Saturday 17 April 2010

Sticks and stones.

My first weekend on call with Deyo. I'm feeling a little anxious in case there are any theatre cases (the untrained leading the untrained...) but we do have 3 seniors around Ingwavuma on standby. And we're one night down with out any problems.
There was the usual selection of chronic cases (and unlike in the UK, asking "why have you come in with this on a Friday night? Has something got worse?" adds nothing except a shrug and a convoluted explanation about a lack of transport) and drunken assaults. One of the latter of these was a well-dressed (albeit fairly blood stained) English-speaking 30 year old who had been hit in the face following an altercation regarding another man talking to his girlfriend. After a quick assessment I suggested we get the blood off his face so I could see whether he needed any stitches. I lead him to the sink and handed him some swabs. He looked at me increduously. Was I suggesting that he wash the blood off his own face? I laughed and told him I wasn't his mother. At this he rounded on me, was I being racist? After a brief consideration I assured him that I didn't think I was being, that I would treat any patient the same way but that around here, that probably wasn't great evidence of a lack of racism. He didn't seem to appreciate that but did let me stitch up his face.
It was an interesting question though and one that I haven't faced here before, presumably for the reason I pointed out. I can't deny that skin colour is something you notice (an unkown white person see in Spar, let alone OPD, will cause a flurry of discussion) but I genuinely don't think that my patient care differs as a result.
More interesting perhaps, would be where his assumption that someone telling him to do something he doesn't want to do must be doing so based on his skin colour, comes from. Does he really believe that or is he just an angry young man?
Personally I think he may have missed where I do think my patient care differs; English speaking patients. I find the inability to communicate with the vast majority of my patients a constant source of frustration, so when I see someone with whom I can have what I consider a proper consultation, I revel in it and they undoubtedly recieve more information and are more involved in their treatment decisions. But then that would be a discrimination that benefited him so perhaps it was less of an issue.

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