Communication

One of the more difficult aspects of working in  Chinle is communication with patients and families.  It is made more challenging by the fact that for many English is a second language and the cultural divide between conventional medicine and the traditional ways of the Navajo.

Illness is often viewed in families as a spiritual weakness or flaw no matter the cause.   If one is strong is spirit one does not get sick.   This has caused many parents to bring children in with the feeling on the part of parents that they have failed spiritually.  When taking a history one has to dance around what is really going on as parents and patients are reluctant to bring up past problems or health issues.  A child may have heart disease and been hospitalized in the past month and a parent will not mention that when they bring a child in with a fever. A  common feeling is that a good doctor will know what it wrong without knowing all the facts and even without examining the patient.  After all, the spiritual healers do this all the time.

With each patient and family I work hard to bridge the cultural gap.   I try to establish some common link I might have those I see.  I ask about other family members and where they live. Still, I find at times the reserved nature of those I see a bewilderment. After working  with the Afro-American community where being expressive and revealing information is almost an art form the Navajo are quite a contrast.   I do at times miss all the information and stories that I was told by my families in Northeast Portland. It is even more fascinating that some of the favorite television shows and movies for the Navajo are about Afro-Americans.