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PATRICIA Frye Walker, MD, often has to consider more than just tuberculosis in the differential diagnosis of pulmonary infiltrates with hemoptysis. Many of her patients recently have emigrated to the United States from such Southeast Asian countries as Laos and Cambodia, where infectious bacteria and parasites permeate the rice fields. They are susceptible to illness not only fromMycobacterium tuberculosis, but also from agents including lung flukes andPseudomonas pseudomallei. Walker has an inherent interest and sensitivity in caring for foreign-born patients—she was born in Taipei, Taiwan, and lived in Thailand until age 11. Many in the US medical community don't have the benefit of similar experiences but Walker, director of operations for the International Clinic at Ramsay Clinic in St Paul, Minn, says clinicians' interests in cross-cultural health issues are taking root. "Physicians really are beginning to notice that multicultural health is not just a buzzword of the '90s,"
Rebecca Voelker (Wed,) studied this question.