lingua franca

recently i was privileged  enough to go overseas to france for a laparoscopic course. unlike my last trip to deepest coldest europe, this time there was only one other south african on the course, but, as luck would have it, it was the same guy who gave us all a laugh last time. i think the laugh might have been on us this time though.

it didn't take too much time in france to realize theirs is a totally foreign culture to ours. what they are is simply called rude and obnoxious in our country. after a while one gets used to it and can only but look forward to returning home. however when there you sort of have to endure it. our usual south african responses to their behaviour might not go down too well.

the one night i went for a walk in the town (something not generally done in my country for safety reasons). at a stage towards the end of my walk i saw a quaint take-away place and decided to go in for a quick bite. i walked in. the place was totally empty except for the one single employee behind the counter standing with his back to me. he mumbled something in french which sounded to me like their usual greeting phrase, but only glanced up momentarily before he turned his back on me again. by this stage i was quite accustomed to being treated poorly by them so i greeted him back in two languages, both of which he probably understood just as well as i understood his french. he ignored me. i patiently waited for him to finish ignoring me. after a while he turned around and repeated his french phrase. i greeted him again, hiding my irritation well, i thought. i then went through the painful process of ordering something akin to a hamburger. he seemed to resist these attempts of mine, but finally took my order and got to work preparing it.

just about this time my south african colleague coincidentally walked past. he saw me in the small cafe and entered. i was just too grateful to see a friendly face and quite soon we were chatting away in a language there was no chance our french friend could understand. i informed him i had had difficulty with what i perceived as typical french rudeness but had managed to order something i was hoping would be a hamburger-esque thing. my friend greeted the guy in english and received the same french phrase i'd heard.

my friend then attempted to order something for himself to eat. it seemed to go even worse than it had with me. the menu was written on the wall so he simply pointed at an item. the french guy shook his head, indicating that that specific item was not available. not to be put off my friend moved from item to item, pointing to each one in turn and each time without joy. it was quite a comical scene to see him move systematically through the menu and be denied each time. after what must have been about the tenth item he selected, finally the guy indicated that he could supply it. my friend sighed, more from relief that the ordeal was over and we continued our light hearted conversation in our own language, somehow comforted in the knowledge that our words would confuse his ears as much as his did ours.

finally our food arrived and we tucked in.

while we were eating alone in that quaint french cafe late at night chatting in a language that reminded us of the open spaces of africa, probably too loudly for the refined french sentiment, something happened that gave me cause to reflect.

half way through our meal a local walked in. he greeted the guy behind the counter. the guy answered in the phrase that we had heard when we first came in. somehow hearing it just after the french greeting, it no longer sounded like the french greeting. just as i was wondering what he had actually said to us and therefore to this new local, the guy apologized and left. shortly after the same process repeated itself. someone came in, heard the phrase, said sorry and left. i then put it together.

the phrase obviously meant that the shop was closed. the whole time he had been ignoring us was more to do with him no longer being on duty than the usual french rudeness. i couldn't help laughing as i shared my suspicions with my colleague. i could just imagine what was going through his mind as he struggled to make himself understood to us;

"what is the quickest way i can get rid of these people that just refuse to leave? maybe if i just feed them then they will at least eat and go away."

adopt a new yorker

i met a new yorker. it was a fascinating experience. it all started when i was doing a locum in private in nelspruit over christmas. i was seeing a patient in casualties and this touristy looking guy came in with his wife in clear respiratory distress. she apparently had some sort of fibrosing alveolar disease, the domain of physicians, and was duly admitted by them to icu. i just remember this guy in casualties shouting at everyone and saying if the service is not good enough, they were going to just leave. i thought he's an idiot. where is he going to go? nelspruit private hospital is about 2 hours away from any other good medical help and she looked like the ride to icu would be too much for her.

i had my own patient in icu (a gunshot abdomen who bled about 8 liters before and during operation, which means the anaesthetist was quite a wiz, but different story), so i saw her the next day huffing and puffing with a cpap mask on. (a cpap mask is a mask that delivers air under a higher residual pressure. i personally believe it may origionally have been used by the spanish inquisition to illicit a confession in days gone by). the point is she didn't look good and already i started suspecting she was not going to make it.

anyway, i left nelspruit and went back to witbank to finish the year off there. i returned to nelspruit on the second of january. initially i had no place to stay, so the hospital put me up in the local hotel (town lodge). the first evening there this same man came in and sat at the bar with me. i immediately remembered him. he soon greeted me with a twangy "how ya doin'?". i remained polite yet somewhat aloof. but soon his gregarious nature thawed even my hard surgical demeaner and quite soon we were chatting like old friends.

he didn't remember me from the night he brought his wife into the hospital and i didn't volunteer that i'd thought he was an idiot. he told me about his wife and showed me photos of her lying in her icu prison, now with a tube in her trachea, indicating that her condition had gotten worse. i feared the worst.

the poor guy and his wife had come to south africa to enjoy a dream holiday. she got sick and now he was stuck in this hotel without friends or family and also without transport. i offered to take him to the hospital whenever i could and did so a few times. i also offered to take him out just so he could get a bit of a break from what had become his dismal situation. so we spent the evenings together, joking and laughing, often until the early hours. for me it was a cultural experience. he is loud and verging on what we would call obnoxious. at every restaurant he would pepper the waiter with all sorts of demands and unusual requests, always in a loud voice. often i saw them becoming irritated, just as i had done that first day. but now that i knew him i realised that that's just how he is. he means no harm. i actually became embarrassed by the irritability of my fellow countrymen. fortunately the new yorker seemed to be oblivious to their reaction. maybe he just didn't care.

one day i arrived at the lodge in the evening and he was there waiting at the door. he approached me and said the hospital had phoned and requested that he go there as soon as possible. i immediately drove him up. as could be expected, they told him his wife had just passed away. he was devastated! this loud american that i thought so perculiar was reduced to fighting back the tears. i took him out again because he said he didn't want to be alone in his hotel room. when we went out the old man i had come to know was back, hardly giving me a chance to get a word in edgeways, joking and laughing at the slightest thing. only every now and again would he fall silent and i'd see the tears well up in his eyes.

one of the bar tenders in the lodge also befriended him and soon it would be all three of us going out making a nuissance of ourselves. what a mix of cultures and attitudes.

i learned a few things. i firstly reminded myself not to judge people so quickly, because i may not know their circumstances and i don't know them personally. i also saw the whole medical tragedy from the other side, the important side actually. the human drama of what we do we often loose. i suppose we can't always get emotionally involved, but it is still important to remember that what, to us, may be just another case, to the person involved may be the single most signifficant event in his life.

so to this new yorker who i now feel proud to call friend i say thank you for reminding me again that we only do what we do so that the patient can get back to what's really important. the task of living and enjoying life. i'm humbled.