Tag Archive | "experience"

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#RealTalk: Cultural Facts & Perspectives that will make you a better doctor-

Posted on 21 August 2016 by Tammy Wong (Meds 2018)

The #RealTalk series allows our fellow students to share their ideas about how healthcare intertwines with their cultural and/or religious background. Check out this interview with 2nd year medical student Tammy Wong:

What is your background?

I was born and raised in Canada by Chinese immigrants from Hong Kong. My parents are Buddhist and raised me with traditional Chinese values.

What aspects of your culture differ from the stereotypical norms?

Family values: Chinese families focus largely on respecting and caring for elders and often decisions are made as a family, especially in relation to healthcare plans for patients. Furthermore, it may be hard to elicit patient wishes from the family’s wishes if they differ, but if physicians were perceived to ‘go behind/around’ the family then it would cause distrust in the system.

Food: One tradition when family members are in hospital or are ill, is that families will bring lots of cultural food to the patient so physicians should keep this in mind if there are diet restrictions for inpatients (i.e. NPO, low salt, etc).

Perspective on death and dying: Many Chinese immigrants, especially elders, are very superstitious. There is an idea that you will jinx something by saying it aloud so often patients avoid talking about death or risks with procedures. As a physician, you need to talk about these so you have to elicit it somehow from the patient. There is also a feeling of duty from remaining family members that they need to do everything that they can to ensure the patient’s survival, so a discussion about palliative care may be harder to approach but is necessary, especially if it coincides with patient wishes.

Perspective on mental health: There is usually a stigma regarding mental health among Chinese families. Many Chinese people do not really believe in the concept and think that you should just ‘get over it’. They also worry about being labelled with a mental health condition and often refuse to address it. This is something that physicians should be aware about and should try to educate to reduce the stigma.

Language barriers: Like with many other cultures, there may be a language barrier when speaking with Chinese patients. Furthermore, in Chinese culture it is common to nod or make sounds of agreement as a symbol to show that the listener is paying attention and as a form of respect. However, in contrast with Western culture, ‘nodding’ doesn’t always mean understanding and agreement; it is just to show respect and listening. Ask if they need clarification and summarize to check if patients actually are understanding.

Paternalistic view of medicine: Particularly with the elderly Chinese patients, they may be used to doctors telling them what to do and not really asking questions about their wishes or opinions because this was the format they were brought up with. Patients are also taught that doctors deserve respect and should know what is best for you. It is important to ask for patients’ wishes and values and to explain risks to help them make informed decisions, rather than just having them follow what you recommend.

Tell us a bit about Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) is still largely used by the Chinese community under the view that it can treat the body holistically and strengthen the body. Often patients will use TCM while also being treated with Western medications. In some cases, private insurance companies may require prescriptions for acupuncture, etc in order for the treatments to be covered. Without the prescription, the treatment can be very expensive and patients may need to go to ‘sketchier’ or unlicensed providers to save money which is more dangerous. Consider prescribing these treatments even if you don’t really believe in it to help out a patient pay for this, especially for a chronic disease that may not be curable with Western Medicine.

When performing a physical exam, what should be done that differs from what we are taught at school?

While there isn’t anything specific to ask about, many Chinese citizens are very modest so proper draping is very important, especially with elders. Ask if the patient would like anyone else in the room (i.e. spouse or family members) and explain what you are doing very clearly.

If you could give one piece of advice to us future doctors on providing care for your population, what would it be?

Always ask for clarification/understanding and take a bit of time to ask if there are any other issues when speaking with Chinese patients. They may not discuss their true fears or opinions until later on in the interview, especially if it is something embarrassing, sensitive or worrying to discuss. Mental health issues also fall into this category because it is often brushed under the rug. Be sure to ask and also suggest lots of supportive resources for these patients.

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Getting to know Alzheimer’s patients

Posted on 23 May 2012 by Sofia Nastis (Meds 2015)

Never underestimate the value of companionship and support, because it helps those whom you least expect. For three of my four years that I spent at Western in undergrad, I had the pleasure of becoming involved with the Alzheimer’s Society of London. My interest in the club was mainly due to the fact that I was extremely curious about neurodegenerative disorders, and I thought being able to interact with these types of patients in a volunteer setting would be a good stepping-stone in finding out if this is an area of medicine that I enjoyed. In the beginning, my main goal was to immerse myself in an area of the health care field that I was not very familiar with. In the end, the experiences that I had and the interactions that I was exposed to made it a much more enlightening learning experience. Continue Reading

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My Summer Experience- Ingersoll and Tillsonburg MedQUEST

Posted on 01 May 2012 by Caitlin VanDeCappelle (Meds 2014)

It took me 11 minutes. Only 11 minutes to drive from my front door to Alexandra hospital in Ingersoll, and yet I had never been there before. At first glance the hospital seemed small and very different from the hospitals I’d been to in London (the free parking may have had something to do with that!). Over the course of my next six weeks in the MedQUEST program, the small town and its people became friendly, warm and welcoming.

