Legacy: A Black Physician Reckons with Racism in Medicine
“Legacy is about the stories we inherit — and the ones we choose to write.” — Dr. Uché Blackstock
Dr. Uché Blackstock’s Legacy: A Black Physician Reckons with Racism in Medicine is a deeply personal and powerfully researched book that exposes how systemic racism continues to shape healthcare in America — and what it takes to create truly equitable, trust-based spaces. While it focuses on medicine, the resonance with coaching is unmistakable.
Reading this book left me humbled and hopeful. It also left me with a clear message: we cannot coach the whole person unless we understand their whole context. That means slowing down, checking our assumptions, and building trust with deep intention.
Why This Book Matters for Coaching
One of the biggest lessons I took from Legacy is this: trust isn’t automatic. It’s something we build deliberately — through presence, respect, and a willingness to see people as fully human.
As a coach, that resonated deeply. Without trust, there is no coaching. There’s performance. There’s surface-level dialogue. But there isn’t the real, raw, transformative work that coaching is meant to create.
This is especially true when coaching across differences — whether those differences are racial, cultural, generational, or experiential. Legacy reminded me that I can’t fully know another person’s experience. But I can create a space where their experience is honored.
That’s the heart of ICF Core Competency 4.1: Seeks to understand the client within their context, which may include their identity, environment, experiences, values, and beliefs.
Dr. Blackstock shares that her mother’s medical practice was a model of “structurally competent and culturally responsive care.” Every part of a patient’s life was considered. That same level of care is what we are called to offer in coaching.
Three Insights That Shifted My Practice
1. Structural Competency and Cultural Responsiveness
Dr. Blackstock challenges us to go beyond “being kind” or “listening well.” Structural competency means understanding the systems that shape a client’s life — and holding space for those realities without minimizing or bypassing them.
This applies directly to how I think about coaching agreements and presence. Am I truly attuned to my client’s lived experience? Do I understand the forces — visible and invisible — that influence their choices and challenges?
“Client context isn’t background noise — it’s central to the work we do.”
2. A Commitment to Ongoing Learning
Legacy makes it clear that awareness isn’t a one-time achievement. It’s a lifelong process.
Dr. Blackstock notes that her medical education didn’t teach the full truth about how systemic racism impacts health. That same gap exists in coaching — unless we choose to fill it.
This has challenged me to reflect on what I don’t know — and to stay open to learning, especially in areas of culture, equity, and social context. It aligns with ICF Competencies 2.2 and 2.4: Engages in ongoing learning and Remains aware of and open to the influence of context and culture.
“As coaches, we must be willing to acknowledge the gaps in our education — and commit to closing them.”
3. The Power of Slowing Down
One story that stayed with me was about a physician asking for permission to sit by a patient’s bed during a moment of crisis. It was a small act — but it changed the entire dynamic.
That story reminded me how often we rush. How easily we skip past consent and connection. And how much can shift when we slow down.
I’m bringing that awareness into my own coaching. I’m re-examining how I build agreements, how I invite participation, and how I create space that feels truly safe and collaborative. This connects to ICF Competency 3: Establishing and Maintaining Agreements.
“Small gestures of partnership and consent are crucial to trust-building.”
Applying Legacy to Everyday Coaching
Reading Legacy has deepened my resolve to coach with greater humility, presence, and purpose. I’m making a few intentional shifts:
Slowing down and focusing on relational trust — not just task or outcome.
Creating clear coaching agreements that affirm the client’s agency.
Asking more about my client’s background, values, and beliefs — without assuming I know.
Listening more deeply — and believing what my clients tell me.
Committing to continued education around systems and contexts that affect my clients' lives.
These may seem like small things. But together, they create the kind of coaching container where transformation is truly possible.
“Legacy reminds us that we are responsible not just for our skills, but for the context we create for those skills to unfold.”
Ready to Learn More?
If this message resonates with you, I invite you to listen to our full episode of The Coaching Book Club Podcast where I explore Legacy alongside co-host Ken McKellar. We share takeaways, real-world coaching applications, and our own questions as we continue to learn.
Coaching isn’t just about technique — it’s about presence, context, and relationship. Legacy shows us what’s possible when we bring those elements into every conversation.
