02 March 2011

Cultural Differences in Value

Everyday I learn something new.  Somedays it's even several somethings.

This morning my lesson was: Value has a cultural context.

Exhibit A.  This morning I was rounding with our Nigerien surgeon, Dr. S.  I love rounding with Dr. S. because he speaks to me in French and I learn A LOT from him about so many things, not just medical, but also sociocultural.  So there's this old man that Dr. S. operated on, I believe yesterday, who was having a prostate issue.  This morning, when we went to see him, he was a new man!  Energetic, alert, and pain free.  He said something to Dr. S. in Hausa that made Dr. S. laugh out loud.  This patient told him that until today the most important thing in his life was his cows.  This old man is a cow herder . . . they are his life and wealth, his most prized possessions.  But as of today, it is Dr. S. who is the most important thing in this man's life -- he took away his pain.  

Exhibit B.  After rounds were finished and I had stretched a burn patient, did ROM exercises with a guy and his newly repaired thumb, and began pre-handwriting skills with some chalk on the hospital room floor (that's another story for another post) I made my way to the surgical consulting room of the out-patient department.  Dr. S. was on duty today so I sat back, ready to learn some more.  In walked another old man, about 90 years old.  He was dressed very traditionally . . . except . . . wait, what's that??  Hanging around his neck, the way a doctor ports a stethoscope, was his foley catheter and urine bag.  So there's no confusion, the catheter was inserted where it's supposed to be, but the bag was daintily placed around his neck all the same.  Now, normally foley's work well with the force of gravity, not against it.   But his explanation was simple: it is a device of such high value to this man, he didn't want to take any chances that it would be ruined or damaged.  (I suggested to the doctor that maybe someone could make him a special bag he could wear over his shoulder . . . Dr. S. informed me that his traditional robes actually had large pockets inside.  When suggesting to the patient that he utilizes these pockets, his response was 'Well, if there's enough room, maybe we can give it a try, but it's been working well this way so far.)

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