Legacy by Dr Uché Blackstock is a heartfelt and courageous memoir that explores her life, family, and community while highlighting the ongoing health inequities that disproportionately affect Black communities.
She pays loving homage to her mother, “the original Dr Blackstock,” and writes about her with so much tenderness, admiration, and appreciation. Her mother worked as a doctor, caring for her community, and passed the baton to her daughters, who also became doctors.
As an African woman living in England and now Scotland, I had many moments of recognition while reading this. I am often in spaces where I am the only Black woman. One particular light-bulb moment came when Dr Blackstock described:
“I often was the only Black person in the room. In such situations, I felt as if I were under a microscope, always hyperaware of how I spoke, the words I used, the way I dressed. I found my body would stiffen up as I walked into a patient’s room. I’d stand up straight, trying to project confidence, to prove myself. I didn’t know the term for what I was doing, but now I can see that it was what is known as ‘stereotype threat’—a psychological phenomenon in which an individual feels at risk of confirming a negative stereotype about a group they identify” (p. 101 – Kindle Edition).
Just how many of us do this without even realising it, and just how stressful it is on the psyche and the body to live and present oneself in this way?
Book Summary
This book is essential reading for anyone seeking to understand (or deepen their knowledge of) the health disparities that communities of colour, particularly Black communities, face in the United States. I would argue, however, that Black communities universally experience the issues identified in this book. Dr Blackstock does not shy away from the brutal truths: the disregard, the lack of care, and the heartbreaking maternal mortality rates among Black women. She also humanises every person she writes about in this book, and this is crucial: recognising the fear behind people’s eyes, instantly knowing where it stems from, and acting accordingly to support them.
In addition to her lived experience, those of people around her and those she came to care for in her community, Dr Blackstock also incorporated research into her book, including key historical facts that everyone should know – exposing how deeply rooted many preconceptions about Black people, and Black women in particular, are. She also highlights the often-erased contributions of Black people to medical advancements. For instance, I did not know about the HeLa cells until reading this. Dr Blackstock traces the structural and systemic issues that affect health: racism, exclusion, inequity in medical training, and the institutional culture of academic medicine.
Key Themes
1. Interlocking Systems of Oppression
Dr Blackstock goes deeper than surface-level explanations. She uncovers layers of interlocking systems that produce and reproduce health inequities.
She reflects on how people often have no choice but to use the ER as their primary source of care, where medical insurance is out of reach:
“I came to see that the woman who couldn’t take time off work to get her blood pressure medication wasn’t only suffering from high blood pressure, she was suffering from lack of workplace protections. The young man who lost his life to gun violence clearly needed better educational and employment opportunities. The elderly gentleman who had his diabetes medication stolen at the homeless shelter would need safe, permanent housing before his health could ever begin to improve in meaningful ways.” (p. 111, Kindle Edition)
Here, she shows that health outcomes are not simply medical; they are social, political, and economic.
2. Medical Racism and Academic Medicine
She writes openly about her experiences in academic medicine, including being thwarted and eventually pushed out for advocating for true diversity and health equity. These sections are heartbreaking, especially her reflections on supporting Black students navigating hostile, racist, and exclusionary environments. I thought, though, that this was a great show of building one’s own table instead of waiting for a place at another ‘s table. She went on to create her own organisation to do the work she wanted to do correctly.
Recommendation
As a Black African woman living in the UK at the time of writing this review, so much of this book felt familiar. I recognised the burden of representation, the isolation, the resilience, and the ways racism shapes everyday encounters, especially in professional spaces.
Legacy is an essential read.
For Black women, it offers recognition, truth, and healing. For everyone else, it offers education, accountability, and a clear look at the systems that must change.
If you work in health, community care, academia, or social justice, this book should be on your reading list.
About the Author
Dr Uché Blackstock is a physician, educator, and founder of Advancing Health Equity, an organisation dedicated to dismantling racism in healthcare. Her work focuses on reproductive justice, health equity, and advocating for communities most impacted by structural racism. Read more about her, her work and order her book HERE.
