowledge—a way to survive or as a secret guarded from an early age. There are many Drs. Blackstocks, so, I’ll refer to the author of the book Legacy: A Black Physician Reckons with Racism in Medicine by her given name, as if I knew her personally. I’m aware I’m breaking a basic rule of inclusive writing: female authors should be referred to by their full name, just as we do with men, to avoid infantilizing them. But I’ll call her Uché because she feels closer to the readers than white male authors (and I sense that was her intention too), and as a way to honor the other Drs. Blackstocks.

I turned to Goodreads, a versatile, wide-reaching website that offers a space to track, search, and reflect within a community (a convenient and complex platform.) I searched for Legacy and read the reviews; in summary, readers find a lot of value in the book. I noticed the images accompanying the reviewers’ names: there are many women, Black, brown, white. I have no doubt that women are the primary readers of women’s work and that for men, reading a book by a female author is a significant leap—and I cannot help but be a bit angry when I write the last part of the sentence, knowing that it is not just a bad joke. Authorial power seems reserved for men—it is an almost homoerotic authority to which so many misogynists surrender.

One comment catches my attention:

The person comments that during her anesthesia training, she was told that Black people had tougher skin and more resistance to pain and that if they asked for pain medication, it should be considered “drug-seeking” behavior. She was shocked that, forty years later, racism in medicine was still so rampant. Her review ends bittersweetly with, “The people who most need to read this book probably won’t.”

I believe only a sensible woman could have written Legacy. In some parts of the book, it’s clear to me that it’s not just a woman writing, but a sensible Black woman. White people boast about everything they’ve done alone and believe in the superficial marvel of their existence and achievements. Only a sensible Black woman could say: my mother, who was special, was also just another woman, another physician.

This struck me deeply—Uché’s ability to step outside the simplistic white dichotomy: either you’re gifted, or you’re a failure. She speaks of her mother and sister with pride, love, compassion, admiration—yet never losing sight of the bigger picture. Perhaps that’s why this book is a tapestry of legacies, stories, and questions: because Uché weaves complexities, rather than just listing achievements.

I had heard too that Black people have better genetics and therefore can build more muscle, and I had accepted it as fact. I also thought it was a compliment to Black people. I considered it an advantage they had, not realizing that this idea stripped Black people—bodybuilders or athletes, for example—of their discipline and hard work. In a way, I wanted it to be true, that Black people were superhuman. I continued reading Uché’s book, and I began to question: what’s wrong with believing that Black people are superhuman (superheroes)? When we label someone this way, we demand that they save the world, save all of us, and in doing so, we strip away their humanity. It's a dangerous trap.

Uché recounts events from her mother’s life and the responsibilities Dr. Dale Blackstock had to face—not just because she was strong and capable, but because Black women are expected to do three times as much. In this pressure to save us all, we’re actually trying to annihilate the individual.

Recognition and prestige are also themes touched upon in the book, and it’s vital we discuss them because, on one hand, historically, they have tended to exclude the Black population. On the other hand, we may need to redefine them to align more with self-efficacy and kindness. The fact that Harvard has been around for over 400 years and that the Blackstocks are the first to form a legacy is bittersweet. Good for the Blackstock doctors, and bad for everything else: the educational system, the Ivy League, the idea of legacy… But interestingly enough, perhaps it is not shocking that a legacy of Black women has broken away from the established narrative. They've navigated the white path, both through their own efforts and, indirectly, through the work of Black women who came before them. And once they achieved that, they were able to deviate. The best story of humanity—the most supportive, revolutionary, and human—is the story of deviation (the stories of deviation.)

Now, when I think of “legacy,” I do think of Harvard. And, when I think of legacy at Harvard, I also think of… that other thing.

I found the following on the Ivy Coach website on “legacies”:

“We at Ivy Coach have long called out the unfairness of legacy admissions in the Ivy League, and Harvard in particular. Legacy applicants at Harvard are overwhelmingly white, wealthy, and the recipients of a lifetime of privilege. In fact, a 2023 study found that 43% of white students at Harvard are either legacies, recruited athletes, or the children of major donors.”

