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AIBU?

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That consultant said this word...

514 replies

Ozwizard · 16/01/2016 10:57

I went to the hospital to see my results from my consultant. Result of this is that I will have to have surgery that has a six to eight week recovery time. As he was explaining my condition he said that it is very common in " Negroid ladies"!!
The nurse in the room looked at me and shifted uncomfortably in her seat! And I took a second to register if he really did say that. Then I did a nervous laugh and said to him " you must not use that word" he said "what, that is what you are" " what is wrong with Negroid"? I said " stop, use another word". He said " oh I didn't know that Negroid would offend you"
Aibu that he should not have said that word?

OP posts:
kesstrel · 19/01/2016 10:07

But Lweji's point wasn't about speaking TO patients: she said that African doctors writing in medical journals were "ignorant" for using the term.

She also said the term "of African descent" was wrong. How are leaflets and other promotional materials about something like sickle cell anemia (which is a devastating genetic disease) supposed to be phrased?

I agree with you, however, that Lweji is wasting her time, given her obvious ignorance of the important role of genetic knowledge in medicine.

Lweji · 19/01/2016 10:09

Yes there is greater diversity between individuals than any group.
Although true, I didn't mention that, nor is it relevant for this discussion.

There are however obvious and distinct differences between peoples of differing geographies.

That is true.

But for different geographies within Africa as well. There isn't one African type.

Most studies, perhaps not surprisingly, focus on African-American, which should not be extended to "African" or "Black" at all. African-Americans did not come from all African regions. So, it shouldn't be extrapolated to all Africans, or to any "negroid" group.
I'd prefer to be cautious.

Sadly, most research is still very much white-centric. Us and them.

The map shows the main origins of African-Americans. Mostly from West-Africa. We can't extrapolate that the rest of Africa, or people of African roots in other countries have the same prevalence of any condition.

We can't also assume that just because someone looks more black or white that their DNA is mostly of black or white heritage, respectively. Which renders the whole classification into races meaningless.
Particularly at individual level.
Which is another reason for the doctor not to mention race associations to an individual patient. What was it supposed to achieve at this stage?
If he offered earlier diagnosis, then perhaps it would have been relevant.

That consultant said this word...
Lweji · 19/01/2016 10:17

She also said the term "of African descent" was wrong. How are leaflets and other promotional materials about something like sickle cell anemia (which is a devastating genetic disease) supposed to be phrased?

Black Africans do tend for example to have higher incidence of sickle cell anaemia because the gene has spread in regions of high malaria incidence. Where I live there are pockets of higher incidence of genetic blood disorders that also protect against malaria, including sickle cell anaemia.

Those leaflets are relevant because they aimed at a generic group (and malaria is widespread in many African regions, and therefore among different Black African groups (but not only). And they aim at early detection and management.

In this case, for one patient who already needs treatment, the comment about race was irrelevant. What was she supposed to do with it?

What if she actually belongs to a sub-group that has a lower incidence? What if, despite her physical appearance, her genome is actually more "white" than "black"?

I agree with you, however, that Lweji is wasting her time, given her obvious ignorance of the important role of genetic knowledge in medicine.
I'd say the opposite, actually. :)
More that most people are ignoring the role of genetic knowledge in medicine, because they forget to take into account the actual genetic background of the patients.

Lweji · 19/01/2016 10:25

YABVU. I am white therefore I'm Caucasian. You are black therefore you are negroid. The consultant used the anthropological/scientific term for your race as the condition is commonly seen in black/African/Carib -negroid women. The term negroid covers all those ethnicities. What would you have him referred your race as? Am I to be offended if I'm referred to as Caucasian.

What is a "race"?
How do you define it?

While Caucasian really can refer to a fairly genetically close group, the term "negroid" doesn't. It includes very distant genetic groups. More distant between each other than any non-African group.
It is really "white" centred, as in we don't care what you actually look like (apart from dark skin and frizzy hair) or your genetic background is.

It's a shame that Black Africans still tend to be put all in the same bag.

LagoonaBlu · 19/01/2016 10:36

This reply has been deleted

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HelpfulChap · 19/01/2016 10:37

MrsDeVere

Wow. Best I put the word 'lighthearted' in next time.

Nice rant though. Doffs cap.

Lweji · 19/01/2016 10:39

For references about diversity in Africa in relation to the rest of the world:
www.nature.com/nature/journal/v448/n7151/full/nature05951.html

Easier read:
www.sciencedaily.com/releases/2007/07/070718140829.htm

It shows that there is not only greater genetic diversity, but also phenotypic (as shown by skull morphology - who mentioned anthropology earlier on?) in Africa in relation to other regions.

Lweji · 19/01/2016 10:43

Still waiting for kestrel to explain to me the "important role of genetic knowledge in medicine".
I must also inform my colleagues that I won't be giving my lecture on genetic epidemiology, as I'm clearly ignorant about the subject, as determined by a random person on MN.

kesstrel · 19/01/2016 12:27

In this case, for one patient who already needs treatment, the comment about race was irrelevant. What was she supposed to do with it?

I have already said that I understand why the OP reacted the way she did. And my earlier comments about this probably being down to the doctor being a foreign language speaker, possibly newly arrived in the UK, should indicate that I agree that another term should be used.