Reading Time: 10minutesCover of Sisters of the Yam: Black Women and Self Recovery by bell hooks captured on my Kindle after a refreshing morning walk.
Year of publication: 1993 Genre: Nonfiction – self-help; Black feminist thought/essays Country: United States
Introduction
This book is the self-help book I never knew I needed. As a genre, I don’t tend to read self-help books, but I read this book for an article I was writing. In the end, I was glad I did, because this book was for me too. Much of the time, it felt like bell hooks was addressing me personally, either speaking about my childhood, my work life, and my life as a mother.
I loved how she wrote that choosing wellness is a political act, mainly because I am emerging from a long period of putting my well-being last, working myself to the bone, never resting, and only ever surviving and existing. Healing is also intentional; as hooks states, healing can only occur if one is willing for it to (referencing here The Salt Eaters, a 1980 novel, by Toni Cade Bambara, another incredible book that I went on to read).
Conversation and storytelling are essential for healing and recovery. The telling of our stories enables healing. Healing happens through testimony. Black people must talk to one another. We must find communities within ourselves and form formidable sources of support to heal, share our stories, and thrive together. This is by no means a message to become reclusive within our own community, but an emphasis on the importance of Black communities, especially because this is our natural way of being (Ubuntu), and because community is the very thing oppression tried to take away from us.
I loved this book so much that I will review it differently from the rest of the books I have reviewed this year. I will go through it chapter by chapter, providing more details about some chapters than others, to guide those who may want to read it. It is not a book to read in one go (although this will be tempting). It is one of those books to read and savour chapter by chapter, letting its words and message soak in, permeate, and envelop you. So if you do decide to pick it up, take your time with it.
Chapter 1: Seeking After Truth
Telling the truth is essential. In this chapter, hooks emphasises the importance of honesty, a trait that some may take for granted. hooks quotes Audre Lorde, “Eye to Eye: Black Women, Hatred, and Anger,” Sister Outsider: “we have to consciously study how to be tender with each other until it becomes a habit because what was native has been stolen from us, the love of Black women for each other.” (p. 11) Most importantly, hooks starts the book by connecting healing to being honest, especially about our lives and telling our stories.
Chapter 2: Tongues of Fire – Learning Critical Affirmation
hooks continues with honesty in this chapter, admitting that “writing about truth-telling in relationship to black experience is difficult” (p. 21). She most poignantly writes about Black parenting: some Black mothers being cruel to their children, saying cruel things to them, being harsh because they intend to raise “proper” children, using harsh critique to police children’s behaviour. To heal our wounds, we must be able to critically examine our behaviour and change. Some, and probably much, of this behaviour is inherited, but examining ourselves and recognising that change is needed to bring up well-loved children is essential.
Chapter 3: Work Makes Life Sweet
This chapter explores the experiences of Black women in the workforce, highlighting their consistent desire to work or, at the very least, an understanding that they will work. hooks said even in her own household, her mom had always made it clear that her children would grow up into working women, and they did. I do not know any Black women who do not resonate with this. Personally, growing up and even now, all the women I know have always been working and taking care of everybody. For me and my family, and I suppose for most Black women, working was not a simple desire; it was a means of survival and a way to establish a better life for ourselves and our families. But I think the critical point hooks is making in this chapter is that work is not the be-all and end-all. We can work, but we do not have to work ourselves to the bone; we can rest; indeed, rest is resistance. We can also aspire to other things, such as following our passions. In the book, hooks writes about herself and how she has always taught and stayed away from writing, her true passion and desire, because work is what she grew up knowing.
Chapter 4: Knowing Peace – An End to Stress
Black women think they have to work to the bone. And really, we do not, unless it is a matter of survival. However, I believe that sometimes, even when we are past the survival mode, we continue to work hard.
