Over the course of my medical training, I’ve thought “what would I do in the face of injustice?”. I have learned about so many. The prejudices and biases we hold, the decisions we make, the things we say when we don’t think anyone is listening.
Each time this question comes up in class, we recognize how hard it is to challenge these injustices in practice. Unfortunately, there are huge power dynamics at play. I am a first year. My medical knowledge is still limited (READ: almost none). I am brand new at this whole “being an elective student thing”. Oh and one other MAJOR thing… this person will be writing my evaluation at the end of the two weeks, NO BIG DEAL.
I’ve been trying to work on acknowledging my biases and asking myself why they exist. I’m 90% through an incredible Indigenous Cultural Safety training right now. The training covers a gauntlet of information. We cover the history of Indigenous peoples in Canada and tangible ways we can make healthcare safe(r) for these folks.
I also just finished an AMAZING book called Small Great Things. It’s by Jodi Picoult and follows the case of a black L&D nurse who is barred from caring for a patient. The baby’s parents are white supremacists and don’t want her anywhere near their baby. The book works to call out us white folks who say we’re “not racist”. It challenges classic ideas of racism and highlights the insidiousness of non overt racism.
With all that said, today was my first day of electives. I was a bright eyed and bushy tailed first year student, ready to conquer this new and uncharted territory. My staff is honestly quite wonderful. They are great with patients and they really try to teach me as much as they can.
Alas, people are not perfect. The smallest incident happened today and I am kicking myself in the pants over my inaction. While calling for a psych consult, they mentioned that the patient was “Aboriginal”. I was taken a bit off guard. This was a piece of information that to me, seemed entirely irrelevant. The patient was a “frequent flier” as they say. They presented to the emergency department 4 times in 48 hours after swallowing paint thinner. They were finally admitted to ICU under a form 1 on the fourth presentation.
Looking back I should’ve asked “Why did you mention they were Aboriginal, do you think this is contributing to their presentation?”. I mean, maybe it WAS contributing to the presentation. Years of colonization and trauma can take their toll. If this was the root of the comment, I applaud the physician for realizing that our cultural practices and the colour of our skin can make this world a lot harder to walk through.
But, I don’t think this comment was rooted in anything other than bias and stereotyping. I was frozen in fear. After all, it was the FIRST day of my FIRST elective – I DIDN’T WANT TO SCREW THIS UP!! I should’ve asked my question though. It would’ve forced my staff to unpack their comments and thoughts, and we both could’ve grown as physicians.
So what do you do in these situations? Seriously, I want to know because I’m not sure how to realistically deal with this in the future.