Paul Preciado, in Yo soy el monstruo que os habla, places himself at the center of academia to confront it through his own life story. “What are we going to do?” he seems to ask. “I do this, I stand here to talk about violence and ask which path academia and psychoanalysis should take: the hetero-patriarchal-colonial system, or one that makes political critiques and opens up to different identities and technologies.” Paul’s ability to challenge the system comes from the fact that he has already earned recognition from the same circle he is now confronting. Uché does something similar in her own way when she deviates from some legacies she has earned and given.

Prestige and recognition are very hard to question. It’s hard to let go of that small patch under a sunny sky, that little place without shade. So much applause is given to anyone who achieves and challenges it. Confronting given prestige reconfigures one’s sense of self-worth. Who are these people who’ve granted me this value? Do they truly have the power to provide me with value?

In Legacy, the legacies of family history, Harvard University, and the Black community beautifully intertwine. It’s a book that takes you by hand, is easy to read, and flows like a river. Even the medical anecdotes are written in an easily understandable way for those of us not in that field of knowledge, and for that, we are very grateful. The reader will learn a lot about what still needs to be done and what must be unlearned.

I told my partner I wanted to try to go regularly to the botanical garden of my city because I knew it would do me good. I never let on that the idea came from one of the Drs. Blacktock, I realize I’m part of this other legacy—one about self-care and temperance. Walking in a botanical garden to find emotional balance isn’t my idea, and that’s fine by me: I’m just a river stone. Water surrounds me, flowing before and beyond me.

In the final pages, Uché offers ideas on what should be done, or what can be done, on an individual, professional, and institutional level to confront systemic racism. I’ve found many times that in moments of desperation—any kind of desperation—Black women are capable of offering sensible ideas for action. They’re not only expected to save us, they’re the ones who do. Could this be another legacy—a part of the history of Black women?

When I think of the importance of Uché’s book, I think of the act of writing itself, often so undervalued by those who write merely for the sake of writing. I had a university professor who used to say that before writing anything, we must evaluate whether there’s something of value in what we’re writing; so much has already been written. Essentially, she was advising against the cluttering of bad books and pointless works. I believe she was right, of course, from day one. With that in mind, I know it’s a good thing that Legacy exists as a written work. Now it belongs to our collective imagination. I hope it reaches as many people as possible—the ones who need it most and those who need it more.

Read it.

Q&A

In November, we had a book club with Uché and had the opportunity to talk with her and ask her questions. But time was limited, so we sent her the questions we didn’t have time to ask. We trust you’ll find her answers meaningful. And if you have more questions, feel free to leave them in the comments.

What kind of reception did your book have when it was published?

The reception to Legacy was overwhelmingly positive. I was grateful for the support and validation I received from readers and reviewers alike. During the writing process, I was surprised by how many people shared similar experiences with systemic racism in medicine. This made me realize that our struggle is not isolated and that there is power in sharing our stories.

What’s the question you’re asked most often?

People often ask how I managed to overcome the challenges I faced in my career.

Is there a question you wish someone would ask but never has?

I wish someone would ask me about the hope and resilience that I've witnessed in the fight against systemic racism.

How did you navigate separating yourself from the prestige of academia and the medical field, and how do you define prestige?

I've found that defining prestige is a complex issue. For me, it's about making a difference and advocating for change. I see prestige connected to white supremacy in the ways it maintains power and privilege within the system. I thought it was important to be intentional about redefining what success looked like.

Was there any topic you wanted to include but didn’t have the time or opportunity to explore?

I would have loved to explore policing, mass incarceration, and their impacts on health.

After the entire process of writing a book and exploring new ventures, what additional insights have you gained about systemic racism in medicine?

After writing Legacy, I've gained a deeper understanding of the insidious nature of systemic racism. It's not just about individual biases, but about the structures and policies that perpetuate inequality.

A Review: Legacy: A Black Physician Reckons with Racism in Medicine

Q&A