The Price of Exclusion: The Pursuit of Healthcare in a Segregated Nation

This searing debut from journalist Carr explores the underexamined history of discrimination against America’s Black medical students and doctors. Seeking to understand why there remain disproportionately fewer Black physicians than Black patients, “a ratio that has barely budged in more than a century” and which negatively impacts Black patient outcomes, Carr traces a legacy of exclusion in medical training. She does so primarily through the life of her great-grandfather, Lawrence St. Clair Ferguson, a Jamaican doctor trained at Howard University, who faced numerous racist indignities, including struggling to find an internship after school, which forced him to return to Jamaica. Along the way, Carr spotlights other shocking historical examples of bias against Black medical professionals, such as white Union doctors complaining to Abraham Lincoln about having to serve alongside legendary Black surgeon Alexander T. Augusta; the devastating closure during the Spanish flu pandemic of North Carolina’s Leonard Medical School—“a key producer of Black doctors”—over stringent new American Medical Association regulations; and the AMA’s refusal to desegregate until 1968. Black doctors and students continually fought back, she notes—including founding an alternative to the AMA in 1895—but current government anti-DEI purges pose a renewed threat. It adds up to an eye-opening revelation of systemic racism in American medical training and a moving celebration of the Black doctors who persisted. (June)