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On Being a Doctor |

Through a Glass Darkly

Tumi Johnson, MD
[+] Article and Author Information

From Gouverneur Healthcare Services, New York University School of Medicine, New York, New York 11217.


Requests for Single Reprints: Tumi Johnson, MD, 413 Pacific Street, Apartment 2A, Brooklyn, NY 11217.


Ann Intern Med. 2010;152(6):400-401. doi:10.7326/0003-4819-152-6-201003160-00013
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The first time I heard the term “neglect” regarding an African mother was during my work in Niger, West Africa, as a member of the medical team of a well-respected relief organization. I might have been sitting in one of the weekly meetings at which we had to review the clinic and hospital admission numbers, deaths, and patterns of morbidity and mortality we were seeing. Someone mentioned that the reason a child had died was that “her mother waited too late to bring her in to the hospital.” A few nodded knowingly. A common scenario: Septicemia that began as a localized illness was left untreated and, given the rich medium of a malnourished child's immunosuppressed state, had become a widespread ticking time bomb. The physician or nurse in charge could not be blamed for such a death. The child simply arrived too late. Implicit in the statement, in the reassuring head bobs and shakes, was the understanding that the mother had come too late. Regardless of whether we wanted to admit it, someone was getting blamed, and it was not us.

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