Understanding Sickle Cell Disease: Insights from The Pitt

This article discusses the chronic illness known as sickle cell disease and addresses issues related to racism as it intersects with healthcare.

Sickle cell disease (SCD) is a central theme in the second episode of The Pitt. While the show, featuring a talented ensemble cast, portrays a stark and realistic depiction of the healthcare industry, it falls short in elucidating the complexities of this chronic condition. The Pitt explores pressing issues such as the nursing shortage and the ongoing repercussions of the COVID-19 pandemic, demonstrating its commitment to presenting the harsh realities faced by healthcare providers. This makes it a fitting platform to address often-misunderstood conditions like sickle cell disease.

In the highlighted episode, a Black woman named Joyce St. Claire (played by Ashley Romans) is rushed to the emergency room in severe distress. Initial assumptions by the paramedics mistakenly label her as a drug addict seeking opioids. However, Dr. Samira Mohan (Supriya Ganesh) quickly identifies Joyce’s true condition: she is experiencing a sickle cell crisis. While the show’s depiction of such medical emergencies may contribute to its strong ratings on Rotten Tomatoes, it lacks a thorough exploration of how sickle cell disease profoundly impacts the lives of individuals.

Understanding Sickle Cell Disease

The Genetic Component of Sickle Cell Disease

Sickle cell disease is genetically inherited and primarily affects individuals of Black and African descent. As detailed by the Mayo Clinic, this condition results in red blood cells that assume an abnormal crescent shape rather than the typical disc shape. These sickle cells are stiffer and stickier, increasing the likelihood of formation of clots and leading to a spectrum of symptoms including anemia, severe pain, swelling, increased infection susceptibility, and vision problems. Unfortunately, individuals with SCD often have a life expectancy that is significantly lower—up to 20 years—compared to the general population, according to the CDC.

Estimated figures indicate that over 100,000 people in the United States are living with sickle cell disease, with a staggering 90% of these cases found in the Black community. The American Society of Hematology notes that 8% to 10% of Black Americans possess the sickle cell trait, establishing the hereditary nature of this disorder that likely originated in Africa as a protective response to malaria.

The Intensity of Sickle Cell Crisis

Challenges Faced During a Sickle Cell Crisis

A significant and excruciating symptom associated with sickle cell disease is the sickle cell crisis, which occurs when misshapen cells obstruct blood flow, depriving tissues of oxygen. As detailed by the Cleveland Clinic, these blockages typically occur in the lower back, chest, and extremities, resulting in extreme pain and fatigue. This agonizing pain can range from manageable discomfort to overwhelming sensations that necessitate emergency medical care.

Dr. Mohan offers a poignant description of the pain associated with sickle cell crisis: “Blood cells get caught and plug up your capillaries and deprive all your cells of oxygen. It’s been described as an electrical stabbing pain that feels like it’s breaking your bones and flushing glass through your body.”The depiction resonates with those who have experienced this condition firsthand, underlining the severity often overlooked by outsiders.

Treatment Protocols and Implicit Bias in Healthcare

Pain Management Options for Sickle Cell Crisis

Despite the debilitating pain that accompanies a sickle cell crisis, many patients face challenges in accessing adequate pain relief. For those experiencing severe crises requiring hospitalization, treatment often involves potent medications such as opioids, including oxycodone and morphine. However, the ongoing opioid crisis in the U.S. has led to heightened scrutiny of narcotics, resulting in reluctance among healthcare providers to prescribe these necessary medications. Unfortunately, this issue is compounded by racial biases that influence treatment decisions.

Numerous studies indicate that racial bias exists within the healthcare system, leading to disparities in the quality of care provided. The National Library of Medicine highlights that minority patients frequently receive a lower standard of care compared to their White counterparts. In the incident described in The Pitt, the paramedics and Dr. Whitaker express bias by incorrectly assuming Joyce is merely seeking drugs, a troubling stereotype that can detract from the urgency of her medical needs.

Research has shown that healthcare providers sometimes perceive patients with sickle cell disease as exaggerating their pain or seeking narcotics for non-medical reasons. This perception can manifest in inadequate pain management, leaving many patients without the relief they desperately need during crises.

By presenting these complex themes, The Pitt provides insight into the nuanced relationship between race, healthcare, and chronic illness. The show serves as a critical lens through which viewers can examine issues of justice, compassion, and the need for patient advocacy in the face of systemic biases that often prevail within the medical community.

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