Head scarves and scrub caps

IT IS ONE of my first stints in the emergency department as a student, and the sounds of buzzing ambience fill the consult room – a steady purr of voices, the shuffle of footsteps, beeping monitors, ringing telephones. I wait with a distressed patient for the doctor assessing her to return.

“So you’ll be a doctor soon?” she asks. I smile at the prospect. She continues nonchalantly, “It’s because of foreigners like you who are stealing our opportunities, our jobs, real Australians like me are suffering.”

Stunned, I remain silent. She continues with a rising voice and words too strong to be shared here. I consider leaving the room, but remain rooted to the chair. The door opens, heralding the return of the doctor. The patient is immediately silent. A quiet breath of relief escapes my lips.

My supervising medical and nursing team are incredibly supportive and shower me with abundant reassurance when they hear about the incident, stating that the patient can be indiscriminately agitated towards healthcare staff when distressed. My rational inner voice reflects that pain, fear and vulnerability during illness can lead to disinhibited behaviour. However, I cannot suppress a twinge of sadness. Even as I progress slowly and humbly through the echelons of medicine, I have not escaped the weight of prejudice unscathed. Moreover, if my very presence is enough to distress the patient and boil over her frustrations, how can I fulfil my duty of care to her?

The incident soon fades from memory but it does not occur in isolation. In the wards I hear comments by patients about the way I dress, my presumed cultural background and the stereotypes this carries. Initially, I never respond but senior staff do in my place, gently and respectfully. They always take time to discuss with me how I feel thereafter, offering practical advice on such patient interactions. One of my supervisors directs me to the 2016 NEJM article, “Dealing with Racist Patients”, an analysis on ethico-legal and practical issues in such cases which resonates with me as I realise I am not alone. This is a common issue healthcare staff face. My resilience strengthens and I learn how to respond confidently, professionally and with a touch of humour. I learn not to take such comments personally and luckily too, as it would be exhausting.

The silver lining that emerges is my feeling of empowerment. It is refreshing that my colleagues respect and value me on the basis of my professional capability in the clinical sphere and never are my beliefs, way of dress or cultural background scrutinised or belittled. The healthcare facilities where I have undertaken my training have also been very inclusive. Most tertiary hospitals contain prayer rooms, the presence of which is vitally important for me as I pray five times a day. One of the hospitals I have worked at has incorporated the Islamic headdress, the hijab, into their policy for appropriate operating theatre attire. It mentions that a hijab may be worn in theatre, provided that it is laundered and a clean one worn daily, similar to those who wear personal scrub caps. This clause in the policy is encouraging as it demonstrates that staff diversity is recognised and accommodated.

Another inadvertent lesson I have learnt is that my diversity is my strength in clinical practice. On one level, it allows me to be privy to many cultural sensitivities for Muslim patients that will enable me to serve them better. More importantly, perhaps, I am astute towards, and empathise with, patients of a variety of social, cultural and religious backgrounds. This is invaluable as we live in a nation of cultural pluralism. The original owners of this land boast one of the oldest surviving cultural histories in the world. A quarter of Australians were born overseas and almost half of Australians have at least one parent who was a migrant. A medical workforce that is flavoured by this diversity will ensure optimal health outcomes for patients of all backgrounds in healthcare environments that are not biased.

Marrwah Ahmadzai is a final year medical student at UNSW.