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A Piece of My Mind
July 9, 2020

Good for Us All

Author Affiliations
  • 1Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 2Division of Gastroenterology, University of Washington School of Medicine, Seattle
JAMA. Published online July 9, 2020. doi:10.1001/jama.2020.12630

I began my second year of gastroenterology fellowship after logging hundreds of procedures, scoring high marks in peer and patient reviews, and developing a reputation as a strong endoscopist and clinician. I was proud of my progress but was even more thrilled to no longer carry the department’s on-call pager every other night. One day while rounding on the transplant hepatology service, I met a patient who prescribed me an awkward dose of reality.

That day began like any other. The patient’s primary physician led the conversation while I listened, took notes, and placed electronic orders. Having gotten good news about a pending liver transplant, the patient was in good spirits and insisted each person introduce themselves by name, title, and role. After every introduction, the patient effusively said, “Nice to meet you Dr X. Thank you for taking care of me.”

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    2 Comments for this article
    Monica Carsky, PhD | Weill-Cornell Department of Psychiatry, Personality Disorders Institute,
    Dr Issaka has my appreciation for sharing her experience and contributing to our awareness.
    Hopefully, were such a situation to recur, the attending would take the responsibility to call out the microaggression.
    Specific Scripts Help
    Kenneth Certa, MD | Department of Psychiatry and Human Behavior, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia
    Thanks to Dr. Issaka for sharing these memories and thoughts, even though it is cringe-inducing. I would hope that we all would be quick to jump in to try to salvage the interaction, but it is not easy to think in the moment.

    I appreciate the replies listed to common forms of (not so) micro-aggressions which can occur in clinical settings. I will file them away.

    For the situation described, which is not uncommon, I hope I would have thought to say "You mean good for us, and for you. Dr. Issaka is a great member of our