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I met almost every nationality at a doctor's clinic

On my very first day as an International fellow at the New york eye and ear infirmary of Mount Sinai, I was introduced to the HIPAA law. and even though the video was fun and colourful, the underlying message was clear, protect patient privacy at all cost. That translated to no undue talking to patients, no divulging of information outside of the necessary, no taking pictures, no copying of patient information files.

As a foreigner, I was not to take back any patient information back with me to India. So clicker happy me has no selfies with the cute patients I saw, unfortunately, but I still have my thoughts and observations, which I am free to share without violating any HIPAA laws.

At Dr  C's clinic I saw the whole world go by in terms of country , colour and class. India has a diverse population too, but we are only a small microcosm, when it comes to the world citizens who live in New York.

this is what I thought of all the nationalities I saw.

The black Americans: Even though India has many shades of brown, they still discriminate against the dark skinned, but the black americans were colourful beyond their skin too. every single one of them have an inherently great sense of humour and its like every one has great comic timing and is playing as a part in a sitcom. they speak in double negatives, the "ain't nothing gonna happen" variety and have a self deprecating style of talking which endearingly funny.

The Hispanics: i didnt know there were so many Spanish speaking nationalities in US! for some reason I always thought it was just Mexicans only, but there were Puerto Ricans, Equador, Dominican Republic, Panama, and so many others. The most striking quality I noted, was the immense pride and love they have for their native country. one assumes that if you leave your country for another one then that must mean that their love for their land of origin is lesser. Infact that is what I believe of Indians who have migrated to the USA as well, and to an extent Indians in America have chosen America over India. But, this was not the case with all Hispanics, they loved their food, their culture, their country of origin, they celebrated their origin every single way possible. Their faces lit up when we said we had been to the Dominican republic, they choose to speak in Spanish even though they now live in an English speaking nation.

Chinese: There is a reason a Chinese mom wrote the book tiger mom, the parents of these patients were demanding, not just from their children but their childrens doctor as well. one lady came in with an entire diary filled with questions and queries. They are simple hardworking people, who prided themselves in being thrifty. Asian races have a high amount of Myopia, wich meant most kids wore glasses from a very young age, and recent evidence shows that if children played out in the sun and spent lesser time indoors with their books, it would benefit their eyes. The parents were aghast by such advice. “less studies!” what kind of sacrilege is that!

Indian: I didn’t see that many Indian patients, I will agree, but the ones I did, disappointed . Now, when you hear a doctor is visiting from your country of origin, I guess I was expecting a glint of recognition of the country if not a smile of welcome.But all of them had a look which said “we didn’t come all this way to the land of our dreams to be seen by an Indian doctor ” they even had that look which said “really they have paediatric ophthalmologists back in the villages?!” I would have loved to let them know that no only do we do the same procedures back in India, but at less than half the cost. And I mean the Indian patients, the patients from the subcontinent however were more welcoming, like Bangladeshi or Pakistani patients. It might have been just my experience, but most of the Indian patients actually have that annoying accent which they show in all the stereotypical Indian characters! Think Raj Kuthrapalli from Big bang theory and that is what they sounded like. I can’t fathom why. I hope to God I don’t sound like them, neither do any of my friends from India who are in US. HIPAA was the only thing holding me back from telling the patients, please, please don’t speak like that!

White Americans: the first thing that strikes you about them is the impeccable bedside manners that the patients have. Now doctors are supposed to cultivate good bedside manners just as part of our natural patient examination protocol. But, when I say “how are you today?” They answer with a “ great, thank you for asking. It’s really nice to meet you, how has your day been today?” . when Dr C introduced me to the patients, the Indian patients just managed a “UHUH. “ but the Americans “Oh that’s great, welcome , hope you are enjoying your stay here, Dr C is a great Dr to learn from. “ It was like all of them had gone to really good finishing schools, places where they teach you how to say and what to say. As one of my Indian doctor colleagues observed ,” Americans are really good at small talk.” Not all of them might have meant what they said, many may have held the biggest and deepest of prejudices against me, but their manners were impeccable. I really appreciated that, it was a very obvious contrast to the way we speak in India to each other, let alone in a hospital. Even while talking to their kids, they would say “Chris would you like to sit on the nice doctors chair, and can I hold your toy for you while doctor examines you?” unlike here where one would say “ give me that toy and go sit in that chair.”

The non native American: Now I don’t think I saw any Native American patients, and every one else has migrated from some part of the world, either a second generation American or a twelvth generation American. They are either from Ireland, or Swedish, or Italian or from other place. But even though they have lived for many generations in the US, and call it home, they still carry a little bit of where they came from with them, either in the way they speak, or in the way they relate to things. It was a concept that I was inquisitive about, even before I went to the US, that how does a nation of immigrants survive as one. Where almost everyone is from somewhere else, where everyone belongs and yet does not belong. How many generations does it take for a person to forget their lineage, and just be an American? There were Korean Americans and Vietnamese Americans, even Iraqi Americans, countries which have shared violent histories with each other, and yet here were these people who said they belonged to both sides, and the best thing about New York was that they were not asked to choose sides. If you are from anywhere else in the world, you would be able to appreciate what a big challenge that is. Again HIPAA the rule which prevented me from getting too personal with my patients prevented me from delving deeper into tjis fantastic duality of their lineage.

In Forensic medicine there is a theory called the Locard’s Principle, which says every contact leaves a trace, or in simple words whenever two people come in contact , both will leave traces on each other. It may have meant to leave only material traces, but I would say that these traces may be just thoughts or feelings or even a change in Paradigm. It maybe difficult to measure, and yes, not all the information exchanged lies in a patients files.

I am thankful for the opportunity to learn from all the patients I met in my visit to New York, which in a way was like meeting almost every nationality in the world.


Pankaj said…
I'm not in USA but I'm Melbourne based so still an NRI :) For your views on the Indian Patient I'll say its perspective and may be differing from person to person. When I need to visit doctor for the first time some years back I thought of taking appointment thinking that it will be easy for me to express myself and I might be more comfortable. After our regular discussion when I tried to have some casual discussion like which Part of India you belong to, looks like he was not interested and don't want to speak about India. May be it's one timevery specific experience but it made an impression on me and from then onwards I prefer taking an appointment from Non-India Doctor ;-)
Pankaj said…
I just realized that there are grammatical mistakes in my sentences (i.e. in above comment) please ignore them as I didn't read it back after typing :P
LauraMedley said…
I really wanted to send a small word to say thanks to you for the fantastic points you are writing on this site.
dear Mr Pankaj, I can understand your emotions. yes, many doctors do not want to be reminded of their country of origin, but many a time it is also the fear of said patients wanting extra benefits or more privileges because they feel they share a special kinship with the doctor. I am a bengali, and even though I stay in Goa. the few bengali patients that I have, tend to boss around in the waiting room wanting special privileges, they spend more time during OPD visits talking, and they also hint at discounts. not all patients are like that, I have some with whom I love to discuss about bengali recipes and how to teach your child the native language,but for a few , one tends to be wary.
John Niemann said…
Thank you for the inbelievably captivating post! I couldn't get my eyes out of it until read till the very last line, you should be a writer! Also I realised how much I miss being a hairdresser, back then I talked to people, watched them and was enchanted by their diversity. Now I spend days answering the questions on what is the best online essay writing service or how much does it cost and write about it.

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