cultural competence Archives

El Jugo Me Hizo Daño

C.A. Rivera February 5, 2021 15 Comments

February 2010:

I toss and turn in bed, trying to fall back asleep; I have only a small cushion of time between getting up and heading to the hospital. I’m a third-year medical student doing my medicine subinternship. I have the choice of going to work or staying in bed a little longer.

On the other side of town, Ms. Garcia doesn’t have much choice about heading to the hospital: She’s bleeding from her nose and rectum. Standing in a puddle of blood, she calls 911.

Eye-Opener

Daniel Lee May 10, 2019 54 Comments

Daniel Lee ~

1. Bipolar disorder
2. History of postpartum psychosis
3. No custody of her children
4. In treatment for cocaine abuse
5. Regular smoker

I digest each of these facts on the computer screen in rapid succession, progressively cementing the picture of Renee Pryce, a twenty-eight-year-old woman in her final months of pregnancy.

I’m a first-year resident in a large urban county hospital. In the course of my training, I’ve learned that some people (mostly older doctors) find the electronic medical record (EMR) burdensome and inefficient.

Native Ways

Jan Jahner November 24, 2017 8 Comments

Jan Jahner ~

They came up from the center of the earth, The People
where sky speaks to corn,
speaks to cottonwoods, to runoff in the wash.
Living beneath black-slashed canyon walls
home to sheep and weavers.
He is one of them, my patient
one of the ancients; leathery face carved and quiet
she is his daughter, fingers on the covers,
ready should he wake.

He is dying and we can’t say it.
Soft sounds unknown to me, their language of wind, cottonwood and wool
in the center of this circle is knowing and not saying
the medicines continue
but we turn, bathe, suction and weave the fibers close.

Learning Respect

David Edelbaum July 14, 2017 5 Comments

David Edelbaum ~

When I finished my medical training, almost sixty years ago, I was like many new graduates: I thought I knew it all.

I opened a private office in Los Angeles and paid courtesy calls on the local physicians to let them know my qualifications and my availability for consultation, as both an internist and a nephrologist. (The treatment of kidney disease was then in its infancy, and I was the area’s first such specialist.)

With a wife, two children under age four, a home mortgage and an office to support, I needed to make a living. I took call at the local emergency rooms, worked nights at the VA Hospital and told my answering service to mention my availability

Life or Death

Taylor E. H. July 14, 2017 No Comments

It was election night. November 8, 2016. As a southern, affluent, white male from a conservative household I leveled with her: “This election isn’t life or death.”

Care in Airplane Mode

William Sperduto May 2, 2017 No Comments

Airplane mode disables me from using Wi-Fi and enables me to provide distraction-free care to the patients in front of me. Truly disconnecting is difficult, but being in rural Honduras allows me to switch my phone settings with ease. My otoscope and ophthalmoscope cannot see texts and emails. My stethoscope cannot hear incoming calls. My hands cannot feel my IPhone screen. I am in tune with my body, my senses and my patient.

A Prescription for Change

Lisa Garcia March 7, 2017 No Comments

I cannot pinpoint the exact moment when I knew I wanted to pursue a career in health care. There was simply an accumulation of moments from different parts of my life that somehow guided me in that direction. I do, though, remember making a definite decision to continue heading in that direction.

After my second year as a premed student, I felt the need for something more hands-on than my studies. I longed for confirmation of the reasons I’d chosen to go into medicine. I decided to join a medical brigade that volunteered in places lacking access to care; the group would choose a location and offer a free, three-day clinic run by volunteer doctors, turning no one away.

Learning to Trust

Cynthia Stock March 4, 2017 No Comments

I admitted Hiral Jacobs, a twenty-something college student who’d collapsed in her dorm, directly to the ICU from surgery.

The OR report said she’d received two units of blood and was still intubated. Given my forty years of ICU nursing, it sounded routine.

“By the way, the patient is Muslim.”

Comfort Amidst the Unfamiliar

Anna Delamerced March 3, 2017 No Comments

In the waiting room, I hear melodious Spanish words and think of my own family.

I think of my abuela (my grandmother) and of my parents–immigrants to a foreign land. They left behind the familiar to come to America. Childhood memories swirl in my mind, of my brothers and me eating empanadas in the evening, of my mother speaking her native tongue. Whenever I crossed the threshold to my school, or back to my house, I remember switching from one language to another.

Enriched and Humbled

Janet Wright March 2, 2017 No Comments

Just over a year ago, a group of my friends and neighbors–after seeing the heartbreak of those forced to flee from Syria–decided to sponsor a Syrian refugee family. We raised money, gathered clothes and furniture and prepared for the family’s arrival. We knew this family had children ranging in age from two years old to twelve years old and had spent several years in a refugee camp. We also knew the youngest girl had some medical problems.

Janitor-Doctor

Anne Vinsel March 2, 2017 No Comments

I knew it wasn’t a good idea to get sick on the Fourth of July weekend, but my body ignored that truism and gave me a raging case of MRSA, an antibiotic-resistant infection, on July 3. I made it through the ER all right, but when I got to the ward, the patient next to me was dying in a messy, noisy, prolonged way and so got all the attention.

An American Story

Sara H. Rahman February 17, 2017 31 Comments

“Mr. Douglas?” I call out into the waiting room. A short, grey-haired man in his sixties staggers towards me, bracing his back with his hands. Despite his pain, he gives me a warm smile, which I return.

As I help him onto the exam-room table, he winces, squeezing my hand.

“I’m a medical student,” I begin. “If you wouldn’t mind, I’d like to examine you before Dr. Smith sees you.”

He nods. “Go ahead, you can learn on me–just don’t break my leg!”

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Tag: cultural competence