Chapter 5: Growing Away from Addiction
Black women are socialised to be caregivers and take this position without thinking, as if it is a given. Many Black women have difficulty letting their children grow; they cannot let go of the thing they know: taking care of their children. It becomes something of an addiction. The link between repressive parenting and addiction must be examined. I thought this was such an important issue to address, as it highlights how some Black women are conditioned to be caregivers and therefore focus all their attention on that, instead of branching out and exploring other passions they may have. This then makes it challenging to be less addicted to the one thing – caring for children- as without that, what will be left? And repression, or those children – having them dependent on us so that they are always close – can be a way to keep this one thing with us.
Chapter 6: Dreaming Ourselves Dark and Deep – Black Beauty
Whiteness says we are not beautiful, and so we have to create our own beauty standards. This is extremely important, especially because of all the things we have been through as a people, all the stripping away of our identity and self-love, all the ridicule and discrimination because of our appearance: our dark chocolate skin, our kinky curls, and so on. While I agreed with much of what hooks wrote here, I did not agree with some of the things she said, for example, about wigs and weaves, and when she used Naomi Campbell as an example. I think Black beauty is layered, and many of those layers do not have to do with oppression; they, at times, have to do with ease and desire. Caring for Afro hair can be a challenging task. I personally have thick, tight (very beautiful) curls, but caring for them is a nightmare. I use all the products and tools, and it is still very hard. So I texturise them and use wigs sometimes to take a break from everyday detangling. This in no way means that I do not love my natural hair or that I am not proud of it; it just means I am exploring the various freedoms my hair offers me. I can have an afro this week, braids the next and wigs the rest of the month. This versatility is an essential and beautiful aspect of Black Beauty. I do get the point she is making about Black women in positions of power like Naomi Campbel who have a real opportunity to represent, teach and change the narrative, however I feel hooks could have dedicated more time in this chapter exploring the diverse reasons black women have with wearing their hair they way they do, – oppression and shame being some of those, but agency, freedom, choice, and autonomy also being part of those reasons.
Chapter 7: Facing and Feeling Loss
In this chapter, hooks writes about death and dying, something I felt sad about, knowing that she passed away in 2021. But it’s a reminder nonetheless that we are not on this earth permanently.
Chapter 8: Moved by Passion – Eros and Responsibility
Another mind-blowing one. Addresses sexuality and eroticism. Also addresses the love we show ourselves, others and our children. “Are we touched enough? Do we give Black children the touching they need?” p. 89. We do not show enough physical affection, but we need it. The point she made about Black children being so devoid of touch that the only touch they recognise is through sexual relations was valid and depressing. She goes on to write about other people’s experiences of lack of touch within families and so on, which is something I could intimately connect with because I grew up just like that – my family and I do not engage in physical affection. Although this did not mean we did not love one another, it did leave either a deep longing for touch or an aversion to it, because it was so foreign. I now describe myself as someone who is not tactile (except with my daughter, who is highly tactile, so I make sure to be that way for her), but it is something to reflect upon. Am I not tactile because I don’t know it? It is not part of my upbringing, so being touched feels strange or maybe even a trauma response? I know, for instance, that I know that I do not show affection easily as a trauma response and a deep fear of rejection. Or do I genuinely not enjoy being touched, which is also okay if that is the case? I think millennials and the generation after that have started changing this narrative. I, for instance, hug my daughter countless times a day, and all my friends with children do this too. We show physical and emotional affection to our children, something we ourselves did not really know. And so, when I read this chapter, I thought about my own childhood and how foreign it felt to be hugged and touched by someone else.
Chapter 9: Living to Love
This was an excellent follow-up to the previous chapter. She begins this chapter with “LOVE HEALS” (p. 97). Our historical experience as Black people living in a racist society has made it challenging to know love. Love is both an intention and an act. hooks addresses not confusing love with abuse, which is an essential issue to address within Black communities. It’s been difficult (not impossible, p. 98) for Black people to know love and very easy to understand pain and abuse. Some other notable quotes from this chapter:
“We know that slavery’s end did not mean that Black people who were suddenly free to love now knew the way to love one another well” (p. 99).
“Slave narratives often emphasize time and time again that Black people’s survival was often determined by their capacity to repress feelings” (p. 99).
