By Damon Tweedy


One doctor's passionate and profound memoir of his event grappling with race, bias, and the original illnesses of black Americans

When Damon Tweedy starts off clinical school,he envisions a vibrant destiny the place his segregated, working-class history becomes principally beside the point. as a substitute, he unearths that he has joined a new global the place race is entrance and middle. The recipient of a scholarship designed to extend black pupil enrollment, Tweedy quickly meets a professor who bluntly questions even if he belongs in clinical college, a second that crystallizes the demanding situations he'll face all through his profession. Making issues worse, in lecture after lecture the typical chorus for various illnesses resounds, "More universal in blacks than in whites."

Black guy in a White Coat examines the complicated ways that either black medical professionals and sufferers needs to navigate the tricky and infrequently contradictory terrain of race and medication. As Tweedy transforms from pupil to training healthcare professional, he discovers how usually race affects his encounters with sufferers. via their tales, he illustrates the advanced social, cultural, and fiscal elements on the root of many illnesses within the black neighborhood. those concerns tackle higher that means whilst Tweedy is himself clinically determined with a protracted illness way more universal between black humans. during this strong, relocating, and deeply empathic ebook, Tweedy explores the demanding situations confronting black medical professionals, and the disproportionate future health burdens confronted through black sufferers, finally looking a fashion ahead to larger therapy and extra compassionate care.

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In any setting, older people have special needs. Their needs, and the consequences of not meeting them, are amplified in the setting of acute illness. Specific areas meriting attention include pressure area care, prevention and treatment of delirium, and optimal nutrition and hydration. Accurate early and comprehensive diagnosis(es) is essential. An acutely unwell older person may present to one of several services depending on: • Local service provision • The individual's understanding of the system • Advice from others (eg relatives, health professionals, NHS Direct) Any service aiming to diagnose acute illness in older people must have access to immediate plain radiography, electrocardiography (ECG), and ‘basic’ blood tests (including prompt results).

In other ‘community’ hospitals a GP may be employed as a clinical assistant. In some hospitals both patterns co-exist. Visits should be both regular—identifying potential problems and planning prospectively—and responsive to acute problems identified by nursing staff. Specialist medical input may be available, including a visiting community geriatrician and psychogeriatrician. Other specialists, eg surgeons may hold outpatient clinics on site. Nurses and therapists are often very experienced in the care of older people, and are able and willing to work more independently from doctors.

A whole system study of Intermediate care services for older people. Age and Ageing 34: 577–583. 27 28 CHAPTER 2 Organizing geriatric services The National Service Framework for Older People This huge document (over 200 pages) was published by the Department of Health in March 2001. It was one of the first NSFs to be produced and set out the government’s agenda to improve health and social services for the elderly with milestones (ie deadlines for service changes) stretching over the following 4 years.

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