{"id":6896,"date":"2020-10-03T20:28:23","date_gmt":"2020-10-03T23:28:23","guid":{"rendered":"http:\/\/bambisafkar.ca\/?p=6896"},"modified":"2020-10-03T20:45:37","modified_gmt":"2020-10-03T23:45:37","slug":"are-toronto-emergency-room-physicians-that-racist-when-taking-care-of-patients-with-sickle-cell-disease","status":"publish","type":"post","link":"https:\/\/bambisafkar.ca\/index.php\/2020\/10\/03\/are-toronto-emergency-room-physicians-that-racist-when-taking-care-of-patients-with-sickle-cell-disease\/","title":{"rendered":"Are Toronto emergency room physicians that racist when taking care of patients with sickle cell disease?"},"content":{"rendered":"\n
\"\"
Red blood cells (taken from the Mayo Clinic<\/em> website)<\/figcaption><\/figure><\/div>\n\n\n\n

Sickle cell disease or anemia is a group of disorders,\nwhich is an inherited red blood cell disorder in which there are insufficient\nhealthy (normally shaped) red blood cells to carry oxygen throughout our body (https:\/\/mayocl.in\/2Gdue1R<\/a>).\n<\/p>\n\n\n\n

The abnormally shaped red blood cells can shorten life expectancy due to possible strokes, organ damage, and lung disease. <\/p>\n\n\n\n

Patients can suffer from symptoms such as anemia, pain\nepisodes (joints, etc.), common infections, swelling of feet\/hands, delayed\ngrowth\/puberty, vision issues, etc.<\/p>\n\n\n\n

Sickle cell disease, which is due to a genetic\nmutation, is most common people whose ancestors come from much of the\nSub-Saharan Africa as well as Mediterranean countries (e.g., Greece, Turkey,\nItaly, etc.), Arabian Peninsula, India, South and Central Americas, and parts\nof the Caribbean. <\/p>\n\n\n\n

In Canada, there are about 5000 Canadians, including\nchildren (https:\/\/bit.ly\/2SqcX84<\/a>).<\/p>\n\n\n\n

This being said, this post is about a CBC<\/em>\narticle\/radio segment entitled \u201cER a ‘last resort’ for\nsickle cell patients who face racism when seeking care, says advocate<\/em>\u201d (https:\/\/bit.ly\/3jtxSmu<\/a>). The underlying\nmessage here is that our healthcare system is systemically racist (i.e., stigmatizing)\nagainst sickle cell patients because they are black. It features one patient\nand advocate (see below). It is based on her own story (of visits to the ER\nduring the pandemic) but it generalizes it to the whole 5000 Canadians living\nwith sickle cell disease.<\/p>\n\n\n\n

Ms. Weikle\u2019s CBC<\/em> article cites a systematic\nreview on the health-related stigma of patients with sickle cell disease to\nsupport her statement that \u201cstigma and racism are well known<\/em>\u201d: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6186193\/<\/a><\/p>\n\n\n\n

Systematic reviews are considered the \u201cgold standard\u201d of evidence in the medical literature. However, this systematic review is published in a low-impact journal and has many limitations. For instance, the review includes 27 studies located in different parts of the world, including Nigeria, Jamaica, and Brazil, in addition to the United States (none in Canada). How can we expect the experiences of patients living in Africa or South America to be comparable to those of patients living in other countries (i.e., USA) and to be generalizable to Toronto, Canada? The included studies are about patients who are both youth and adults. Again, their experiences and the impact of any stigma is not comparable between adults and adolescents\/youth.<\/p>\n\n\n\n

Of note, Toronto is the largest most cosmopolitan (i.e., diverse) Canadian city. Thus, healthcare providers likely more frequently encounter patients with sickle cell diseases or similar conditions (e.g., thalassemia). Healthcare providers are also likely more diverse than in smaller Canadian villages. Some may be from Africa, Lebanon, Palestine, Israel, Italy, Greece, Saudi Arabia, etc. Thus, more familiar with similar conditions, as described below. <\/p>\n\n\n\n

