Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments

When Cultural Practices Affect The Treatment Of Patients

In quite a few of the cultures in south africa people tie ribbons, strings and tassels around their own and their children’s wrists and waists. These tassels are imbibed with power to keep evil spirits at bay, I am told. If these tassels come off then the patient is completely unprotected from any and all marauding evil spirits that may be lurking around. Of course, not wanting to be responsible for the unopposed assault by multiple evil spirits, most people are fairly reticent to remove these things. I saw it slightly differently.

As a student I took my lead from my senior. If he removed the tassels then I would be ok with it. If he felt that we should respect the culture of the patient and sort of try to move the tassels out of the way of the operating area or even operate around them, despite the increased infection risk, I sort of reasoned it was his patient and even if I medically didn’t agree with him, the reasoning of respecting the patient’s culture surely held some water at least and I didn’t argue. The fact of the matter was that a number of the sisters would become quite aggressive with the doctor if they thought he was going to remove the tassels and strip the patient of his evil spirit protection, and I think some of the doctors were scared. Then one day something happened that cemented my views and actions for the future.

I was working with a senior doctor that had grown up in one of the ‘tassel cultures’ of south africa, so when I prepared the gunshot abdomen patient in theater for him to operate, I left the tassels alone. It was one thing calling down the wrath of evil spirits upon me but I was not willing to call down the wrath of my senior. It was not worth it.

My senior walked in. He took one look at the patient lying on the theater table, already anesthetized with a nice round bullet hole in his mid abdomen oozing a mixture of blood and feces and with the tassels tied securely around his waist, left in position by me. without saying a word he grabbed a pair of scissors, walked up to the patient and unceremoniously cut the tassels off and threw them away. The sister immediately layed into him.

“Doctor! What the hell do you think you are doing? That is the patient’s culture and you have no right to remove that!” I saw the corner of the doctor’s mouth edge upwards in a mischievous smile as he answered.

“Come now, sister. Besides the obvious medical and hygienic reasons that I could give for removing a dirty piece of string before we operate, even you must agree, this tassel just doesn’t work. I mean it didn’t protect him from getting shot in the first place so I think it is safe to assume it is pretty much not going to protect him from anything else. so I am removing it and I don’t really care what you have to say about that.” His logic was flawless and the sister had to keep quiet. I also tried to keep quiet but the faint sound of a laugh did escape from behind my theater mask.

Since then I have cut every tassel off, explaining to everyone that will listen that it clearly is no longer working.

*This blog post was originally published at other things amanzi*

You may also like these posts

    None Found

Read comments »

Comments are closed.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »