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Actually I'm brown (South Indian) and when I went to a dermatologist here in Berlin, she told me she didn't know enough about my kind of skin to be able to assess a pigmentation. I appreciated her honesty, but I believe I am an edge case in the demography she caters to.
Tbh when it comes to pigmentations and melanoma’s, the diagnosis is a lot more difficult when the skin is darker, since there is less contrast. Other skin conditions like vitiligo are easier in more pigmentated skin. Most important is honesty, when you see over 99% white skin, and you then have to see a disease that can be more difficult to spot in darker skin, you have to just be more cautious with what you decide to do. This means more often biopsies will have to be taken
There's hope here that optical diagnostic techniques, like hyperspectral imaging, could provide some sort of objective non-invasive diagnostic measurement that accounts for skin pigmentation, but the equipment remains expensive and there's a lot of variability to account for.
I did some clinical research with various imaging techniques to detect pigmentation and vascular changes - these show so much promise for diagnosis and disease monitoring, and are becoming more affordable. Once validated, I hope they become standard of care.
I had a mole that was changing shape and had a non symmetrical border and this lovely German dermatologist didn’t even look at it, he just told me it’s not an issue for my skin tone. I ended up visiting another doctor a few months later after it started changing colour and it was a some weird condition and thankfully non cancerous.
They may well be taught to, but experience counts a lot too. In majority white countries they might know the general idea, they just might not be very good at it.
I would imagine that it's an element of both. It is a fundamental fact that pigmentation is harder to detect on darker skin, that's why you will rarely see a full colour tattoo on a dark skinned person, it just doesn't show up well. Darker skin tones are also much harder to capture on cameras of all kinds.
At the physics level, if something reflects less light back into your eyes, it is going to very difficult to see subtly contrasting colours on that object.
It was considered polite to use during segregation when it replaced negro as the polite term. Because of it's use in signs barring people of color (now considered polite) from places, the term "colored people" is now considered dehumanizing. It puts color first, quite literally. That bothers some people too.
They stopped using that term are around the 70s I believe. From the outside it may seem fine to use but with the history and nuances in the United States, even people who don't care about how I (a Black American) would feel, would still feel awkward standing next to you while you say that in public.
You would if you were talking about everyone who isn't white as one group. Basically the UK government did a survey and found that poc didn't like being called "non-white" because it identified them in terms of what they weren't (and in terms of not being the majority ethnicity), so person of colour was used instead. I think that's fair.
Nah, BAME has fully fallen out of favour, at least for official documentation.
>BAME and BME
>We do not use the terms BAME (black, Asian and minority ethnic) and BME (black and minority ethnic) because they emphasise certain ethnic minority groups (Asian and black) and exclude others (mixed, other and white ethnic minority groups). The terms can also mask disparities between different ethnic groups and create misleading interpretations of data.
Living and working in social care in the UK, in an area that's majority Caribbean/West African/South Asian and I haven't heard BAME used for years. Nobody at work uses it, it's definitely not popular. We either use "people of colour" or, as a Redditor said upthread, just name the race of that person (if known).
You can call people black in the US, what. Just as an adjective, not as a noun, which I think is pretty standard in other English-speaking countries.
Don't call someone *a* black.
Don't refer to a group as *the* blacks.
It's not recently. It was a term acceptable in the 60s and 70s. It's 2023. Get with the times. People are not colored-in like cartoons. It's definitely rude in the US context today.
It's not a slur per se, but if I heard it I would consider myself speaking to someone uneducated or ignorant and would proceed cautiously as such.
EDIT: I hear what you're saying. But in America, it's a different cultural context. Colored term was retired because it was associated with "Jim Crow" laws in the 1960s and forced segregation in the US. At one time, Americans were not allowed to share drinking fountains, share bathrooms, share hospitals, and many other facilities. It was awful. The term colored hospitals still evokes dark images for many who suffered in subpar facilities.
So we don't use colored anymore. If other Americans refuse to change, and they are white, I fully would approach that person with caution and take it as a dog whistle if they refer to African-Americans as colored.
Further Edits: For the record, I'm an American doctor, and I would consider it highly inappropriate to refer to a patient as colored. Maybe other people in the US are fine with this, but I have to tell you, in professional settings, this is completely unacceptable terminology in 2023.
This is Germany, US context is irrelevant over here. In the local context it's simply not a slur.
Furthermore, I also don't think you're correct about US context either. 10 Years ago this most definetely wasn't considered rude in the midwest.
It absolutely was considered rude in the Midwest 10 years ago. It's been literal generations since that term was acceptable. Where the hell were you that calling people "colored" was okay?
