Human Like Me

When I pulled the maggots and bits of chewed tobacco leaf from the young lady's hip wound her husband rocked sideways, closed his eyes and softly hit the floor. That was probably the best place for him. In his present state, lying quietly and breathing regularly, he was harmless. Nurses Announcements Archive Article

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Human Like Me

His wife was a superstitious woman. She believed, as did many Brazilian farmers, that the enfermera formada Americana (college-educated American nurse) would perform some bizarre procedure that would render her lame or sterile -- or both. Her bravery was made evident not only by the fact that she allowed me to originally incise her purulent boil but that she was now returning for follow-up treatment.

The wound looked beefy and moist. The red streak snaking into her groin was gone. She could walk now, when but a week ago she had been carried in on her husband's back. I was satisfied the maggots had done their job and was relieved the river had dropped enough to allow a vehicle to take this patient to the nearest hospital. With her permission, I injected her with penicillin, packed her wound with gauze that had been boiled over a charcoal fire and laid a pliant tobacco leaf over the pack. It took several hours to find someone with enough courage to drive over the river but eventually, a Jeep happened by and the woman was safely on her way.

The woman and I were of different educational backgrounds and different socio-economic statuses. We held contrasting religious beliefs, too, as my patient's family contained many 'espiritos,' those who donned masks and performed animal sacrifices for healing, good weather, and safe travel. Our methods of communication varied, as did our food preferences and even our clothing styles.

Initially, she believed it was possible for me to draw her womb out through the hole in her hip and she refused to stay the night at the aide station, telling me honestly that she feared I would remove her leg while she slept. But ultimately -- courageously -- she trusted herself to my care.

Being a nurse allowed me to enter the homes of -- and speak freely to -- those in power in our village. Not everyone trusted me and my "modern" treatment methods. But many did and word eventually spread about the enfermera Americana, bringing in patients from rural areas, patients like the woman with the hip wound.

This woman's culture and mine were so different. And yet, looking back at this seemingly insignificant case, I can clearly see that I did not at the time recognize culture as a barrier. A woman in distress is a woman in distress. An infected boil is an infected boil. Does it matter that a patient believes painting an affected leg with river mud will keep away the evil so long as, along with the mud, she allows me to lance the wound and use maggots to eat away the rot? Does it make a difference that her husband placed a cut root in his pocket to prevent me from stealing his fertility when he entered my clinic with his wife on his back? And do I honestly care if the patient's family refused to watch her being transported, fearing that if they watched her leave they would never watch her return, so long as she did allow -- of her own accord -- transport to a facility that would preserve her leg and her life?

I was lucky. When I was young, my parents exposed me safely to the world. Men and women of every color and ilk crossed my path. In our family, we had college professors with house servants and ranchers with outhouses. And, yes, there was bigotry and ignorance, as there is in everyone's life. But I learned early that we worry too much about getting things wrong and not enough about making things right. We stew and fret that in our ignorance we may insult someone when we should simply apologize up front for being uninformed and tell our patient what we want to do and why. If the patient consents, we should proceed with professional grace. If the patient does not consent, without guilt or condescension, we must try to find out why. It may be something easily fixed -- facing a window to sleep, not keeping dairy and meat on the same tray -- or it may be something quite complex -- not allowing a woman to touch a man. We may never be able to broach the transcultural barrier we are up against. But it can always be made better through understanding.

The outcome is what counts. We are not our patients' parent, spouse, child or sibling. Our duty is to provide respect, not patronization, and treatment, not condemnation. We want what is best for our patient, but we may not agree on how to get there. I believe the solution is fairly simple: Unless a patient's behaviors infringe on the rights or safety of others, we don't need to alter his cultural beliefs to provide competent, compassionate care. Respecting others' decisions about their own choices, even if we disagree, is what matters.

Culture is a skin-tight uniform we all wear, from the moment we are born to the instant we die. We are dressed by others in that culture at birth and alter that culture day by day, encounter by encounter, choice by choice. I am not naive enough to say that we are all the same. You and I are very different in many ways. You may say, in fact, that we are nothing alike and have no common bonds. But look deeper. Underneath, you are human. Just like me.

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Atheos

2,098 Posts

I usually think these essays are cheesy but that was pretty darn good. :yeah::yeah::yeah::yeah:

Specializes in CCU.

Indeed, interesting and good refresher class!

Great writing!

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Joe V

8 Articles; 2,493 Posts

Specializes in Programming / Strategist for allnurses.

Outstanding!

Very descriptive - I felt like I was there.

madwife2002, BSN, RN

26 Articles; 4,777 Posts

Specializes in RN, BSN, CHDN.

The most interesting article in a long time thank you for sharing