but they are less likely to question it. That’s a big
problem, Dr. Durán explains, especially when
the doctor thinks that nodding means a person is
simply agreeing.
“We have to learn to talk back, question and
do things that may be antithetical to our basic
values,” he says. “Latino people have to learn a
different way of communicating when working
with the medical system. For example, we teach
Latinos that in the U.S., physicians expect you to
ask questions—it’s not seen as disrespectful.”
Another approach is to work with healthcare
partners who better understand you. Perez, whose
parents moved to Los Angeles from Mexico,
says he found it very helpful to have a Spanish-speaking neurologist. “I feel like there’s cultural
empathy, which makes me more at ease. I feel like
I’m able to disclose more about my situation and
struggles.”
Illness as stigma
Hispanic/Latino people tend to value religious
faith, which can help some people cope with living
with a chronic disease. But it can have negative
repurcussions, Dr. Durán says. “Certain religious
attitudes may lead some people to feel as though
they should quietly bear their suffering, or that
they’re cursed. If they feel that God is punishing
them, there’s little they can, or even should, do
about their situation.”
Religion is not the only source of illness-related
stigma, Dr. Amezcua emphasizes. “There’s a
huge stigma in the community attached to MS
symptoms, such as fatigue,” she says. “A lot of my
patients tell me that their families write them off
as being lazy.”
Depression is another MS symptom with stigma
attached. “The Latin world doesn’t always
appreciate that depression is a real biological
disease and symptom of MS,” says Dr. Conill.
“There’s more stigma associated with emotional
than even physical disease. So people aren’t getting
relief for their secondary conditions.”
Leopoldo Perez says he hid the fact that he was
going to see a psychiatrist. “I felt it would be
met with resistance from family and friends, who
would say, ‘You’re fine, you’re young, nothing is
wrong.’”
Learning more, moving forward
A combination of studies currently being
conducted on Latinos/Hispanics with MS, and
increased MS awareness in the Hispanic/Latino
population, will not only help us understand how
the disease manifests itself in these communities,
but could bring about quicker diagnoses and
improved therapies for everyone.
To contribute to this growing body of knowledge,
Latinos/Hispanics can participate in the Hispanic
MS Registry, a project maintained by the MS
Comprehensive Care Center at USC. Call 323-
442-6817, email mscare@usc.edu or go to
keck.usc.edu/mscenter.
Meanwhile, Dr. Conill
emphasizes a proactive
approach to taking care of
oneself. “There’s no shame
in needing or asking for or
receiving help,” she says, “and
it’s really important to get the
best support possible.” An MS
Navigator can help anyone get
started. Call 1-800-344-4867
(for a Spanish-speaking MS
Navigator, choose option 3). n
Elinor nauen is a new york–based
writer and editor who covers health,
sports, science and other topics.
gary Sullivan is the content project
manager for the Society.
