Abstract

As physicians, the acknowledgment of one’s implicit bias can lead to more equitable care for patients and avoid egregious errors such as misdiagnosis and delay in care. Here, we examine the case of a 40-year-old Hispanic male in ICE custody who presented to an inpatient psychiatric unit following a documented history of multiple suicide attempts and depression. He reported suffering a fall approximately two weeks prior when he intentionally jumped off the second tier of his dormitory and landed on his head. A CT scan of the brain with and without contrast and a CT of the cervical spine was ordered again at the Behavioral health hospital. A scan of the cervical spine showed multiple fractures of the anterior spinal column. In this case, we examine the intersection between the implications of bias and the population of the patient, ultimately contributing to an unethical delay of his care prior to admission. A primary takeaway from this case is the importance of following protocol in all cases of head trauma to bypass any implicit bias a physician may have. A patient that fell from a significant height that resulted in a head injury must be subject to a standard fall protocol that involves a workup consisting of a physical exam and imaging. We present this case as an example for clinicians to acknowledge and learn from their bias when working with populations who have unique challenges in providing care.