Posted by My OB said WHAT?!?.
Jul
30
Posted by My OB said WHAT?!?.
“…We Work With A Lot Of Non-English Speakers & Too Much Information Is Just Confusing.”
“Well you see, sometimes patriarchal medicine is a good thing because we work with a lot of non-English speakers and too much information is just confusing.” -OB to mother who spoke English as a second language when she asked if the OB informed his patients prior to the admittance of pitocin.
There are 31 comments to this post.
Alyson Miers had this to say,
Jul 30, 2010 @ 5:04 pm (Quote)
Hey, Doctor Stabby-Hands, why don’t you just come right out and say that you openly despise non-native English-speakers and that you have zero regard for their bodily autonomy and no interest in their informed consent?
In fact, I’ll be willing to bet you have about that much respect for ANY patient’s bodily autonomy and ability to give informed consent, but perhaps you figure the immigrants are less likely to sue your ass off.
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Becky Reply:
July 31st, 2010 at 5:26 pm (Quote)
Yep. They don’t expect to get sued by non-English speakers. I saw a doc to a HIGH forceps extraction (not legal) on a lady who didn’t speak English, just so the doc could get to an activity. I WISH I could scream out the dr’s name, and the baby’s outcome.
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That’s horrible. I hope there was a lawsuit?
I think Alyson hit the nail on the head naming this person “Doctor Stabby-Hands.” The comment they made was just all in all.. disgusting. It doesn’t matter what nationality your patient is, what culture they’re from, you ultimately have to treat them with respect. If there is a language barrier, that’s what interpreters are for!
PS- if you don’t have an interpreter handy, you’ll usually find that one of the younger people in the family (kiddos are great for this) speaks English well and can help. Not ideal, but at least it will help.
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Jane Reply:
July 30th, 2010 at 6:55 pm (Quote)
But the doctor didn’t say “They might not understand.” What s/he said was “too much information is just confusing.” Note the passive voice there. What the doctor is implying is that they’re unable to sort through the information, not that they can’t communicate the information effectively.
And yeah, I thought most hospitals had an interpreter on staff. Plus, if they routinely deal with a non-English speaking population, you’d think they’d hire bilingual nurses.
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Kelly Reply:
July 30th, 2010 at 10:19 pm (Quote)
While I totally agree about the implications of what this doctor said, I must point out that this isn’t an instance of the passive voice. The verb in the sentence is the copula “is” and has no passive form. An example of the passive voice is “They were confused by too much information.” Its active counterpart is “Too much information confused them.” See Language Log for more information (possibly too much!): http://itre.cis.upenn.edu/~myl/languagelog/archives/000991.html
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Jane Reply:
July 31st, 2010 at 4:27 am (Quote)
“Too much information is confusing to them” is a passive construction. The active construction would be “They are confused by too much information” or “I would confuse them with too much information.”
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mamamor Reply:
July 31st, 2010 at 6:11 pm (Quote)
Passive voice is when the subject of the sentence is unstated. ‘They are confused [by too much information].’ Sorry to be such a grammar nerd.
That said, the sentence is misleading because the doctor points to the information as the subject here, the thing which is confusing, rather than saying more straightforwardly that there are communication problems, etc. Then again, maybe it’s really telling because it demonstrates the doctor’s belief in the complicated nature of childbirth, and the difficulty women have understanding the (usually poorly communicated) information they receive.
More than that, hospitals do generally have interpreters on hand for the most common languages. A lot of hospital staff also are bilingual. And for less common languages, there is telephone translation service in most places where translations can be done via speaker phone. A lot of immigrants can also find translators through non-profits to bring with them so they don’t have to deal with the hospital’s services. This was true when I worked with resettled refugees, at least.
But then there is a lot of resentment and xenophobia in the hospitals, too, and the tendency for immigrants to live in poorer neighborhoods with access limited to walk-in clinics rather than more traditional family doctor-style services just reinforces an atmosphere in which the patients can be treated poorly or less-than-people, because there is no real relationship developed between the patient and the care provider.
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Serene Reply:
August 2nd, 2010 at 1:21 am (Quote)
That can depend on where, Jane…
I know what you mean and I agree, but in my region, we have a high number of unskilled migrants who barely speak any english, and we are unable to keep up with enough interpreters to satisfy. Its at the point where we (student nurses) are writing our own little notes with the day-to-day phrases on them for multiple languages just to be able to ask if a patient wants a shower now or after breakfast.
