A CLAS ACT — BREAKING BARRIERS in CULTURALLY and LINGUISTICALLY APPROPRIATE STANDARDS
A practical guide to helping patients from other cultures and languages
by TOM JAMES , MD
It was a huge leap for me coming from medical school in Lexington to residency in Philadelphia . After residency , my National Health Services Corp experience was in South Philadelphia . I made house calls in the Italian neighborhood east of Broad Street . These were the row homes with the “ good furniture ” covered in clear plastic sheeting so the sofas and chairs would not get dirty or worn . My elderly patients who emigrated from Italy or Sicily did not speak English — at least not to me . I depended upon the children or grandchildren to communicate . Capisce ? Coming into these homes required that I nod my head in deference to all of the elders and take my time for espresso and an Italian pastry before I could start my American history , physical , assessment and prescription before saying Ciao . A 15-minute visit really took 45 minutes .
Then , I ’ d drive across Broad Street to the West into the Black community where my NHSC office was . For two years in the South Philadelphia Medical Center , I was the only white practitioner . The patients there did not stand on ceremony in the office . I could be relaxed there . I could not be judgmental when patients told me of receiving Mississippi clay sent from family down South , as that was better eatin ’ clay than Philadelphia street dirt . With time , my patients would bring me sweet potato pie , collards and chitlins . It was an honor to be asked to go to church with them as many of my patients were parts of gospel choirs , and these patients were generally very
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