February 12, 2020 ⋅ 6:30 P.M ⋅ Faaizah Arshad ⋅ Editor: Guadalupe Sandoval
Disclaimer: Although the story depicted below is fictional, it is based on relevant research on the impact of racial and socioeconomic factors on health.
Eight years ago, I was diagnosed with atherosclerosis, so every couple of years, I take a trip to my cardiologist to get my heart checked. Lately, my chest pain has increased and my blood pressure often rises. I took another trip to the doctors today, and was hoping he wouldn’t prescribe another medicine— I’m already taking Statin, Aspirin, and Gemfibrozil.
Before I became atherosclerotic, I was a strong opponent of medications because my grandparents were hard-line believers in medicinal herbs. They thought herbal therapy would cause fewer adverse side effects because it was richer in antioxidants than synthetic drugs. When I shared this with my doctor, he dismissed my opinion, insisting, “I used to believe in medicinal herbs too, but when I became a doctor, I realized that manufactured drugs are more effective and promising.” He must have my best interest at heart but every time I take a trip to the doctor now, I can’t help but get agitated. I am afraid that I’ll be walking out with yet another cholesterol-lowering, blood-thinning medication prescription. It’s hard not to feel like his goal is geared toward rushing me out the door.
When I walk into a hospital, I am distracted by the aseptic smell of alcoholic disinfectants that is subtly countered by the aromatic smell of flowers in the hospital lobby. I’m hopeful, yet scared because I know that medicine can save most people but it can’t save everyone. I’m recognizant of doctors in scrubs rushing through the corridors, sleep-deprived yet alert. But, ultimately, I’m numb to the experience because I’ve been there countless times. I’ve realized that hospitals are paradoxical places. They are places of optimism and devastation, sterility and contamination, life and death.
...it feels like a routine that has stripped her of individual and personalized needs.
As I sat in the admit room waiting for my cardiologist, a young Latina female told me that she works an extra job just so that she can afford her medical co-pays. Since her co-pays are expensive, she wants her doctor to maximize his time with her. Unfortunately, what often happens is that he reviews her medical record, spends an inadequate amount of time explaining her next steps, and prescribes medication. For her it feels like a routine that has stripped her of individual and personalized needs.
Across the room, an old Black patient overhears our conversation and shares that even though he lives in an affluent community with a top-performing medical facility, he takes three buses to get to this doctor's office because it is the closest one that has employed a Black doctor— he wants to be treated by someone who looks like him and who can understand his perspective. I came to realize that hospitals are so paradoxical because every patient who enters and exits has a different experience. Even though I had walked through the same corridors and would meet the same doctors as the patients in the waiting room, each of us had a different background and health condition, a different reason to be here. I was Pakistani, she was Latina, and he was Black. I was atherosclerotic, she was low-income, and he was a senior. Yet, for all of us, time and individual attention from our physician was crucial. We didn’t care to get the best doctor in the nation or to have one who practiced medicine all his/her life; instead, we wanted one who would understand and translate our intensely personal and complicated narratives while still providing quality care.
Finally, my doctor called me in and asked, “How’s it been? Have you been taking your medications?” I didn’t know which question to answer first? Should I tell him about how I went on a roller-coaster last week at Disneyland, which led to some chest pain, and about how I felt dizzy when walking to class? It only happened one time, so maybe it isn’t an important incident worth sharing. I responded with a blatant “Yes— yes I’m taking my medications.” At the end, he added Ezetimibe to my list of medications.
Author's Note
I’ve written multiple pieces about inequities in health and how hospitals should improve patient care. This time, I thought I’d construct a creative piece that depicts the topics I’ve learned about and am currently helping to overcome as a member of SOS. Patients attempt to convey their stories to their doctors, hoping that their doctor will interpret the stories carefully, handle them with care, and respond with empathy. Often patients don’t know how important some information can be and whether they should share these details with their health professional. Nevertheless, they are storytellers, and they carry with them intimate and powerful stories.