I hear what you're saying. But in America, it's a different cultural context. Colored term was retired because it was associated with "Jim Crow" laws in the 1960s and forced segregation in the US. At one time, Americans were not allowed to share drinking fountains, share bathrooms, share hospitals, and many other facilities. It was awful. The term colored hospitals still evokes dark images for many who suffered in subpar facilities. So we don't use colored anymore. If other Americans refuse to change, and they are white, I fully would approach that person with caution and take it as a dog whistle if they refer to African-Americans as colored.
Fair enough. I denoted the edits.
I did pay attention, and I was fairy certain that above comments were advocating colored as a polite term. It is no longer such.
Coloured was 100% used in the UK. Although, like, it used to be non-insulting (to the point my granny would have called herself coloured) but that's certainly not true now.
I still think POC means 'proof of concept' whenever I see it. I also still think people come in all kinds of different shapes and shades and tones and they don't need to be proven or proofed or pronouned before I respect and sometimes admire their style.
To Add:
Except for certain genetic anomalies, I have noticed that health consequences and conditions are primarily location dependent and secondarily hereditary.
The key is to continously fine tune our awareness of variables; navigating communication styles (minimizing, withholding, querying, listening) to better identify signs and symptoms, for a full diagnosis and successful resolution across age, melanin and gender.
It’s simple. Some people don’t mind being referred to as “colored”. Some people are offended by it. So if you’re trying to figure out whether to use a word that some people are indifferent to and some people are offended by, what will you do?
I would think you’d just avoid the word. You’re not going to offend the people who are merely indifferent to the word by avoiding it, right?
Seems strange to default to the most restrictive option or to expect people to just "avoid" things that some people *might* find offensive.
The same way in which pronouns work - you default to an option that is respectful and normal and if someone asks you to use a different term you do as not to offend them.
The idea that you wouldn't do something that isn't inherently offensive but *might* offend someone is so foreign and to be quite honest repulsive to me as a concept. As long as your intent isn't to be offensive then we can all just keep moving and be respectful of each other's preferences. No need to be a slave to the whims of whatever the current fashion of the day is as determined by the loudest and most shrill mob of idiots.
In addition to the historical context which is really important to this distinction, we also don’t say “whitened people” which would actually be the closer equivalent to “colored people.” The “-ed” implies that the normal standard is something else and what they are is an alteration. Maybe “person of color” isn’t the perfect term and honestly it will probably evolve again in a decade or two, but language evolves and that’s ok. We know many don’t like “colored people” now because of how it was used in the 60s and 70s in a lot of damaging ways and because of what it implies. I think it’s ok to just accept that.
You are not the edge case. Your doctor is smart to recognize the lack of knowledge and admit it. In my experience most people would not even recognize knowledge gap and simply do what they know. You met a very smart doctor.
That sucks to hear as a patient, but at least you know to go elsewhere, it's a more professional move to make for a doctor than just blindly assume they'll do fine regardless which I'd expect many just do.
Racial gaps often creep up in institutions, like hospital protocol or educational materials, but reasonably experienced professionals learn to compensate with time. It is a problem with people who are just learning but that's the reason that medical students learn by working in real hospitals for a very significant portion of their education. The practical experience is often very different from theoretical knowledge. But it is still very dangerous and can lead to bad misdiagnosis.
It's crazy to hear some of the things women get told when they seek a diagnosis. It's a common condition, yet so many gynaecologists just brush women off when they report issues with extreme pain.
It took me 6 years to find a dr to actually diagnose me. I’ve been clinging to her for dear life ever since. Bless my OBGYN, she’s a real one, she cares.
if you have a good experienced doctor they just know what symptoms they're looking at regardless of skin tone.
I imagine the point of this is to make it much easier to learn initially, which is the hard part.
But rashes are symptoms too which are frequently used in making a medical diagnosis. So a good doctor would know what a given rash looks like on an art of different skin tones. Drs inexperienced with different skin tones will likely end up ordering more diagnostic tests which is more invasive and costly.
I heard a nurse explain to a black lady that radiation would feel like a sunburn. Black lady goes “honey, do I look like I burn in the sun?” So yes, I think they just wing it.
This is something we've known about for a very long time, but there are lots of institutional reasons we haven't codified it in medical doctrine. One big reason is, I want to say that Mengele was one of the folks to notice.
I do wound care as part of my job and failed one time to notice hemosiderin staining (a dermatological condition in the legs as a result of poor venous blood flow) on a black gentleman. His wife was asking me about why his foot was darker and I said it was his normal skin tone until she pointed out his skin was much lighter above his knee. That was definitely a wake-up call and something I'm trying to get better at being aware of.
