I am a Doctor without Borders, in the sense that I help with the little talent I have as a Pubic Health physician based on Endocrinology and Anthropology, in many countries whether it is a rich country like the USA (where paradoxically middle class patients need more help than poor people of Colombia) or a poor country like Cambodia.
I am also very attached to CUBA, like we say in Cuba, it is tattooed into my heart. (tu no eres un amigo mio, tu eres un tatuaje en mi corazon)
I admire the health care delivery system of France the most and I am a product of the UK (student) and Australian (junior doctor) systems for which I have respect too. I have admiration for the Israeli health care system in a country pounced upon by armed but less developed nations around, I wish the surrounding countries would look after their people rather than sending rockets to Israel.
The capitalist exploitative technologically advanced system of the USA which it exports to other countries (tertiary care in India, Brasil, Malaysia and countries in Africa among them) is not a humanistic health care but a zombie like movement of so many people who call them doctors (imagine the audacity of audiologists, this sound like a plural animal names like a conspiracy of lemurs, who now call themselves Doctors.. every one in the USA health care system is now doctors , so we distinguish ourselves by saying , physicians, then the title doctor become a honorific) with very little consideration for the FEELINGS of the patients.
A Gynaecological Endocrinologist orders a Genetic test, a commonly done test but of great clinical significance and of immense emotional significance to the patient. Few days later, a Nurse or a medical assistant calls from the doctors office and says, the patient is POSITIVE (?) and then blurts out Muscular Dystrophy. The next day the Commercial company which did the test, some employee calls her and explains about the X linked recessive nature of the disease.
This is where CUBA, my proud Island is a shining example of HUMANISTIC health CARE.
In Cuba it is forbidden to give the results of the Genetic testing over the telephone and the patient has to be seen face to face by the Doctor (I mean physician not her assistant) and then the result explained and referred immediately for Genetics counselling by the Geneticist (an MD) and also a Psychologist (who is not a social worker with a degree in Social Work) but a university trained clinical psychologist.
As Indians say, I will not make judgements on others until I walk a mile in their moccasins. Imagine the distress of the patient and her family being told that she is a carrier for a deadly disease.
Because of my long association with the psychologists at the Centro Atencion Diabetes of the National Institute of Endocrinology in La Habana, Cuba, I have learned tools of counseling patients and the ways in which to express it to the patients (I thank my colleagues Cari, Lorraine, Made and Babe and Evelyn).
I tried to console my colleague who is the patient in question. I knew I needed help. Thanks to Barack Obama, the relationship between this colossus to the North and Cuba had increased including telephone and Internet access (courtesy of a cable by Chavez). I put in a call to my friend who is my Endocrine colleague, she works at a Reproductive Centre at a hospital in Vedado and begged her to put me in touch with a Geneticist and also a Genetics Psychologist.
Within minutes I was talking to the Geneticist from the Reproductive Unit of my friend's workplace and she laboriously explained the genetics behind Muscular Dystrophy of Duchenne, a x chromosome linked recessively inherited disease.
My distressed colleague was happy to know that I had spoken to a Geneticist (MD) and promised to send me the results of the test as it arrived .
The next day when the test results arrived by email, I briefly noted that the abnormality mentioned was not the same as the one mentioned by the doctors office or the Commercial company had counselled upon.
It was a Friday afternoon (In clinical medicine we always say, things of importance happen on Friday afternoon and around 4 pm!). The Geneticist MD, a friend of my Endocrinology colleague MD, returned my call immediately and during the long conversation she explained very clearly the clinical aspects of the results, the mode of transmission and inheritance.
and in the typical Cuban fashion she concluded: if anything I can do for you or your friend I am at your disposal. Either you or your friend can call me.
You can imagine how elated I felt, immediately called my colleague who was relieved beyond belief and she became busy calling her mother and her siblings to give them the good news.
Thank you, mi isla rica, MI CUBA and my MEDICAL COLLEAGUES in the island.
There is a Lakota concept of HOLLOW BONE, and I felt as such on this day.. and I lit the shabbat candles with great joy..
this blog is dedicated to mi pequena estrella, Dr J and my new friend, Dr H
Viva Cuba..
