The attending physician who oversaw the patient’s care also happened to be the chairman of the hospital’s OB/GYN department. My mentor described him as “full of himself”- he would tear down anyone who would ask questions and make that person feel sorry and stupid for having asked a question.
New to this formidable physician’s team to care for the 13-year-old patient was an African American medical student from the Deep South. No one had the chance to warn this student about the physician’s condescending ways. Thus, when the physician presented the patient to his team and he asked, “Does anyone have questions?” the medical student said, “I have a question”. The others on the health care team held their breath in terror, thinking, “Oh no, this guy is going to get torn apart!” The physician wrinkled his eyebrows and squinted his intimidating eyes behind his spectacles and said to the medical student, “Yes, what is your question? Do you want to ask me or do you want to ask the patient?” The medical student replied, “I want to ask the patient”.
The medical student approached the young girl lying on the hospital bed, and asked her, “Honey, does your mama feed you dirt?”
The attending physician was so upset that he doubled back against the door of the room. Surely, no one in his or her right mind would ask such a stupid question!
However, the patient responded, “Yes”. And that “silly” question turned out to save her life. Drawing on his cultural background, the medical student explained to the patient and her mother that pregnant women in the Deep South are sometimes fed dirt because it is rich in iron. However, the dirt in Pennsylvania is different- it has a chelator that actually removes iron from the body. The simple solution of removing dirt from the patient’s diet stopped her anemia, and she gave birth to a healthy baby.
As a medical student, sometimes I doubt my ability to care for others. My shyness and occasional lack of confidence sometimes drive me to hide in the corner. However, this story illustrates that if health care providers have the capacity to care, think, and ask questions then patients will benefit. Another important lesson to this story is that cultural competency is key. That is why I believe that helping the underserved and seeing patients from different cultures, such as the Latino community at Outreach Clinic, is so valuable. By gaining exposure to different cultures, I feel that I could pick up some nuances in various communities and eventually learn to ask the right questions.
UCI Dispensary Blog
7/30/12
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