Structural Competency in Villarosa

Landrum is repeatedly invalidated by medical professionals, who dismiss her concern and her pain due to a racialized view of her symptoms and a poor understanding of cultural competency. The interweaving of both “chart talk” and her more personal narrative accounts is entirely necessary in order for the reader to understand her story, and the weight that it carries.

For example, when she writes about her headaches and exhaustion in conjunction with her “elevated blood-pressure reading of 143/86” it is necessary for the reader to be able to contextualize this information; this is where chart talk becomes remarkably handy, giving the reader the vocabulary necessary to understand the gravity of her situation. One drawback of interweaving this information is that it dilutes the hard-hitting pathos of her narrative. By having her recount her entire story in one chunk of emotional narrative, it would read like a political speech seeking to drive action and engender compassion in her audience. However, for our purposes, the intermingling of narrative and “chart talk” is really the backbone of a medical ethnography.

This interweaving of narrative and more scientific jargon fits into the idea of cultural competency because medical care for minorities is vastly different from the one that whites experience. As a black woman, Landrum carries an intersectional set of cultural and structural boundaries to overcome, and not only pertaining medical care. She recounts that “It was like he threw me away,” and that her symptoms were clearly being dismissed on the basis of her race, her gender, and quite probably the racial biases carried by the doctor. As soon as the reader has the chance to think that maybe this is a one-off case, an anomaly, Villarosa chimes in with facts like “black women are three to four times as likely to die from pregnancy-related causes as their white counterparts” or that every single year there are “4,000 lost black babies.” By including more logos based information, Landrum’s story is bolstered with an artillery of research that adds to her credibility and the overall impact of the article.

It is important, in seeing how connected her narrative of the loss of a child is with a failed example of structural competency, that our healthcare professionals integrate knowledge of the human body, the person in that body, and the person in the system into everyday medical care.

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