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Somewhat sad
Mar. 12th, 2015 09:33 amLast Wednesday, I had a patient who was polite and cooperative, but very disengaged from the process. She asked no questions, didn't laugh at any of my jokes, and seemed uninterested in the information I provided.This happens. It's not my favorite experience, but I figure that patients have a better understanding of their coping mechanisms and desire for information than I do. Since communicating with patients does not come naturally to me, I tend to think about failures in the middle of the night. I don't care if the patient doesn't want to be chatty, but I do try to think about what signs there are about what information the patient actually wants and needs, and try to strategize ways to do better. Late at night when I'm bored, I think about all sorts of things. This is one. I wonder if race plays any role, here. My patient was a black woman of a certain age. I know that African Americans have historical reasons to distrust medical institutions. I also know that older women, and women who are overweight tend to have a difficult time getting medical professionals to pay attention to what they are saying. I wonder which, if any of these, are a factor in her being disengaged from the process. There's nothing to fix here. It's just a curiosity, and if I think of something clever to overcome a challenge, that'd be cool.
In the morning, she was more cheerful, probably because she wasn't sleepy. Also, the test was over, and she hadn't qualified for CPAP. More rest, less stress, more cheerful. Makes sense. She's dressed in a perfectly normal fashion, casual, with a knit cap over her gunked up hair, but nothing particularly weird. Five minutes after she leaves, a white female security guard comes up. She says, "Did you just have a patient leave?" I don't really understand why she's asking. Is my patient lost, is she hurt, is there a problem? I hesitate before responding because I'm a little worried that something is wrong. "A black woman," the security guard clarifies.
"Oh, yes, yes, she did just leave," I say, still not sure what this is about.
"Well, good, then. I was just worried that maybe she was just someone wandering around, you know." She leaves while I am still staring at her in shock.
Here's the thing. There is exactly zero chance that this would have happened if my patient had been white. Was the security guard a racist? Fortunately, I am not called upon to make judgments of other people's character. But did she act in a racist fashion? Yes, yes she did. There was absolutely no reason whatsoever to wonder anything about my patient. Polite, casually dressed, in a place where it is perfectly reasonable for a person to be on the way out the door, at a time perfectly in concert with normal operations. Indeed, so normal that the security guard thought to check with me. Which she absolutely would not have done if my patient had been white. But she did. Because some older black woman might be, I don't know, anyplace at all?
And I wonder, again, if her reticence the night before is built out of a lifetime of these types of occurrences.
In the morning, she was more cheerful, probably because she wasn't sleepy. Also, the test was over, and she hadn't qualified for CPAP. More rest, less stress, more cheerful. Makes sense. She's dressed in a perfectly normal fashion, casual, with a knit cap over her gunked up hair, but nothing particularly weird. Five minutes after she leaves, a white female security guard comes up. She says, "Did you just have a patient leave?" I don't really understand why she's asking. Is my patient lost, is she hurt, is there a problem? I hesitate before responding because I'm a little worried that something is wrong. "A black woman," the security guard clarifies.
"Oh, yes, yes, she did just leave," I say, still not sure what this is about.
"Well, good, then. I was just worried that maybe she was just someone wandering around, you know." She leaves while I am still staring at her in shock.
Here's the thing. There is exactly zero chance that this would have happened if my patient had been white. Was the security guard a racist? Fortunately, I am not called upon to make judgments of other people's character. But did she act in a racist fashion? Yes, yes she did. There was absolutely no reason whatsoever to wonder anything about my patient. Polite, casually dressed, in a place where it is perfectly reasonable for a person to be on the way out the door, at a time perfectly in concert with normal operations. Indeed, so normal that the security guard thought to check with me. Which she absolutely would not have done if my patient had been white. But she did. Because some older black woman might be, I don't know, anyplace at all?
And I wonder, again, if her reticence the night before is built out of a lifetime of these types of occurrences.
