The scenario illustrates several important points. First, the hospital staff did not possess any resources to communicate with this patient. Second, the staff appeared unaware of the implications of this serious failure, incorrectly attributing the patient's behavior to confusion rather than to his clear need to relieve himself. Would the staff have made the same assumption if the patient looked and acted more like someone of their own cultural background? Was the staff consciously or unconsciously biased by their own prejudices? What will be the result of this unfortunate encounter for the patient? Will he trust health care providers in the future or avoid care? Expectations of the health care system are often shaped by the "bad experiences" that patients have had.
Robert Like, MD, MS
I'll introduce my story with a quote from Dr. White, "Statistics are people with the tears wiped off." As a fourth-year medical student, I had the privilege of working on the Zuni Indian reservation. On my first night on call, a Navajo family brought in a premature baby who was delivered in a pickup truck. The baby was cyanotic and limp, and we could not resuscitate the infant. Having failed in our resuscitation, an interdisciplinary team came together to provide support for the family as best as we could. But then it was on to the next patient and the next situation.
Afterwards, I began to think about the sense of futility and aloneness that I was feeling, and that got me thinking about what this experience must have been like for the family. Did this tragic event occur because the system didn't provide access to care? Was it poverty? Was it geography? Was it institutional racism? Was it distrust in the system? Was it lack of information about prenatal care? What about support? Was there adequate support for the family and for the providers? There is sort of a sense of sadness that sticks to me even to this day as I start to think, not only about her, but about all the other families who have lost babies. It is because it reminds me of the disparities that exist and are reflected in our statistics. Yes, if we think about it, "Statistics are people with the tears wiped off." |
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