How to practise medicine in a multicultural society
Sabina Dosani gives some practical advice
You may know a typical Begum. She is an Asian woman suffering from non-specific pains and weakness. When questioned, pains change places. On examination, nothing is apparently wrong. Investigations are normal. Begum comes to casualty with her large extended family who interpret for her, insisting that this is sorted out once and for all. Gynaecologists see Begum and diagnose functional dyspareunia. Perhaps you observed her endoscopy result and were taught about functional dyspepsia. Or perhaps you met her in the professor's neurology outpatient teaching clinic where her numbness disobeyed dermatomes. She visits many different departments and gets increasingly nervous. Doctors become irritated. Students are perplexed. Twenty years ago, someone wrote her up: “The Begum syndrome.”1
Compliance with medication depends on patients' personalities, attitudes, and beliefs, all of which are influenced by culture.
It is 2am. Begum is back. With abdominal pain. The nurses are anxious that she is dealt with