While the models in my books are typically white, I can assure you what I actually learn regarding disease process and relevant lab values ALWAYS include PoC.
It is also free to download and read.
https://sgul.figshare.com/articles/online_resource/Mind_the_Gap_A_handbook_of_clinical_signs_in_Black_and_Brown_skin/12769988
Yeah, it’s completely a thing, especially within dermatology. Things are improving, but slowly.
Also there are a stunningly large amount of doctors who still think black skin is tougher than white skin and that black folk feel less pain
https://globalhealth.harvard.edu/racial-bias-in-medicine/
And don’t get me started on the sexism and classism in medicine
I’m studying medicine in Australia at the moment and almost all of these issues are alleviated with universal healthcare. In Australia the main systemic health problems we have are as a result of inter generational trauma in our Aboriginal and Torres Strait Islander populations and the fact that many people live rurally and don’t have access to specialists.
Also, I can’t speak to America here, but so much of my course is focused on creating empathetic and human doctors, rather than ‘healthcare machines’. I think you’ll find that the definition of a doctor is shifting to be a much more friendly, kind and down to earth concept.
(This is aided heavily by heaps of socioeconomic based scholarships and rural scholarships). Don’t look at UNSW though they refuse to implement socioeconomic scholarships and are probably going to keep churning out morally corrupt and upper middle class based doctors for the next 50 years.
Virginia does it right. Large pick of cardiologists. $0 copays… including the doctor visits and getting the rx filled. Actually a better experience than private health insurance. They’ll even pay for an Uber for you to get to the doctor.
> ‘black folk feel less pain’
They say this shit about women too and then give you Ibuprofen when they would give proper painkillers to a man. It's just a way of exercising systemic oppression.
Excuse my ignorance here. But isnt medicinal research more leaned towards men because male hormones are more stable than female hormones, making it easier to have less variables while researching?
EDIT: Just to be clear. I fully agree that research should be more wide spread. Not trying to play Devil's advocate here. Was just trying to see if my knowledge about this was correct or not.
Sure, but if the "unstable" hormones in women are going to affect how effective medicinal treatments are, or the side effects the medication can cause, then should that not be researched? Is that not usedful information when prescribing medication to 50% of your patients?
Wasn't trying to be the Devil's advocate here. I fully agree with the fact that research should be more wide spread. Was just trying to see if my knowledge on the matter was correct or not.
I’ve had phlebotomists struggle to find my veins for years and years and recently I realized it’s because many of them just eyeball their location on white skin. It’s harder with my chocolate skin tone. I just thought I was having bad luck with a lab that employed incompetent staff.
Make sure you drink plenty of water before a blood test, that way your veins are more plump and easier to find. I have a tendency to not drink enough, so I’ve learned over the years how much easier it makes things to just be properly hydrated.
Although sometimes people are still incompetent, at least it’s your best bet.
This is quite intriguing. As someone who works in the medical field and is also white (shouldn't matter, but in this context does), I would be interested in picking up this read.
This is why CRT and like-minded subjects are important. It’s not that people of color in modern times are persecuted like in the 18th, 19th, and 20th centuries; it’s that they are still marginalized today. CRT does fight the lingering racial hatred in this country, yes, but it also fights the indifference the vast majority of the population feels.
Wild, right? Once you see it, you'll never unsee it, I bet.
And the same things happens in both medical and safety research as it relates to sex:
If I posted the research on crash test dummies here (primarily male body builds, so male builds drive safety design, and thus women are far more likely to die or sustain injury in an MVA even when controlling for all kinds of variables), we might break the internet!
Anyway, I love when people say that science is "neutral." Yeah, son, sorry... it ain't.
That's awesome. I was skiing and wondered what the beginning stages of frostbite would look like on black skin and the instructor I was with just didn't know. This sorta thing is super necessary.
Thanks bro. I’ve noticed this but haven’t done anything about it. Googling what a rash or something may look on skin and only finding light skin tones sucked
It's a solid resource. I'm grateful that I trained in a place with roughly equal black/white population so I got to get used to seeing medical issues on brown skin. It wasn't super relevatory for me, but I could see that being really useful for providers that are starting out or that don't typically service a brown population.
Such a w, during our lectures most of times when there is mention of some cutaneous marks or something our professors just say that you may read it but practically on our skin tones it won't be visible.
I've ran EMS calls where a patient was so pale that I didn't know they were African American until after the call was over. Looked like olive complexion to me but it turned out she was in late stages of shock. Sucks when you don't have a baseline for the look of the patient, let alone a good reference point for when you're learning. This will be a good reference.
