Nina Rodriguez, MS3, Icahn School of Medicine at Mount Sinai
Tengo miedo. Estoy solo en este país, the patient – we’ll call him Señor P – looks up at me, with tears in his eyes. The official interpreter has already logged off. I look back at the team – an attending, a resident, and an intern – and I translate, “He says that he is scared. He’s alone in this country.” They say nothing. I look back at the patient and I do my best to console him before our team must step away to see the next patient.
An hour or so later, after rounding on our list of 14 patients, we return to the team room. My attending introduces a new concept to us called ‘Health Equity Rounds.’ She describes it as a way for us to discuss inequalities in the care we provide and as an opportunity to acknowledge our own biases. She starts and the first patient on the docket is Señor P.
My attending explains that Señor P came to the hospital for an acute issue and just a few days into his admission, he became medically stable and ready for discharge. However, there was a delay in transferring him to an acute rehabilitation center because of his undocumented immigration status. A few days later and still admitted, the patient developed pneumonia requiring treatment and further prolonging his stay.
In the U.S., hospitals are required to provide lifesaving care to all patients – regardless of their immigration status. However, in Señor P’s case, the hospital intended to help him, evidently caused him undue harm. During ‘Health Equity Rounds,’ we discussed Señor P’s case in detail, exploring preventative actions that the team could have taken. This initiative surprised me – I had never heard of this type of “rounds” before and found the discussion to be extremely productive. We acknowledged our own limitations while simultaneously discussing possibilities to advance Señor P’s medical care and prevent similar cases from occurring in the future.
I went back later that same day to visit Señor P. I wanted to let him know that while his friends and family were miles away, he had me and the rest of the medical team in this hospital caring for and advocating for him. Es normal tener miedo, pero no estás solo en este país.
About the author: Nina Rodriguez is a third-year medical student at the Icahn School of Medicine at Mount Sinai. She grew up in Miami, FL but has been living in New York City since graduating from Princeton University in 2019. She is a big foodie, and enjoys doing crossword puzzles and reading memoirs in her spare time.
About the Work: This piece is about a direct patient encounter that later influenced "rounds." It sheds light on the harm often done by hospitals on patients with undocumented immigration status.
Commenti