When a “foreign” element is introduced into the medical context, it can challenge expectations, assumptions, and even procedures. That element can be a patient or doctor from another country or culture, a foreign language, or even a medical condition that is alien to traditional medical approaches. And for patients, of course, the very experience of being ill can be utterly foreign and destabilizing. This month’s issue explores what happens when these unfamiliar elements appear on the medical scene.
The communication gulf is not only one of language, but also one of culture, understood broadly. And, despite the priority of medical concerns, every effort should be made to obtain consent consistent with appropriate care.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”
An undercurrent in all debates about allocation of health care resources to the poor is the matter of access to and coverage of health care for immigrants, particularly low-income and undocumented ones.