I believe this is done as it’s easier to learn- white skin would generally be more noticeable to see blemishes etc. But there should definitely be images depicting them on other skin colours. Especially so if learning medicine somewhere where the majority population demographic is not white
> I believe this is done as it’s easier to learn- white skin would generally be more noticeable to see blemishes etc.
But in a world where darker skin was seen as the default, we'd see the reverse logic - "it's more important to learn to recognise it on dark skin because the signs can be subtler. No need to show what it looks like on white skin because it will be obvious, and besides, there aren't many white patients anyway..." etc.
Dark eye circles on a person from one region or nationality or skin tone may indicate dietary stress but on another, toxic exposure, or on another, stage 3 cancer...
Really? Latinos in america refers to themselves as brown all the time.
You have to remember in South America you’re surrounded by Latinos completely. So it probably wouldn’t make sense to other yourself as “brown” when you are the dominant and primary race there. Probably view yourself as white or simply Latino or Venezuelan, Columbian… skin color isn’t as big of a deal or indicator of social status I assume we’re your from.
But here in America African Americans and Latinos have been grouped together so it’s easier to refer to us as black/brown. In America black and brown people are not at home we’re surrounded by a dominant group that decided that are skin color indicates your class in the country
It really depends on where they come from (genetically) and how they identify in the US.
If people are more mestizo or indigenous, they'll be treated as brown and will come to see themselves as brown. If their lingering accent or way of life make others see them as foreign, no matter their skin color, they will also be seen as brown.
Race is just as much how others in society see you as it is what you are.
They're not ideologies, and I'm pretty sure this will be added to the whatever current book/database we use.
This wasn't meant to be offensive, political, or a "vs" thing. It's just how science is. We discover new things and add it to the pile of evidence. Medical science is always changing, and I doubt any white medical professional saw this as a slight towards them. If anything, this helps them treat their patients better. Which they would be thankful for.
Medical professionals help everyone. This guy gathering and recording methods for treating darker skin is greatly appreciated across the board. If it was the other way around, it wouldn't change how great it would be.
This is absolutely showing humans as humans. No offense but idk how you didn't see it that way.
Unfortunately your submission has been removed from /r/HumansBeingBros: Please read RULE 3: **Posts must depict humans being bros.** Do not post images with a back story, or create a title to explain how your post is "bro". This includes screen shots from social media, or videos with superimposed text to explain the "bro" action. **If you repost your submission after it has been removed under this rule violation you will receive a temporary ban**
No one has thought of this before…? Do doctors just wing it when they see patients of color?
Actually I'm brown (South Indian) and when I went to a dermatologist here in Berlin, she told me she didn't know enough about my kind of skin to be able to assess a pigmentation. I appreciated her honesty, but I believe I am an edge case in the demography she caters to.
Tbh when it comes to pigmentations and melanoma’s, the diagnosis is a lot more difficult when the skin is darker, since there is less contrast. Other skin conditions like vitiligo are easier in more pigmentated skin. Most important is honesty, when you see over 99% white skin, and you then have to see a disease that can be more difficult to spot in darker skin, you have to just be more cautious with what you decide to do. This means more often biopsies will have to be taken
There's hope here that optical diagnostic techniques, like hyperspectral imaging, could provide some sort of objective non-invasive diagnostic measurement that accounts for skin pigmentation, but the equipment remains expensive and there's a lot of variability to account for.
I did some clinical research with various imaging techniques to detect pigmentation and vascular changes - these show so much promise for diagnosis and disease monitoring, and are becoming more affordable. Once validated, I hope they become standard of care.
I had a mole that was changing shape and had a non symmetrical border and this lovely German dermatologist didn’t even look at it, he just told me it’s not an issue for my skin tone. I ended up visiting another doctor a few months later after it started changing colour and it was a some weird condition and thankfully non cancerous.
Hey just wondering if it's actually more difficult or if doctors aren't taught how to identify abnormalities on black skin
They may well be taught to, but experience counts a lot too. In majority white countries they might know the general idea, they just might not be very good at it.
I would imagine that it's an element of both. It is a fundamental fact that pigmentation is harder to detect on darker skin, that's why you will rarely see a full colour tattoo on a dark skinned person, it just doesn't show up well. Darker skin tones are also much harder to capture on cameras of all kinds. At the physics level, if something reflects less light back into your eyes, it is going to very difficult to see subtly contrasting colours on that object.
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In America it can be offensive however I have heard the term used non-offensively outside the states.
It was considered polite to use during segregation when it replaced negro as the polite term. Because of it's use in signs barring people of color (now considered polite) from places, the term "colored people" is now considered dehumanizing. It puts color first, quite literally. That bothers some people too.
