Showing posts with label humanizing the patient. Show all posts

Operation: Multicultural Medical Care

Deciding whether or not to do surgery requires a lot more than just the puzzle pieces doctors can offer. There's this whole other side to what goes into patient decisions based on cultural values, religious beliefs, and even family dynamics. Unlike the medical piece these other aspects don't usually have as quantifiable an existence. You can't really measure how much religious belief should sway parents to go ahead with surgery during certain religious holidays. You can't exactly pin point how much cultural value is going to influence the kinds of foods a patient can have after surgery, or who is present in the operating room during the surgery. I know that these other variables might not rank as high on the 'critical' scale when considering an operation, but nevertheless when a medical team is working with a patient and family members, these undoubtedly need to be factored into their over all care delivery. 


A patient can't respect the way a medical professional practices medicine if they are not being respected as a human being, first and foremost. I'm a human before I am O.I. 

I know this now and even though I did not have a strict religious upbringing, my cultural values were well embedded into my family structure. It was to the point where I was often confused as to whether or not my family did something because this was something we do, or if this is the way we do things because we are Chinese. 

During my senior year of high school I was looking to get away from all of that. I'm not sure that as a senior in high school I could have told you why I wanted to go to college. It was some cobbled together answer that involved all of the following: "because I'm supposed to?" "Because everyone in this town and high school is expected to be college educated." "Because my parents said that I must." "Because it is my chance to live in a dorm, away from them." "Because this is the first step in my grand escape plan." Ultimately this last reason was what mattered most to me, this was the answer that ranked highest on my 'critical decisions' list. 
So, like many other thousands of students in 2005, and the hundreds of thousands of students before me - my senior year of high school was all about leaving. I had already dropped whatever identity I had been struggling with, and was ready to become immersed in something out there. Some where. Until I got that call that went something like this --

"Sandy you have to have surgery, sooner rather than later. I've reviewed your x-rays and the bowing in your tibia is getting worse. You've had repeated breaks and it will continue to do so and I would recommend a rod." It was my orthopedic surgeon, the guy you know by now who diagnosed me. The guy my parents have done his every bidding since day one. 
He gave me open dates for the surgery and I noted them to tell my parents when I got home.

In my mind I thought perfect, the sooner I got this operation over with the sooner I will be out of the cast and ready to start college. I couldn't wait to start this next part of my growing-up that I had linked with being a real American teenager. (Because, remember, I didn't really consider O.I. was a part of me until after college..)
Except my parents thought otherwise. I couldn't have the surgery during any of the dates the doctor had offered because it was during Chinese New Year. 
"It is terrible luck to begin the new year in a hospital. No one does that! You can do the operation after Chinese New Year is over." An avalanche of question marks hit me at that moment. What? Why? Who cares? Was this like how my parents thought the number 4 could not be any part of our lives because in Chinese it is a homophone with the word 'death'? (So our phone numbers could never have the number 4 in it.) Was this one of their ridiculous traditional beliefs where chopsticks had to be balanced just so across the bowl of rice, not jammed into it because that was somehow bad luck? 

I didn't care, I thought it was dumb. I was interested in leaving, and in my mind postponing the operation meant delaying my freedom to leave. When I called my doctor back to tell him why my parents wanted the surgery date moved, he had given a chuckle and told me he'd talk to my parents for me. They had their grown-up discussion. I was busy writing Personal Statements, and preparing to answer interview questions about "What will you bring to our campus?" My parents and my doctor were preparing for me to have surgery, on a date that everyone could be satisfied with - reminding me that while I might be packing up my childhood room I still have a history and a community I belonged to to respect.
I had the operation and though I was in a long leg cast on graduation day, by the time Admitted Students Orientation came around I was just another freshman clutching a campus map. Ready for everything. 




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On Being a Patient Patient

It's almost a misnomer isn't it? A patient patient. I think if you totaled the number of hours I have spent in the Waiting Room, the sum would be enough time for me to circumnavigate the Earth.
How many of us have spent exhausting hours twiddling our thumbs as we waited for the doctor? How many of us have played the game where you think, maybe if I don't keep looking down the hall he'll magically arrive? Or you begin to think up all the worst case scenarios has she forgotten that I'm still here? My last resort is to just close my eyes and take a nap, everything comes faster when you sleep.

