Exhibit A

Notes from the daily life of a medical student in Cork. 92.5% fact and 7.5% fiction.

Xenophobia (my homework)

In the smaller general hospitals the number of doctors working on site who did not have English as their first language struck me.  Although the majority of doctors at consultant level in Clonmel are Irish, less than a quarter of the more junior staff are. I do not understand the politics of Irish hospitals and so I am left with numerous questions about these micro-societies: why are Irish doctors not applying for positions in these more rural areas? Why are there not similar ratios of foreign doctors to Irish doctors in the larger centres like Cork and Dublin? Does this reflect on the standard of teaching/exposure/care offered in these hospitals?

These questions lead me to another, more personally troubling, question: Does it matter where your doctor comes from? I’ve seen both sides of the argument. I have seen the reassuring body language of a doctor, uninhibited by our social norms of personal space, placing a concerned and comforting hand on a shoulder that needed it. I have seen doctors of foreign extract provide the most irreproachable care and perform to the highest standards of clinical excellence. But I have also seen communication break down. I have seen the look on a patient’s face of confusion and mistrust. I have seen them clam up, unwilling to ask further questions due to the stilted nature of the interaction. I have seen these doctors fail to pick up on the more subtle clues from a patient indicating that there is more going on than has been expressed in plain speech. But then again, I’ve seen Irish doctors do these things too.

I’ve given it a lot of thought and have come to a conclusion that satisfies my both pragmatic considerations and most deeply rooted moral convictions. No, it does not matter where your doctor comes from; however it does make their job harder. I am pleased to see diversity in our hospitals; it is good for our development as professionals, good for our patients and good for our society but these doctors encounter problems on a daily basis. These are simple problems of miscommunication that add to the arsenal of those who are xenophobic and burdened by ignorant prejudices. This is especially a concern in these times of economic instability and scapegoatism.

We need to help these doctors in their communication and integration. As it is, I find myself alienating the patients at Clonmel by not being familiar with the training rituals of Tipperary’s Hurling team, how is a colleague from, for instance, Pakistan supposed to cope with such capricious people. Patients must feel satisfied that their doctor has understood them and comfortable in asking the questions that are worrying them. There are enough barriers to communication in hospitals without adding a Tower of Babel dimension to proceedings.

I want to practice in Ireland simply because this is where I can best communicate. I feel that I cannot do this as well in any other country. Even the sum of the subtle differences that exist in the use of the English language in America and Australia amount a chasm. In these countries I lack confidence in my ability to read the personality and to read the situation. I want to be able to leave a consultation and know that I have listened to all that was to be heard and that my communication and reassurances were understood in the spirit they were intended. This cannot always be the case but it is what we should strive for and what we must aid our colleagues in achieving.

 

  1. kitey posted this