When I was on my Junior Surgery rotation, we had a 94 year old lady who presented with Stage IV breast cancer after having had a mastectomy for cancer in the other breast.
The tumour this time was a rock solid, fungating mass that had already changed colour, and I had to wonder as I often did and will how a patient waits at home for their situation to deteriorate this badly before coming to the hospital. Breast cancer is a terrible thing – any illness is. But patients keep presenting at such late stages, all hope is almost lost.
Just like the countless diabetic patients who present with severely infected feet days or weeks after the initial problem. Sometimes they show up so late, the only option is to amputate the limb.
We have this pervasive culture of “I going to watch it likkle first” whenever we see something going wrong. Then we sit and watch and watch until it becomes so much bigger than anything we thought we could handle. Like another patient who had to piece together brassieres to fit her growing tumour until she finally presented with one breast twice the size of the other.
I don’t know if it stems from the general antipathy toward doctors that we have as a nation (especially Jamaican men!) or if it is just that we underestimate the problems we are faced with. Jamaicans do have a tendency to put troublesome things out of their minds until we can bear it no longer.
Whatever the reason, we need to stop it. The business of healthcare is prevention, not intervention. Doctors don’t want to have to cut the foot off. Or remove the breast. We want you whole and healthy and happy.
But your health is your responsibility.
2 thoughts on “An Aside on Jamaican Culture (potentially upsetting imagery)”
Wow! It sounds like your country is so much like mine! Last year I rotated through head neck and breast surgery and saw SO many cases like this. On urology I had a patient who had had an enlarging testicular tumour for more than two years and only presented to us when the skin started fissuring (and the tumour was about the size of a soccer ball, I kid you not). My dad, who did a course on medical sociology at university, says it’s something about the idea of hospitals as a place where people go to die rather than to live. Sounds like a class I would like to attend. Really enjoying your blog!
Medical sociology sounds fascinating.
Recently, I had a patient with a similar case! Only it was a benign tumour of the radius. Same two year history of a growing mass! We could swap stories all day, haha.
Thanks for commenting! :)