Category Archives: Considerations in Medicine

From the Earth to Its Harvest (Environmental and Dietary Understanding)

Environmental Factors:

In different places in the world, there are different illnesses and diseases that can occur. This is a crucial part of healthcare that must be understood by doctors prior to treating patients. For example a doctor in the Dominican Republic would be more likely to diagnose Malaria while a doctor in Alabama would be more likely to diagnose diseases from tick bites if presented with the same set of symptoms. In the Dominican Republic there is a larger amount of the mosquitos that carry the malaria virus and it is therefore a more common disease. However, Malaria is less of a problem in Alabama due to the different environment and therefore would be diagnosed less often.

Tick-Lyme-Disease.jpg

Tick bite

Another example of area specific diseases was called Kuru, which is only found in the New Guinea Highlands (http://anthro.palomar.edu/medical/med_4.htm). Kuru is specific to this area as a result of the cultural ritual of eating dead relatives, but the initial cause of the disease is unknown. However, the Kuru symptoms is very similar to a degenerative brain disorder. While Creutzfeldt-Jakob Disease is not common, there are roughly 300 cases in the United States a year (http://www.ninds.nih.gov/disorders/cjd/detail_cjd.htm). With Kuru the incubation period is between 30-40 years, it is possible for an individual to contract the disease at a young age and then move to the United States before showing symptoms of the disease. A doctor would be very unlikely to diagnose a patient with Kuru without prior information about the disease and could easily misdiagnose the patient with Creutzfeldt-Jakob disease.

As a result it is important for doctors to know about diseases that are specific to certain areas. This information is something that must be learned through a combination of being taught and through life experience. In some ways there are things that must be taught like the history of the region as far as the Kuru disease. Because it is not a common disease it is not something that a doctor would be likely to experience first hand. However for a doctor that grows up in an environment in which diseases are more common, they would be able to accurately diagnose certain diseases.

Dietary Factors:

The president of a local branch of Slow Foods once told me, “Food is something we have in common. Everyone eats.” This isn’t uncommon wisdom, but significant nonetheless. There are no exceptions to our shared need for nutrients. However, people approach nutrition in various ways for various reasons (some healthier than others). For the purpose of medical learning, I would like to think that nutrition is partially experienced and taught.

Early humans had the important job of establishing culinary understanding. It may sound fancy and illustrious, but it really consisted of trial and error. But with error came death (via poison, food fighting back, etc.), which teaches the living. Cooking with fire and different hunting methods were very important for the development of early humans, which made nutrients more accessible and less dangerous (http://humanorigins.si.edu/human-characteristics/tools-food). Therefore, all of our dietary knowledge had to be experienced first. Teaching would have to take place afterwards. In order for doctors or other professionals to educate others about nutrition, they should at least have some kind of direct experience (“Physician, heal thyself.” -Luke 4:23).

However, as Eleanor Roosevelt once said, “Learn from the mistakes of others. You can’t live long enough to make them all yourself.” How obnoxious would it be if a doctor could only learn by experiencing things themselves (not to mention impossible)? Thankfully, as the internet so kindly reminds us, there are a lot people experiencing different things. Teaching comes in handy through compilation and distribution of the experiences of others. While experience may be vital, teaching is much more realistic and efficient. It would have taken a long time for you to understand that you can’t eat mac and cheese all the time when you were younger; your parents had to teach you by forcing you to eat vegetables. I’ll let you ponder the effectiveness of such a method.

-Emily Donkervoet and Kasey Marshall

Cultural Education in Medicine

In medicine, It is important to note differences in cultures, customs, and practices displayed by different patients. Educating the future doctors of the world in these differences and the problems they could create has the potential to save the lives of thousands. Making sure medical students learn the pillars of world religions, or the specifics of customs in different geographical areas could avoid costly missteps in treatment. Students can analyze a broad view of demographics and use previous cases to address problems before they arise. The process should be expedited by a student’s forethought into where they want to practice. From there, Students and doctors could look at patient histories in that area, find problems, and assess possible solutions before the student is out in the world and is dumbfounded by a cultural brick wall. Some problems can be nipped in the bud before the student has been released to practice, but not all possible issue can be played for in advance. The student may be faced with a problem in the field not seen before in case histories. A slight difference in practice may arise and the new doctor may have to change his routine to solve this. A patient from a different culture with different customs may move into the area in which this new doctor has chosen to practice. The doctor must find a way to treat this patient. Creativity is key as the doctor explores respectful ways to manage and treat the patient’s ailment. This situation forces the doctor to think, and it can be added to the archive of cases for future doctors to learn from. In conclusion, a doctor’s education is the cultural practices of a certain region can help avoid problems in patient care, but some issues must be tackled in practice which can be archived for the education of future doctors hoping to practice in this region.

Written by Doug Dulske, John Wheeler, and Matt Klein.

Family History (Medical History) How would we approach this as physicians?

The question that we proposed: how would the learning and teaching of family history be possible and help connect you to a patient if you were in a medicinal based career?

