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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
Healing the patient, healing the physician.
In helping people, not stereotypes........
Third world country clinical senario
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Richard W Pretorius, Buffalo, New York, USA Associate Professor of Clinical Family Medicine
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These are strong images and powerful metaphors. Medicine is always personal, both for the patient as well as the physician, regardless of the degree to which one’s soul is engaged, as the author’s is so poignantly here. Medicine brings healing in many ways. Sometimes it is in the birth of a child who comes into the world backward—and who is not stuck in the birth canal after all. Sometimes it is in the quiet affirmation of a grandmother who values the mere presence of the physician healer—and the importance of “being” and not just “doing,” shades of Martin Buber’s I and Thou. Sometimes it is in the heartrending anguish of a physician who feels inadequate when even inadequacy can be enough. Medicine is always bigger than ourselves, bigger than our preconceived notions, bigger than our formal education in medical schools and residencies. In our bleakest moments the kernel of hope still stirs within. The author, not surprisingly, continues as a healer, teacher and student in his new role in training the next generation of physicians. Thank you, Dr Allen, for reminding us that medicine—in all its richness—is a journey and not a destination. Competing interests: None declared |
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Sara J. Jumping Eagle, Rapid City, South Dakota, USA Pediatrician, Adolescent Medicine Specialist; University of Colorado
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Pilamaye, thank you Dr. Allen for this story. In reading your words, I became gradually angrier with the descriptions of the communities you worked in, yet didn't really live in. The use of words and stereotypes such as "government handouts", promiscuity, and descriptions of the alcoholics near the hotel were painful for me to read. Yet I recognized the realism as you described the trash and the health problems there. I feel sad for you, that at least in this description, it seems that you didn't get to be a part of the community or get to know the people you served. Because of this, you missed out on seeing the beauty and strengths of our culture that endure and thrive today. (The stories, songs, dances, ceremonies, give-aways, games, etc...) Despite the trash, the alcoholism, the drunk drivers.. there are people who are trying to raise their children in a good way. Native people have the highest rates of abstaining from drugs and alcohol. I hope that simply because we have higher teen pregnancy rates and possibly higher rates of STDs, that this isn't automatically associated with promiscuity in your mind. Those statistics are also a reflection of lack of access to care, lack of culturally competent care (especially for teens), lack of opportunities, and closed sexual networks within which men are hardly ever screened or treated. I truly appreciate your writing as I can see how so many other health care providers who work in under-served financially impoverished communities will think like this and never have the opportunity to really experience the people and culture they are helping. I hope they will recognize themselves within your writing and learn to do something different. (Maybe you did eventually do things differently and think differently. Hopefully that is the next story.) Maybe they will join in a community event, maybe they will sit down and get to know the person they are writing a prescription for, maybe they will attend a powwow, give a talk at a school or on the local radio, help develop prevention programs, lend their expertise to the tribal council, or even ask why? Why are you sad? Why aren't you taking care of yourself? I also hope that in their mostly brief experiences in providing health care in Native communities, that they don't automatically think of themselves as experts on all Native Americans (or whichever community they will work in). I see this all too often in my experience. Thank you for writing about issues which are rarely discussed. Thank you for the powerful journey your story took me on. Sincerely, Sara Jumping Eagle,MD; Oglala Lakota, wife and mother of two Competing interests: None declared |
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Emmanuel M Monjok, Houston TX ,USA HIV research fellow, Institute of community health, University of Houston, Houston TX
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Thank you Dr Allen for educating me. I never believed that the same similar clinical scenario that we physicians encounter in rural and even urban settings in sub-Saharan Africa do also occur right here in some communities in the US, an advenced and developed country. I am a trained family and preventive medicine physician from my native country,Nigeria and have served and worked in resource -limited conditions in Nigeria and Mozambique for more than 15 yrs before coming to the US for public health research. Maybe , the American Academy of Family physiciians and the American board of medical examiners should relax some of the rules and allow International medical graduates with rural general practice experience to serve in rural America for a 2yrs period and thereafter go take a board exams for rural family practice. This proposal will reduce the waiting time for certification but the gain will be the underserved and rural population in the US. Emmanuel Monjok MD.MPH Competing interests: None declared |
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