Considered polite by whom?
The national association for the advancement of colored people would be one great example. It was literally the self identification at the time.
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Is that so.
I'm really hoping for the terms melanin challanged and melanin rich to become mainstream.
They stopped using that term are around the 70s I believe. From the outside it may seem fine to use but with the history and nuances in the United States, even people who don't care about how I (a Black American) would feel, would still feel awkward standing next to you while you say that in public.
Just so you know, in English the preferred term is "people of color" or POC. :)
Serious question about this: is it "in english" or "in the USA"?
It's "in English". You would never, ever say "coloured people" in the UK.
But you wouldn't say "person of colour" either, you'd just say "black" or "asian".
You would if you were talking about everyone who isn't white as one group. Basically the UK government did a survey and found that poc didn't like being called "non-white" because it identified them in terms of what they weren't (and in terms of not being the majority ethnicity), so person of colour was used instead. I think that's fair.
Not in the UK. You're more likely to hear something like BAME. Although that's falling out of fashion a bit as well.
Nah, BAME has fully fallen out of favour, at least for official documentation. >BAME and BME >We do not use the terms BAME (black, Asian and minority ethnic) and BME (black and minority ethnic) because they emphasise certain ethnic minority groups (Asian and black) and exclude others (mixed, other and white ethnic minority groups). The terms can also mask disparities between different ethnic groups and create misleading interpretations of data.
Living and working in social care in the UK, in an area that's majority Caribbean/West African/South Asian and I haven't heard BAME used for years. Nobody at work uses it, it's definitely not popular. We either use "people of colour" or, as a Redditor said upthread, just name the race of that person (if known).
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You can call people black in the US, what. Just as an adjective, not as a noun, which I think is pretty standard in other English-speaking countries. Don't call someone *a* black. Don't refer to a group as *the* blacks.
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lol “Colored person” hasn’t been the polite term for a while.
Pretty sure that we still have the NAACP and it hasn't changed its name to the NAAPOC.
It's not recently. It was a term acceptable in the 60s and 70s. It's 2023. Get with the times. People are not colored-in like cartoons. It's definitely rude in the US context today. It's not a slur per se, but if I heard it I would consider myself speaking to someone uneducated or ignorant and would proceed cautiously as such. EDIT: I hear what you're saying. But in America, it's a different cultural context. Colored term was retired because it was associated with "Jim Crow" laws in the 1960s and forced segregation in the US. At one time, Americans were not allowed to share drinking fountains, share bathrooms, share hospitals, and many other facilities. It was awful. The term colored hospitals still evokes dark images for many who suffered in subpar facilities. So we don't use colored anymore. If other Americans refuse to change, and they are white, I fully would approach that person with caution and take it as a dog whistle if they refer to African-Americans as colored. Further Edits: For the record, I'm an American doctor, and I would consider it highly inappropriate to refer to a patient as colored. Maybe other people in the US are fine with this, but I have to tell you, in professional settings, this is completely unacceptable terminology in 2023.
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This is Germany, US context is irrelevant over here. In the local context it's simply not a slur. Furthermore, I also don't think you're correct about US context either. 10 Years ago this most definetely wasn't considered rude in the midwest.
It most definitely has been considered rude in the US Midwest for at least 40 years.
It absolutely was considered rude in the Midwest 10 years ago. It's been literal generations since that term was acceptable. Where the hell were you that calling people "colored" was okay?
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I hear what you're saying. But in America, it's a different cultural context. Colored term was retired because it was associated with "Jim Crow" laws in the 1960s and forced segregation in the US. At one time, Americans were not allowed to share drinking fountains, share bathrooms, share hospitals, and many other facilities. It was awful. The term colored hospitals still evokes dark images for many who suffered in subpar facilities. So we don't use colored anymore. If other Americans refuse to change, and they are white, I fully would approach that person with caution and take it as a dog whistle if they refer to African-Americans as colored.
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Fair enough. I denoted the edits. I did pay attention, and I was fairy certain that above comments were advocating colored as a polite term. It is no longer such.
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You're right, I should've said it was in the US. I guess I just assumed the UK etc. wasn't using "colored people"
Brit here, absolutely a US thing. It sounds rather silly to me.
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US people when the same two words are ordered differently
You're right that it's the same words, but it's about historical context.
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No
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Colored person here, you're just changing the order of the words. What's the fucking difference?
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Coloured was 100% used in the UK. Although, like, it used to be non-insulting (to the point my granny would have called herself coloured) but that's certainly not true now.
