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212 epilogue In the more than fifty years since my graduation from the University of Michigan Medical School in 1946, as the only African American among the 145 graduates, I have been both an eyewitness to and an active player in the changing role of Blacks in American medicine. When I graduated, I was advised that I could choose my internship and subsequent postgraduate appointments from among no more than half a dozen hospitals. Half of them had almost all Black patients, and the others were general public charity hospitals serving low-income populations. It was only a few years later that increasing fractions of medical school graduates began to pursue additional years of residency training to become specialists. The medical world in those years was segregated by race and income , though this system was beginning to change with the end of World War II. In 1946 the huge Wayne County General Hospital accepted me and another graduate from Meharry Medical College as its first Black interns. At the end of that year, during which we were well received both by patients and the hospital staff, we were stunned to find that we had not been invited to attend the staff Christmas party. One of the other interns, a White physician who had graduated from a southern medical school, told me that he and several others had argued that we should be invited. Having lost that argument on a vote, he wanted to make a gift to me if I would accept it. His father, the owner of a clothing store, had sent him two suits; he and I wore the same size, and he wanted to give one of the suits to me. I accepted, assuring him that he was not indebted to me because of the party. This incident taught me a personal lesson: young professionals, beginning a year as Blacks and Whites, could at the end of that year recognize each other as persons—as persons who see and renounce the intimate cruelty of race prejudice. Another powerful experience occurred in the 1950s, when I was developing a private practice toward the end of my training. My first office was in our home in Brooklyn, an attractive brownstone that had been the home and office of a White psychiatrist who was moving out of the neighborhood because it was rapidly becoming all Black. One of my White instructors , who supervised my psychotherapy cases, thought highly of my work and referred a young White schoolteacher to me. She had been sent to him by an internist who thought her psychosomatic problems might respond to therapy. She came to see me several times but then terminated. The internist, it turned out, had learned that the patient was being treated by a Black psychiatrist in a Black neighborhood, and denounced my instructor for sending the patient to me. My instructor and I reviewed the situation in great detail and came to one important conclusion—I should relocate my office to downtown Brooklyn Heights, where most of the specialists practiced. Both Black and White patients would be comfortable on visits to me at such a site. Being accepted into one of those office buildings was a tortured process, but the fifth landlord or business manager I approached rented me an attractive office . By happenstance his firm managed the real estate properties of one of Brooklyn’s largest Black churches. As the next few years unfolded, my practice flourished. My patients were about evenly divided between Blacks and Whites, and I received referrals from my professional associates and personal friends, who were also about evenly divided between the two races. A number of my patients were family members of my White colleagues, who referred them to me for care. Contrast this with another story. A friend of mine, a White specialist in internal medicine, had for some years taken care of a prominent Black businessman who was plunged into a deep depression after his son committed suicide. The internist wanted to refer him to me, but the patient refused. He insisted on being referred to a White psychiatrist. My reaction to this is—you win some and you lose some. For the best treatment result, the patient must make the choice. But many of the Black middle class must overcome their view that Black specialists are second-rate. There is room for new learning all around. My first year at Cornell, 1968, was in many ways a pivotal one. I had been...

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