Revisiting empathy- Medicine and asylum seekers
Review of On call – France, 2016, directed by Alice Diop
Showing at the BFI- London Film Festival on Wednesday 12th, and Friday 14th October 2016, London
Reviewed by Dr Khalid Ali, Screening Room Editor
In the current international refugee crisis, no country is immune from facing directly or indirectly the impact of millions of people being displaced from their countries of origin. Health and social care professionals are at the forefront of dealing with refugees from all over the world. On Call is a documentary film showing several encounters of asylum seekers in a clinic in Avicenne Hospital close to Paris. The clinic is an exceptional facility offering consultations without pre-booking for newly arrived immigrants. Dr Jean Pierre Geeraert provides medical advice for physical ailments, counselling for psychiatric problems, and completes certificates for social benefits, and housing requests for African and Asian refugees. Each consultation is unique in its specific details, but the common underlying factors are the hopelessness, discrimination and frustration that these unfortunate people experience on a daily basis.
These patient stories poignantly illustrate that health is a reflection of physical, mental and social well-being, and as such a doctor needs to be an expert physician, psychiatrist as well as a social worker. Dr Geeraert is almost single-handed in trying to sort out his patients’ refugee visas, their work permits, and housing appeals. His frustration is evident as his genuine desire to help is met with total indifference from immigration departments and social security offices. The ever-so-brief consultation sessions do not allow him the much-needed time to explore what ‘really matters to his distraught patients’. He resorts to regularly referring them for clinical psychology support.
Maintaining a note of authenticity, the film shows Dr Geeraert as a human being as well as a professional doctor; he can be annoyed by a patient who repeatedly begs him to save his life. He cannot be ‘Dr Nice’ all the time; he gets bored, and upset by some patients and the receptionist in the clinic. However trivial his shortcomings may be, he still embodies the true essence of ‘empathy’ by listening to patients, by acknowledging their fears and anxieties, and by encouraging them to share their most traumatic experiences without being embarrassed. Winning his patients’ trust does not come easily; it has grown over many years. His genuine commitment and dedication is rewarded by humane gestures of recognition from his regular clients in the form of little souvenirs that they can afford to buy.
In the 1940’s, Marjory Warren (http://www.bgs.org.uk/index.php/geriatricmedicinearchive/203-biographies/2437-marjory-warren) called for the establishment of a new speciality, namely Geriatrics Medicine, and advocated for training doctors in the holistic management of older people who were locked away in old workhouses. In the current turbulent times, it is crucial that disadvantaged citizens of the world, asylum seekers, are recognized as patients with special physical, mental, spiritual and social needs. Perhaps eminent organizations such as the Worshipful Society of Apothecaries of London through their Course in Conflict and Catastrophe Medicine’(http://www.apothecaries.org/faculty-of-the-conflict-catastrophe-medicine/course-in-conflict-catastrophe-medicine) should champion a call for training and education of doctors in a new specialty of Refugee Medicine across the wider international arena. Several NGOs have already established professional medical networks to support refugees in affected areas around the world; Doctors of the World (https://www.doctorsoftheworld.org.uk/) and Doctors 4 Refugees (https://www.doctors4refugees.org/) are notable examples. Doctors can no longer practice in silos, they need to adapt and respond to evolving international crises and challenges affecting their patients and them.
Address for correspondence: Khalid.ali@bsuh.nhs.uk