Cultural Competency as a Rite of Passage By Rose Jones, Ph.D.

 

Rose Jones, who has a PhD in Anthropology from Southern Methodist University, has been actively engaged in medical education for more than two decades:  teaching, writing curricula, conducting research, and lecturing.Her essay “Hot Stones and Cold Rice”  appears in the Spring 2017 issue of The Intima.

Rose Jones, who has a PhD in Anthropology from Southern Methodist University, has been actively engaged in medical education for more than two decades:  teaching, writing curricula, conducting research, and lecturing.Her essay “Hot Stones and Cold Rice”  appears in the Spring 2017 issue of The Intima.

Transitioning from a cross-cultural neophyte into a culturally competent warrior is a precarious and arduous process in medicine. It is typically a journey accomplished on one’s own with little guidance, training or support. It’s also a journey that requires deep self-reflection and the ability to objectively critique the culture of biomedicine.  Until this process changes on a large scale, until cultural competency training moves away from being an ad hoc rite of passage to one that is fully integrated into the medical curriculum, the ability of physicians to truthfully and critically assess their own place in the cultural competency learning process remains the single best venue for becoming a cultural warrior. This was brilliantly demonstrated in Hans Steiner’s Field Notes, “The Cat Doctor” (Intima, Spring 2015). In this narrative, Steiner uses self-deprecating humor to demonstrate how he transitions from cultural neophyte to cultural warrior.

Arriving in the United States for his first externship, Steiner, a native of Austria, is immediately set on a course for cultural collision.  Eager to impress the seasoned medical team, Steiner rotely conducts an H&P on Leeroy, his very first patient. What ensues is a quintessential comedy of medical errors, a series of clinical and social misunderstandings that emanate from the cultural divide that separates Steiner from Leeroy. In the end, Steiner recognizes that clinical skills and decisions are mediated by the cultural dynamics that transpire between physicians and patients. Steiner embraces his own cultural incompetencies, understanding that Leeroy has a lot to teach him and recognizing that the line that separates physicians from patients is both blurry and arbitrary.  

Steiner’s cultural journey is very different from the one I write about in “Hot Stones and Cold Rice” (Field Notes, Spring 2017). While conducting research in St. Lucia for my doctorate, I shadowed a French physician as he treated STI patients. Although this physician understood that his patients believed that sitting in the sun on hot steps was a risk factor for contracting a STI, he refused to modify his behavior even when it became evident that this caused him to lose credibility and trust with patients. He stubbornly and boastfully continued to sit on “hot stones.” It is hardly surprising that Steiner was affectionately nicknamed “Hans, the Cat Doctor” in homage to his cultural gaffes; while the French physician was clandestinely nicknamed “The Dek-Dek Doctor,” which translates as the “dumb” or “stupid” doctor.    

 


Rose Jones, who has a PhD in Anthropology from Southern Methodist University, has been actively engaged in medical education for more than two decades:  teaching, writing curricula, conducting research, and lecturing. Dr. Jones has held faculty positions at UT Southwestern Medical Center, Parkland Health and Hospital System, and Children's Health at Dallas. Her areas of expertise include cultural competency, health literacy, community advocacy, and ethnographic assessment.  She has conducted research in diverse settings, including Mexico, Jamaica, St. Lucia, Barbados, and East Texas.  Dr. Jones is currently the Director of Evaluation at the Perot Museum of Nature and Science in Dallas.

© 2017 Intima: A Journal of Narrative Medicine