How should doctors handle racist patients? A general practitioner registrar describes the unease she still feels over the way she responded to a volubly racist patient she encountered while a house officer 10 years ago, and other authors comment, from different perspectives, on how they would deal with such a situation.

It is 10 years since I met Mr B, who was perhaps the most unpleasant patient that I have ever had to deal with. I used to pride myself on the fact that I had treated him no better and no worse than any other patient … and of course that is as it should be … but I am still uncomfortable about my inability to respond to the things he said while he was on my ward.

I was a junior house officer when Mr B was admitted to hospital after a transient ischaemic attack. This turned out to be secondary to polycythaemia. Mr B's packed cell volume and haemoglobin concentration were abnormal, and it was decided that I should venesect him, and draw off blood daily until his haematological values returned to normal.

One of the other house officers was German. For some reason she took against Mr B, although she would not say why.

During the first venesection, Mr B asked what I was going to do with his blood.

“Sister wants it,” I said cheerily, “for her roses.”

“Fine, I don't care what you do with it, as long as you don't give it to Jews.” Not sure that I had heard correctly, I smiled nervously.