Pocahontas Goes to the Clinic: Personal Experiences

This article had a particularly deep meaning for me, as I grew up in hospitals for much of my life. My mother has been a nurse for more than twenty years, most of which was spent working in the emergency room. When I was younger I would go there with her whenever we could not find or afford a babysitter. I was always deeply disturbed by how the doctors treated some patients, at the time while we did not live in a very racially diverse area there was a very large income disparity, and remember asking my mother and the other nurses quite frequently why. They never seemed to have an answer, but as I got older I realized it was basically what this article was discussing. I don’t believe that doctors make assumptions on purpose, or that any are really out to hurt another group, but when you have to consider what they see every day it becomes harder not to. It hurts that some patients are denied the pain medications that they need, like African American sickle cell patients, but it’s a sad fact in this country that emergency rooms are flooded with med seekers almost every night. This certainly does not excuse dismissing a truly sick patient, or making that priority call based on their outward appearance, but it sheds a little light on why it might happen.

When Mattingly was discussing how trust is a key issue for a lot of families when it comes to dealing with there doctor all I could really think of is how the article seemed to be downplaying how much clinical distrust comes from sources outside of the actual clinic. There has become such a culture in this country especially surrounding how doctors are portrayed in the media as nonchalant and invincible that it has seeped into familial values. While living in the deep south I met countless people that would not even give a doctor a chance because their family had taught them that doctors would never care about them, and assume that their opinion will be ignored as soon as they step through the door. This happens, but more so as that image has spread. The “good family doctor” role seems to have disappeared from American culture, and been replaced by someone who is to be treated the same as someone in any other service business. It can become a mindset of why go out of your way to help this person that will not likely be grateful.

The main point of the article, that popular culture, particularly that of children, has become pervasive as a connection method in clinical situations, is one that I don’t think anyone could really argue. Even recently during the swine flu epidemic I saw local hospitals using Disney masks and bracelets to identify children based on their infection status. It didn’t seem like much at the time but with the analysis offered in this piece I realize that it was a big step in making them feel more comfortable. I think because of my exposure to hospitals as a child I never really developed that fear or distrust, so I can’t really say I understand the need to make that connection, but I can certainly see how a favorite character or a simple icon could help children to find a friend in their doctor. The use of those characters in physical therapy was also a bit of a personal experience for me, as I remember having severe pneumonia in elementary school and being bribed by my therapist with a sheet of Aristocats stickers each time I did my cardio. At the time it just seemed like a reward system, but I’ll never be quite sure whether or not her understanding that I did not like the same movies my sister did--my sister was also in physical therapy for quite some time--had something to do with my quick progress.

I had not considered the concept of clinical situations as a border zone in all honesty, because I never realized how much of their own emotional and cultural concepts that people bring with them into what I’ve always considered to be a completely rational situation. I’m not sure that I agree that they should be however, but there is no viable way to prevent it. There is a still a long way toward acceptance in this country, and it may never be fully realized, so studies like these are vital in understanding what works and what parts of the system need adjustment. Mattingly spoke about how minority patients and families must try and cross boarders to receive proper treatment, something that I don’t think many physicians consider. This is only recently starting to be realized in diabetes education, particularly in the south where it has a high occurrence in the African American community. For years my mother railed about how many African American patients they would have coming in in sugar crises or already suffering from preventable complications, but never really questioned why the rates were so much higher. It became obvious when my father was diagnosed with diabetes. Whereas she had seen patients being given a handful of literature and told to call if they had problems, a doctor who had done just that to an African American patient instead sat down with my father for three hours discussing all possible outcomes of various treatment options and the dangers of ignoring it. She was shocked, and asked the doctor why afterward. His response was somewhat blunt, clinical I suppose you could say, that my father was more likely to listen. He could not come up with a reason why, but realized in himself that he had been profiling patients based on their lack of knowledge and skin color. That same doctor has now changed diabetes education protocols in that hospital to include a thorough preventative information session available for each patient at no cost. This is not the norm however, and there is a lot of work necessary to ensure that patients are treated based on their individual merit and not preconceived notions based on their skin color, heritage, or social status. The study preformed in this article was a strong reflection of that, and reinforced the notion that physicians need to use any and all available resources to make the same sorts of connections with their patients that popular culture allows them to make with children.