In the world of medicine, all professionals need to know much more than the basic textbook information. They need to be both dedicated and passionate, have good judgment, and hold good communication skills. But, aside from these skills usually taught in schools, one would need to know about socioeconomic status, governmental influence, the environment, culture, religious practices, family history, and dietary information. More specifically, our group will be focusing on how plausible the investigation of family history would be in these practices. To know the family history, we would need to investigate certain family history libraries and know the ancestry of the certain patient which would allow us to connect and empathize with the patient. Whether it being from personal experience or a deeper emotional bond, there should be nothing withheld between the patient and physician. Empathy allows clean communication and gives the ability for one physician to situate themselves in the patient’s perspective. For example, specific races are more susceptible to certain disease pertaining to their ethnicity. As the three of us are different ethnicities, we can relate to patients of different races or backgrounds because we could potentially share a genetic disease. In my family (Jordan), there is a line of both diabetics and one with breast cancer. When working with an African American patient, yes, I would understand the possible genetic diseases that I know about my personal family. In no way would this be justifiable for any patient of my race or of any race for that matter. One would need to wholly devote themselves to the patient at hand. There are many databases and resources where the specific physician could find about family history (http://www.patient.co.uk/doctor/Diseases-and-Different-Ethnic-Groups.htm) and (http://www.ancestry.com/). I (Kevin) have a genetic disposition for diabetes and high blood pressure resulting from the risk stratification of my family. To explain, risk stratification is a way to determine your risk for certain diseases based on a set criteria. The criteria is based upon age, smoking, weight, family history of diseases. And with this knowledge, I’ll will be able to further explain to the patient and sympathize with them. In conclusion, to understand family history, a physician would need to know much more than a simple list of other family diets and causes of death. They would need to both internalize their personal experience with genetic diseases and do more research in databases to see how they could approach differing races.In the world of medicine, all professionals need to know much more than the basic textbook information. They need to be much more than a neuroscientist or a surgeon. They need to be well rounded and understand as much they could about the patient, their community, and the lens in which they view life.

A collaborative effort by Jordan Maia and Kevin Nguyen

Alternative Medicine

Many people turn to medicine for a solution to almost all their problems. Although this may seem like the usual method to all pain and sickness, what about those that don’t or can’t take medication? There are various methods people use to help take care of agony. Some believe in hypnosis, some believe in natural remedies, others believe in mindfulness. Regardless of which method you choose, all require some form of learning and/or teaching. When performing hypnosis, you must be taught the techniques it takes to control a person’s actions, body and the nerves so they obey your commands. Gradually as you continue hypnotizing various people, you begin to learn that everyone is not the same and it takes a little more work to follow through with the hypnosis. When it comes to mindfulness, it is a technique that must strictly be taught. One must learn how to meditate and teach meditation to others. Another form of alternative medicine is homeopathy. An example of this would be with the Ebola virus. Instead of using treatment, in Nigeria, many uneducated people use traditional methods that they believed would cure it, one of these methods being eating the local bitterkola. This alternative form of medicine can be taught and also learned over time through experience. There are many remedies that can improve or cure conditions, without the use of medication or treatment. Alternative medicine can be necessary for several reasons. For example, many people follow certain religions that prohibit certain medical treatments and procedures. Additionally, it can be beneficial to use an alternative if a person has an allergy to any medications or a personal preference against it. Also, many places in the world are limited on resources and it can be difficult to get the money for required treatment, equipment, or medication.

by: Crystal, Miranda, and Daniel

Socioeconomic Factors of Medicine

When traveling to a location with a new socioeconomic norm there are multiple factors that a physician will have to keep in mind. The physician will need to learn ahead of time about the insurance that most people have in the area. If she is in a location with people who generally have a higher income, most patients will have insurance and vice versa. In a low income area, a physician must know and respect the fact that patients may not be able to afford certain medical procedures. Because of this, a clinic will need to consider hiring volunteers and preforming free examinations in order to benefit the community. The physician will have to learn certain things, such as how to interact respectfully with low-income patients, through experience in the field. Depending on the healthcare of the area, the government may step in and help. A physician must be taught medical practices and how to diagnose diseases typically seen in the area through school, but the culture and social norms must be learned through experience in the area.

Written by Mia Davis and Henry Earp

Religion applied to medicine: is it learned through experience, or can it be taught?

In the medical field whether it be in a rural or urban place there are many cultures and religions , some of which have varying beliefs regarding medicine. For those who are preparing to be medial physicians, approaching different religions can be a daunting task. Many wonder if the skills to deal with such situations can be taught in classroom setting or simply must be learned out in the field. Our answer to this question is both. How to handle medical obstacles regarding religions MUST be learned both in the class room and out. For instance, medical trainers can inform themselves with various religions in the classroom. Becoming familiar to their customs and rituals makes them better informed when treating the patient. However, it is not that simple. No person is exactly the same, you may not be able to assist the patient without violating some of their religious beliefs. Such situations will require hands on experience. For example, some religions don’t condone blood transfusions or organ transplants. Other religions have certain dietary restrictions which could cause health problems for some people. Some religions don’t believe in any medicine at all and refuse medical attention even if it is fatal. Doctors need to be empathetic, resourceful, and open-minded when dealing with patients of different religions. Medical physicians should be blunt with their patients about their health issues and how their religious beliefs could be hurting them, but doctors should not disrespect the patient’s beliefs either. While medical physicians can inform themselves on different religions, they still need hands-on experience in order to learn how to cope with those sorts of situations.

by- Maggie Crumbliss and Ashley Krueger