We must pay attention to current events that may be significant to our patients. Staying curious may help us to connect and build rapport with those we serve.
Lifelong Learning in Clinical Excellence | May 26, 2022 | 3 min read
“Next patient, please.” The words rolled effortlessly off my preceptor’s tongue. And understandably so. At this poor, urban, and understaffed hospital, there was much to be done but very little time. As I began searching for the next patient on the psychiatric floor, I couldn’t help but wonder what patient story we would encounter next. Schizophrenia. Bipolar Disorder. Heroin Use Disorder. Suicide. In just a few hours on the floor, I already heard each of these diagnoses at least once.
I finally found the patient’s room. “Hello, sir, can you please tell me your name?”
“Deon,” the patient mumbled.
“The doctor is ready to see you now,” I replied.
He didn’t seem pleased. In fact, he seemed agitated. Like many of the patients on this floor, he had one objective and one objective only. To leave the hospital.
We made our way to the interview room and the patient sat down. The physician quickly rattling off the standard list of questions. “Have you ever been hospitalized? Who do you live with? When were you first diagnosed?”
However, amidst the rapid barrage of questions, one question punctuated the air like a shotgun. “It says here in the chart that during your episode, you said, ‘I don’t want to die like Trayvon Martin.’ Who is Trayvon Martin?’”
I felt my ears get warm. My mind suddenly felt cloudy and my heart began to race. Who is Trayvon Martin?! Who is Trayvon Martin?!
The irony of these words couldn’t be more pronounced. Trayvon Martin, the unarmed 17-year-old African American, followed, shot, and fatally killed by a neighborhood vigilante as he walked home from the convenience store. Trayvon Martin, the teenager whose death was the very impetus behind the now-infamous phrase and social justice movement BLM. Black.Lives.Matter.
At this very moment, seated across from me was a young Black man from one of the poorest neighborhoods in the city who had uttered these words amid a psychiatric episode before being brought to the unit by police. I, too, a Black man, was seated across from him. And together, we sat in this poor, severely under-resourced hospital that served a primarily Black community.
To not know about Trayvon Martin under these circumstances was, to put it charitably, unacceptable. The patient’s statement was far more than an innocuous statement about not wanting to die. It was a statement about not wanting to die young, about not wanting to die unfulfilled, and about not wanting to die unjustly. Dead at 17, we don’t know who Trayvon Martin could have become. Without this understanding, it was hard to see how my preceptor could fully address the patient’s psychiatric diagnoses: schizoaffective disorder and substance use disorder.
1. Patients are more than their disease.
Ask about a patient’s cultural background or community experiences. In many instances, this information has implications for how you address a patient’s diagnosis.
2. Do your research.
My preceptor didn’t know who Trayvon Martin was and should have. However, he wasn’t afraid to ask. If you don’t know, ask, and if you still don’t get an answer, do more research.
3. Cultural competency is key.
If you’re working with an underserved community, know that the experiences of your patients will likely be very different from yours. Things you take for granted, such as fears of dying young, might be commonplace in the community. Build trust with your patients by getting to know them and being sensitive to the challenges outside the healthcare setting that might affect their care.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.