Keywords

45-year-old African American male with medical history significant for chronic low back pain, spinal stenosis s/p laminectomy 2012, HTN, CKD stage V on dialysis. No history of illicit drug use, drinks alcohol occasionally, doesn’t smoke.

I saw that patient once in the clinic and took care of him for 4 days when he was admitted for community acquired pneumonia. Patient has been complaining of his PCP not willing to prescribe him stronger pain medication. The Tylenol he is taking doesn’t really relieve the pain. He has tried physical therapy multiple times which doesn’t help with the pain. Since the laminectomy, the low back pain has been worse. He thinks that his PCP has been refusing to give him stronger pain medication because he is black. He thinks that doesn’t make any sense because he doesn’t have a history of illicit drug abuse, not even a smoker. He would like to switch PCP, his actual PCP is white, and he thinks if he has a PCP of color, maybe she/he can treat him better.

The patient also complained of the health-care system to be unfair. Since he is young, he was thinking about getting a kidney transplant from organ donation. He asked his nephrologist who proceeded to inform him that he is doubtful he will ever have a kidney donation that will match, because he is black and black people don’t usually donate organs. This was offered as an explanation of why they tend to favor white patients who are in the waiting list. The patient told me that he is very confused. He can’t understand how the health-care system is that unfair.