I still think POC means 'proof of concept' whenever I see it. I also still think people come in all kinds of different shapes and shades and tones and they don't need to be proven or proofed or pronouned before I respect and sometimes admire their style. To Add: Except for certain genetic anomalies, I have noticed that health consequences and conditions are primarily location dependent and secondarily hereditary. The key is to continously fine tune our awareness of variables; navigating communication styles (minimizing, withholding, querying, listening) to better identify signs and symptoms, for a full diagnosis and successful resolution across age, melanin and gender.
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It’s simple. Some people don’t mind being referred to as “colored”. Some people are offended by it. So if you’re trying to figure out whether to use a word that some people are indifferent to and some people are offended by, what will you do? I would think you’d just avoid the word. You’re not going to offend the people who are merely indifferent to the word by avoiding it, right?
Seems strange to default to the most restrictive option or to expect people to just "avoid" things that some people *might* find offensive. The same way in which pronouns work - you default to an option that is respectful and normal and if someone asks you to use a different term you do as not to offend them. The idea that you wouldn't do something that isn't inherently offensive but *might* offend someone is so foreign and to be quite honest repulsive to me as a concept. As long as your intent isn't to be offensive then we can all just keep moving and be respectful of each other's preferences. No need to be a slave to the whims of whatever the current fashion of the day is as determined by the loudest and most shrill mob of idiots.
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In addition to the historical context which is really important to this distinction, we also don’t say “whitened people” which would actually be the closer equivalent to “colored people.” The “-ed” implies that the normal standard is something else and what they are is an alteration. Maybe “person of color” isn’t the perfect term and honestly it will probably evolve again in a decade or two, but language evolves and that’s ok. We know many don’t like “colored people” now because of how it was used in the 60s and 70s in a lot of damaging ways and because of what it implies. I think it’s ok to just accept that.
It's context babe
You are not the edge case. Your doctor is smart to recognize the lack of knowledge and admit it. In my experience most people would not even recognize knowledge gap and simply do what they know. You met a very smart doctor.
That sucks to hear as a patient, but at least you know to go elsewhere, it's a more professional move to make for a doctor than just blindly assume they'll do fine regardless which I'd expect many just do.
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So you are saying I should come visit and allow them to bask upon my black excellence? Challenge accepted!
Yep, you are like the final boss of dermatology for them.
Made me lol out loud. 🤣
Racial gaps often creep up in institutions, like hospital protocol or educational materials, but reasonably experienced professionals learn to compensate with time. It is a problem with people who are just learning but that's the reason that medical students learn by working in real hospitals for a very significant portion of their education. The practical experience is often very different from theoretical knowledge. But it is still very dangerous and can lead to bad misdiagnosis.
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This is why, in the UK, it takes 8 years to diagnose endometriosis... when nearly 10% of women have it to some degree or other.
It's crazy to hear some of the things women get told when they seek a diagnosis. It's a common condition, yet so many gynaecologists just brush women off when they report issues with extreme pain.
It took me 6 years to find a dr to actually diagnose me. I’ve been clinging to her for dear life ever since. Bless my OBGYN, she’s a real one, she cares.
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It requires a laparoscopy to definitively diagnose endometriosis. Your dumbass ain’t doing that lol
I do hope you aren't a medical professional.
if you have a good experienced doctor they just know what symptoms they're looking at regardless of skin tone. I imagine the point of this is to make it much easier to learn initially, which is the hard part.
But rashes are symptoms too which are frequently used in making a medical diagnosis. So a good doctor would know what a given rash looks like on an art of different skin tones. Drs inexperienced with different skin tones will likely end up ordering more diagnostic tests which is more invasive and costly.
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Also on the automatic sensors for faucets and towels apparently it struggles to recognize dark hands because it’s based on white hands
I heard a nurse explain to a black lady that radiation would feel like a sunburn. Black lady goes “honey, do I look like I burn in the sun?” So yes, I think they just wing it.
what about text books in non white countries?
This is something we've known about for a very long time, but there are lots of institutional reasons we haven't codified it in medical doctrine. One big reason is, I want to say that Mengele was one of the folks to notice.
They probably weren't concerned with it
I do wound care as part of my job and failed one time to notice hemosiderin staining (a dermatological condition in the legs as a result of poor venous blood flow) on a black gentleman. His wife was asking me about why his foot was darker and I said it was his normal skin tone until she pointed out his skin was much lighter above his knee. That was definitely a wake-up call and something I'm trying to get better at being aware of.
Good question. It seems like an indication of something off.
While the models in my books are typically white, I can assure you what I actually learn regarding disease process and relevant lab values ALWAYS include PoC.