There's no doubt that it can be unbelievably frustrating when you're waiting to see a doctor or nurse. Especially when all I  need is just a signature on this note! Or just an authorizing signature to re-fill this prescription! And when you're sitting there in pain or discomfort every second feels like an hour.

What I've learned is that patience is not so much waiting around for someone to come, but instead free time for yourself. The more we think when is that doctor coming? My appointment was nearly an hour ago! The more energy we spend on needless worrying and anxiety. The fact of the matter is: Throwing a thousand questions into the air about why your name hasn't been called isn't going to make the doctor or nurse come any faster. Going to ask the front desk about how many people are ahead of you, or how much longer will the doctor be might be a little more productive - but even so not by any drastic or noticeable measures.

Instead, use that chunk of time you've been given for yourself. (After all, if you think about it, it is YOUR time!) Read a book, work on knitting, play a game, watch T.V., think about what you need from the doctor, prepare your questions, think about what still needs to get done at work, go over study questions for that test, take a nap, play hangman, devise a strategy for the impending zombie apocalypse, tell your parents all the popsicle flavors you want right after surgery, etc. Time is whatever you make of it; we can choose to make time infuriating and become slaves to it, or we can choose to use time for our own benefits. We can decide to think "the doctor is late and that means I'm going to prepare to yell at her the second she appears" or "the doctor is late which means I'm going to sit here and finish reading this chapter." It's all a matter of choice and perspective.  

Will doing something else while you're waiting actually shorten your waiting time? No. Will distracting yourself make the doctor notice that you've been sitting there for thirty minutes? Probably not. But I am certain that utilizing your time for you will make a visit to the doctor's office less butt-numbing, less frustrating, and maybe a little less agonizing for you.

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Translating Medical Speak to Patient Life

I'm not always the best at paying attention to the part when healthcare providers are talking to me.  (Truthfully? I struggle with paying attention in general... well hello ADHD, aren't you shiny today?) 

It seems that during the part of the appointment where they say "So what this means is...." triggers some kind of chemical reaction in my head. Eyes glaze over, I rest my chin in my hand, I look at the coiled wire of the blood pressure cuff and wonder "how long could I stretch that out to?" "what am I going to have for dinner?" "Is it still raining outside?" "It was so much fun at bar trivia last night, I'll have to remember to keep that team going." "Am I going to run into the super creepy hospital clown when I leave?" "How does one go about making sangria?" 
"...any questions Sandy?"
"Umm no.." I reach over and take the prescription, or sit there and wait till the cast has dried, or I smile blankly back at the slew of medical stuff that was just thrown at my ears. Yet again.

So with that in mind I thought it'd be fun (maybe even helpful?) to make a list of the most commonly stated medical speak that I've heard, and then translate what that means in my only-half-assed-focused mind:


THEM: We're looking at probably a 3 to 4 month healing time for this fracture
ME: Great. I hope I have enough plastic bags and rubber bands at home for showering


THEM: This will help you get to sleep better

ME: It'll be more fun to be on that during the day..

THEM: Don't take this with alcohol

ME: Totally doing it

THEM: Call the front desk to schedule the surgery, my secretary will have my schedule

ME: When's my next school vacation?

THEM: This is only going to hurt for a few seconds. I'll be quick, I promise

ME: Lies. Lies. Lies. Outside the hospital walls a few seconds does not equal 3 minute 

THEM: Don't scratch

ME: Only if you don't breathe

THEM: How many servings of fruits and vegetables do you eat each day?

ME: Dammit why don't they have a picture of the food pyramid in here? 

THEM: On a scale of 1 to 10 with 10 being the worst pain, how is your pain?

ME: 15. Stop standing there asking me dumb questions, hurry with the painkillers!

THEM: So we'll have a follow-up appointment in 2 weeks, you can schedule it on your way out

ME: On my way out I'll be leaving and scheduling diddly squat 

THEM: Do you need a note for school? 

ME: Yea I need to be excused until June, just in time for the last day of school party 

THEM: Are all your vaccinations up-to-date? 

ME: Oh yea, absolutely 200% up-to-date

Did I miss any? Let me know in the comments! (Side note: I don't necessarily encourage the above..)

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