The case resumes three years later. Clyde tried to take the diabetic medications faithfully, but had less success in controlling his weight and exercising. In the past year he stopped going to the health centre for his blood glucose levels because they always told him it was bad — too high. In the past six months he has been feeling increasingly unwell, with numbness and shooting pains in his legs. He was unable to take a construction job because he felt weak and dizzy. He has been drinking more alcohol as well, and Amy has been worried about letting him look after the younger children. Two weeks ago, Amy noticed a sore on Clyde’s lower left leg that looked infected. She persuaded him to see the nurse.
Part 3, A
Clyde is found to have peripheral neuropathy, hypertension and renal insufficiency, all complications of his diabetes. The physician decides that Clyde needs to go to the medical centre for assessment and treatment so he is flown there and admitted. The resident responsible for his care speaks to his supervisor about Clyde.
As you watch the next scene, look for examples of:
- Ethnocentrism in a medical culture (e.g., the way we do things is the right way)
- A “blame the victim” approach
- Learner-centred teaching
Part 3, B
In this scene, Dr. West and Keith talk about Clyde. Note the similarity in Dr. West’s approach to teaching to that of the patient-centred model. Analyze the conversation regarding the following techniques and/or styles:
- Questioning style
- Listening style
- Information gathering
- Information giving
- Integration of biomedical and psychosocial information
Part 3, C
The case continues
Dr. West suggests that Keith talk to the hospital’s Indigenous interpreter.
- Why does she do this?
- If she knew anything about Clyde’s life, why did she not tell Keith herself?
Analyze this conversation. For instance, note the difference in worldview in Keith’s first statement and that of the interpreter.
Continuing Keith’s education, Dr. West models patient-centred behaviours in talking to Clyde. Again, analyze this conversation and note the non-verbal behaviours of all three.
Clyde returns to the reserve and takes up his life helping his mother with the younger children. Spring weather improves and a few weeks after his return, Amy calls on her friend Christine, who is the community health representative.