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Matters of the Heart

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Mom whispered to me from her hospital bed, her eyes bulging with urgency, Something is not right. I've been in pain all night.

Just a few weeks earlier, she had some heart palpitations and was admitted to the hospital for a routine work-up. The news came back that all of her test results were normal. But now her body appeared tense; she looked panicked and afraid. At her bedside, the attending physician suggested endoscopy, offering that her pain may be related to a gastrointestinal condition.  I introduced myself immediately as a medical student and quickly advocated for a consultation with a cardiologist.

I shared that a few months prior, she had been rushed to this same hospital by ambulance with idiopathic ventricular fibrillation. The attending shook his head. He started moving toward the nurses' station and I followed behind.'  He reviewed her case with me again and then he shouted, 'Endoscopy!' I said, 'Cardiology consult.' Trembling with fear, I left quickly, without waiting for a response.

For a medical student, learning to observe in clinical settings is a skill that comes with practice and time as well as teaching.'  Furthermore, practicing medicine well involves seeing the whole patient, looking beyond the chart to examine the situation. My concerns about Mom were influenced by both my first-hand knowledge of her complaints over time but also concerns about being sure that as a black woman she received the best care.'  The recently released book by Dr. Augustus White, Seeing Patients: Unconscious Bias in Health Care offers the following:

'the race and sex of patients [influences] physicians' decisions about whether to refer patients for catheterization If you were black, the report concluded, you were less likely to be referred.  If you were a woman, you were also less likely to be referred.'  And if you were a black woman, you were especially less likely to be referred.

As I sat outside trying to figure what my next steps would be, my phone rang. It was the nurse, calling to tell me that the attending had in fact agreed to the cardiology consult. I returned to our house to care for my grandmother. In the absence of my mom, she had no caregiver.  In the afternoon the cardiologist called me to express his concern with mom's condition. He recommended, pending insurance approval, that she be transferred to another hospital with full cardiology services for more tests and further observation.

Mom was transferred that night. Additional test results showed significantly blocked coronary arteries. Early the next morning, she had cardiac catheterization to open her blocked blood vessels. After a short hospital stay, she returned home.

As an African American woman training to be a physician, I was glad to witness good medicine, as well as Mom's progress.

 

More Blog Posts by Katherine Ellington

author bio

Katherine Ellington is a medical student and writer. Her work has been featured in The New Physician magazine, at KevinMD.com and she blogs at World House Medicine. This post is the second in a three-part series; read the first post here and the second here.


Tags for this article:
Heart Disease   Health Care Access   Katherine Ellington   Make Good Treatment Decisions   Health Disparities  


Comments on this post
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googinup says
April 18, 2013 at 7:44 AM

The heart is one of the main organs in the body. If the heart problems comes, the entire body is at risk. By finding these problems and solve them, The Best Cardiologist are help to people fix these issues. These are also help people learn about ways to obtain better heart . There are many things that can go wrong with the heart. Some of the very serious issues include heart disease and heart attacks.
The heart is a muscle that squeezes blood and functions like a pump. Each part of the heart is susceptible to failure or dysfunction and the heart could be divided into the mechanical and the electrical.
The electrical part of the heart is centered on the periodic contraction (squeezing) of the muscle cells that is caused by the cardiac pacemaker located in the sinoatrial node. The study of the electrical aspects is a subfield of electrophysiology called cardiac electrophysiology and is epitomized with the electrocardiogram (ECG/EKG). The action potentials generated in the pacemaker propagate throughout the heart in a specific pattern and is the system that carries this potential is called the electrical conduction system. Dysfunction of the electrical system manifests in many ways and includes Wolff–Parkinson–White syndrome, ventricular fibrillation, and heart block.