Its not just one nationality of migrants either. They are from all over the world. My uni caters for a massive international population, hence the explosion of non-english speakers in my region. We just cannot keep up with the demand for interpreters! Unfortunately its going to start breeding the same attitude this doctor has, but we are trying. LOL I can say “here is your morphine in 9 languages now 
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Translation: “People who don’t speak English as a first language are too stupid to understand, so I’m not going to waste my time trying to explain it to them.”
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And this is why I didn’t find out until I was recovering from an unnecessary c-section, that I was automatically administered max pitocin upon admission — despite my numerous expressions that I did NOT want medical intervention outside of IV fluids and being constantly assured that I would only be given fluids for dehydration.
I swear, sometimes I think I really am better off giving birth in a ditch than in another hospital.
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Sarah Dorrance-Minch Reply:
July 31st, 2010 at 1:59 pm (Quote)
Unless there is a rare emergency of birth that needs to be addressed, you’re nearly always better off in the ditch.
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Dee Reply:
August 1st, 2010 at 11:20 am (Quote)
I’m sorry this happened to you, and stories like yours ALWAYS make me grimace at the “mandatory” IV. It’s way too easy for things you don’t want to be put there when you are busy with the task of laboring. So when people say, “What is the big deal?” this is exactly the bad situation I think of.
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Serene Reply:
August 2nd, 2010 at 1:32 am (Quote)
I had to giggle about this. My local, IV is not mandatory. Nothing is (I love it ). When the nursing shift changed, My husband asked the new Midi when my second IV cannula was being put in. Without realising that I actually NEEDED one, she replied that I would not be getting a second IV and should not have even had ONE unless there were complications. While normally I would have loved to hear this, I wanted to smack her for not paying enough attention at handover to know that I had one IV in for a necessary induction, and needed my second one started when the first was half complete!
One size does NOT fit all.
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When my son had been in the nicu a few days a baby from a family that spoke romanian (or some similar dialect) was brought in. I felt so bad for them, all huddled around the incubator as the doctors struggled to explain what was wrong with the baby and what needed to be done working with the very limited english the father spoke. It took them almost 2 days to track down an interpretor, but once they did the family and doctors were both obviously thankful to be able to communicate fully and the parents switched from timid to very outgoing with their interaction with the staff. Now I can understand how this hospital wasn’t expecting to suddenly needed a romanian translator, they had birthed at another hospital and been transfered, but if the ob/hospital is seeing a woman prenatally i’d think they’d have time to track down a translator from ANY language before the actual birth! This kind of attidude is completely indefensible.
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Sarah Dorrance-Minch had this to say,
Jul 31, 2010 @ 1:54 pm (Quote)
Note to self: doctors believe violating human rights is okay when it makes things simpler and easier (for the medical staff, anyway, if not for the patient, who would probably do perfectly well with a translator, and maybe even without depending on certain factors, such as the hospital staff’s willingness to use nonverbal communication. Say, pointing to bag of Pitocin, showing a picture of a patient hooked up to Pitocin, waiting for a response.)
It’s not just non-English speakers that doctors and hospital staff treat as hopelessly stupid, you know. You’re also assumed to be too stupid to understand ANYTHING if you are poor or on Medicaid, if you’re a homebirth transport, if you’re any sort of minority, if you’re too young, if you’re overweight…
Sometimes if you’re female…
But the prejudice is more overt if you aren’t a native speaker of English and don’t know much English, or if you are obviously a charity patient.
Note: my use of “patient” here rather than “client” is deliberate. The dispossessed of the world are never considered to be “clients.” That’s part of the patriarchal medicine package.
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Sarah Dorrance-Minch Reply:
July 31st, 2010 at 1:57 pm (Quote)
PS. Deciding whether or not to come out of the autism closet when in the hospital for an emergency is always a trip. On the one hand, it’s a medical issue and it should probably be addressed. On the other hand, I do not like being treated like an overgrown ten year old or worse, an idiot.
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Cmat Reply:
July 31st, 2010 at 2:25 pm (Quote)
That sucks that you have to have an inner debate to tell staff about being autistic. I think a lot of people.. and I mean a LOT of people don’t realize that the term “spectrum” really does mean that there is a spectrum for conditions. They vary so widely and the level of functionality varies too. Actually, now that I think of it, my husband’s cousin is autistic and epileptic. Its actually not the autism that messes with him so much as the epilepsy. Even with both of those conditions together he’s very able to understand without being spoken to like he’s 5.
