March
27, 2002: Better bedside
manners '94ers Jennifer Greene,
Kim Newell, and Mary Lantin help doctors cross cultural barriers
that divide them from their patients
By A. Melissa Kiser '75
Photo: Last
fall, Greene, Newell, and Lantin produced an educational video.
Early in medical school at the University of Pennsylvania, Kim
Newell '94 heard an emergency room physician tell a 19-year-old
female patient who had recently emigrated from Haiti that he was
concerned that she might have HIV. The patient, who had complained
of fatigue and occasional dizziness, had no other symptoms beyond
a fever and a low platelet count. Fearful, she asked the doctor
what would happen if the HIV test were positive; he responded matter-of-factly:
"You will die." The patient refused the test and left
the ER.
Newell found herself wondering: If the patient had been a friend
of the physician, would the doctor have had the same suspicion of
HIV? Would he have answered his friend's questions in the same brusque
manner? In this case and some others, she recognized that something
was creating boundaries between doctor and patient and asked herself,
"Is it culture? Is it race? Is it class?"
When Newell returned to Princeton for her fifth reunion, she reconnected
with Jennie Greene '94, who was pursuing a master's degree in health
and social behavior at the Harvard School of Public Health. Each
had just finished reading the same book chronicling the tragically
ineffective efforts of doctors to work with an immigrant family
in treating their seriously ill child, and their conversation at
Reunions revealed a shared interest in what Newell calls the "invisible
wall between patient and medical professionals" when their
communication crosses racial and ethnic lines.
Subsequent discussions and research led them to collaborate on
an educational video that would help the medical community better
understand the issue of cross-cultural communication. They enlisted
Mary Lantin '94, also a student at the Harvard School of Public
Health, to help with strategy and funding. The Harvard Center for
Cancer Prevention provided both sponsorship and a specific focus
for their yearlong study. Specializing in communication about cancer
was appropriate, Greene points out, because "certain populations
have higher rates of cancer."
Newell joined Greene in Boston, where they conducted interviews
and focus groups, often using interpreters. One interpreter observes
that patients and health care providers from different cultures
"have different beliefs, different systems. And sometimes when
I'm interpreting perfectly well, I'm saying everything that's being
said, they don't connect. There's something that's missing, which
is the cultural part."
The nonprofit video they produced, Community Voices: Exploring
Cross-Cultural Care through Cancer, uses real people discussing
their own experiences. Released in the fall of 2001 for use in medical
schools, hospitals and health systems, and community-based organizations,
it explores the potential for misunderstanding between medical providers
and patients from various Asian, Middle-Eastern, and Hispanic cultures,
as well as from African-American and Appalachian backgrounds.
By A. Melissa Kiser '75
A. Melissa Kiser is public relations officer at The Pennington
School.