I have the greatest privilege of being associated with Native cultures of many continents.. thus satisfying my curiosity and desire to travel and the chance to help them with my medical expertise. these notes are from those travels. I am a professor at the University of Havana
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jeudi 10 décembre 2015
FRACTURED MEDICAL CARE IN TIME OF ARROGANCE OF BIOMEDICINE
MEDICAL CARE IN THE TIME OF TECHNOLOGY
There is a
shortage of Primary Care Providers so the burden has been shared with not so
well prepared Doctor’s Assistant and Nurse Practitioners. Unfortunately both of
these para professionals, they are called mid-level for a reason, are modelled
after the broken metaphor of a dominant male biomedical model of Disease care.
has deviated so far away from the social aspects of the suffering of the
patients that these mid-level professionals have become much like car
mechanics. Attending to the problem, but with the added prejudices of
objectification and depersonalization as if the body is a machine and that no
one actually lives in it.
I had one
such experience today at a hospital and ER clinic catering for a poor community
of American Indians in a remote part of USA.
Mr. E had
come to see me, I have known him for a while. He has type 2 Diabetes but his
life is complicated by the fact that he is at the end of a failed surgery for
his back and is in constant pain and in fear of a second surgery. He had gone
to the dentist the day before and had one of his molars pulled out, adding to
his pain and discomfort.
When I saw
him this morning, his Blood sugar was elevated and clinically I could determine
that he was a little dehydrated. I sent him to the ER attached to the clinic
where I consult, requesting that he be given one litre of fluids with some
drive through (temporary) mid-level saw him, he began accusing the patient of
not taking his insulin and began victimizing him.
man, in his sixties had gone to get some relief but was being abused by someone
who had no knowledge of his social circumstances and the medical history of
what was taking place except the fact that he had high blood sugar.
He looks at
the paper, the end product but does not have the intelligence to look at what
has made that blood sugar high. It was a very unpleasant experience for the
patient who does not wish to see the drive through temporary mid-level provider
very bad copies of the bio medically oriented medical doctors
me of what that wonderful poet of the beat generation of Americans had written
just a copy
all the candy bars
is yet another form of colonialism, continuing from an earlier sort, but with
the same dire consequences.
teacher had taught me
must be treated with respect, regardless of age and how they are dressed. If
you respect them and love them a little you will never go wrong
been my motto during all these years of working with Indians of USA
leave the consulting rooms happier than they came in and we must do everything
to meet that objective. “I learned a long time ago that I can't control the challenges the creator sends my way, but I can control the way I think about them and deal with them” ― Wilma Mankiller, Ex-Chief of the Cherokee Nation of Oklahoma
Lessons for Health Care Providers
Try to have a relationship with the patient. Learn a little bit about him.
As Dalai Lama has said: if you want to make another person happy, be compassionate.
To be truly compassionate, you need to walk in their moccasins, you must feel something for what they are going through, you must cultivate empathy.
Empathy is respectful and soothing
I am so fortunate to work with MS, who is probably the best Diabetes Nurse Educator in the world, with compassion towards all and assertion of how to achieve a better health status for them.