Today's post is a rant with a purpose. Its long, so I'm going to dive right in.
Women of color face certain barriers to access health care that are not always acknowledged as significant problems. These minor assumptions can result in a woman who needs health care making the choice not to pursue it. That choice puts her life in jeopardy and also jeopardizes the safety of her family. When we take into consideration that very often these women are the primary caregivers for their children (and sometimes their parents and/or siblings as well) and that they may be the primary source of financial support for their families... perhaps you can understand why anything (no matter how trivial it may seem) that occurs that forces her to reconsider that appointment or to ignore that issue with her breasts can be a major problem.
My terrible experience (luckily it was just one situation).
I think I've mentioned the story about a problem I had with one medical assistant during my treatment. I was about 2 months into my 4 month chemotherapy treatment. I was bald. I was weak. I was tired. I was fragile. I was home on disability because I didn't have the strength to work. But, I also had a ton of doctor's appointments at the hospital and I had to make them happen. Doctors don't make house visits anymore, after all.
So, this particular day... I went to an appointment to see my plastic surgeon so that we could discuss the plans for my breast reconstruction. Again, I was EXHAUSTED and in hindsight... I know I looked bad. Hell, I felt bad. But I had a smile plastered on my face and my boyfriend was there that day to help me get through my appointment. It was supposed to be a quick appointment with a very busy doctor who I had been trying to see for months.
I got off the elevator, I walked up to the front desk. I gave my prettiest smile and put a happy lilt in my voice and checked in. I signed my name and went to sit in the waiting area. The young lady took my information and then proceeded to take a personal phone call on her cellphone. I watched her talk to her friend about a party in a certain part of town, what she wore, what some other chick said to her about her man... and on and on and on the clucking went. Personally, I didn't care about her phone call. I just wanted to be done with this appointment and back on my way to bed as soon as possible. Time passed. Patients were called back, somewhat slowly it seemed but, meh. Sometimes it takes a while, right? Patience... Finally, I think she went to lunch and I looked at my boyfriend's watch and realized that we had been sitting there for well over an hour.
I'm no genius but something tells me that a hospital doesn't normally keep chemotherapy patients waiting in an open waiting room that long. I walked back to the front desk and asked the other person working if there had been a problem that I wasn't aware of. Imagine my anger when he realized that I had not even been checked into the computer. They thought that I had not showed up.
*blink, blink* Deep sigh.
I pointed to the sign in sheet and the time by my name -- which was 15 minutes prior to my appointment time -- and said that I was very weak and very tired. I had just spent about 4 days in the hospital the week before because I had a bad case of neutropenia (my immune system was very weak and compromised). I just wasn't in the space for shenanigans from people who didn't want to do their job. He took care of me immediately, a nurse came from the back to retrieve me... and I saw the plastic surgeon pretty soon after that. However, I made sure to register my anger and frustration with the young man who worked with me because I felt that his co-worker did not take her job seriously enough. She was a receptionist for an oncology surgeon. Even if she didn't have a sensitivity to that... I LOOKED like a damn cancer patient. She worked in a hospital. Do the math. Better yet... do your damn job.
I snitched to my oncologist, because he was the head of the oncology department. I snitched to the head nurse in the cancer center. In fact, anyone who listened, heard my concerns (in a pleasant tone) about the chick who left me waiting for over an hour because she wanted to talk about a party by the Shrimp Boat. One thing I learned during the course of my treatment was that it is the patient's life in jeopardy but for some medical workers it is merely their job. And those are two different perspectives and they can often lead to different appreciations of what is going on.
...and the second scenario - my friend's situation
I was reminded of this terrible episode today when I talked to a friend who was having a few issues with her breast. She wanted to talk to someone who understood what she was dealing with and I tried to provide an insight to my journey while alleviating her anxiety as much as I could. But then she mentioned that in discussing her appointment with someone at the breast center, she was asked whether or not she had someone to watch her children. The appointment taker said to her, more than once, that she needed to find a babysitter because she wasn't sure that kids sitting in a waiting room was acceptable.
My friend is a single parent. I know that children can present a challenge in some situations because of their innate desire to be active and rambunctious... the larger view of this situation was, my friend had an issue with her breast. That issue was of enough concern that she was now making an appointment with a breast care center at the suggestion of another doctor who felt she needed more tests. That means that perhaps whatever is going on was a bit deeper than a pimple or something. So... let's remain focused on the goal -- checking out her health --- not disparaging her efforts as a single mother to care for herself and her children alone.
To the person on the other side of the phone, this was one appointment out of many made just that day. I have worked as a front-line person in an office; I know that the position can be stressful and repetitive. It is easy to look at each action as just another task on your list of things to do. However, in a health care environment, I think we have to remember that the people on the other side of the desk or the phone are human beings in a scary situation. No one likes the anxiety of wondering what is wrong with their body. When it comes to our breasts, it is more than just something hurting us physically, this is an emotional situation too. Our breasts sort of define our femininity - or at the minimum they make us feel like a girl. The fear of dealing with cancer and mastectomies and reconstruction (in my case) or the fear and confusion about whether or not it is cancer or simply a cyst (in my friend's case) cannot be overstated.
Dammit we're scared. Is it too much to ask that we're treated with some respect for what we're feeling? And that we're not treated like an old Buick going in for an oil change? Nothing about these appointments feels great for us. We're trying to maintain our composure in the face of something frightening. Just do your job... save the foolishness for your personal time.
These stories may seem somewhat trivial. Perhaps we both could have been more understanding of whatever challenges the person in the office may have been dealing with, after all they are human too. However, the larger picture here for me is... dealing with medical personnel who seem not to care, or who seem to be less than concerned about our lives can often be just enough to make someone hang up the phone, or leave the hospital and not receive the treatment that they need.
In the case of my friend, many black women are single parents. This is a reality of their lives. They work hard to maintain their composure for themselves and for their children but they also don't often have the same safety nets that other people have. My friend didn't have a babysitter. That was just the reality of her day. She needed this appointment, and she didn't have a sitter. Which choice was she supposed to make? Imagine the numbers of women who look at their choices and opt to care for their children, or not deal with the bad attitudes of workers having a bad day.
It is a little thing and still a big thing.
Even when women are not single parents, they are often the primary caregiver. Same problems apply. Where they go, the kids go too. Who has an office geared towards women's health and doesn't take into consideration that with women often come children? If this is happening at your doctor's office, may I suggest speaking to your doctor and the office manager and explaining to them that childcare issues are a real thing. Some type of accommodation -- either in attitude or actual space -- is necessary for many of their patients. We aren't just numbers and insurance accounts. We are living, breathing people with lives and we're coming to you because we want to keep our lives so that we can keep being there for our families.
If you are a healthcare worker: Don't allow the lack of childcare or disinterested workers keep your patients from getting the treatment that they want and need.
If you are a patient: Don't allow mistreatment go unchallenged. You can be kind in your delivery but bring your concerns to the attention of the office manager, the head nurse or the physician you are seeing. Someone may just need more training. But your complaint can help to ensure that another patient doesn't face this same issue.
Talk to me... tell me your stories and your thoughts about barriers to access. There are more... I know. Language, transportation, cost, insurance, etc. Leave me a comment below.