Civility and Racism in Life and in Medicine

And I’m back…

My children started school today. Like any parent, I have mixed emotions. Some of you may have noted that I do not post pictures of my children or really speak of them in my writing. Yes it is deliberate….

An aside…I believe that my children have a right to privacy, and they have been taught from birth that they will make their own way through life (not judging anyone). Yesterday I discovered that I am free-spirited…humm…did not see that coming… Someone described me as being ” like a genie in a bottle”. With that in mind, I am allowing my children to put themselves out there when they are ready. Not when I am ready…

So what does my view on talking about my children and contemplating my personality have to do with civility, racism, life, and medicine? Maybe a lot…

I have watched this spring and summer as we have killed and maimed each other for reasons that have escaped me. So when I need to feel centered in my thoughts and feelings, I turn to my Bible…

29 Jesus replied, “The most important commandment is this: ‘Listen, O Israel! The Lord our God is the one and only Lord. 30 And you must love the Lord your God with all your heart, all your soul, all your mind, and all your strength.’[a] 31 The second is equally important: ‘Love your neighbor as yourself.’[b] No other commandment is greater than these.” Mark 12:29-31

So, how does this apply to life today? Medicine? And what is missing in our society? One word: Civility. (I am borrowing this term from my children, their incredible teacher, and their amazing school. And yes, they are really talking about civility)…

The Merriam-Webster dictionary defines civility as “polite, reasonable, and respectful behavior”. So, if we are going to be “civil” to each other, that would preclude engaging in any form of racism. As a society, it seems that we are not able to accomplish civility in many settings.

So, how does this manifest in medicine? Many, many ways…Just a few real examples…

  1. A nurse pages the doctor on call because a patient is not doing well. The doctor takes 30 minutes to call back, yells at the nurse for disrupting his evening, and refuses to come in and take care of the patient. (Impolite, unreasonable and disrespectful)
  2. A patient with Bipolar Disorder goes to the emergency department with severe back pain. Her symptoms are attributed to her mental illness and she is discharged without having her complaints addressed. (Unreasonable, disrespectful)
  3. Two men come to the hospital with chest pain. One of the men is white…the other is African-American. The African-American man receives a toxicology screen for cocaine. The white man does not…. (Disrespectful)
  4. And my personal favorite: a doctor faxes end of life prescriptions to a pharmacy for a patient with Hospice Care who is actively dying at home. It just happens to be Thanksgiving Day. The pharmacist declines to fill the prescriptions. When the doctor calls to find out the problem, the pharmacist states that he believed the prescriptions to be forged since “doctors don’t work on holidays”. (Impolite, unreasonable, disrespectful) 

The fourth example actually happened to me….did I handle the situation with civility?…Not a chance…I was disrespected, but that was not really my concern…my dying patient was not receiving reasonable medical care…and that was both impolite and disrespectful….

So, how can we change behavior?…I am not pretending to have the answers…

But, for me it starts with awareness of my own behavior, and a core belief that if I expect to receive Grace, then I must be willing to extend Grace to others…and my “free spirit” needs a lot of Grace everyday…

Do the right thing…At the right time…For the right reason…No matter how much it may inconvenience you or make you uncomfortable…

–Veridical Doc 

May you find God’s Grace in everyday….

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