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Sarah Dorrance-Minch Reply:
July 31st, 2010 at 3:06 pm (Quote)
Seizure disorders and migraines (which are neurological cousins – both involve kind of a brain backfire, for lack of a better term) are much more common in the autistic population than in neurotypical people. This is probably because our neurological connections are jury rigged in places.
When I go to the ER, it’s nearly always for an intractable migraine. Some of my migraines, usually the ones triggered by motion sickness or flashing/too bright light, wind up making me pass out after I’ve had something of an emotional fit. My paternal grandfather apparently had something similar, only he actually fell to the ground afterward and frothed at the mouth – or so I am told. Which sounds like a seizure to me (and I got my autism from my dad, who has no diagnosis but it’s pretty obvious if you live with him).
So I may or may not have a seizure disorder.
And I’m afraid to bring it up with health professionals in the ER because I’m afraid that if I say, “I have reason to think I might be prone to seizures due to my autism,” I’ll be treated like dirt. At best, a hypochondriac. At worst, the Rain Woman.
And people wonder why I do so much time researching health issues and considering treatment options that don’t necessarily rely on doctors.
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Cmat Reply:
July 31st, 2010 at 4:29 pm (Quote)
Don’t get me wrong, sometimes medicines do some great things for people.. but sometimes they don’t. My mom had tonic clonic seizures and she was put on anti-convulsants. All they did was whack out her system so bad she could barely function and didn’t seem to stop anything no matter what they put her on. So in reality, you might just be better off without the anti-convulsants. She eventually weaned herself off of them and has had very few seizures since. The majority of the ones she does have seem to be centered around high stress situations and low glucose.
Any chance your midwife might be able to refer you to someone that won’t treat you like dirt? Just a thought. Sometimes one medical professional can provide a link to another.
Just my experience. I know DH’s cousin needs the meds because the seizures do so much damage to him. They actually tried some type of surgery that gave him an internal monitor or something that was supposed to help when one came on. It doesn’t sound like it’s really done a darn thing for him.
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Sarah Dorrance-Minch Reply:
August 1st, 2010 at 3:54 pm (Quote)
I think I’m going to ask around in the local autism community for names of good neurologists.
Right now I self-manage by learning my migraine triggers and avoiding them, especially the triggers of severe migraines, because those seem to be the ones that give me meltdowns followed by me sort of passing out. And if I get a headache, I try to nip it in the bud before it gets worse, because severe pain seems to bring on the weirder symptoms. That’s why I’ve gone to the ER several times when a migraine didn’t respond to at-home treatment; I don’t want it to get worse, it might become something else.
I’m going to start growing poppies this autumn. They take two years to reach maturity, but after that I can milk the pods for opium, and make it into laudanum so that I don’t have to go to the ER for a narcotic that costs several hundred dollars a visit plus various hospital-related fees. The last ER doctor I saw I told about my plan, and he actually said, “Go for it.” Not all doctors like the way pharmaceutical companies stick it to the customer.
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Jane Reply:
August 1st, 2010 at 4:24 pm (Quote)
I’ve had this debate often about my own son, when I sign him up for an activity and the form asks if there are any medical diagnoses they need to know about. Often I decide they don’t need to know.
Because yes, my son requires accommodations and it would be a lot easier in some respects if they knew. But this is also a very small town and I don’t know whether people will begin treating him differently or if he’ll be harassed and bullied at school if it gets around.
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Sounds alot like the Hospital that was giving spanish speaking women consent forms to sign for circumcision. They were given english forms and told they were forms to sign the babies out of the hospital. Needless to say they got their assed sued when the poor moms found their babies with a whole lot less then they were born with. Informed consent applies to EVERYONE DOUCHBAGS!
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Dee Reply:
August 1st, 2010 at 11:22 am (Quote)
Yes, totally! I love a previous poster’s comment about kids–they are a great resource. I think that the bottom line is that any doctor or nurse administering meds that are specifically something the patient has said she doesn’t want is terrible.
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Sarah Dorrance-Minch Reply:
August 1st, 2010 at 3:55 pm (Quote)
How horrible. I’m glad they got caught, and taken to court. Serves them right.
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Oh my goodness. I would have smacked him upside the head.
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