Friday, July 27, 2012

Tales from Residency: Senegal

When I was doing primary care clinic as an intern, I once had a patient who was a recent immigrant from Senegal and only spoke Senagalese.

As the nurse handed me the chart, I looked at the name and saw that the first name was different from the name on my patient list. I asked the nurse about this and she said, "Oh no, I gave you the wrong patient!"


It turned out there were two sisters from Senegal and both needed physicals. One patient was for me and one was for Virginia, another intern.

The patient didn't speak even a word of English. I called up the translator services and actually managed to get a Senegal translator. Yay. I started asking the usual routine history and physical questions and found out that this woman had been told by "some doctor somewhere" that she had "anemia and a fast heart beat."

"Do you have any documentation of this?" I asked.

She told me that she did have papers from the doctor, but her sister had the papers. Her sister was in the next room with Virginia, but they hadn't reached a translator yet, so I couldn't ask for the papers myself. So I brought my patient to the next room and she asked her sister for the papers herself. After they talked for a minute, no papers had been produced. So I brought my patient back to the examining room to figure out what happened through the translator.

Apparently, the BROTHER had the papers and he was out in the waiting room. OK, so now we had to go out to the waiting room and locate her brother. A man stepped forward who seemed to know my patient and they talked for a minute. The man didn't speak any English either. No papers were produced.

A nurse passed by and said to me, "If you're looking for her brother, Sam is examining him right now." (Sam was one of the residents)

I was completely confused now.

I brought my patient back to my examining room and knocked on Sam's room. When I opened the door, I saw Sam talking to a patient through the translator phone who looked a lot like my patient. I told Sam I needed his sister's papers.

Sam to the translator phone: "Can you ask him if he has any of his sister's papers? This other doctor needs them."

Translator: "What?"

Sam: "He has some of his sister's papers."

Translator: "What? You're breaking up!"

Finally, I brought my patient into the room so that she could ask her brother for the papers. But when my patient saw Sam's patient, it turned out they didn't know each other. "I'm from Sudan," Sam's patient said.

"Great," Sam said, "now we seem really racist."

I gave up on finding these mysterious papers. I attempted to get more of a history from the translator phone, but it wasn't easy. She told me that she thought maybe she had hepatitis, but then the translator said: "No, not hepatitis. Jaundice. Are those different?"

And she was taking some medication for the anemia. Maybe iron. She wasn't sure and she didn't have the medication with her. Where was it? Her brother had it (of course).


  1. Psht. Obviously all countries that start with the letter "S" are really the same place. God Fizzy. Don't you know anything?

  2. How were these Senegalese able to immigrate to the US in the first place? I immigrated here in 1995 with a Master's Degree, a firm job offer, and another company that wanted to poach me, and it still took four months to get my visa approved.

    1. Along with illegal immigration, US is also a hotspot for refugees.

  3. Senegalese is not a language.

  4. "Great," Sam said, "now we seem really racist."

    Umm, wha? How the heck is that even remotely racist??

    1. I guess b/c it looked like we thought all African people were related.

  5. Don't most Senegalese speak (at least a bit of) French?

    1. I'm not an expert on Senegal. I think I just told the translator phone that my patient was from there. I have no clue what they were speaking.

  6. Not that it would have likely helped in this particular instance, but situations like that (sketchy medical history due to confusion, lack of compliance, specialists sending information to outdated primaries, etc. etc.) would be so much improved with a comprehensive electronic medical record that could be accessed by physicians. So much time gets wasted, inpatient especially, with docs and nurses trying to do detective work on what the heck people's bodies have been doing over the course of a lifetime. Even people who are "with it" forget this condition or that over the years. Not that I relish the thought of the feds potentially having access to private pt. information for insurance reasons, but in this day and age, there's really no excuse for a doc to be given an incomplete or inaccurate PMH. (sorry for the tangent, just a pet peeve of mine)

  7. I'm still stuck on the disposition - was she actually anemic, tachy...? Lol...