Ingersoll and Tillsonburg were looking for physicians, like many other areas in Southwestern Ontario. It wasn’t until my experience in MedQUEST though, that I came to know the strength in a small, tight-knit community when it came to getting something they needed. I had dinner with the mayor, was given a tour of the local CAMI automotive plant, and even got a free library card. Continue Reading

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The Global Health Experience

Posted on 08 April 2012 by Dan Wong (Meds 2014)

Travelling to China this summer as part of a global health initiative was about a lot more than building international relationships for the future, or learning about China’s healthcare system. It was about a lot more than participating in clinical observerships, or trying to adapt and communicate in an unfamiliar environment; or even about gaining a valuable experience that may help open the door to future global health initiatives. Although Medical Students Initiative in China (MSIC) did offer all of these things to me, the true value of this initiative was the challenge it presented and the opportunity for self-discovery and self-growth. Continue Reading

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“How was India?”

Posted on 15 February 2012 by Horace Cheng (Meds 2014)

The answer to this seemingly simple question eluded me upon my return from a summer spent in India as part of the India Health Initiative (IHI). I struggled in vain to compress such a rich experience into a few words or sentences.

Looking back, the things that stood out most were the friendships we formed with the individuals encountered in this journey. The most precious moments were those spent playing with the children, caring for the babies, chatting with spinal cord rehabilitation patients, and being alongside families at Lifeline Express. I wish to share these heart-warming moments through a collection of photographs and the little vignettes that accompany them.

Families for Children (FFC) is an orphanage providing care and education for children, youth, and women regardless of any physical or mental handicaps. I had previously envisioned an orphanage as a sad and gloomy place, but my experience at FFC has changed that view completely. The children are all brothers and sisters in one big family, and they take care of each other. They welcomed us with their open hearts and warm smiles such that within a few days I felt like I was part of this big extended family.




There is no better way to start the day than walking to school with the boys. They told us many things about their neighbourhood: which houses have scary dogs, where the safest place to cross the busy street is, and what kind of plants are growing in the gardens and roadside.





A picture capturing one of the heart-warming moments at FFC: walking the “big babies” from kindergarten back to nursery. We spent a lot of time taking care of them: playing, feeding, and changing cloth-diapers.








“Draw a monster! Draw a monster!” I sketched a monster on a page from our notebook. The boys liked it so much that they copied the drawing onto their backpacks.




Located at the village of Ayikudy, Amar Seva Sangam (ASSA) is an NGO dedicated to the service of the disabled in rural South India. The India Health Initiative was formed by two UWO medical students who visited this organization in the summer of 2003. It was wonderful to have this long-standing relationship and to be able to see the contributions IHI teams have made over the years.




We were active participants in the children’s daily physiotherapy sessions. Many of them have physical disabilities that require treatment and we were able to integrate simple games into the therapy sessions.








Simple things such as accompanying the children to their daily physiotherapy session and having lunch with them filled my days at ASSA with joy.




We also had the opportunity to take part in village-based rehabilitation home visits; it provided personal insight as to what life in rural India was really like. We witnessed first hand how one’s economic status is not the sole determinant of one’s happiness







We were also active participants in their learning environment. This picture was taken at a school assembly.




We quickly became friends with the residents of the Spinal Cord Rehabilitation Unit at ASSA. In addition to taking part in their medical care and rehabilitation, we also shared our life stories with each other. In our free time, we played chess, card games, and frisbee (as shown in this photo).

The third NGO we visited, Lifeline Express, is a mobile train hospital with the mission of serving the underserviced population in rural India. It took us 48 hours to reach the remote Bastar district in Chhattisgarh, among the bottom five of India’s 643 districts for development and health. It was an eye-opening experience to see the staggering medical needs as well as the tireless efforts of the volunteer medical staff. In addition to learning about the various medical conditions and surgical operations, it was very touching to witness and be part of such tangible positive change.



Mother with daughter waiting for her cleft-lip repair surgery at Lifeline Express. She was elated that her daughter could receive this free treatment that would significantly improve her life.





