Black Man in a White Coat by M.D. Damon Tweedy

about my dad’s hypertension, because he’d avoided doctors for more than three decades. When he was finally diagnosed, he wound up requiring three different medications to control his blood pressure. But I did know that his older brother, who died from a stroke when I was fourteen, had hypertension. Like my grandmother, he apparently had not followed medical advice either.
    Despite this family history, I had not expected to find myself in this position, certainly not in my early twenties. “How’s your diet?” he asked.
    Terrible, I admitted. I’d grown up eating whatever was placed in front of me—and then seeking out more. My mom worked long daytime hours and my dad worked nights, and healthy homemade meals were the exception rather than the rule. Ready-made processed meals, fast food, and buffet restaurant trips were dietary staples. Every so often, my mom would go on a Weight Watchers diet and eat healthier foods, but that didn’t impact me. Since I was very tall and skinny throughout childhood (I stood six-five and weighed 160 pounds at age sixteen), what harm could come from two foot-long steak subs, an extra-large pepperoni pizza, or a half-dozen hot dogs?
    This eating pattern only worsened in college, as I tried to add weight to keep from getting pushed around during basketball games. Even with an extra thirty pounds, I still fell within the normal weight range for my height, so I saw no reason to cut back. This approach to food continued upon my arrival at Duke, where each day brought dinner at a regularly rotating group of fast-food spots. Just as in college, I rarely drank more than a glass of water daily, and I could go several days without eating a fruit or vegetable (not counting French fries and potato chips). However, with a myopic focus on weight as my barometer for wellness, I’d chosen to ignore basic nutritional facts and believe that I was perfectly healthy.
    Dr. Katz performed a basic physical exam that he said was normal. He then sent me downstairs to the lab, where a pimply-faced young phlebotomist took two tubes of blood from my arm and sent me to the adjacent bathroom to collect a urine sample.
    The following day, I returned to see Dr. Katz to get the results. He wasted no words: “Your creatinine is 1.6.”
    I took a deep breath. Serum creatinine is the baseline test used to assess kidney function. The upper limit of normal at Duke’s lab was 1.3. Something was wrong with my kidneys.
    I searched his face for reassurance, but he looked down at the lab report before speaking. He had more bad news.
    â€œThere were also traces of protein in your urine,” he said.
    A detectable level of protein in the urine, known as proteinuria, is another sign of kidney disease. My face fell into my hands. Worst-case scenarios flashed through my mind.
    Sensing my distress, Dr. Katz tried to calm me down. Even though he spoke for several minutes, I made out only the bare outline of what he said. Something about restricting sodium intake and supplementing basketball with other aerobic exercises, such as jogging or swimming. At the end, he told me to check my blood pressure weekly and return in a few months for repeat tests.
    The day before, Dr. Katz had said that my heart and lungs sounded normal. But as I stepped outside the clinic into the crowded parking lot, my heart pounded as if it were going to explode from my chest. My shirt was soaked with sweat. I could barely breathe. Although I had never experienced one before, I knew I was having a panic attack.
    During the ensuing sleepless night, my mind flooded with images of my grandmother. Around the age of seventy, her memory began to fail rather abruptly—likely from vascular dementia, the result of decades’ worth of mismanaged hypertension. At age seventy-three, she suffered a massive stroke and was later found to have heart failure, which was also related to her hypertension. In those few years,