You are back-pedalling from your earlier assertion that "Doctors shouldn't go on about assigning characteristics to non existent groups", by trying to ref-focus the issue on the narrower question of this particular consultation. Since you concede that the term "of African descent" is relevant with regard to sickle-cell anemia health promotion, I am satisfied that I have made my point.

And I am aoologise that I spoke ill of your professional knowledge; I will leave the professionalism of calling Dr Okogbo and many, many other doctors "ignorant" for others to determine.

Lweji · 19/01/2016 13:34

Since you concede that the term "of African descent" is relevant with regard to sickle-cell anemia health promotion, I am satisfied that I have made my point.

What point is that?
Because, as I explained, not all black Africans will have lived in areas where malaria is prevalent and other groups in other regions may also have mutations that confer some resistance to malaria and cause blood disorders.
Saying of African descent is not the same as attributing a term or a "race" classification as "negroid".
What could be classified as a white person could have African ancestry and be at risk for sickle cell anaemia anyway.

Lweji · 19/01/2016 14:06

Even for sickle cell anaemia, there are different origins for the mutation in different groups. And it's certainly not present throughout Africa.

See map

Also notice that populations with high incidences are not only in sub-saharan Africa, although the vast majority of people will be from there.

Then, each mutation is present in the context of other nucleotide polymorphisms in the gene that seem to lead to variation in how severe the disease may be. For example, the Arabian/Indian haplotype seems to cause a milder form, which is probably why these populations are not targeted so much in campaigns.

www.nature.com/scitable/topicpage/sickle-cell-anemia-a-look-at-global-8756219

And notice how the WHO doesn't attribute race when discussing these issues
www.who.int/mediacentre/factsheets/fs308/en/

That consultant said this word...
DeoGratias · 19/01/2016 14:25

I can't understand if people are disagreeing with me or not. My point a good bit above was that nothing like enough research is being done into how medicines after women v men, aduts v child, different races and that people suffer for that. I presume no on the threads want those of us who advocate for that to stop doing so. I certainly agree race can be hard to define but that would not stop me say putting out leaflets to local Indians (my borough is 25% hindu) about diabetes eg as they get it much more and worse than say my group (white).

LagoonaBlu · 19/01/2016 14:34

deo that is not about 'race' but culture; Indian diet is a lot of white rice. Maybe genetic component...but that doesn't make a 'race'

Equally sickle cell anaemia gives resistance to malaria therefore become prevelant.. Under treated malaria = death of those without SC. This is environmental/socioeconomic/ natural selection...it doesn't make a 'race'.

My family are Black Africans and come from an area with little malaria

LagoonaBlu · 19/01/2016 14:35

Or SC

LagoonaBlu · 19/01/2016 14:35

Geographical/environmental

ilovesooty · 19/01/2016 14:39

I never actually said uppity was racist. It is however surely undeniable that it implies someone is inferior and should know their place.

Lweji · 19/01/2016 14:59

DeoGratias

Certainly all associations should and are looked at in research studies.
What I'm disagreeing is how certain groups are stratified. Race is not a good criteria for stratification because it is an artificial construct for the most part and often ignores the genetic background, which is the important factor there.

Age is clear, as is sex.

But, for studies to be done based on the genetic background, we shouldn't really use race. Instead, the population should be stratified genetically (which is more expensive, but certainly more accurate).

However, rough approximations could be used for implementation of control/surveillance measures, or raising awareness, as they tend to be more simple to use in the community. Or to identify an initial approximation or clue that genetics are involved.

OurBlanche · 19/01/2016 15:00

Oh! I thought 'uppity' meant someone was arrogant, self aggrandising, picky and unpleasant.

So someone putting on airs and graces, being unpleasant and snobbish is uppity - like Hyacinth Bucket.

Lweji · 19/01/2016 15:03

Or in the case of diabetes type II, mostly the environment, which is often defined by culture, and so ethnicity more than genetics (or "races").

OurBlanche · 19/01/2016 15:12

What I'm disagreeing is how certain groups are stratified.

Was anyone stratifying, if so who was high, who low?

I understand what you mean Lweji, but I think you are splitting hairs now. There are morphological differences between 'peoples'. These differences have myriad causes, genetic, environmental, etc.

Even Steven Hawking refers to The Human Race. Stupid, stupid, ignorant man that he is!

Lweji · 19/01/2016 15:26

Stupid, stupid, ignorant man that he is!

Well, in biology yes he is mostly ignorant. Grin

I wouldn't say he's stupid, though.

Lweji · 19/01/2016 15:28

"Stratification" means dividing into categories. Not in up or down.

Sorry, it's probably jargon.

As in a population study we stratify according to sex (male or female --possibly alternatives as appropriate), age (say, 0-4, 5-9, 10-14, etc), social classes, income, and so on.

Lweji · 19/01/2016 15:33

I wouldn't want to be quoted as an expert on theoretical physics (which allows me to say all sort of crap on muons and flavoured quarks, strings, black holes and neutrinos), so I don't think Hawking should be quoted as a source of biological knowledge either.

MrsDeVere · 19/01/2016 15:36

This reply has been deleted

Message withdrawn at poster's request.

OurBlanche · 19/01/2016 16:01

Ah! Stratification is layers to me... rock, muscle sheathes, social hierarchy, etc Smile

And Hawking was talking about saving the human race from itself, artificial intelligence (AI), nuclear war and genetically-engineered viruses as just some of the man-made problems that pose an imminent threat to humanity

I think he has a point - though maybe this isn't the thread for it! Then again... Smile