Twice as Hard: The Stories of Black Women Who Fought to Become Physicians, from the Civil War to the 21st Century

“The closing words in Brown’s important and fine book put her in a class with the brilliant women whose life stories she shares. Like them, she notes, other ‘Black women physicians faced off against a system designed for Black women to fail . . .’”

Medical student Jasmine Brown, a woman to watch, is already an impressive future physician, writer, and social justice advocate. A student at the Perelman School of Medicine at the University of Pennsylvania, she completed an MPhil in the history of science, medicine, and technology at the University of Oxford, UK, as a Rhodes scholar. She also founded the Minority Association of Rising Scientists as an undergraduate at Washington University in St. Louis, where as president of the organization she worked to increase the number of underrepresented minorities in science and medicine.

All of her interests and credentials come into play in her first book, Twice as Hard, which profiles the medical careers of nine pioneering black women physicians who precede her, and whose contributions to healthcare are monumental.

Beginning with Dr. Rebecca Lee Crumpler, the first African American woman to earn a medical degree in the U.S. shortly after Abraham Lincoln signed the Emancipation Proclamation, and concluding with Dr. Risa Lavizzo-Mourey, who became the president and CEO of the Robert Wood Johnson Foundation in 1996, Brown takes a chronological approach to the achievements of the women she has profiled. That approach provides a structure that reveals the interconnections between all nine women philosophically and experientially.

Fundamental to their stories is the institutional racism they all encountered while striving to excel, prove themselves, and maintain the energy required to complete medical school and be accepted into fellowship and residency programs. Brown experienced this racism as a medical student when she was questioned by a man who refused to believe that she worked at the laboratory she was entering, even after she answered his questions and revealed her university badge.

Every one of these amazing women had to stay strong when confronted with racial slurs and insults, professors and guidance counselors who discouraged them from applying to medical schools in the belief that they weren’t smart enough to have careers in medicine, and assumptions or beliefs that smacked of racism. 

Women like Dr. Lafizzo-Mourey and Joycelyn Elders, who became the U.S. Surgeon General, suffered painful insults. Rebecca Crumpler was told that M.D. stood for Mule Driver. Dr. Marilyn Gaston was told by a high school guidance counselor that she was unfit for medical school as a Black girl.  Similarly, Risa Lafizzo-Mourey was told by a college counselor that she would never succeed in medical school despite her academic achievements. That was in the 1970s. Even today students like Jasmine Brown are told that they “stole a medical school spot from a more deserving nonblack medical applicant,” or that they “would bring down the class averages” and “just weren’t as hardworking as our peers.”

Very few of these women came from privileged or even middle-class backgrounds. Many had parents who were sharecroppers lucky to have had a sixth or eighth grade education in secondhand, ill-equipped one-room schools. That makes their stories, fortitude, motivation, and courage even more remarkable.  Much of that strength came from the families that supported them and encouraged education from early on, often at large self-sacrifice.

Interspersing her own experiences and doubts, Brown reflects on the role of mentors, the importance of role models, the challenges of being Black in a racist culture, the exhausting demands of medical education, and the creativity and chutzpah required by Black women (and men) who forge ahead despite myriad obstacles.

The closing words in Brown’s important and fine book put her in a class with the brilliant women whose life stories she shares. Like them, she notes, other “Black women physicians faced off against a system designed for Black women to fail, and not only do they succeed by becoming great physicians, . . . they make medicine more accessible for those coming after them, while working tirelessly to improve the health of a sector of Americans who are too often overlooked.” Brown’s book is not only a testament to that statement. It is a part of our history that needs to be acknowledged and ended.