A young girl woke up from anesthesia after her orthopedic surgery for congenital talipes equinovarus (CTEV). There was a passing train in the background through the windows.




It is my wish that these photos can convey a sense of what I experienced in a way that my words cannot. I have come to realize and experienced the fundamental basic human connections that transcend cultural and language barriers. These people we met have enriched my life by the generosity of their friendship; for that I am truly grateful. I have learned a lot from this summer elective experience and I hope to return to these places one day as a physician and a friend.

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My experience with IHI (India Health Initiative)

Posted on 15 February 2012 by Charu Prasad (Meds 2014)

I had heard of complete chaos, but not truly experienced it until that very instant. I stood frozen, looking upon the scene. I was in a laparoscopic tubal ligation camp at a small primary health care centre just outside of Jagdalpur, Chattisgarh, India. We, the India Health Initiative team, had spent the past four weeks learning about health care and rehabilitation medicine in different areas of South India. Nothing we had seen so far had prepared us for this. Women, maybe only a few years older than myself, clad in their gorgeous colourful saris, half-sedated, were being led to tables in a chamber the size of a small clinic room. Men, who were there as nurses or volunteers, were carrying the women out in their arms after the minor operation that would drastically affect their lives, only to place them upon rickety beds in the outer hall, for their entitled two sutures. As the men walked between the chamber and the hall, they nearly tripped over the dozens of women who were tossing and turning in discomfort, as they lay on a threadbare carpet on the floor in the hallway.

My head was spinning with questions, and a general feeling of uneasiness settled over me. Where had I come? What was happening here?

The gynaecologist was alternating between two beds with his laparoscopic instrument. Enthusiastically, he showed us how he pierced the skin near the umbilical region. He allowed us to look through the camera and see the rings surrounding the fallopian tubes, displaying the tubal ligation that would ensure the women would have no more children. “This camp, like others, is a government initiative,” he said, “And a much needed one.” He insisted that the ladies were aware of that, and had come for the procedure of their own accord. But I couldn’t help but think: had these women, lying awkwardly with their eyes half-closed and legs raised up, truly given consent for this procedure? Did they know the risks, the consequences of having this done to them? Did they even understand what was going on?

I felt helpless, enclosed, and claustrophobic. With absolutely no power in this place, was there even anything I could do? Then it came to me. I recalled a scene from earlier in our trip: we had been observing the dressing changes for a spinal cord injury patient in the post-acute rehabilitation centre at Amar Seva Sangam, Tamil Nadu. The man was in extreme pain and terrified. Even when there was seemingly nothing we could do to help him, being untrained and out of our comfort zone, one of our teammates, Julia, reached out to hold the man’s hand as he had his bedsores dressed. Though they spoke different languages, she made eye contact with him, and smiled encouragingly. I saw the gratitude in the man’s eyes. This moment stayed with me.

It struck me that I could do the same for these women, and so I did. As the next woman was lowered onto the bed, I took her hands in mine and held on to them as tightly as I could as she underwent the procedure. The nurses around me looked at me strangely, but their gaze, though scrutinizing, was not unkind. I ignored them as I felt the returning squeeze of the young woman’s hands with the sharp intake of breath that told me the local anaesthetic was not as well administered as it could have been. I held on tighter, whispering words of comfort in Hindi, hoping that she could hear me and gather some strength from my presence.

I came away from the experience with mixed feelings, unsure of what I had just experienced. It made me question many things – basic things that we sometimes take for granted here at home like hygiene and privacy, and deeper layers such as motives in health care and the ethics of consent especially in poor, young women. It is not an issue that can be explored overnight or that I can resolve on my own. Though there will definitely be resistance, I will continue to think about these issues and hope to do my part to contribute to global health and awareness, to be able to preserve the innate sanctity of the delivery of health care.

But it also taught me that even in the depths of despair, even when I was confused beyond belief, and upset by the loss of dignity of these women, I was not helpless. There was still something I could do to preserve the human spirit and trust in that situation. It was possible to reach out and connect to another human being. And it does not require a medical degree, years of training or experience. It requires only a heart that feels…a hand of care…a voice of warmth…

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Life in the Truck

Posted on 15 February 2012 by Jean-Marc Beausoleil (Meds 2015)

In the first draft I wrote up for this blog post, I tried to write a grand overview of the life and culture of paramedics, without success. I realized I was trying to do one of the things that being a paramedic had taught me to avoid: I was lumping everything together, when paramedics are actually an incredibly diverse and dynamic group of people. So I went back to the drawing board to draft a version of the only paramedic story I’m qualified to tell- my own. Continue Reading

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