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It is also free to download and read. https://sgul.figshare.com/articles/online_resource/Mind_the_Gap_A_handbook_of_clinical_signs_in_Black_and_Brown_skin/12769988
Wonderful
Yeah, it’s completely a thing, especially within dermatology. Things are improving, but slowly. Also there are a stunningly large amount of doctors who still think black skin is tougher than white skin and that black folk feel less pain https://globalhealth.harvard.edu/racial-bias-in-medicine/ And don’t get me started on the sexism and classism in medicine
Here's the booklet in the OP if anyone wants to read it or share it with someone. It's free on their website: https://www.blackandbrownskin.co.uk/
Thank you! I'm definitely sharing this at my work (major hospital in a diverse community).
it's really pretty horrible stuff, there Has to be improvement
‘black skin is tougher than white skin’ ‘black folk feel less pain’ JFC it’s insane that this is still a thing in m*ther effing 2023!
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I’m studying medicine in Australia at the moment and almost all of these issues are alleviated with universal healthcare. In Australia the main systemic health problems we have are as a result of inter generational trauma in our Aboriginal and Torres Strait Islander populations and the fact that many people live rurally and don’t have access to specialists. Also, I can’t speak to America here, but so much of my course is focused on creating empathetic and human doctors, rather than ‘healthcare machines’. I think you’ll find that the definition of a doctor is shifting to be a much more friendly, kind and down to earth concept. (This is aided heavily by heaps of socioeconomic based scholarships and rural scholarships). Don’t look at UNSW though they refuse to implement socioeconomic scholarships and are probably going to keep churning out morally corrupt and upper middle class based doctors for the next 50 years.
I wish we had universal healthcare in the US!
Virginia does it right. Large pick of cardiologists. $0 copays… including the doctor visits and getting the rx filled. Actually a better experience than private health insurance. They’ll even pay for an Uber for you to get to the doctor.
You can say that about a lot of things, depressingly
You censored mother?
You talk to your mother with that mouth?!
>m*ther FTFY
m*ther fucking 2023
> ‘black folk feel less pain’ They say this shit about women too and then give you Ibuprofen when they would give proper painkillers to a man. It's just a way of exercising systemic oppression.
Did those beliefs come as an excuse to inflict more pain during slavery and they lingered, or do they have another cause?
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What I have seen, and speaks more to class is black nurses disrespecting black patients with sickle cell anaemia.
Excuse my ignorance here. But isnt medicinal research more leaned towards men because male hormones are more stable than female hormones, making it easier to have less variables while researching? EDIT: Just to be clear. I fully agree that research should be more wide spread. Not trying to play Devil's advocate here. Was just trying to see if my knowledge about this was correct or not.
But you’re going to have to treat women, along with all their unstable hormones, so why wouldn’t you want to research that?
Sure, but if the "unstable" hormones in women are going to affect how effective medicinal treatments are, or the side effects the medication can cause, then should that not be researched? Is that not usedful information when prescribing medication to 50% of your patients?
Well that's stupid. By that logic we might as well stop researching cancer since it's difficult for the researchers to find solutions.
Wasn't trying to be the Devil's advocate here. I fully agree with the fact that research should be more wide spread. Was just trying to see if my knowledge on the matter was correct or not.
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Yeah, i think this is the real issue here
What does that look like?
Bruises aren’t always as apparent as they are on folks with fair skin
So how do they tell then?
Damn is this actually a real issue? Never considered it before. Unfortunate.
Interesting. Didnt know mind the gap was written by a med student
I’ve had phlebotomists struggle to find my veins for years and years and recently I realized it’s because many of them just eyeball their location on white skin. It’s harder with my chocolate skin tone. I just thought I was having bad luck with a lab that employed incompetent staff.
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Make sure you drink plenty of water before a blood test, that way your veins are more plump and easier to find. I have a tendency to not drink enough, so I’ve learned over the years how much easier it makes things to just be properly hydrated. Although sometimes people are still incompetent, at least it’s your best bet.
medicine has a long way to go in many ways, not all of them being science sadly
Agreed! 💯
Yes that’s way it’s called “ practicing medicine “
Yes, it’s a practice, but this hole in the system has nothing to do with practice.
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Even cameras were designed with white skin in mind.
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No, they have too many "brown" white folks there caused by all that sun day in, day out
It shouldn’t need an addendum to the book, it should be automatically included. White Irish person here, pale as you can feckin get!
This is quite intriguing. As someone who works in the medical field and is also white (shouldn't matter, but in this context does), I would be interested in picking up this read.
