About the Author: Mazvita (pronounced Ma-ZHEE-ta, but she just goes by Z) is in my class at medschool. She’s always ready to: bust it up on the dance floor, pick a fight with you about culture (don’t ask how she feels about Halloween), and ruthlessly speak her mind in her sweet accent–which is NOT British, mind you. Read on as she analyzes how doctors take race into account when treating a patient. It’s usually the second thing we say: “Patient M is a 57yo black male presenting with…” We often use race to help us find a diagnosis–Z argues it shouldn’t be a topic of conversation at all.
I was talking to my Psychiatric attending, and he brought up the issue of race and asked what it means to me, a member of the new generation. How important is it for me to know and emphasize the race of person, especially a patient that I am caring for. To me, the colour of your skin is of little importance, even in healthcare.
This argument was raised: Race helps you develop a better differential diagnosis. My response is: a patient does not come in to the hospital with their ethnicity determining what the diagnosis is, his/her symptoms do. Granted, based on genetics, one may be at greater risk for developing a certain condition or have poorer outcomes of an illness, but does anyone truly know which genes determine race–and how likely they are to be inherited with the other genes that decide your risk of a disease? Since the scientific community has not yet developed a concrete answer to that question, why do we continue to base some of our medical practices on “race?”
We live in a world where people marry for love and not necessarily the colour of your skin. What we used to think were distinct “races” are now in fact a mangled, jumbled mess of chromosomes. One cannot look at a person and know his/her genetic make-up. If I were to walk into a hospital in the USA, it would be assumed that I am African-American, when I am in fact African. Since I have the same skin tone as another ethnicity, do I still have the same health risks? I do not share the same heritage.
Research has been done for various ailments; some conclusions state that one race is more likely to have more complications than another. However, just as race is a polyallelic trait, disease outcomes are multifactorial. I was told that there is a correlation between race and disease outcome. This is true, but instead of just accepting this as fact, shouldn’t one question why this correlation exists? It is well known that certain people have better access to resources than others, be it access to healthcare, ability to pay for services, socioeconomic status or education. I have faith that this, along with genetics, determines one’s true risk of a disease, not the amount of melanin that they produce.
I keep on referring to genetics as being the true determinant of a person’s probability of developing a condition, and I have stated that the colour of your skin is also genetic. So, why do I not accept that your skin colour determines the likelihood that you will develop a disease? I say that some genes are stronger than others; you may have inherited a darker skin tone from one parent but gotten protective genes from your other parent. I am reminded of an article I read about a set of fraternal twins, born to an interracial couple, that have opposite skin tones. Yes, paternity was a question initially, but after genetic counselling it was determined that the father of the twins, who is considered black, had European and African ancestry. Combined with the European lineage of the twins’ mother, one child appears black (due to the father’s African heritage) and the other child white (a combination of both parents’ European descent).
To the twin that appears “white,” would one tell him that he is not black because he is not dark enough? Or would one tell him he is black because his father is black? Why should his racial affiliation be a concern or an issue? He is a human being, not a box to be checked on a demographic questionnaire.
Bottom line – I believe that continuing to base medical diagnoses on what is most likely to occur in people with the same skin tone is an advanced practice of prejudice. And just because there are examples that prove the rule more often than not, it’s still not acceptable. I am convinced that the rule is true most of the time because we live in society that has a tendency to repeat a vicious cycle, maintaining certain differences between races. I just hope that eventually we, as inhabitants of the same planet, come to the conclusion that we are all one human family, and that we should focus on what unites us, not what segregates us further.