Thursday, February 8, 2007

The Culture of Health

Sometimes, when days at the private practice get a bit dull, I think back to the good ‘ol days at Baragwanath. Those 30 hour calls when all you ate was a Bar One. Those frantic trips, wheeling a patient over to X-Rays (Porters? What porters?) JUST to escape a whining aunty. Those blissful moments where you scream back at the psychotics. And those daydreams of actually having sex in the on-call room. Contrary to popular belief, and a horrible TV doctor culture – DOCTORS DON’T ACTUALLY SHAG ALL OVER THE HOSPITAL.

Back to the aunties. It gets me thinking about the culture of health. South Africa is such a racially and culturally diverse country, that you’re bound to encounter some gems.

As Doctors, believe it or not, we've got our favourites. Here's the rundown:

WHITE PATIENTS: White patients believe the world owes them a favour. Why? I don’t know. If you aren't doing moving the earth for them (and they will check that by getting 3 consults) - there MUST be something wrong with you.

In fact, if I a white person dared to walk into Bara - THE WORLD MUST. COME. TO. A. STANDSTILL.

They are the only patients in the room. White doctors, of course (didn't you know?) should give preferential treatment to their white brothers.

The consequence of this entitlement complex - I have many doctor friends who are too afraid to go work in private practice, in white suburbia heaven, because of the perceived special treatment that has to take place. Agh!

INDIAN PATIENTS: Ah, aunties and their hubbies. They are PAINFUL. More painful to us than anything that might be afflicting them (excuse the sarcasm, but this applies to the ones that actually aren’t dying – which is most of them!).

Indian patients believe that every pain, every feeling and every thought that had crossed their minds in the LAST 10 YEARS... are all interlinked. These patients will proceed to tell you how the itch in their left ear, is related to the pain in their right groin, which is OBVIOUSLY going to give them a heart attack. In the next 48 hours.

And no matter how you tell them otherwise, the talking just does noooooot stop (cue Perry Cox extended syllables). Add to this, by the end of the conversation, you'll know the entire family history, eating habits and lengthy diagnosis of daughter's boyfriends's mother's uncle's skin condition. And WHY it’s just such a damaging relationship. Which one you ask? My point exactly.

BLACK PATIENTS: Perhaps it’s just because of demographics, that we happened to see more black patients, working in a government hospital. Perhaps it’s a cultural issue I just don’t understand – but black patients seem to have a more inherent trust and understanding of the pace and pressure of a health environment. These patients will will tend to tell you exactly what's wrong, and nothing more.

There have of course been those wonderful examples of:

"Noooo... I can't be pregnant."

“Have you been having sex?”


"Then you can be pregnant".

But then again, that pretty much happens with everyone.

Give me our black bruvvas. They are certainly a lot more appreciative! To this day... Not a single courtesy curry. Or even an invite to meet the daughter's boyfriend over a mango lassie. And definitely no invitation to Sandton kitchen tea.

Ah, patience, patients.

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