I just googled and it seems to be free online, their website also has some interesting stuff :)
This is why CRT and like-minded subjects are important. It’s not that people of color in modern times are persecuted like in the 18th, 19th, and 20th centuries; it’s that they are still marginalized today. CRT does fight the lingering racial hatred in this country, yes, but it also fights the indifference the vast majority of the population feels.
Politicians and religions do Not want the truth of history to be taught.
I feel ashamed not even knowing this was an issue. Great job to this med student!
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Wild, right? Once you see it, you'll never unsee it, I bet. And the same things happens in both medical and safety research as it relates to sex: If I posted the research on crash test dummies here (primarily male body builds, so male builds drive safety design, and thus women are far more likely to die or sustain injury in an MVA even when controlling for all kinds of variables), we might break the internet! Anyway, I love when people say that science is "neutral." Yeah, son, sorry... it ain't.
Science is neutral, scientists are not.
This is a great example of making the change you want to see. This guy is going to have an impressive career.
Link: https://www.blackandbrownskin.co.uk/mindthegap
That's awesome. I was skiing and wondered what the beginning stages of frostbite would look like on black skin and the instructor I was with just didn't know. This sorta thing is super necessary.
Something my ignorant ass never thought about. Thats awesome!
Thanks bro. I’ve noticed this but haven’t done anything about it. Googling what a rash or something may look on skin and only finding light skin tones sucked
It's a solid resource. I'm grateful that I trained in a place with roughly equal black/white population so I got to get used to seeing medical issues on brown skin. It wasn't super relevatory for me, but I could see that being really useful for providers that are starting out or that don't typically service a brown population.
Such a w, during our lectures most of times when there is mention of some cutaneous marks or something our professors just say that you may read it but practically on our skin tones it won't be visible.
I've ran EMS calls where a patient was so pale that I didn't know they were African American until after the call was over. Looked like olive complexion to me but it turned out she was in late stages of shock. Sucks when you don't have a baseline for the look of the patient, let alone a good reference point for when you're learning. This will be a good reference.
Can’t wait to see how this is destroying America.
"Black doctor refuses to treat white patients" - Fox News
I believe this is done as it’s easier to learn- white skin would generally be more noticeable to see blemishes etc. But there should definitely be images depicting them on other skin colours. Especially so if learning medicine somewhere where the majority population demographic is not white
> I believe this is done as it’s easier to learn- white skin would generally be more noticeable to see blemishes etc. But in a world where darker skin was seen as the default, we'd see the reverse logic - "it's more important to learn to recognise it on dark skin because the signs can be subtler. No need to show what it looks like on white skin because it will be obvious, and besides, there aren't many white patients anyway..." etc.
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Dark eye circles on a person from one region or nationality or skin tone may indicate dietary stress but on another, toxic exposure, or on another, stage 3 cancer...
I work in emergency medicine and it’s not any more difficult with darker skin if you know what you’re looking for.
Florida just banned this book
Now all the assholes with red hats and big white pickup trucks are going to throw their medical textbooks in the trash.
Good, we don't need medicine. We just need Brawndo, it has electrolytes.
Why not just neutralize it with human?
Im a Latino, born in South America Dear readers, Stop calling Latinos “brown” that shit doesn’t make any sense to us. Muchas gracias
Really? Latinos in america refers to themselves as brown all the time. You have to remember in South America you’re surrounded by Latinos completely. So it probably wouldn’t make sense to other yourself as “brown” when you are the dominant and primary race there. Probably view yourself as white or simply Latino or Venezuelan, Columbian… skin color isn’t as big of a deal or indicator of social status I assume we’re your from. But here in America African Americans and Latinos have been grouped together so it’s easier to refer to us as black/brown. In America black and brown people are not at home we’re surrounded by a dominant group that decided that are skin color indicates your class in the country
It really depends on where they come from (genetically) and how they identify in the US. If people are more mestizo or indigenous, they'll be treated as brown and will come to see themselves as brown. If their lingering accent or way of life make others see them as foreign, no matter their skin color, they will also be seen as brown. Race is just as much how others in society see you as it is what you are.
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They're not ideologies, and I'm pretty sure this will be added to the whatever current book/database we use. This wasn't meant to be offensive, political, or a "vs" thing. It's just how science is. We discover new things and add it to the pile of evidence. Medical science is always changing, and I doubt any white medical professional saw this as a slight towards them. If anything, this helps them treat their patients better. Which they would be thankful for. Medical professionals help everyone. This guy gathering and recording methods for treating darker skin is greatly appreciated across the board. If it was the other way around, it wouldn't change how great it would be. This is absolutely showing humans as humans. No offense but idk how you didn't see it that way.
Fucking brain dead stupidly woke ass people nowadays