“A slave who could not repress and contain emotion might not survive” (p. 100).
“The practice of repressing feelings as a survival strategy continued to be an aspect of Black life long after slavery ended.”
Black mothers/parents often do not validate the emotions of their children; they expect them to be emotionally strong, to be in a space where they are able to ignore their emotions. Example: a young girl comes home crying after racial bullying; her mother becomes angry, offers no emotional support, and goes to confront the bullies. hooks says this mother could have taught another valuable lesson- yes, we should fight oppression, but we should also expect emotional comfort from those around us.
Black mothers are hardly described by their daughters as loving and affectionate. Mothers often have a need to dominate and be right, constantly seeking to be correct and critiquing themselves. Lack of positive recognition and evaluation. Some Black women are addicted to controlling.
“Black women who are choosing for the first time (note the emphasis on choosing) to practice the art and act of loving should devote time and energy showing love to other Black people, both people we know and strangers” (p. 109).
I read this chapter multiple times because of the various excellent points hooks addressed. I am happy that hooks teaches (understanding where some of the issues Black people face come from- for African Americans, predominantly from the condition of enslavement- and this she does throughout the book), and also provides hope – it is not impossible to reframe, change and re-create. We can choose to love and be loved. It is not impossible to learn and unlearn internalised lived experiences.
Chapters 10 and 11: Community, Communion, and Reconciliation
These two chapters connect us all as people living within communities. This is important because our reserves of resilience can be stored within our communities. Our communities possess healing qualities, and these qualities depend on various aspects, such as forgiveness, which she addresses in Chapter 11. Healing communities: as a people, we are our own communities of healing. Binding together is valuable in this healing. Sweet communion: communities are a healing place. The joy of reconciliation: forgiveness is important. We must say it, even if we feel it.
Chapters 12–13: Touching the Earth; Walking in the Spirit
The final two chapters bring us back to connecting with our environments and spirituality. The penultimate chapter (12) – Touching the earth addresses Black people’s connection to the world – We wish to live, and so do we hold this wish for others. Loving our environment is part of making living possible and continual. We are also a people of the earth – traditionally, we cultivate our food from the land – the land belongs to everyone, despite the ways of whiteness (p. 130).
The final chapter (13) – Walking in the Spirit, hooks addresses spirituality and various connections we have to it. Cultivating a spiritual life can be an essential aspect of healing, involving the recognition, understanding, and acknowledgement of the divine connection within ourselves.
Closing Reflection
This is a book filled with nuggets of knowledge delivered gently and delicately. And even then, hooks was not afraid of being honest in this work. The parts about Black women not knowing love were particularly poignant. hooks addresses various other aspects that are important in Black people’s lives – the historical, generational and environmental trauma that Black people, particularly Black women, face. hooks covered a wide range of lived experiences in this book, including healing, motherhood, love, work, death, spirituality, community, and the earth, among others. It was great to read something I could reflect on personally and recognise patterns that show up in my own life – it feels validating. It opens up the gateway to knowing, being known and choosing an appropriate healing that is relevant to me.
I hope that other readers of this book find it relatable in some ways. If not, I hope it can serve as a means to understand those around us and support them in an informed and sensitive manner.
Recommendation
Everyone, especially Black women, should read this book.
About the Author
bell hooks (1952–2021), born Gloria Jean Watkins in Hopkinsville, Kentucky, was an American author, cultural critic, educator, and Black feminist thinker. Her pen name was inspired by her great-grandmother, and she intentionally wrote her pen name in lowercase to divert attention from her name and identity to her work. She published more than 30 books spanning feminism, race, class, love, education, and culture, including Ain’t I a Woman? (1981), Feminist Theory: From Margin to Center (1984), Teaching to Transgress (1994), Sisters of the Yam (1993), and All About Love (2000). hooks taught at institutions including Yale, Oberlin, City College of New York, and Berea College, where the bell hooks center was established to continue her legacy of radical love, community, and transformative pedagogy. She died on December 15, 2021, from kidney failure, aged 69.
