Wednesday, October 17, 2007
Of Mongols and Spots
A mom with a newborn recently showed up in clinic with a copy of the newborn's hospital examination, as is customary for our locality. I noticed, buried in the usual neonatologist scrawl a note that read "melanocytic patches on sacrum, AKA Mongolian spots."
These dark patches on the proverbial baby's butt are more common in people of color, especially Asians and North American aboriginals. How they ever came to be associated with Mongolia, I do not know.
Numerous other names exist, some with an ethnic tone, like the Semitic streak. But apparently, there is anthropological descriptor know as Mongoloid race, which includes people of East Asian, Polynesian, Indonesian and Micronesian descent. Mongolian spots are reported to occur at 90% frequency in this group.
I wish I knew why this pediatrician elected to document choosing those words. Was it political correctness in face of an ethnic characterization? One thing for certain, the use of the term always raises eyebrows amongst lay people, especially the social workers to whom you end up having to explain this lesion to. Is 'melanocytic patch' or 'macule' any clearer to the lay population?
I was personally involved in a circumstance where a child was removed from their parents' custody over a weekend for abuse. Our group received notice Monday morning and, fearing the worst, went straight to the chart. Thank God that someone was thorough enough to document the presence of the spot, so common amongst our patients, I confess, I sometimes just forget to write it down.
"Yes ma'am, it's a birthmark. No, I don't think it's a bruise if he was born with it. Yes, it seems to be the same place you describe the bruise. It should fade in a few years, usually by the time they child is six or seven. No, it can't be a bruise if it's been there so many weeks already."