THE PRICE OF EXCLUSION

A journalist delves into the history of discrimination against Black American MDs as she uncovers the story of her gifted physician great-grandfather.

Fourteen percent of the U.S. population is Black, yet the number of Black doctors is only 5% of all practicing physicians. In this thoughtful, deeply personal book, Carr examines the roots of this century-old problem through a combination of historical and genealogical research. She brings to life the many, often unsung Black physicians who worked against a white-supremacist medical establishment to not only earn their training as doctors but transform an unjust public health system. Among them is her own brilliant Jamaican-born great-grandfather, Lawrence “Fergie” St. Clair Ferguson, whose life she began piecing together at the start of the Covid-19 pandemic. A veteran who experienced British mistreatment as a Black soldier in World War I, Fergie came to the United States during the Spanish flu pandemic to attend Howard Medical School. That institution was one of the few Black medical colleges that remained open after closures both imposed by the Flexner Report and supported by a racist American Medical Association. Fergie eventually returned to Jamaica to open a successful practice and advocate for community hospitals that served the poor and people of color. His teachers and colleagues in the U.S., meanwhile, fought against the segregationist, often violent legacy of Jim Crow. Some defied the odds to create much-needed services and institutions, only to have that legacy erased—a pattern that has in turn created the health care shortfalls that persist in the Black community to this day. Inspiring and sobering, Carr’s book is a necessary reminder of the reforms still needed to ensure diversity and equality in the public health system.

A profoundly moving testament to the courageous Black doctors who fought against institutionalized racism.