Our Doctor Spoke Chinese, Lacked Understanding
New America Media, Commentary, Eugenia Chien, Posted: Jan 21, 2008
NAM's contributing writer, Eugenia Chien, says her immigrant parents have a Chinese speaking doctor but it didn't help when her father was told that he had prostate cancer. Compassion was lacking, despite the fact that there was no language gap.
Four months ago, my father was diagnosed with prostate cancer. Cancer itself is terrifying enough, but the way that my parents found out about the diagnosis was the most traumatic part of our experience.
As a reporter I have written about health care for immigrants and read lots of literature about the importance of language access and cultural competency. But none of that work seemed useful when a life-threatening disease happened in one’s own family. The language we needed the most was compassion, but that was something we didn’t get that day.
Dad had scheduled a biopsy for some time with his urologist, who is also from Taiwan. Even though my parents speak English reasonably well, the idea of having a Chinese-speaking doctor comforted them.
At the doctor's office, the urologist delivered the frightening diagnosis. But don’t worry, he said casually, you can find a lot of information on prostate cancer on the internet.
What can we do? My parents asked the doctor.
The doctor told them that surgery is an option -- but he didn't bother to explain that many different types of surgery are now available for prostate cancer. He didn’t mention that nerve-sparing surgeries can often save patients from incontinence and sexual dysfunction, two of the most common effects from prostate cancer treatment. He didn’t talk about laparoscopic surgeries that can minimize blood loss. Instead, he told them vaguely about traditional surgery, which makes a large incision in the lower abdomen -- a terrifyingly invasive procedure usually reserved for patients with late-stage tumors.
What about radiation? Dad asked.
There are generally three types of radiation therapy for prostate cancer: external radiation, implantation of radioactive seeds inside the tumor, or a combination of the two approaches, depending on the patient. But my parents would not get that information from their doctor that day.
Instead, he said, "Oh sure, you could get radiation seeds implanted, like what Rudy Giuliani did."
Well, if it's good enough for Rudy Guiliani.
The urologist signaled that it was time for my parents to leave. Not knowing what to do, my parents asked if they should still keep their plans of going to Taiwan in two weeks.
"Sure, enjoy your life! After all, you're only at stage one," the urologist said.
When I think about this part of my parents’ appointment with the urologist, all I can hear is my mom's soft voice over the phone, indignant with anger. "We didn't even know what stage Daddy's cancer was at, and the doctor didn't bother to tell us until we were leaving!”
Although an urologist is not a cancer specialist, their doctor could have outlined some of the treatment options to ease my parents’ minds. He could have at least directed my parents to an oncologist who could explain the treatment options better. At the time, they knew nothing about prostate cancer, and nothing about where to go after hearing this very vague but terrifying diagnosis.
For all the writing I had done about health care for immigrants, nothing prepared me for the fundamental lack of basic sympathy my parents saw that day. Making sure that my parents had Chinese-speaking physicians and telling them about their right to a medical interpreter seemed completely pointless. I thought that a Chinese-speaking doctor would naturally be more compassionate about his immigrant patients. I couldn’t have been more wrong.
With the help of friends, we eventually found a top cancer hospital in New York, where the staff helped my parents navigate the maze of doctors and treatments. After a surgery to remove his prostate, my dad now is cancer-free.
Many immigrants may not be able to get adequate healthcare because of language or cultural barriers, but another barrier exists that is far more systemic and less visible: the lack of compassion in healthcare. Without compassion, all the Chinese-speaking doctors and nurses would be no good to my parents that day.
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User Comments
George Paris on Jan 21, 2008 at 13:51:28 said:
You have to be your own Doctor these days. Medicine is a business and there is no money in it, or room for compassion. My Urologist told me to ignore all other treatments and stick with Anti-androgens. I didn't trust him and explored all the other options on my own. Only to find a year later, after exploring every option that he was right. I was hard sold on all the other options and almost succombed, when I came to realize that my Urologist was right for me, but he didn't have time to describe the other options. I am 84 years old and am exected to die with but not of Prostate cancer
T. Bryer on Jan 21, 2008 at 09:48:28 said:
Urologist's income increased the most in 2006, outpacing other specialists. They focus on a tiny part of the body and should have the time to devote to their patients. This is just a lousy doctor!
H Bowman, MD on Jan 21, 2008 at 08:13:14 said:
Well, your parents are getting exactly the same care as most other patients in the US.
-->I guess that means that they weren't being disadvantaged by the language gap.
Just the compassion gap.