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More Gestures that Leave an Impression

Nancy A. Kelly shares a volunteer story that shows how small gestures can have a positive cultural impact, bridging language divides.

I recently wrote of how the small gestures volunteers make can have a positive cultural impact, and are often greatly appreciated by our overseas hosts.

Dr. Anne Zink was volunteering with our Emergency Medicine project in Bhutan and shared this story of a patient who made a long-lasting impression:

This amazingly sweet 82-year-old woman came in with pneumonia and hypoxia. She ended up staying four days in the Emergency Department, and on the first day, she smiled this huge broken tooth grin.

She, like all the patents in the department, was never in gowns (we don’t have them), so she sat in her traditional clothing, necklaces, and beads for the four days she was with us. Later that first day I went to check on her, and she grabbed my white coat and just started talking. She smiled and nodded and kept talking, without me understanding a word. But I smiled back and bowed and held her hand until she was done. She gave me one more squeeze, and off I went to the other patients.

This same thing continued to happen for the next four days, with her always telling me some elaborate something, me never knowing what she was really saying, and she was steadily improving. The team started to tease me about my favorite patent, and they were right; she made my day. On my last day before she went upstairs, she did something different, she kept holding her belly. I was worried. What had we missed? I pressed, and she was soft, did not seem tender; I could feel her aorta as she was very thin, but she looked good. So I did what we always do in the Emergency Department when we don’t understand something – I got more data. I went and got the ultrasound machine and looked all over – what was bothering her? I could find nothing wrong. Her liver, spleen, heart, gallbladder, and aorta – all seemed fine. I finally asked one of the students to help translate for me; what was I missing?

Turns out that she was saying I am like one of her children to her (which is why she was holding her abdomen and smiling), and she was thanking me for listening. I laughed and thanked her for sharing her care and stories with me. She reminded me of how much more healing we sometimes do with holding a hand or sharing a smile. I then mentioned she was a little dry and should keep drinking lots of water. She asked, “So more alcohol, more tobacco, and more Doma?” I smiled and said, “No, just water and maybe tea”, and was glad this time I had the translator and wondered what else I had nodded “yes” to before!

This is such a delightful encounter with a patient and, language aside, the two were able to communicate their concern and affection for each other.