CHAPTER 14

Culture and Diversity

Mr. Jackson is an African-American man in his 50s, known to the staff in the clinic as a difficult patient, not because he is angry or disrespectful but because his health only worsens and never improves. The clinicians and nurses in the office try to treat him with kindness but never seem to be able to get past what they perceive as his “disengagement.” Dr. Barrett, Mr. Jackson’s primary care clinician, feels resigned and sometimes hopeless. Though Dr. Barrett would never openly criticize him, she privately wonders whether Mr. Jackson just doesn’t care about his diabetes, hypertension, and chronic kidney disease. Whenever Dr. Barrett asks her patient, “Do you have any questions about your health?,” the answer ...

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