Related to the above point, if she may, Bambi will share her own story here (she does not mind). She has been a patient in four different provinces (Qu\u00e9bec, Ontario, Nova Scotia, NB). In each of these jurisdictions, she experienced excellent and sensitive care concerning what falsely appears to be a trait for a red blood condition called thalassemia (mentioned above).<\/p>\n\n\n\n

Thalassemia, which is also inherited (passed from\nparents to children through genes) is due to the body\u2019s inability to make\nenough of protein called hemoglobin, which is a key part of red blood cells. Traits\nfor thalassemia are more common in Canadians from Mediterranean countries, like\nLebanon, Greece, Turkey, Italy, Palestine, Israel, Syria, etc. Some Canadians\nfrom Africa as well some parts of Asia and the Middle East (not a Mediterranean\ncountry) may also have traits.  <\/p>\n\n\n\n

Anyhow, no worries, Bambi does not have thalassemia. Mind you, she would have known that since childhood, as blood transfusions would have been needed. She does not even have any thalassemia traits, the false appearance, so to speak.<\/p>\n\n\n\n

Indeed, in almost every province she did blood work\nfor different reasons, even when results are normal, her blood seems to appear slightly\ndifferent (less \u201cred\u201d and with differently shaped red blood cells). Sometimes,\nit was assumed that she had anemia, but after iron supplementation, no change\nin her hemoglobin levels would occur. Almost every time, she would receive a\ncall, after lab work, telling her that, given her genetic ancestry, she may\nwish to be tested for thalassemia traits (the milder form). Well, in Ontario,\nher family physician went over and beyond herself to solve this mystery. She\neven asked her if she can ask her mother to send her an example of her own blood\nwork results from abroad. She even ordered a full molecular genetic testing. It\nturned out that Bambi truly has nothing, despite her weird red blood cells.\nBambi likes to joke, repeating that she has this form of red blood cells in\nsolidarity with her former fellow Mediterranean citizens ? (In Greek, \u201cthalassa\u201d and \u201chaema\u201d\nmean sea and blood respectively; hence the name of the health condition of\nthalassemia common in Mediterranean countries).<\/p>\n\n\n\n

OK, you may perhaps think: Oh well, Bambi\u2019s experience\nwas more positive because she is not black. She will sarcastically reply: Maybe,\nbut remember, she is supposed to be a BIPOC deer ?.\nThe latter is that funny acronym that makes Bambi smile each time because she\nrefuses to be reduced to a label (even it can make her a \u201cholier\u201d deer, so to\nspeak). As a reminder, this term means \u201cBlack, Indigenous, and People of\nColour\u201d. Mind you, if you think that her story is unique, she will share that\nher Torontonian friends with traits for thalassemia also had the same positive\nexperiences as her.  <\/p>\n\n\n\n

Does that remove anything from the experience of the\npatient and advocate featured in the study, Ms. Serena Thompson. Of course not!\nBambi wishes her ALL the best (hopefully no more pain!!) whilst thanking her for\nbringing awareness about sickle cell disease. <\/p>\n\n\n\n

To conclude this post, please let us keep our critical\nsense alive\u2026 She does not know about you, but Bambi finds it worrisome and is\nhighly disturbed by the infiltration of racial ideologies in our medicine.  <\/p>\n","protected":false},"excerpt":{"rendered":"

Sickle cell disease or anemia is a group of disorders, which is an inherited red blood cell disorder in which there are insufficient healthy (normally shaped) red blood cells to carry oxygen throughout our body […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/posts\/6896"}],"collection":[{"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/comments?post=6896"}],"version-history":[{"count":9,"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/posts\/6896\/revisions"}],"predecessor-version":[{"id":6907,"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/posts\/6896\/revisions\/6907"}],"wp:attachment":[{"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/media?parent=6896"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/categories?post=6896"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bambisafkar.ca\/index.php\/wp-json\/wp\/v2\/tags?post=6896"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}