ourjamesvata asked: Hey. Sorry to bother you, I see your post about healthcare in POC and women. I'm a med student and I struggle to find resources about that (specially in my language -french-). My school book dont say anything about that. Do you have any tips ? Thanks
Mmmmkay, I don’t really have time right this second to do an appropriately thorough scouring of the internet to find some books or resources for you–which I will do when I’m not writing a thesis, because I should have some resources to reference–and I’m not supremely comfortable giving out how-to-medicine advice, but I will tell you a couple things that have helped me.
- The only thing that really works: ask someone. Just do it. Find a doctor or an EMT or whoever is on hand who you trust to answer you, and ask them outright. It works best if you have a justified starting point, something like “Okay, so if that’s how I check for cyanosis on a fair-skinned person, how would I check for cyanosis on a person with dark skin?” (You check the inside of the lip, by the way.) Or “How should this intake procedure be different if my patient is trans?” Or “Should I ask any additional questions about vaccinations/previous illness if my patient is a traveler or immigrant?” Or “What if my patient has a pre-existing disability?” Or “Does this chest examination need to be conducted differently if my patient is a large-chested woman?”
- Be polite while you’re doing the asking. More often than not, it’s a problem the other person has noticed too, and it’s not that individual’s fault that humanity has spent 2000+ years screwing itself over on this subject. Also, these questions make people uncomfortable, and being rude will decrease your odds of getting an answer.
- Listen to non-doctors in the affected populations. If a woman you know has a laundry list of complaints about not being listened to by a doctor, assume she’s not being histrionic. If you know a black guy who says he was fucked over by the EMTs after he was sideswiped by a car or fell from a ladder or spiked a 105 F fever (40.5 C), he doesn’t need an MD to know he wasn’t treated as well as he should have been. If you know a trans woman who was repeatedly referred to as ‘he’ in the hospital, take note. Decide not to be that kind of doctor, and then pay attention to how you act.
- Listen to the nurses around you. First of all, that’s a good general rule, the nurses probably know more than you and nurses are treated terribly by a lot of doctors. Behind every successful doctor is a whole host of nurses who probably haven’t been thanked. But moreover, nurses spend a lot of time with the patients, and they’re the ones who field complaints about the doctors. They’ll know who gets fucked over and who doesn’t, and they know all the secrets to the medical trade.
- Be attentive to your patient (unfortunately this is the ‘learn on the job’ part of the answer). If a woman expresses discomfort with the normal proceedings of an examination, listen to her. If a patient prefers name and pronouns not matching those on their legal documentation, adhere to their request. Be aware that there are some conditions which are more common in people of specific ethnicities–for example, black women have a higher incidence of breast cancer and a lower statistical chance of having it caught by a doctor than a white woman.
- Ultimately, I’d say decide what kind of doctor you want to be. If you’re already asking this question, that’s a good start, and telling about how you’ll act as a doctor. Be self-aware of how you act with patients of various genders, ethnicities, etc. In a perfect world, it would be the responsibility of the medical school to teach that behavior and ensure that all the students were able to treat people other than the cis white able-bodied male ‘standard patient.’ This is not a perfect world, and that means it’s on you.
I…feel like this was pretty unhelpful and round-about, but I hope it at least gave you a starting place? I think you’re doing great because it occurred to you to ask this question, keep it up.
